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

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



Case Details (Reverse Sorted by Onset Date)

This is page 231 out of 8,010

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VAERS ID: 1719076 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, 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: Benadryl, pseudoephedrine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: In the evening after my second vaccine dose, my ears began aching and tinnitus started. Over the next couple days the ear aches slowly away, but the tinnitus has persisted.


VAERS ID: 1719079 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chest pain, Electrocardiogram ambulatory, Extrasystoles, Headache, Heart rate increased, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (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: Progesterone 100MG
Current Illness: none
Preexisting Conditions: chronic bronchitis
Allergies: Lortab - rash
Diagnostic Lab Data: Currently wearing a heart monitor. Echocardiogram is scheduled.
CDC Split Type:

Write-up: 103 fever. Joint pain/body aches. Nausea, headache - duration of all but body aches about 48 hours. Joint pain/body aches lasted 4 days. All of these symptoms started early morning on the 9th - about 9 hours after shot. Rapid heart beat - chest pressure and intermittent pain - the feeling of my heart skipping a beat started around 10 AM on the 9th.


VAERS ID: 1719248 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-09
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: niraparib gabapentin miralax
Current Illness: ovarian cancer
Preexisting Conditions: ovarian cancer
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe thrombocytopenia one week after the first dose of the vaccine


VAERS ID: 1719427 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Lymphadenopathy
SMQs:, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aleve, multi-vitamin, methylphenidate ER, tumeric
Current Illness: None
Preexisting Conditions:
Allergies: lactose intolerent
Diagnostic Lab Data:
CDC Split Type:

Write-up: Very swollen lymph nodes in armpits, which went away in a week. Also, severe joint pain in all joints, including knuckles, that was not present before. The joint pain is still ongoing with no relief by over the counter medication; 2 weeks since the 2nd injection.


VAERS ID: 1719437 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO191 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Musculoskeletal pain, Pelvic pain, Pubic pain, Ultrasound Doppler normal, Ultrasound antenatal screen normal
SMQs:, Rhabdomyolysis/myopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PNV
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 3 ER visits, fetal ultrasounds performed and reassuring, doppler tones reassuring. Strong suspicion for MSK pain in pregnancy.
CDC Split Type:

Write-up: Pt received vaccine at 16wks EGA, EDD 2/11/2022. Reported onset of pelvic pain and pubic symphysis pain within 48hrs of vaccination., persisting for 3 wks after first vaccine.


VAERS ID: 1719443 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-11
Onset:2021-09-09
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Tested PCR positive for COVID 9/9/21 after being fully vaccinated.


VAERS ID: 1719548 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-02-22
Onset:2021-09-09
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Dyspnoea, Oxygen saturation decreased, Pleural effusion, Pneumonia, SARS-CoV-2 test positive, Walking distance test abnormal
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Atrial fibrillation, heart failure, end stage renal disease on peritoneal dialysis
Allergies:
Diagnostic Lab Data: COVID PCR+ 9/9
CDC Split Type:

Write-up: 9/9/21: Patient came to the ED today due to SOB. Patient initially on 2 L in the ED due to conversational dyspnea, currently maintaining saturations on room air. 6 min walk test showed patient desatting to 90 after taking approximately 20 steps but then needed to stop due to him feeling weak. Patient initially tested negative on rapid Covid test but subsequently tested positive on PCR. Patient admitted to floor on isolation precautions. Discharged 9/11/21 Readmitted 9/18/21 with pleural effusion and pneumonia.


VAERS ID: 1719572 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Dysstasia, Gait inability, Mobility decreased, Muscle spasms
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Vitamin D-3, Vitamin C, Calcium, B-12, Levotayroxine (synthroid)
Current Illness: none
Preexisting Conditions: spine and shoulders injury, 0% on feet.
Allergies: Sulfa drugs, dairy, elastic, rubber, grass, trees, hay, cats, mold, dust
Diagnostic Lab Data: none
CDC Split Type:

Write-up: On 09/09 started w/ back pain and could not walk. Bed ridden until 09/20. Experienced muscle spasms in lower back. Unable to stand


VAERS ID: 1719577 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-27
Onset:2021-09-09
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea, Vaginal haemorrhage, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: My symptoms started 9/9/2021, it started with terrible abdominal cramping pain, vomiting, diarrhea, vaginal bleeding, large tissues leaving my body (cast). I called the advice line the following day because I could barley function or move the day it started. When I called the advice line I spoke with the OB nurse on call due to me thinking I had a miscarriage. She noticed that I had just recently got the Covid vaccine and said that she has had many calls stating the same thing, that many women have called complain of irregular bleeding with pain after having the vaccine. I do not remember the nurses name, but my OB told me that it was a cast that was coming out which is why I had pain and to take a pregnancy test the next couple cycles to make sure I am not pregnant. I have my tubes tied , so this shouldn''t even be something that I should be worried about, but the terrible pain and bleeding I felt, left me out for the week.


VAERS ID: 1719640 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-01-10
Onset:2021-09-09
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Malaise, SARS-CoV-2 test
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol 75 mL ? albuterol HFA 25.5 g ? Allegra-D Allergy & Congestion 90 tablet ? BD Pen Needle Nano U/F ? chlorthalidone ? Dexcom G6 Transmitter ? dicyclomine ? escitalopram 90 tablet ? fenofibrate ? Glucagon Emergency ? ins
Current Illness: None
Preexisting Conditions: Past Medical History: Patient has a past medical history of Anxiety, Arthritis, Asthma, Colitis (6/101/9), Colon cancer (CMS/HCC) (Dx 12/2018), Diabetes mellitus (CMS/HCC), GERD (gastroesophageal reflux disease), History of colon cancer, stage III, partial colectomy 1/2019 (5/28/2020), History of shingles, Kidney stones, Pyloric stenosis (1966), and Sleep apnea. Past Surgical History: Patient has a past surgical history that includes Laparoscopic cholecystectomy; Hernia repair; Appendectomy; Tonsillectomy (1980); Extracorporeal shock wave lithotripsy; PYLORIC STENOSIS SURGERY (1967); Vasectomy; Colonoscopy (05/27/2020); Colectomy (Left, 01/16/2019); and Esophagogastroduodenoscopy (05/27/2020).
Allergies: Chlorhexidine, Hydrocodone, Oxycodone
Diagnostic Lab Data:
CDC Split Type:

Write-up: Spoke with patient he states he took a home test, he is going in employee health this afternoon for rapid test Pt states symptoms began 09/08/21


VAERS ID: 1721564 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Kansas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 - / OT

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

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

Write-up: expired vaccine that was punctured past 12 hours; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (expired vaccine that was punctured past 12 hours) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047B21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (expired vaccine that was punctured past 12 hours). At the time of the report, EXPIRED PRODUCT ADMINISTERED (expired vaccine that was punctured past 12 hours) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant and treatment information were reported by the reporter


VAERS ID: 1721572 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-27
Onset:2021-09-09
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Malaise, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Not feeling good; Headache; Fever; Tested positive for COVID 19; This spontaneous case was reported by a consumer and describes the occurrence of SARS-COV-2 TEST POSITIVE (Tested positive for COVID 19), MALAISE (Not feeling good), HEADACHE (Headache) and PYREXIA (Fever) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 27-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Sep-2021, the patient experienced SARS-COV-2 TEST POSITIVE (Tested positive for COVID 19). On an unknown date, the patient experienced MALAISE (Not feeling good), HEADACHE (Headache) and PYREXIA (Fever). At the time of the report, SARS-COV-2 TEST POSITIVE (Tested positive for COVID 19), MALAISE (Not feeling good), HEADACHE (Headache) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. No treatment medication was reported. Reporter did not allow further contact


VAERS ID: 1721579 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-09-01
Onset:2021-09-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Received my first dose on September 1. Now on September 9, the arm with the injection site is red and swollen; Received my first dose on September 1. Now on September 9, the arm with the injection site is red and swollen; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE ERYTHEMA (Received my first dose on September 1. Now on September 9, the arm with the injection site is red and swollen) and INJECTION SITE SWELLING (Received my first dose on September 1. Now on September 9, the arm with the injection site is red and swollen) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced INJECTION SITE ERYTHEMA (Received my first dose on September 1. Now on September 9, the arm with the injection site is red and swollen) and INJECTION SITE SWELLING (Received my first dose on September 1. Now on September 9, the arm with the injection site is red and swollen). At the time of the report, INJECTION SITE ERYTHEMA (Received my first dose on September 1. Now on September 9, the arm with the injection site is red and swollen) and INJECTION SITE SWELLING (Received my first dose on September 1. Now on September 9, the arm with the injection site is red and swollen) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medications were reported. No Treatment information was reported.


VAERS ID: 1721582 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-10
Onset:2021-09-09
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 1 - / OT

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

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

Write-up: Received an expired vaccine; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (received an expired vaccine) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002B21A and 011A21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (received an expired vaccine). On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED (received an expired vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications were not provided by reporter. Treatment information was not provided by reporter.


VAERS ID: 1721589 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-13
Onset:2021-09-09
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pyrexia, Vaccination site erythema, Vaccination site induration, Vaccination site swelling
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SERTRALINE [SERTRALINE HYDROCHLORIDE]; NORTRIPTYLINE; SUMATRIPTAN; OCRELIZUMAB; V12; ZOLPIDEM
Current Illness: Sclerosis multiple
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Redness in the area of injection; Very hard to the touch in the area of the injection; Swelling at the site of injection; Fever; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (Redness), VACCINATION SITE INDURATION (Very hard to the touch in the area of the injection), VACCINATION SITE SWELLING (Swelling) and PYREXIA (Fever) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 041l20a and 041l20a) for COVID-19 vaccination. Concurrent medical conditions included Sclerosis multiple. Concomitant products included SERTRALINE HYDROCHLORIDE (SERTRALINE [SERTRALINE HYDROCHLORIDE]), NORTRIPTYLINE, SUMATRIPTAN, OCRELIZUMAB, HYDROXOCOBALAMIN ACETATE (V12) and ZOLPIDEM for an unknown indication. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, the patient experienced PYREXIA (Fever). On 10-Sep-2021, the patient experienced VACCINATION SITE ERYTHEMA (Redness) and VACCINATION SITE INDURATION (Very hard to the touch in the area of the injection). 10-Sep-2021, the patient experienced VACCINATION SITE SWELLING (Swelling). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency; MORINDA CITRIFOLIA (MORIN [MORINDA CITRIFOLIA]) for Adverse event, at an unspecified dose and frequency and IBUPROFEN for Adverse event, at an unspecified dose and frequency. At the time of the report, VACCINATION SITE ERYTHEMA (Redness), VACCINATION SITE INDURATION (Very hard to the touch in the area of the injection), VACCINATION SITE SWELLING (Swelling) and PYREXIA (Fever) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.


VAERS ID: 1721601 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Migraine
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: USMODERNATX, INC.MOD20213

Write-up: Severe migraine since having the Moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (Severe migraine since having the Moderna vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced MIGRAINE (Severe migraine since having the Moderna vaccine). At the time of the report, MIGRAINE (Severe migraine since having the Moderna vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment information was provided.


VAERS ID: 1721615 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / UNK - / OT

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

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

Write-up: Dose administered $g12 hours post puncture; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED. On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was reported. No treatment medication was reported.


VAERS ID: 1721616 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / UNK - / OT

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

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

Write-up: Expired dose/ expired vaccine administered to 33 patients from Thursday, 09/Sep/2021 to Friday morning, 10/Sep/2021; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired dose/ expired vaccine administered to 33 patients from Thursday, 09/Sep/2021 to Friday morning, 10/Sep/2021) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037A21B) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired dose/ expired vaccine administered to 33 patients from Thursday, 09/Sep/2021 to Friday morning, 10/Sep/2021). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Expired dose/ expired vaccine administered to 33 patients from Thursday, 09/Sep/2021 to Friday morning, 10/Sep/2021) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant products were reported. No treatment information was provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 13-Sep-2021: Added onset date and stop date for the event.


VAERS ID: 1721655 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-09-09
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Heart rate increased, Malaise, Pain, Tachycardia, Vaccination site erythema
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

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

Write-up: tachycardia; felt achy; She didn''t feel good; injection site started to turn red; headache; heart rate increased; This spontaneous case was reported by a consumer and describes the occurrence of heart rate increased, tachycardia, PAIN, MALAISE, and VACCINATION SITE ERYTHEMA in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 058E21A and 017E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included LEVOTHYROXINE and VITAMINS A & D for an unknown indication. On 12-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, the patient experienced heart rate increased, PAIN, MALAISE, VACCINATION SITE ERYTHEMA, and headache. On 12-Sep-2021, the patient experienced tachycardia. The patient was treated with TYLENOL at an unspecified dose and frequency and HYDROCORTISONE at an unspecified dose and frequency. At the time of the report, heart rate increased, tachycardia, PAIN, MALAISE, VACCINATION SITE ERYTHEMA, and headache outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment information provided. Patient stated that She started noticing increased heartrate next day after receiving 2nd dose. She had been monitoring heart rate on her Fitbit. After 2 days, heart rate started to settle down but it has never gone to baseline. On Sunday (12Sep2021), she went to ER because of increased heart rate. She wants someone to call from safety to follow up because she is concerned about tachycardia. She wants to know about compensation as she went to ER. This case was linked to MOD-2021-317431 (Patient Link).


VAERS ID: 1721735 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-10
Onset:2021-09-09
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Exposure to SARS-CoV-2, Product dose omission issue
SMQs:, Medication errors (broad), COVID-19 (narrow)

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

Write-up: She was due to get the second dose on 07SEP2021 and she was out of town and missed it.; So far asymptomatic for COVID-19 Disease; Exposed to COVID-19 infected person; This spontaneous case was reported by a consumer and describes the occurrence of EXPOSURE TO SARS-COV-2 (Exposed to COVID-19 infected person), PRODUCT DOSE OMISSION ISSUE (She was due to get the second dose on 07SEP2021 and she was out of town and missed it.) and ASYMPTOMATIC COVID-19 (So far asymptomatic for COVID-19 Disease) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006D21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced EXPOSURE TO SARS-COV-2 (Exposed to COVID-19 infected person). On 13-Sep-2021, the patient experienced ASYMPTOMATIC COVID-19 (So far asymptomatic for COVID-19 Disease). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (She was due to get the second dose on 07SEP2021 and she was out of town and missed it.). At the time of the report, EXPOSURE TO SARS-COV-2 (Exposed to COVID-19 infected person) and ASYMPTOMATIC COVID-19 (So far asymptomatic for COVID-19 Disease) outcome was unknown and PRODUCT DOSE OMISSION ISSUE (She was due to get the second dose on 07SEP2021 and she was out of town and missed it.) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. No treatment information was provided.


VAERS ID: 1721785 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: achy all over, back, collar bone; shoulders ache; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (achy all over, back, collar bone) and ARTHRALGIA (shoulders ache) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced MYALGIA (achy all over, back, collar bone) and ARTHRALGIA (shoulders ache). At the time of the report, MYALGIA (achy all over, back, collar bone) and ARTHRALGIA (shoulders ache) outcome was unknown. Not Provided Concomitant medication information was not provided by the reporter. Treatment information was not provided by the reporter.


VAERS ID: 1722161 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-13
Onset:2021-09-09
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078CZ1A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Insomnia, Malaise, Movement disorder, Nasopharyngitis, Pain, Peripheral swelling, Pyrexia, Vaccination site pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Arm was swollen ,gigantic, humongous like the incredible hulk,; Can put their hand around it.; Cold and sweating; Couldn''t sleep; Felt sick; Pain in their entire body; Headache; Fever; Arm was hurting; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Arm was swollen ,gigantic, humongous like the incredible hulk,), MOVEMENT DISORDER (Can put their hand around it.), NASOPHARYNGITIS (Cold and sweating), INSOMNIA (Couldn''t sleep) and MALAISE (Felt sick) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 004f21a and 078cz1a) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, the patient experienced NASOPHARYNGITIS (Cold and sweating), INSOMNIA (Couldn''t sleep), MALAISE (Felt sick), PAIN (Pain in their entire body), HEADACHE (Headache), PYREXIA (Fever) and VACCINATION SITE PAIN (Arm was hurting). On 11-Sep-2021, the patient experienced PERIPHERAL SWELLING (Arm was swollen ,gigantic, humongous like the incredible hulk,) and MOVEMENT DISORDER (Can put their hand around it.). The patient was treated with NAPROXEN ongoing since an unknown date for Adverse event, at an unspecified dose and frequency. On 11-Sep-2021, NASOPHARYNGITIS (Cold and sweating), INSOMNIA (Couldn''t sleep), MALAISE (Felt sick), PAIN (Pain in their entire body), HEADACHE (Headache), PYREXIA (Fever) and VACCINATION SITE PAIN (Arm was hurting) had resolved. At the time of the report, PERIPHERAL SWELLING (Arm was swollen ,gigantic, humongous like the incredible hulk,) had not resolved and MOVEMENT DISORDER (Can put their hand around it.) outcome was unknown. Concomitant product use was not provided by the reporter. it was reported Paitent arm was still gigantic. This case was linked to MOD-2021-295327 (Patient Link).


VAERS ID: 1722194 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site erythema, Vaccination site pruritus, Vaccination site rash, Vaccination site swelling, Vaccination site warmth
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Breast cancer.
Preexisting Conditions: Medical History/Concurrent Conditions: Lymph node excision (lymph node removed from her right arm 15 years ago); Lymph node excision (also got her lymph node removed from her left arm part of her breast cancer.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Right arm was warm; Itchy; Red; Rash; Swollen; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Right arm was warm), VACCINATION SITE PRURITUS (Itchy), VACCINATION SITE ERYTHEMA (Red), VACCINATION SITE RASH (Rash) and VACCINATION SITE SWELLING (Swollen) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. The patient''s past medical history included Lymph node excision (lymph node removed from her right arm 15 years ago) and Lymph node excision (also got her lymph node removed from her left arm part of her breast cancer) in June 2021. Concurrent medical conditions included Breast cancer. On 09-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced VACCINATION SITE WARMTH (Right arm was warm), VACCINATION SITE PRURITUS (Itchy), VACCINATION SITE ERYTHEMA (Red), VACCINATION SITE RASH (Rash) and VACCINATION SITE SWELLING (Swollen). At the time of the report, VACCINATION SITE WARMTH (Right arm was warm) and VACCINATION SITE SWELLING (Swollen) outcome was unknown and VACCINATION SITE PRURITUS (Itchy), VACCINATION SITE ERYTHEMA (Red) and VACCINATION SITE RASH (Rash) had not resolved. No concomitant medications information was reported. Patient used ice to treat her symptoms Patient use a soap, regularly as it was recommended by her doctor due to her breast cancer. .


VAERS ID: 1722246 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 1 RA / IM

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

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

Write-up: Vaccine given after manufacturer beyond use date exceeded by 1 day (product expired on 9/8/21 and give on 9/9/21). No ADRs noted by pt.


VAERS ID: 1722548 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Chest X-ray, Chest discomfort, Discomfort, Dyspnoea, Electrocardiogram normal, Fibrin D dimer normal, Full blood count normal, International normalised ratio, Metabolic function test, Troponin normal
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: All test results were normal and were performed on 9/14/2021 APTT CBC Auto Differential Comprehensive Metabolic Panel D-Dimer Quantitative Protime-INR Troponin - 0 Hour Troponin - 2 Hour Extra Red Plain Chest PA and Lateral ECG 12 Lead ECG Open
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA Started having discomfort from pressure in chest. Appeared 4-6 hours after first vaccine. Some trouble breathing from pressure in chest, particularly at night when laying on back. Chest pressure is still present at this time (two weeks as of writing this), but has seemed to lessen in severity as time goes on. Physical labor or exercise does exacerbate the issue and can cause more discomfort than was previously there. Went to ER five days after first vaccine, and was released shortly after admittance. All tests performed came back clear.


VAERS ID: 1722725 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-23
Onset:2021-09-09
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thrombosis, Ultrasound scan
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

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

Write-up: Blood clotting. Taking Ibuprofen daily for a week.


VAERS ID: 1722791 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Cough, Decreased immune responsiveness, Depression, Dizziness, Dysstasia, Energy increased, Feeling abnormal, Genital pain, Head discomfort, Headache, Insomnia, Tachyphrenia, Vaccination complication, Vulvovaginal pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Sexual dysfunction (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: I have not taken an over the counter medication since april 2012. As far as herbal remedies and Supplements at time of vaccine: Vitamin C Vitamin D CoQ10 probiotic
Current Illness: No illnesses... and no history of illnesses since april 2012, except for January 2020 when I likely had an early case of Covid. Recovered naturally in a few days.
Preexisting Conditions: Up until April 2012, I had had a build up of sensitivities to processed foods and medications. Culminating in 2011 with a severe cause of leaky gut due to candida overgrowth of the intestinal track, which then entered my blood stream. For a period of a year, doctors were unfamiliar with what was occurring as my body began to leach minerals from bone sources in my body to alkalize itself. I deduced, without doctoral assistance, my situation, and began a healing regiment of removing all inflammatory substances from my diet and my life in April 2012, and completely reversed what was becoming severe auto immunity. I have not taken even an advil since April of 2012.
Allergies: Gluten, Corn and Soy cause severe inflammation. I stay away from all medications especially ones that contain a starch in them (typically corn starch). Sugar and preservatives also cause inflammation... I stay away from refined sugars and all processed foods and foods with preservatives and additive chemicals since april 2012.
Diagnostic Lab Data: none because it is not currently apparent to patients like myself that do not have regular doctors they visit and know and trust who understand and know their medical history, to know even what laboratory or medical tests may be available.
CDC Split Type:

Write-up: I received the Covid-19 Vaccine in my left arm by a skilled practitioner on Wednesday afternoon Sept 8th. The remainder of the day I felt slightly light headed and then extremely energized, almost hyper toward 9pm. I noticed an immediate pain in the back left of my head. not deep like a headache and not surface like a scratch. something more like a near the surface pulsing. I began detox protocols that night, taking epsom salt bath and getting into bed at a good time with a book and had had lots of water and continued to drink lots. That night --- and unlike anything I''d experienced since my teenage years --- I had racing mind for hours. Unable to fall asleep from 9pm - 3:30 am. I am highly intune with my body and my immune system and this was not a typical bout of self induced stress, and believe it was in reaction to the Vaccine. - at 5:30 am, needing to get up to go to the bathroom, I found myself nearly unable to stand up and severe cramping (more severe than I''ve ever experienced) in my abdomen and vaginal and sexual organs area. - i stumbled to the bathroom and from the toilet, unable to make it to the sink to wash my hands, curled up on the floor to wait out the feeling of black out I was experiencing. - i was given water by my roommate around 6 am and was able to stumble my way back to my bed - i slept for another 7 hours. - the rest of the day I felt much more human, the cramping much less painful. the pulsing in the spot in back left of head continued. - Next two week and a half, up until Saturday Sept. 18th, the racing mind at night/insomnia continued, and severe depression. my brain has not responded to such powerful chemicals in decades and I also have not suffered from depression since my teenage years. I also believe this is in reaction to the vaccine. - depression began to live Saturday sept 18th. - as of Sept 19th what was a left back of head pulse is now also on the right. the pain not severe but very sensitive in both spaces. my immune system also feels weakened and I''ve developed a cough as of Sept 19th. Again... since 2012, I have not taken any medications, nor been sick... at all... minus what might have been undiagnosed covid Jan 2020. I believe this is all in reaction to the vaccine.


VAERS ID: 1722804 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Gabapentin, Requip
Current Illness: N/A
Preexisting Conditions: HTN, Restless leg syndrome
Allergies: Lisinopril
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Lip swelling, starting on morning following 2nd COVID-19 vaccine. Treated with Benadryl.


VAERS ID: 1722826 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: CEREBRAL INFARCTION (UNSPEC.), CHRONIC KIDNEY DISEASE, HYPERLIPIDEMIA, ESSENTIAL(PRIMARY)HYPERTENSION, MUSCLE WEAKNESS (GENERALIZED), CHRONIC COMBINED SYSTOLIC (CONGESTIVE) HEART FAILURE, CHEST PAIN (UNSPEC.), NEURALGIA AND NEURITIS (UNSPEC.), OTHER CHRONIC PAIN, GASTRO-ESOPHAGEAL REFLUX DISEASE
Preexisting Conditions: CEREBRAL INFARCTION (UNSPEC.), CHRONIC KIDNEY DISEASE, HYPERLIPIDEMIA, ESSENTIAL(PRIMARY)HYPERTENSION, MUSCLE WEAKNESS (GENERALIZED), CHRONIC COMBINED SYSTOLIC (CONGESTIVE) HEART FAILURE, CHEST PAIN (UNSPEC.), NEURALGIA AND NEURITIS (UNSPEC.), OTHER CHRONIC PAIN, GASTRO-ESOPHAGEAL REFLUX DISEASE
Allergies: SHELLFISH
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: NO ADVERSE EVENT - ONLY VACCINE ADMINISTRATION DEVIATION. Administrator named provided what was believed to be the 1st dose of an mRNA COVID-19 (Pfizer) vaccine when it was reveled to them after the fact that the Pt received a first dose of a different mRNA COVID-19 vaccine (Moderna), months prior. The administrator named was not able to locate any information for the 1st dose in the COVID Vaccine Management System or any health records.


VAERS ID: 1722872 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Dyspnoea, Fatigue, Headache, Pain, Pyrexia, Rash, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Systemic Rash all over the body, headache, soreness, chills, aches, fever, fatigue, loss of appetite, and shortness of breath.
Other Medications: Nexplanon Implant
Current Illness: Covid tested positive on 08/04/2021
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Systemic Rash all over the body, headache, soreness, chills, aches, fever, fatigue, loss of appetite, and shortness of breath.


VAERS ID: 1723003 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Basophil count decreased, Basophil percentage increased, Chronic lymphocytic leukaemia stage 2, Computerised tomogram thorax abnormal, Condition aggravated, Deep vein thrombosis, Differential white blood cell count, Dyspnoea, Dyspnoea exertional, Eosinophil count decreased, Fatigue, Febrile neutropenia, Feeling abnormal, Haematocrit decreased, Haemoglobin decreased, Illness, Immature granulocyte count, Infection, Lung infiltration, Lymphocyte count decreased, Lymphocyte percentage, Malaise, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Monocyte count decreased, Monocyte percentage increased, Myelocyte percentage, Neutropenia, Neutrophil count decreased, Neutrophil percentage decreased, Packed red blood cell transfusion, Pancytopenia, Platelet count decreased, Pneumonia, Pneumonitis, Polychromasia, Pyrexia, Red blood cell count decreased, Red blood cell nucleated morphology, Red cell distribution width increased, Respiratory failure, Ulcer, White blood cell count decreased
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (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), Dementia (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal ulceration (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Myelodysplastic syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Haematological malignant tumours (narrow), Infective pneumonia (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81mg po nightly ezetimibe 10mg po daily metoprolol succinate 25mg po daily rivaroxaban 10mg po nightly terazosin 1mg po nightly
Current Illness: This is a 71 yo man.. He was admitted initially back in January due to covid-19. He had a very prolonged course and was on the ventilator and eventually trached and was dcd to a LTACH. He was re-admitted in May for PNA and then in June for tracheitis. During his June admission, noted to have tracheal stenosis and he was transferred to medical for tracheal surgery. He improved and then was transferred to rehab. Finally, he did recently return home. He was recently vaccinated against covid-19 and received a 2nd shot on 9/9. Since this 2nd shot, he has noted high grade fevers and increased sob. He did have a fever of 103.3 in the Er and an O2 sat of 84%. His CT scan was negative for a PE, but did show b/l infiltrates. His wbc was noted to be 0.68.
Preexisting Conditions: Arthritis CAD Chronic lymphocytic leukemia DM HTN Hyperlipidemia
Allergies: morphine - shaking atorvastatin - muscle spasms penicillin- swelling hydrocodone - nausea
Diagnostic Lab Data: Results for Patient (MRN private) as of 9/22/2021 12:47 9/14/2021 03:36 WBC: 0.68 (LC) RBC: 2.45 (L) HGB: 7.3 (L) HCT: 21.1 (L) MCV: 86.1 MCH: 29.8 MCHC: 34.6 RDW-SD: 48.8 RDW-CV: 15.6 (H) NRBCS % AUTOMATED: 0.0 NRBCS # AUTOMATED: <0.01 PLT: 84 (L) MPV: 9.6 Neutrophil #: 0.01 (L) Lymphocyte #: 0.17 (L) Monocytes #: 0.50 Immature Granulocyte #: 0.00 Neutrophils %: 1.0 Lymphocytes %: 25.0 Monocytes %: 74.0 Polychromasia: 1+ Morphology Comment: PRESENT CBC Path Review: SEE BELOW 9/15/2021 06:19 WBC: 0.85 (LC) RBC: 2.48 (L) HGB: 7.4 (L) HCT: 21.8 (L) MCV: 87.9 MCH: 29.8 MCHC: 33.9 RDW-SD: 49.0 RDW-CV: 15.3 (H) NRBCS % AUTOMATED: 0.0 NRBCS # AUTOMATED: <0.01 PLT: 98 (L) MPV: 9.7 9/16/2021 05:49 WBC: 1.43 (L) RBC: 2.72 (L) HGB: 8.1 (L) HCT: 24.8 (L) MCV: 91.2 MCH: 29.8 MCHC: 32.7 RDW-SD: 51.8 (H) RDW-CV: 15.9 (H) NRBCS % AUTOMATED: 0.0 NRBCS # AUTOMATED: <0.01 PLT: 183 MPV: 9.9 Neutrophil #: 0.03 (L) Lymphocyte #: 0.71 (L) Monocytes #: 0.61 Eosinophil #: 0.07 Immature Granulocyte #: 0.01 Neutrophils %: 2.0 Lymphocytes %: 49.5 Monocytes %: 42.6 Eosinophils %: 4.9 Myelocytes %: 1.0 (A) Polychromasia: 1+ Morphology Comment: PRESENT 9/17/2021 06:28 WBC: 1.41 (L) RBC: 2.35 (L) HGB: 7.0 (LC) HCT: 21.1 (L) MCV: 89.8 MCH: 29.8 MCHC: 33.2 RDW-SD: 49.8 RDW-CV: 15.3 (H) NRBCS % AUTOMATED: 2.1 NRBCS # AUTOMATED: 0.03 PLT: 149 MPV: 9.6 Neutrophil #: 0.19 (L) Lymphocyte #: 0.59 (L) Monocytes #: 0.45 Eosinophil #: 0.12 Basophil #: 0.03 Immature Granulocyte #: 0.04 Neutrophils %: 13.3 Lymphocytes %: 41.8 Monocytes %: 31.6 Eosinophils %: 8.2 Basophils %: 2.1 Metamyelocytes %: 1.0 (A) Myelocytes %: 2.0 (A) Polychromasia: 1+ Morphology Comment: PRESENT 9/18/2021 09:01 WBC: 2.29 (L) RBC: 3.09 (L) HGB: 9.1 (L) HCT: 27.8 (L) MCV: 90.0 MCH: 29.4 MCHC: 32.7 RDW-SD: 47.8 RDW-CV: 14.9 (H) NRBCS % AUTOMATED: 0.0 NRBCS # AUTOMATED: <0.01 PLT: 173 MPV: 9.2
CDC Split Type:

Write-up: 9/22 Per Patient: received the 2nd Pfizer vaccine Thursday, 9/9/21 at 1900. By Friday he was feeling bad and on Monday 9/13/21 he was very SOB and had to come to the ED. 9/14 Per ED: Patient is a 71-year-old gentleman comes in with shortness of breath, fatigue and dyspnea on exertion. Patient states he had COVID back in January of this year. States he spent 6 months in the hospital. His DVT to self hot a walk. He states that since last week and not been feeling well and felt like he was coming down with something. He states he went and had his 2nd COVID vaccination this past Thursday since then has been feeling very bad. The duration is constant. The onset progressive. The intensity moderate. The quality as above. This is single episode. No radiation. Nothing makes it better or worse. No other associated symptoms. Patient arrived with a fever. 9/14 Per ID: 1. Neutropenic fever: Appreciate Dr. note. Neutropenia thought to be due to to vaccine. Per pt, has not received recent chemo. Cbc from 8.9 shows a wbc of 5, ANC of 3800 and plts of 163. D/w Pharmacy. Not a known side effect. Will report this to VAERS For now continue cefepime + doxy. 2. Possible PNA: Chest CT reviewed. Old changes, but possible new infiltrates. Continue cefepime/doxy 3. H/o COVID-19 4. CLL 5. Sacral ulcer: Much improved. Continue local care 9/17 Per ID: 1. Neutropenic fever: Appreciate Dr. note. Neutropenia thought to be due to to vaccine. Per pt, has not received recent chemo. Cbc from 8/9 shows a wbc of 5, ANC of 3800 and plts of 163. D/w Pharmacy. Not a known side effect. Will report this to VAERS For now continue cefepime + doxy- upon discharge can convert to Levaquin 750 mg every 48 hours x 3 doses. WBC improving , hemoglobin low 7.0- to receive transfusion today 2. PNA: Chest CT reviewed. Old changes, but possible new infiltrates. Continue cefepime/doxy-- $g po Levaquin upon discharge. procal better today. Initial value may not have reflected the peak. 3. H/o COVID-19 4. CLL 5. Sacral ulcer: Much improved. Continue local care 9/17 Per Oncologist: Pancytopenia/Acute illness - New and acute onset - I suspect secondary to acute reaction to COVID vaccine and inflammatory cascade process but secondary to infectious process also possible - No evidence of lymphocytosis with WBC differential - Will hold off on G-CSF support due to increase theoretical risk of neutrophil activation and lung inflammatory process - No evidence of b12 or folate deficiency - Counts seem to be slowly improving with increase in ANC and PLT count now normalized. Hgb lacking behind somewhat. Patient complaining of marked fatigue. Will transfuse 1 unit of PRBC today CLL - RAI stage II with complex karyotype (trisomy 12, deletion 13q, and 11q deletion) - Diagnosed in July 2019 - Enrolled in Clinical trial at medical. EA9161. Ibrutnib/Venetoclax/Obinotuzumab - Treatment has been on hold since initial admission for critical COVID in end of January 2021 - Imaging studies have indicated partial response to therapy with no indication to resume therapy. Patient was last seen at medical in August 2021 at the time WBC was 5.0/Hgb 10.1/PLT 163 with no absolute lymphocytosis PNA - Covered with cefepime and doxy - Afebrile now Hx of CAD - Has hx of CAD s/p PCI and stent placement in May 2019 Respiratory failure - Now resolved - Tracheostomy has been removed - has required intervention for tracheal stenosis COVID PNA in January 2021 - Prolonged hospital stay with respiratory failure and trach and peg placement and need for renal replacement therapy - Patient is now s/p COVID vaccination


VAERS ID: 1723052 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Head discomfort, Impaired work ability, Laboratory test, Tension headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: PCN-rash
Diagnostic Lab Data: Video Chat with MD -September 10 (note was given to be off work 9-11 to 9-13 Message to Md (Tuesday 9-12-21) with regards to symptoms not being relieved and was advise of continue to go to urgent care Urgent care visit with other doctor (Thursday 9-14-21) advise to take Sudafed for three days and to give it a week if symptoms do not go away to follow up with primary care physician 9-22-2021- Office visit to MD for symptoms not being relieved: orders for labs to be done and CT scan. Also note for medical leave with tentative date of return 10-11-21.
CDC Split Type:

Write-up: Shortly after the shot. Experienced heaviness/pressure/tightness to left side of head and has been experiencing symptoms since for 13+ days: over the counter Tylenol/Motrin Sudafed with no relief. Also had video chat, urgent care visit and return visit with primary care physician: have labs and CT ordered and pending


VAERS ID: 1723282 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 00FZUA / UNK RA / IM

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

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

Write-up: woke up the morning after teh shot with a WICKED stiff neck and headache. i still have it 2 WEEKS LATER. will it go away?? and should i even get a second shot? i have hypogammaglobulinemia, and my doc said that if my antibodies were tested and were corpulent that only one shot would suffice. please ADVISE - I NEED THIS TO GO AWAY.


VAERS ID: 1723337 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-09-09
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Injection site pain, Neck pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (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: losartan , plavix 75 mg aspirin 81 , atorvastatin
Current Illness: no
Preexisting Conditions: iBS with fecal incontinous DSAP skin Diease , high blood pressure
Allergies: ivp contrast dye
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9/9/21 pain at the injection site started . 9/13 21 pain spread up arm to neck and head


VAERS ID: 1723854 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Hello - following my second Pfizer COVID shot I had a low grade fever and body aches. 24 hours following this incident, by 100% breastfed 9 month old baby also had fever and developed intense stomach pain and diarrhea. He was sick for 5 days. I am writing to report the side effects on Breastmilk on children following the second PFIZER COVID shot.


VAERS ID: 1723867 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-13
Onset:2021-09-09
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Dyspnoea, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: he notes worsening nocturnal shortness of breath that is unrelieved with his albuterol rescue inhaler. Reports that he will take a sleep aid and go to bed and wake up approximately 1-1.5 hours later feeling as if he cannot breathe or get a full breath.


VAERS ID: 1723869 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-09
Onset:2021-09-09
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, Chest pain, Cough, Diarrhoea, Dyspnoea, Fatigue, Fungal infection
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: presenting to the ED via EMS from an assisted living facility for chest pain, shortness breath, abdominal pain and a fulminant yeast infection in her groin. She was diagnosed with COVID last thursday. She is difficult to ascertain an accurate history from. She states that she has had intermittent diarrhea for the last few weeks as well as a new cough and increased fatigue. She denies nausea, vomiting, fevers or chills.


VAERS ID: 1724084 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FDO809 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Feeling hot, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine 10 mg Hydrochlorothiazide 5 mg Xywav at night, 6.5 mL total
Current Illness: None
Preexisting Conditions: Narcolepsy
Allergies: none
Diagnostic Lab Data: I have not spoken to my doctor about it, because it is diminishing and I expect it to fully resolve on its own.
CDC Split Type:

Write-up: I had an intense warm feeling in my arm a few minutes after the injection, which seemed to spread down to my hand. After a while, the feeling transferred to my left leg, It''s best described as a moving hot flash, which starts in my thigh and ends in my foot over the course of a second or two. I though it would go away. Co-workers reported also feeling that warm sensation travelling through their arm and chest for the night after receiving the vaccine (we all got it at about the same time), but to my knowledge I am the only one who is still feeling it, weeks later. It was more intense and constant in the week following the vaccine. Now I will feel it once or twice a day. I am hoping it will go away, but mostly I just want to document it so that other people who feel it know that they are not alone. I saw a paper in the literature which was a case study of one woman experiencing something similar, but she termed it "burning," whereas I find it not to be burning, but an intense warmness, like a traveling hot flash. I guess in the end it is some sort of paresthesia.


VAERS ID: 1724290 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-20
Onset:2021-09-09
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anembryonic gestation, Exposure during pregnancy, Human chorionic gonadotropin positive
SMQs:, Tumour markers (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (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: Prenatal vitamin, Zoloft
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/11 positive ovulation test 8/20 1st vaccine 8/24 positive pregnancy test 9/3 2nd vaccine 8/30-9/9 positive HCG blood levels 9/9 first ultrasound = blighted ovum


VAERS ID: 1725307 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-05
Onset:2021-09-09
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 1 - / OT

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

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

Write-up: receiving an expired vaccine; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (receiving an expired vaccine) in a 27-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002B21A and 031B21A) for COVID-19 vaccination. No Medical History information was reported. On 05-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (receiving an expired vaccine). On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED (receiving an expired vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication reported. No treatment information reported.


VAERS ID: 1725328 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-01-14
Onset:2021-09-09
   Days after vaccination:238
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Feeding disorder, Headache, Pain in extremity, Pyrexia, Somnolence, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Slept all day and night; Couldn''t see anything - "it shouldn''t have been like that dark"; "Explosive diarrhea"; Had "absolutely no energy"; Little bit of fever; Headache "but not a big deal"; Arm got sore; Could not eat anything until Friday night; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Had "absolutely no energy"), PAIN IN EXTREMITY (Arm got sore), SOMNOLENCE (Slept all day and night), VISUAL IMPAIRMENT (Couldn''t see anything - "it shouldn''t have been like that dark") and DIARRHOEA ("Explosive diarrhea") in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 038C21A, 030M20A and 029L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Mastectomy. Concurrent medical conditions included Breast cancer since 2008. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, the patient experienced PAIN IN EXTREMITY (Arm got sore) and FEEDING DISORDER (Could not eat anything until Friday night). On 10-Sep-2021, the patient experienced ASTHENIA (Had "absolutely no energy"), SOMNOLENCE (Slept all day and night), VISUAL IMPAIRMENT (Couldn''t see anything - "it shouldn''t have been like that dark"), DIARRHOEA ("Explosive diarrhea"), PYREXIA (Little bit of fever) and HEADACHE (Headache "but not a big deal"). On 10-Sep-2021, VISUAL IMPAIRMENT (Couldn''t see anything - "it shouldn''t have been like that dark") had resolved. On 11-Sep-2021, SOMNOLENCE (Slept all day and night) and HEADACHE (Headache "but not a big deal") had resolved. On 12-Sep-2021, DIARRHOEA ("Explosive diarrhea") had resolved. At the time of the report, ASTHENIA (Had "absolutely no energy"), PAIN IN EXTREMITY (Arm got sore) and PYREXIA (Little bit of fever) outcome was unknown and FEEDING DISORDER (Could not eat anything until Friday night) was resolving. Concomitant product use was not provided. Treatment information was not provided. It was reported that patient was not sure whether she was immunocompromised. This case was linked to MOD-2021-318772 (Patient Link).


VAERS ID: 1725403 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-07
Onset:2021-09-09
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product dose omission issue
SMQs:, Medication errors (broad)

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

Write-up: Did not yet received her second dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Did not yet received her second dose) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. No Medical History information was reported. On 07-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Sep-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Did not yet received her second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Did not yet received her second dose) had resolved. No concomitant drug information was provided by reporter. No treatment drug information was provided by reporter


VAERS ID: 1725552 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-26
Onset:2021-09-09
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101216550

Write-up: Broke out in shingles; This is a spontaneous report from a contactable consumer. A 36-years-old female patient received first dose of bnt162b2 (bnt162b2, PFIZER-BIONTECH COVID-19 MRNA VACCINE, formulation: solution for injection, lot number: FC3180, expiry date: unknown), via an unspecified route of administration on 26Aug2021 as DOSE 1, SINGLE for covid-19 immunisation (age at the time of vaccination was 36 years). The patient''s medical history and concomitant medications was not reported. The patient experienced broke out of shingles on 09Sep2021. It was reported that the patient called to report an adverse reaction for that she went to emergency room. She got this shot on 26th and then on Saturday, she broke out in shingles but did not know where those came from at that time, so she had to go to an emergency doctor''s appointment to see what was going on, from where she got the shingles. The treatment received was valtrex 500 mg every 8 hours. The clinical outcome of the event was unknown.


VAERS ID: 1725580 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Alopecia, Arthralgia, Chest discomfort, Feeling hot, Hypoaesthesia, Illness, Lethargy, Nasal congestion, Pain, Palpitations, Peripheral swelling, SARS-CoV-2 antibody test, SARS-CoV-2 test, Throat irritation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Hypoglycaemia (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TETRACYCLINE; TYLENOL
Current Illness: Lethargy; Pain
Preexisting Conditions: Medical History/Concurrent Conditions: Feeling abnormal (Phantom, distorted, no smell since February); Long COVID (Longhaul Covid-19 sufferer); Loss of smell (Phantom, distorted, no smell since February); Multiple allergies (Known allergies: Yes); Phantosmia (Phantom, distorted, no smell since February)
Allergies:
Diagnostic Lab Data: Test Date: 20210820; Test Name: COVID-19 test; Result Unstructured Data: Test Result:Antibodies 16.4 positive (greater than 0.8); Comments: Blood test; Test Date: 20210916; Test Name: COVID-19 test; Test Result: Negative ; Comments: Blood test
CDC Split Type: USPFIZER INC202101226373

Write-up: Arm swollen to wrist; Could not feel fingers; Tight chest; Burning throat to chest; Lethargy and pain is worse since shot; Palpitations; Nasal congestion; Lethargic hair loss; Joint pain; All around sick; Overheating; Lethargy and pain is worse since shot; This is a spontaneous report from a contactable healthcare professional, the patient. A 49-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 09Sep2021 at 09:00 (at the age of 49-years-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19 from Dec2020 to an unknown date in 2021, ongoing lethargy and pain from an unknown date. The patient was a long haul COVID-19 sufferer. The patient had phantom, distorted and no smell since Feb2021. The patient had unspecified allergies. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included tetracycline (MANUFACTURER UNKNOWN), paracetamol (TYLENOL) and unspecified allergy nasal and pill; all for unknown indication from unknown date and unknown if ongoing. On 09Sep2021 at 09:00, the patient had arm swollen to wrist, could not feel the fingers, tight chest, burning throat to chest, lethargy, palpitations and nasal congestion. The patient felt as if she had COVID-19 all over again. On the same day, the patient experienced lethargic hair loss and joint pain. The lethargy and pain were worsened since the shot and the patient was all around sick. The patient also experienced overheating. The events resulted in emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19. On 16Sep2021, the patient underwent COVID-19 test (reported as blood test) and result was negative. On 20Aug2021, the patient underwent COVID-19 test (reported as blood test) and the result showed antibodies 16.4 positive (greater than 0.8). Therapeutic measures were taken as a result of events and included treatment with an unspecified "recommendation" and testing. The clinical outcome of the events arm swollen to wrist, could not feel fingers, tight chest, burning throat to chest, lethargy and pain is worse since shot, palpitations, nasal congestion, lethargic hair loss, joint pain, all around sick and overheating were resolving at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1725600 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy
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: Metoprolol
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?: Yes); Eosinophilic esophagitis; Fatty liver; Iodine contrast media allergy (Known allergies contrast Iodine); Postural orthostatic tachycardia syndrome (POTS); Rheumatoid arthritis; Supraventricular tachycardia (SVT).
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101227745

Write-up: Swollen left sided supraclavicular lymph node, now almost two weeks out still swollen; This is a spontaneous report from a contactable nurse, the patient. A 29-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: 301308A) via an unspecified route of administration in the left arm on 08Sep2021 at 15:00 (at the age of 29-years-old) as a single dose for COVID-19 immunisation. Medical history included supraventricular tachycardia (SVT), rheumatoid arthritis, postural orthostatic tachycardia syndrome (POTS), fatty liver, eosinophilic esophagitis, asthma, COVID-19 and allergy to contrast iodine. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included metoprolol (MANUFACTURER UNKNOWN) for an unknown indication from an unknown date and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 07Aug2021 (at the age of 28-years-old) as a single dose for COVID-19 immunisation. The patient previously took clarithromycin (MANUFACTURER UNKNOWN) and ketorolac tromethamine (TORADOL) both for an unknown indication from unknown date and experienced drug allergy. On 09Sep2021, the patient experienced swollen left sided supraclavicular lymph node, almost two weeks at the time of report and still swollen. Therapeutic measures were not taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event swollen left sided supraclavicular lymph node, almost two weeks at the time of report and still swollen was not resolved at the time of this report.


VAERS ID: 1725640 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Fatigue, Headache, Hot flush, Pain in extremity, Paraesthesia, Vertigo
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Vestibular disorders (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: ATENOLOL; AMITRIPTYLINE; ATORVASTATIN; ALENDRONAT
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 INC202101236841

Write-up: Bad headaches; Extreme fatigue; Hot flashes; Vertigo; Weakness; Left hand to left elbow tingling; Left hand to left elbow tingling with pain; Left hand to left elbow tingling with pain; This is a spontaneous report from a contactable consumer, the patient. A 72-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3184) via an unspecified route of administration in the left arm on 08Sep2021 at 14:30 (at the age of 72-year-old) as a single dose for COVID-19 immunisation. The patient did not have any relevant medical history. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included atenolol (MANUFACTURER UNKNOWN), amitriptyline (MANUFACTURER UNKNOWN), atorvastatin (MANUFACTURER UNKNOWN) and alendronate sodium (ALENDRONAT) for an unknown indication from an unknown date and unknown if ongoing. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 09Sep2021 at 09:00 the patient experienced bad headaches, extreme fatigue, hot flashes, vertigo, weakness, left hand to left elbow tingling, left elbow pain and left-hand pain. The adverse events did not result in doctor or other healthcare professional office or clinic visit and emergency room or department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. No therapeutic measures were taken as a result of the events. The clinical outcome of the events bad headaches, extreme fatigue, hot flashes, vertigo, weakness, left hand to left elbow tingling, left elbow pain and left hand pain were not recovered at the time of this report.


VAERS ID: 1725976 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone 100mg, Broad Spectrum CBD 30mg, Zyrtec, Vitamin E 400IU, Dr Berg Vitamin D3 & K2, Dr Berg Advanced Immune Support.
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Left arm injection site pain when touched for approx. 5 days. No treatment needed.


VAERS ID: 1726227 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Confusional state, Dizziness, Headache, Heart rate increased, Maternal exposure during breast feeding, Muscle spasms, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Neonatal exposures via breast milk (narrow), 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: Vaginal bleeding, cramping, high heart rate, dizziness, headache, confusion. Patient is a breastfeeding mother and had given birth one month before receiving the vaccine. Patient?s baby experienced diarrhea following the vaccine.


VAERS ID: 1726401 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-22
Onset:2021-09-09
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Benign neoplasm of thyroid gland, Biopsy thyroid gland, Neck mass, Ultrasound thyroid abnormal
SMQs:, Hypothyroidism (broad), Hyperthyroidism (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control Larin 1.5 iron 1 tablet daily, Muti- Vitamin and Vitim D calcium, Magnesium and Omega 3
Current Illness: No
Preexisting Conditions: PCOS
Allergies: Penicillin and Latex not antifelatic
Diagnostic Lab Data: diagnostic biopsy, Ultra sound
CDC Split Type: vsafe

Write-up: Ultrasound a problem 09/09/2021 Had a lump on side of her neck from their a ultra sound of the neck that showed a unglue in the left lobe of the thyroid measure 3.6 cm scheduled a diagnostic biopsy that 09/20/2021 and the finding are a biean follicular nodule No family history of thyroid problem.


VAERS ID: 1726403 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine 10 mg take 1 tab daily Aspirin 81 mg DR take 1 tab daily Baclofen 10 mg take 1 tab TID Clonidine 0.2 mg take 1 cap TID Gabapentin 400 mg take 1 cap BID Hydrochlorothiazide 12.5 mg take ? tab BID Lisinopril 10 mg take 1 tab daily
Current Illness: Asthma, HTN, Tobacco Use
Preexisting Conditions: Asthma, HTN, Tobacco Use
Allergies: PCN
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient was given expired vaccine


VAERS ID: 1726462 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Periarthritis
SMQs:, Arthritis (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient went to the doctor today and was diagnosed with capsulitis. She was given a steriod regimen.


VAERS ID: 1726474 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Depression, Pain
SMQs:, Depression (excl suicide and self injury) (narrow), 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: lexapro, atorvastatin, vitamin D, vyvanse.
Current Illness: Covid-dec 2020
Preexisting Conditions:
Allergies: Sulfa drugs, morphene
Diagnostic Lab Data:
CDC Split Type:

Write-up: body aches for 2 days. Extreme depression for 2 weeks, joint pain still going on as of today 9/23/21


VAERS ID: 1726830 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-04
Onset:2021-09-09
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Fatigue, Occupational exposure to SARS-CoV-2, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/14/21 2nd dose02/04/21 Diagnosed covid positive:09/13/21 Symptom onset:09/09/21 Exposure:work Symptoms:fatigue, sore throat,runny nose


VAERS ID: 1727196 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Blood pressure increased, Computerised tomogram, Dyspnoea, Eye irritation, Headache, Heart rate increased, Intracranial pressure increased, Lacrimation increased, Ocular discomfort, Ocular hyperaemia, Visual field defect
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Lacrimal disorders (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: CT scan- normal vision test, they checked the thickness of my cataracts, and the saturation levels in my eyes- The saturation level in my right eye is low and they said my optic nerve behind my eye had thicken. He said it was intercranial hypertension and peripheral vision loss.
CDC Split Type: vsafe

Write-up: I woke up at about 5:00 am the next morning and I could not see out of my right eye. My right eye was burning and watering. The sclera was completely red, there was no white in there. I could only see light. I could not see shapes or read. It lasted for about 2 hours. I also had a headache and my heart was beating really fast and I had SOB. I went to the ER. By that time I could see again. I only felt some pressure in both eyes. They could not do anything there. They checked my vitals. My heart rate was 180 beats per minute. They made me stay for a couple of hours until my blood pressure and heart rate went a little lower but they could not get my blood pressure down. They released me and they said to follow up with an ophthalmologists. I called my PCP and she suggested a CT scan of my head. I came back clear. I went to an eye doctor a few days later. They did a bunch of scans. When I went that Monday they did a vision test, they checked the thickness of my cataracts, and the saturation levels in my eyes. The saturation level in my right eye is low and they said my optic nerve behind my eye had thicken. He said it was intercranial hypertension which they said they have seen it in other patients that have been vaccinated. At that point because I had some peripheral vision loss and the intercranial hypertension, they told me to go to a neuro ophthalmologist. I have had a headache ever since. I went to have my blood pressure and heart rate re-checked and it is still high so they put me on hydrochlorothiazide. On 09/27/2021 I will se the neuro ophthalmologist.


VAERS ID: 1727330 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Dysgeusia, Taste disorder
SMQs:, Taste and smell 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: Cyclobenzaprine, Melatonin, Mobic
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The patient is a 21yo acdu usmc HM who scheduled this appointment to discuss adverse effect of the Pfizer covid-19 vaccine on 9/16/21. I called and spoke with the patient. He states he received the first dose of the Pfizer vaccine on 9/7/21. On 9/9/21, he started having a metallic taste in his mouth when he ate an egg or meat, now he has that taste with all protein and fatty foods but not with carbohydrates. He states he s chewing gum with mint after meals. He denies fevers, angioedema or aphthous ulcers in the mouth. He has no other concerns.


VAERS ID: 1727351 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site joint pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

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

Write-up: Pt reports to have joint pain in injection shoulder since receiving shot and pain has increased since then (2 weeks). Patient can''t raise arm past 90 degrees. Patient is being referred to PCP for care.


VAERS ID: 1727454 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-04
Onset:2021-09-09
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Computerised tomogram normal, Fatigue, Headache, Pyrexia, SARS-CoV-2 test negative, Urine analysis abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvidilol, amlodopine, valspartan, hydralazine, vitamins c, d3, zinc, queratine, A..
Current Illness: None
Preexisting Conditions: High blood pressure, high cholesterol, prediabetic.
Allergies: None
Diagnostic Lab Data: CT scan, negative;chest X-ray, negative; Covid PCB, negative. Urinalysis showed infection, white blood count @13 All tests completed 09-13-2021
CDC Split Type:

Write-up: High fever up to 103, severe headache, antibiotics iv, antibiotics for 7 days. Tired for 5 additional days. After 48 hours fever had gone, headache was gone.


VAERS ID: 1727456 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-04
Onset:2021-09-09
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F218 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac flutter, Chest discomfort, Dyspnoea exertional
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Pulmonary hypertension (broad), Tachyarrhythmia terms, nonspecific (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: Loratidine, Detrol, Levothyroxine, Crestor, ASA81 mg, Aleve
Current Illness: none
Preexisting Conditions: Overweight
Allergies: sulfa, clindamycin
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: Onset about day 5 post booster shot. Chest discomfort & occasional fluttering. Stinging sensation during the day. Lungs feel clear. Some mild SOB with mild exertion. Increased my anti-inflammatories but symptoms persist 2 weeks from presentation and 19 days post booster shot.


VAERS ID: 1727503 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-09-01
Onset:2021-09-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: None
Preexisting Conditions: Insulin dependent diabetes, alcohol dependence, hx DVT / PE with IVC filter not on anticoagulation, hx of mucinous adenocarcinoma of sigmoid colon s/p resection
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Pfizer dose #1 Sept 1st and dose #2 Sept 20th. He reported noticing a rash on his skin around 9/9 but did not pay much attention to it. Patient is fairly confident he noticed rash in between 1st and 2nd dose. Admitted to local Hospital 9/21 with rash, prelim pathology results concerning for pemphigus vulgaris. No clear triggers.


VAERS ID: 1729307 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-18
Onset:2021-09-09
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mouth ulceration, Vulval ulceration
SMQs:, Severe cutaneous adverse reactions (broad), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 2 days after vaccine, ulcers appeared in her mouth and vulva


VAERS ID: 1730241 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058F21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Body temperature, Diarrhoea, Off label use, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Heart disorder; Pancreatitis (Patient has Pancreatitis which has been under control for the past 3 years.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: Body temperature; Result Unstructured Data: 100.3 F
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Not immunocompromised/gave booster dose; Vomiting after 3rd dose; Temperature 100.3F after 3rd dose; Abdominal pain after 3rd dose; Diarrhea after 3rd dose; This spontaneous case was reported by a nurse and describes the occurrence of ABDOMINAL PAIN (Abdominal pain after 3rd dose), DIARRHOEA (Diarrhea after 3rd dose), OFF LABEL USE (Not immunocompromised/gave booster dose), VOMITING (Vomiting after 3rd dose) and PYREXIA (Temperature 100.3F after 3rd dose) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 058F21A) for COVID-19 vaccination. Concurrent medical conditions included Pancreatitis (Patient has Pancreatitis which has been under control for the past 3 years.) and Heart disorder. On 07-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced ABDOMINAL PAIN (Abdominal pain after 3rd dose), DIARRHOEA (Diarrhea after 3rd dose), VOMITING (Vomiting after 3rd dose) and PYREXIA (Temperature 100.3F after 3rd dose). On an unknown date, the patient experienced OFF LABEL USE (Not immunocompromised/gave booster dose). At the time of the report, ABDOMINAL PAIN (Abdominal pain after 3rd dose), DIARRHOEA (Diarrhea after 3rd dose), OFF LABEL USE (Not immunocompromised/gave booster dose), VOMITING (Vomiting after 3rd dose) and PYREXIA (Temperature 100.3F after 3rd dose) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 09-Sep-2021, Body temperature: 100.3 (High) 100.3 F. No concomitant medications were provided by reporter. No treatment medications were provided by reporter. Patient received the first dose of Moderna COVID-19 vaccine on 04FEB2021 (Lot number: 031L20A and Exp. Date: 22JUL2021). He received the second dose of Moderna COVID-19 vaccine on 04MAR2021 (Lot number 013A21A and Exp. Date: 20AUG2021). On13 Sep 2021, He was able to hold down clear liquids. His medical history of Pancreatitis was under control for the past 3 years and he had a heart condition. Reporter stated that patient was not immunocompromised. However, took the booster dose. Later, found out that the 3rd slot was for immunocompromised people only.


VAERS ID: 1730245 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-26
Onset:2021-09-09
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 - / OT

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

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

Write-up: I experienced sever itching at different times on different parts of the body(Buttocks,back,shoulders,arms,palms); This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (I experienced sever itching at different times on different parts of the body(Buttocks,back,shoulders,arms,palms)) in an 83-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 26-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced PRURITUS (I experienced sever itching at different times on different parts of the body(Buttocks,back,shoulders,arms,palms)). At the time of the report, PRURITUS (I experienced sever itching at different times on different parts of the body(Buttocks,back,shoulders,arms,palms)) outcome was unknown. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1730287 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

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

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

Write-up: I got Covid 9/9/21; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (I got Covid 9/9/21) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced COVID-19 (I got Covid 9/9/21). At the time of the report, COVID-19 (I got Covid 9/9/21) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication information were provided. No treatment information were provided.


VAERS ID: 1730444 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-10
Onset:2021-09-09
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN; LIPITOR
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to nuts (known allergies: some nuts); Blood pressure high; Fruit allergy (known allergies: Fruit with skins); High cholesterol; Pre-diabetes; Vegetable allergy (known allergies: some vegatables)
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: Antigen Test; Test Result: Positive ; Comments: Nasal Swab; Test Date: 20210910; Test Name: Antigen Test; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20210910; Test Name: Rapid PCR; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101191238

Write-up: Patient tested positively for COVID-19 with symptoms Fever, chills, body/muscle aches, malaise; Patient tested positively for COVID-19 with symptoms Fever, chills, body/muscle aches, malaise; This is a spontaneous report from a contactable consumer. A 52-years-old male patient received bnt162b2 (BNT162B2), dose 2 intramuscular, administered in Arm Right on 10Apr2021 08:00 (at the age of 52-years) (Batch/Lot number was not reported) as dose 2, single and dose 1 intramuscular, administered in Arm Right on 20Mar2021 08:00 (at the age of 52-years) (Batch/Lot number was not reported) as dose 1, single for COVID-19 immunisation. Medical history included High cholesterol, high blood pressure, pre-diabetes, allergies to fruit with skins, some nuts and some vegetables. Concomitant medication(s) included metformin (METFORMIN) taken for an unspecified indication, start and stop date were not reported; atorvastatin calcium (LIPITOR) taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient tested positive for covid-19 with symptoms on 09Sep2021 16:00, Fever, chills, body/muscle aches, malaise. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 09Sep2021 (Nasal Swab), sars-cov-2 test: negative on 10Sep2021 (Nasal Swab), sars-cov-2 test: positive on 10Sep2021 (Nasal Swab). Events results in doctor or other healthcare professional office/clinic visit. No treatment was received for the events. The events were assessed as non-serious by the reporter. Outcome of the event patient tested positively for COVID-19 with symptoms Fever, chills, body/muscle aches, malaise was recovering. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1730446 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 RA / -

Administered by: School       Purchased by: ?
Symptoms: Erectile dysfunction
SMQs:, Sexual dysfunction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101191318

Write-up: Trouble getting and maintaining an erection; This is a spontaneous report from a contactable consumer (patient). A 29-year-old male patient received 1st dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number EW0178) at single dose via an unknown route on 08Sep2021 14:00 at 29-year-old in right arm for Covid-19 immunization. Medical history was reported as "none". Patient had no known allergies. Concomitant drug was not provided. Prior to vaccination, the patient was not diagnosed with COVID-19. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Reported event was trouble getting and maintaining an erection on 09Sep2021 12:00 AM. No treatment received. Outcome of the event was not resolved. Since the vaccination, the patient had not been tested for COVID-19. The report was assessed as non-serious. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1730742 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 - / OT

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

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

Write-up: Administration date of Moderna vaccine past the BUD; Product storage error for vaccine kept in storage $g30days; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) and PRODUCT STORAGE ERROR (Product storage error for vaccine kept in storage $g30days) in a 27-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) and PRODUCT STORAGE ERROR (Product storage error for vaccine kept in storage $g30days). On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) and PRODUCT STORAGE ERROR (Product storage error for vaccine kept in storage $g30days) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant and treatment medications were provided. This case was linked to MOD-2021-320876 (Patient Link).


VAERS ID: 1730746 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 - / OT

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

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

Write-up: Administration date of Moderna vaccine past the BUD; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) in a 24-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD). On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication was not reported. Treatment information was not reported. This case was linked to MOD-2021-320876 (Patient Link).


VAERS ID: 1730759 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Headache, Inappropriate schedule of product administration, Lymphadenopathy, Myalgia, Nasal discomfort, Vaccination site erythema, Vaccination site pruritus, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Medication errors (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: SERTRALINE A
Current Illness:
Preexisting Conditions: Comments: Medical history was not provided.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Very itchy; Soreness came back; Red circle is way bigger; Considering not to have the second dose; Very sore arm; Headache; Achy/Sore like if I had worked out on the gym; Severe tiredness; Swollen lymph node; Big red circle on the injection site; Vision is kind of blurry; Swollen thing in my neck, like a big marble; Feel terrible in general; This spontaneous case was reported by a consumer and describes the occurrence of VISION BLURRED (Vision is kind of blurry), NASAL DISCOMFORT (Swollen thing in my neck, like a big marble), FEELING ABNORMAL (Feel terrible in general), VACCINATION SITE PRURITUS (Very itchy) and LYMPHADENOPATHY (Swollen lymph node) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Medical history was not provided. Concomitant products included SERTRALINE HYDROCHLORIDE (SERTRALINE A) for an unknown indication. On 08-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced VISION BLURRED (Vision is kind of blurry), NASAL DISCOMFORT (Swollen thing in my neck, like a big marble), FEELING ABNORMAL (Feel terrible in general), LYMPHADENOPATHY (Swollen lymph node), VACCINATION SITE ERYTHEMA (Big red circle on the injection site), HEADACHE (Headache), MYALGIA (Achy/Sore like if I had worked out on the gym) and FATIGUE (Severe tiredness). On 10-Sep-2021, the patient experienced MYALGIA (Very sore arm). On 17-Sep-2021, the patient experienced VACCINATION SITE PRURITUS (Very itchy), MYALGIA (Soreness came back), VACCINATION SITE ERYTHEMA (Red circle is way bigger) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Considering not to have the second dose). At the time of the report, VISION BLURRED (Vision is kind of blurry), NASAL DISCOMFORT (Swollen thing in my neck, like a big marble), FEELING ABNORMAL (Feel terrible in general), VACCINATION SITE PRURITUS (Very itchy), LYMPHADENOPATHY (Swollen lymph node), VACCINATION SITE ERYTHEMA (Big red circle on the injection site), MYALGIA (Very sore arm), MYALGIA (Soreness came back), VACCINATION SITE ERYTHEMA (Red circle is way bigger), HEADACHE (Headache), MYALGIA (Achy/Sore like if I had worked out on the gym), FATIGUE (Severe tiredness) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Considering not to have the second dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.


VAERS ID: 1730761 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / UNK - / OT

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

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

Write-up: Patient was administered a dose of the Moderna COVID 19 vaccine that was beyond 12 hours post punctured.; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 17-Sep-2021 and was forwarded to Moderna on 17-Sep-2021. This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose of the Moderna COVID 19 vaccine that was beyond 12 hours post punctured.) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 045C21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose of the Moderna COVID 19 vaccine that was beyond 12 hours post punctured.). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose of the Moderna COVID 19 vaccine that was beyond 12 hours post punctured.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was reported. No treatment medication was reported.


VAERS ID: 1730938 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-12
Onset:2021-09-09
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Emotional distress, Logorrhoea
SMQs:, Psychosis and psychotic disorders (broad), Depression (excl suicide and self injury) (broad)

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

Write-up: more emotional; outspoken; This spontaneous case was reported by a consumer and describes the occurrence of EMOTIONAL DISTRESS (more emotional) and LOGORRHOEA (outspoken) in a 32-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040C21A and 058E21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, the patient experienced EMOTIONAL DISTRESS (more emotional) and LOGORRHOEA (outspoken). At the time of the report, EMOTIONAL DISTRESS (more emotional) and LOGORRHOEA (outspoken) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medication information was reported. No Treatment medications were provided This case was linked to MOD-2021-321099 (Patient Link).


VAERS ID: 1730968 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Site: Bruising at Injection Site-Severe, Site: Redness at Injection Site-Medium


VAERS ID: 1731280 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-27
Onset:2021-09-09
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: CSF protein normal, Chronic inflammatory demyelinating polyradiculoneuropathy, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Muscular weakness, Paraesthesia, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic leukopenia (narrow), Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Demyelination (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Labetalol, trazodone, Lexapro, doxazosin
Current Illness: alcohol abuse, depression, enlarged prostate, HTN
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data: CSF protein 41, WBC 0
CDC Split Type:

Write-up: Per notes, Probable Guillain-Barr? syndrome/CIDP related to Covid vaccination. Patient came in with tingling and numbness, weakness in arms and legs, some difficulty swallowing


VAERS ID: 1731284 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-08-30
Onset:2021-09-09
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blister, Blood test, Computerised tomogram, Inflammation, Pain, Rash, Swelling, Vasculitis, X-ray
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vasculitis (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Macadamia nuts
Diagnostic Lab Data: Cat scan, x-rays, bloodwork, diagnosed with vasculitis
CDC Split Type:

Write-up: Rash and blisters all over body, pain, weakness, swelling/inflammation, several urgent care/e.r. visits, 1 hospital stay for 4 days, diagnosed with vasculitis, prescribed steroids, antibiotics and pain meds.


VAERS ID: 1731289 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / UNK LA / IM

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

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

Write-up: PATIENT WAS PROVIDED 0.1 ML INSTEAD OF THE REQUIRED 0.5 ML; PATIENT IS SCHEDULED FOR 9/23 TO RECEIVE FULL DOSE ?Moderna COVID-19 Vaccine EUA?


VAERS ID: 1731322 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / UNK RA / IM

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

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

Write-up: PATIENT WAS PROVIDED 0.1 ML INSTEAD OF THE REQUIRED 0.5 ML; PATIENT IS SCHEDULED FOR 9/23 TO RECEIVE FULL DOSE. ALL STAFF ARE BEING RE-EDUCATED ON PROPER VACCINE ADMINISTRATION. ?Moderna COVID-19 Vaccine EUA?


VAERS ID: 1731326 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 LA / IM

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

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

Write-up: PATIENT WAS PROVIDED 0.1 ML INSTEAD OF THE REQUIRED 0.5 ML; PATIENT IS SCHEDULED FOR 9/23 TO RECEIVE FULL DOSE. ALL STAFF ARE BEING RE-EDUCATED ON PROPER VACCINE ADMINISTRATION. ?Moderna COVID-19 Vaccine EUA?


VAERS ID: 1731328 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-19
Onset:2021-09-09
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Bacterial test, Blood culture, Blood lactic acid, C-reactive protein, Cellulitis, Differential white blood cell count, Fibrin D dimer, Full blood count, Inflammation, Influenza A virus test, Influenza B virus test, Metabolic function test, Oedema peripheral, Respiratory syncytial virus test, SARS-CoV-2 test
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: C-REACTIVE PROTEIN (INFLAMMATION) COMPREHENSIVE METABOLIC PANEL D-DIMER QUANTITATIVE LAB ONLY-COMPLETE BLOOD COUNT WITH DIFFERENTIAL LACTIC ACID SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL Unknown Icon Lab Tests in Progress CULTURE BACTERIAL, OTHER CULTURE, BLOOD performed 2 times
CDC Split Type:

Write-up: 66 year old female presents to ED. Patient arrived by ambulance to the ER for left lower limb cellulitis that is worsening. The wound that is circumferential on the left lower leg and extends down to the left foot is reportedly expanding in area and the edema associated with the limb in increasing as well. Patient was hospitalized on 09/09/21 for same problem however has gotten worse. She is taking augmentin since 9/13/21, doxycycline since 9/12, ciprofloxacin since 9/21.


VAERS ID: 1731332 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 LA / IM

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

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

Write-up: PATIENT WAS PROVIDED 0.1 ML INSTEAD OF THE REQUIRED 0.5 ML; PATIENT IS SCHEDULED FOR 9/23 TO RECEIVE FULL DOSE. ALL STAFF ARE BEING RE-EDUCATED ON PROPER VACCINE ADMINISTRATION. ?Moderna COVID-19 Vaccine EUA?


VAERS ID: 1731364 (history)  
Form: Version 2.0  
Age: 97.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-13
Onset:2021-09-09
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012620A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 16888

Write-up: Hospitalization for pneumonia COVID19 9/9-9/17 . Treated with IV dexamethasone.


VAERS ID: 1731429 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

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

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

Write-up: Numbness developed 15 minutes after administration. Extends from site of injection to fingertips. Currently lasting 2 weeks and 1 day and ongoing.


VAERS ID: 1731830 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-03
Onset:2021-09-09
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Loss of personal independence in daily activities, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Dementia (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID Pfizer
Other Medications: Cymbalta, trazadone, tramadol, Thyroid Arm
Current Illness: Fibromyalgia
Preexisting Conditions: Fibromyalgia
Allergies: Latex, aspirin, Sudafed
Diagnostic Lab Data: None
CDC Split Type:

Write-up: My left arm in great deal of pain all the way down through hand. Severe fatigue. Much greater than normal. Not being able to do normal activities for me. Feeling nauseous a great deal of the time.


VAERS ID: 1731863 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: PATIENT WAS GIVEN 0.1 ML INSTEAD OF 0.5 ML OF MODERNA; PATIENT CONTACTED TO RESCHEDULE FOR FULL DOSE; STAFF WERE ALL PROVIDED ADDITIONAL TRAINING ?Moderna COVID-19 Vaccine EUA?


VAERS ID: 1731883 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 RA / IM

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

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

Write-up: PATIENT WAS GIVEN 0.1 ML INSTEAD OF 0.5 ML OF MODERNA; PATIENT CONTACTED TO RESCHEDULE FOR FULL DOSE; STAFF WERE ALL PROVIDED ADDITIONAL TRAINING ?Moderna COVID-19 Vaccine EUA?


VAERS ID: 1731903 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-25
Onset:2021-09-09
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 80777-0273-99 / 1 LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 80777-0273-99 / 2 LA / IM

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

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

Write-up: Vaccinated patient hospitalized with COVID-19


VAERS ID: 1732822 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-09
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Hypoaesthesia, Lumbar puncture, Magnetic resonance imaging, Paraesthesia, Peripheral coldness
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Respiratory infection on 08/12treated with omnicef
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Bloodwork 9/13/21 & 9/17/21 : two ER visits on 09/09 & 09/10 Admitted to hospital for testing on 09/23: lumbar puncture and spine MRI
CDC Split Type:

Write-up: Numbness and tingling in extremities ,coldness in hands and feet


VAERS ID: 1732977 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-09-09
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Fatigue, Headache, Hypoaesthesia, Injection site pain, Musculoskeletal stiffness, Pain
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Sexual dysfunction (broad)

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

Write-up: I had the standard symptoms for the first few days after I received the first dose (pain at injection site, fatigue, headache, etc.). 7 days after the first dose, I began to feel a sharp chest pain which led me to the emergency room. They completed an EKG, blood work, and chest x-rays to rule out a heart attack and collapsed lung, and then sent me home. 3 weeks after the first dose I started to have pain and a feeling of stiffness and numbness in my hands, arms, legs, and feet. Its been over 7 weeks since I received the vaccines and I am still experiencing all of the above mentioned symptoms. Doctors have been unable to determine or solve the issues.


VAERS ID: 1733514 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3005272 / 1 - / OT

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

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

Write-up: Syncope; Vasovagal reflex; This case was received via a company (Reference number: 2021TJP092479) on 10-Sep-2021 and was forwarded to Moderna on 21-Sep-2021. This case, initially reported to a regulatory authority by a physician, was received via another regulatory authority (Ref, v21126402). Syncope was assessed as a serious. On an unknown date, body temperature before examination: 36.5 degrees Celsius. On 09-Sep-2021, the patient received the 1st dose of this vaccination in the afternoon. The patient had a sick feeling during follow-up observation after vaccination. Around 14:30, vasovagal reflex developed, which led to syncope. The patient recovered with the leg elevation. The symptoms remitted. The outcome of vasovagal reflex and syncope was reported as recovered. Follow-up investigation will be made. Company Comment: The events developed after the administration of COVID-19 vaccine mRNA (mRNA 1273) and there is temporal relationship.; Reporter''s Comments: Vasovagal reflex accompanied by syncope.; Sender''s Comments: This case concerns a 30-year-old, female patient with no relevant medical history, who experienced the unexpected event of syncope. The event occurred on the same day after the first dose of Spikevax (Moderna COVID-19 vaccine). The rechallenge was not applicable as the event occurred after the first dose. The event was considered unrelated to the vaccine per the reporter''s assessment. The benefit-risk relationship of Spikevax (Moderna COVID-19 vaccine) is not affected by this report. Event seriousness assessed as per Regulatory Authority reporting.


VAERS ID: 1733688 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-10
Onset:2021-09-09
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Inappropriate schedule of product administration, Influenza like illness, Malaise
SMQs:, Medication errors (narrow)

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

Write-up: 3rd dose on 10th sep/ second dose on 10-Feb-2021; slight headache, flu like symptoms, very tired and feeling out of sorts; slight headache, flu like symptoms, very tired and feeling out of sorts; slight headache, flu like symptoms, very tired and feeling out of sorts; slight headache, flu like symptoms, very tired and feeling out of sorts; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (slight headache, flu like symptoms, very tired and feeling out of sorts), INFLUENZA LIKE ILLNESS (slight headache, flu like symptoms, very tired and feeling out of sorts), FATIGUE (slight headache, flu like symptoms, very tired and feeling out of sorts), HEADACHE (slight headache, flu like symptoms, very tired and feeling out of sorts) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (3rd dose on 10th sep/ second dose on 10-Feb-2021) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 10-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced MALAISE (slight headache, flu like symptoms, very tired and feeling out of sorts), INFLUENZA LIKE ILLNESS (slight headache, flu like symptoms, very tired and feeling out of sorts), FATIGUE (slight headache, flu like symptoms, very tired and feeling out of sorts) and HEADACHE (slight headache, flu like symptoms, very tired and feeling out of sorts). On 10-Sep-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (3rd dose on 10th sep/ second dose on 10-Feb-2021). On 16-Sep-2021, MALAISE (slight headache, flu like symptoms, very tired and feeling out of sorts), INFLUENZA LIKE ILLNESS (slight headache, flu like symptoms, very tired and feeling out of sorts), FATIGUE (slight headache, flu like symptoms, very tired and feeling out of sorts) and HEADACHE (slight headache, flu like symptoms, very tired and feeling out of sorts) was resolving. At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (3rd dose on 10th sep/ second dose on 10-Feb-2021) outcome was unknown. Not Provided Patient History contained no known allergies. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1733886 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 - / OT

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

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

Write-up: The date that the vial was 30 days in the refrigerator was 05Sep2021; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (The date that the vial was 30 days in the refrigerator was 05Sep2021) in a 30-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (The date that the vial was 30 days in the refrigerator was 05Sep2021). On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED (The date that the vial was 30 days in the refrigerator was 05Sep2021) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. It was stated that as a reminder, 13 doses of Moderna vaccine were inadvertently given past the vaccine beyond-use-date (i.e. past 30 days at fridge temperature) of 05-Sep-2021. Lot was 007C21A Manufactured date 12-Mar-21, NDC of box 80777-273-99, 00380777273990 and and Expiration date was listed online as 12-Oct-2021 No concomitant medications were reported. No treatment information was reported. This case was linked to MOD-2021-320340, MOD-2021-320876.


VAERS ID: 1733891 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 - / OT

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

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

Write-up: Administration date of Moderna vaccine past the BUD; previously received 1 dose of a non-WHO approved vaccine (Convidecia); This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) and INTERCHANGE OF VACCINE PRODUCTS (previously received 1 dose of a non-WHO approved vaccine (Convidecia)) in a 23-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) and INTERCHANGE OF VACCINE PRODUCTS (previously received 1 dose of a non-WHO approved vaccine (Convidecia)). On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) and INTERCHANGE OF VACCINE PRODUCTS (previously received 1 dose of a non-WHO approved vaccine (Convidecia)) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medications were reported. No Treatment medications were reported. This case was linked to MOD-2021-320876 (Patient Link).


VAERS ID: 1733907 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-04
Onset:2021-09-09
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blister, Feeling hot, Somnolence
SMQs:, Severe cutaneous adverse reactions (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fibromatosis; Neurological disorder NOS (She had an extreme neurological disorder.They said she wouldn''t live past 5 years old.); Seizure (She had 2 shunts in her head that drain into her stomach.)
Preexisting Conditions: Medical History/Concurrent Conditions: Fatigue (No history of cardiac problems Cardiac related signs and symptoms: Fatigue)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Her leg is also hot to touch; Her leg blew up real bad from fluid/couldn''t even see her baby toe/ I stuck a pin in her baby toe to burst the blister. A lot of fluid came out./Fluid still leaks out/Fluid is clear; She began sleeping all day, only getting up to drink water.; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (She began sleeping all day, only getting up to drink water.), BLISTER (Her leg blew up real bad from fluid/couldn''t even see her baby toe/ I stuck a pin in her baby toe to burst the blister. A lot of fluid came out./Fluid still leaks out/Fluid is clear) and FEELING HOT (Her leg is also hot to touch) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013A21A and 059E21A) for COVID-19 vaccination. The patient''s past medical history included Fatigue (No history of cardiac problems Cardiac related signs and symptoms: Fatigue). Concurrent medical conditions included Seizure (She had 2 shunts in her head that drain into her stomach.), Fibromatosis and Neurological disorder NOS (She had an extreme neurological disorder.They said she wouldn''t live past 5 years old.). On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced SOMNOLENCE (She began sleeping all day, only getting up to drink water.). On 14-Sep-2021, the patient experienced BLISTER (Her leg blew up real bad from fluid/couldn''t even see her baby toe/ I stuck a pin in her baby toe to burst the blister. A lot of fluid came out./Fluid still leaks out/Fluid is clear). On 16-Sep-2021, the patient experienced FEELING HOT (Her leg is also hot to touch). At the time of the report, SOMNOLENCE (She began sleeping all day, only getting up to drink water.), BLISTER (Her leg blew up real bad from fluid/couldn''t even see her baby toe/ I stuck a pin in her baby toe to burst the blister. A lot of fluid came out./Fluid still leaks out/Fluid is clear) and FEELING HOT (Her leg is also hot to touch) outcome was unknown. No concomitant medication was mentioned. No treatment medication was mentioned.


VAERS ID: 1733910 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 - / OT

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

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

Write-up: has previously received 1 dose of AstraZeneca; Administration date of Moderna vaccine past the BUD; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (has previously received 1 dose of AstraZeneca) in a 23-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination. Previously administered products included for an unreported indication: COVID-19 VACCINE ASTRAZENECA. On 09-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD). On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (has previously received 1 dose of AstraZeneca). On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) had resolved. At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (has previously received 1 dose of AstraZeneca) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications was not reported. Treatment medications was not reported. It was reported that 13 doses of Moderna vaccine were inadvertently given past the vaccine beyond use-date (i.e. past 30 days at fridge temperature) of 9/5/21. This case was linked to MOD-2021-320876 (Patient Link).


VAERS ID: 1733918 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

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

Write-up: Administration date of Moderna vaccine past the BUD; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) in a 35-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD). On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Administration date of Moderna vaccine past the BUD) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The date that the vial was 30 days in the refrigerator was 05Sep2021. No concomitant medication was provided. No treatment medication was provided.


VAERS ID: 1733938 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:2021-08-10
Onset:2021-09-09
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Muscle spasms, Urinary tract infection, Urine analysis
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (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: Bladder disorder (history of bladder problems)
Allergies:
Diagnostic Lab Data: Test Name: Urine test; Result Unstructured Data: Urine test shows UTI
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: UTI; low back pain; back spasms; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (low back pain), MUSCLE SPASMS (back spasms) and URINARY TRACT INFECTION (UTI) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037F21A and 052E21A) for COVID-19 vaccination. The patient''s past medical history included Bladder disorder (history of bladder problems). On 10-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 09-Sep-2021, the patient experienced BACK PAIN (low back pain) and MUSCLE SPASMS (back spasms). On an unknown date, the patient experienced URINARY TRACT INFECTION (UTI). The patient was treated with IBUPROFEN for Adverse event, at a dose of 800 milligram three times a day. At the time of the report, BACK PAIN (low back pain), MUSCLE SPASMS (back spasms) and URINARY TRACT INFECTION (UTI) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Urine analysis: abnormal (abnormal) Urine test shows UTI. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Patient called her HCP who encouraged her to come in to the clinic as she had a history of bladder problems. She was prescribed a muscle relaxant, pain medication, and antibiotics for her symptoms. She had not yet taken these medications and still needs to get them from the pharmacist. No concomitant medication were provided.


VAERS ID: 1734026 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Lymphadenopathy, Myalgia, Pain in extremity, Vaccination site erythema, Vaccination site pruritus, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Blurry vision; Arm soreness; Swollen lymph node in neck; Felt achy and sore; Itchiness on the injection site; Redness on the injection site; Headache; Severe tiredness; This spontaneous case was reported by a consumer and describes the occurrence of VISION BLURRED (Blurry vision), PAIN IN EXTREMITY (Arm soreness), LYMPHADENOPATHY (Swollen lymph node in neck), MYALGIA (Felt achy and sore) and VACCINATION SITE PRURITUS (Itchiness on the injection site) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 08-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced VISION BLURRED (Blurry vision), PAIN IN EXTREMITY (Arm soreness), LYMPHADENOPATHY (Swollen lymph node in neck), VACCINATION SITE PRURITUS (Itchiness on the injection site), VACCINATION SITE ERYTHEMA (Redness on the injection site), HEADACHE (Headache) and FATIGUE (Severe tiredness). 09-Sep-2021, the patient experienced MYALGIA (Felt achy and sore). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, VISION BLURRED (Blurry vision), PAIN IN EXTREMITY (Arm soreness), LYMPHADENOPATHY (Swollen lymph node in neck), MYALGIA (Felt achy and sore), VACCINATION SITE PRURITUS (Itchiness on the injection site), VACCINATION SITE ERYTHEMA (Redness on the injection site), HEADACHE (Headache) and FATIGUE (Severe tiredness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medications were reported.


VAERS ID: 1734164 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Loss of consciousness, Nausea, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101198197

Write-up: passed out / unconscious; convulsions; tired; chills; nausea; dizziness; This is a spontaneous report from a contactable consumer (patient). A non-pregnant 49-years-old female patient received the second dose of BNT162B2 Pfizer-BioNTech COVID-19 mRNA Vaccine, administered at Health Clinic, via an unspecified route in left arm on 08Sep2021 14:00 (Batch/Lot Number: EW0164) as single dose for COVID-19 immunization. Medical history was none. There were no concomitant medications. Historical vaccine included the first dose of BNT162B2 Pfizer-BioNTech COVID-19 mRNA Vaccine administered via an unspecified route in left arm on 18Aug2021 14:45 (Batch/Lot Number: EW0164) as single dose for COVID-19 immunization, after which the patient experienced a terrible headache for 3 days. The patient didn''t receive any other vaccine in the 4 weeks prior to vaccination. She was not diagnosed with COVID-19 before vaccination and was not tested for COVID-19 post vaccination. The patient reported that she was fine on the day of the second shot, but she woke up the following day very tired and with chills. After eating breakfast, she was overcome by nausea and dizziness and she passed out. She had convulsions while unconscious, so her husband called paramedics. All the events were reported to have occurred on 09Sep2021 at 09:00 and required Emergency room/department or urgent care. The events resolved on an unknown date after receiving treatment with ondansetron (ZOFRAN) for nausea, observation and unspecified tests. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1734171 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Constipation, Epistaxis, Faecaloma, Headache, Herpes zoster, Nausea, Rhinorrhoea, Sinusitis
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Shingles
Preexisting Conditions: Medical History/Concurrent Conditions: Diarrhea predominant irritable bowel syndrome; GERD; Hypothyroidism; Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101198859

Write-up: Severe constipation and impaction; Severe constipation and impaction; Continual runny nose; Inflamed sinus passages which caused nose bleeds; Inflamed sinus passages which caused nose bleeds; Shingles outbreak in right nostril; Headache; Nausea; This is a spontaneous report from a contactable consumer (patient). A 58-years-old female (not pregnant) patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the left arm, on 08Sep2021, at the age of 58 years old, as 2nd single dose for COVID-19 immunisation. Medical history included irritable bowel syndrome with diarrhea, reflux disease (GERD), hypothyroidism, chronic shingles, and known allergies to sulfa, meperidine (DEMEROL), and amoxycillin. Past vaccination history included the 1st dose of BNt162b2 received on 18Aug2021 in the left arm, at the age of 58 years old. There were no other vaccinations within the 4 weeks prior to the 2nd dose of BNt162b2. The patient received unspecified concomitant drugs. The patient had not had COVID prior to vaccination and was not COVID tested post vaccination. On 09Sep2021, the patient experienced continuous runny nose, inflamed sinus passages which caused nose bleeds, shingles outbreak in right nostril, headache, nausea, and severe constipation and impaction. Treatment due to the events included valacyclovir (VALTREX), suppositories, Fleet Enema. The patient was recovering from the above-mentioned events. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1734228 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Dermatitis allergic, Lymphadenitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: BACTRIM DS
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: Body temperature; Result Unstructured Data: Test Result:Max 101; Comments: Fever max 101 for 4 days
CDC Split Type: USPFIZER INC202101251637

Write-up: Left axillary lymphadenitis; Fever max 101 for 4 days; Allergic rash ten days post vaccination; This is a spontaneous report from a non-contactable physician, the patient. A 40-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 09Sep2021 at 12:15 (at the age of 40-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history reported. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included sulfamethoxazole, trimethoprim (BACTRIM DS) for an unknown indication from an unknown date and unknown if ongoing. On 09Sep2021 at 18:00, the patient experienced left axillary lymphadenitis, fever max 101 for 4 days and allergic rash ten days post vaccination. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were taken as a result of the events which included treatment with unspecified antibiotics and antihistamine. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events left axillary lymphadenitis, fever max 101 for 4 days and allergic rash ten days post vaccination was recovering at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1734690 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies: Tree nuts, peanuts, grass, tree, dog, cat
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever 100.3, swollen lymph node under armpit on injection site for 5 days, body aches, tiredness lasting 3 days


VAERS ID: 1734697 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Nasal congestion
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: severe headache, nasal congestion, dizziness, tiredness all lasting 3 days


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