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From the 7/23/2021 release of VAERS data:

Found 506,830 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 237 out of 5,069

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VAERS ID: 1400378 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Fall, Fatigue, Feeling cold, Loss of consciousness, Sluggishness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None that we know of
Current Illness: none
Preexisting Conditions: none
Allergies: Peanut
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt had COVID Vax (Moderna) on June 3rd. On June 4th passed out while sitting down became lightheaded and fell over, felt cold and shivering was alone has never had this happen before. no injuries felt tired and sluggish the rest of the day next day felt ok.


VAERS ID: 1400427 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-23
Onset:2021-06-04
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Irbesartan 75 mg once a day.
Current Illness: none.
Preexisting Conditions: Essential hypertension. Infrequent migraine.
Allergies: Amlodipine--causes severe heartburn. Beta blocker--contraindicated due to existing sinus bradycardia. Hydrochlorothiazide--photodermatitis. Lisinopril--causes persistent cough.
Diagnostic Lab Data: No tests done to date.
CDC Split Type:

Write-up: Developed left sided numbness involving entire body 10-11 days after first Pfizer vaccine. This is persistent and has not improved since.


VAERS ID: 1400877 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis, Myalgia, Neurological eyelid disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: Strongly advised patient to seek medical help, patient stated would consider but will most likely not seek help.
CDC Split Type:

Write-up: On 6/4, started having muscle ache when she woke up. On 6/5, states has bell''s palsy (side of face is pulled down, cannot squint right side)


VAERS ID: 1400879 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Injection site lymphadenopathy, Injection site rash, Injection site reaction
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Upon arrival for second dose of Moderna Covid19 vaccine patient reported a rash at injection site that appeared one week after injection (injection date was 6/2/21), the rash went away after a few days. She was told by the immunizing pharmacy to report back if this occurred again. Patient called 6/4 (2 days after her second vaccine) to report a rash at injection site and a swollen/painful lymph node in the armpit of the injected arm.


VAERS ID: 1401454 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Brain natriuretic peptide increased, Bronchitis, C-reactive protein increased, Computerised tomogram thorax abnormal, Condition aggravated, Cough, Dizziness, Dyspnoea, Electrocardiogram abnormal, Fibrin D dimer increased, Palpitations, Pulmonary oedema, SARS-CoV-2 test negative, Troponin, Upper respiratory tract infection, White blood cell count increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No medications
Current Illness: Patient began experiencing upper respiratory tract infection symptoms approximately three days prior to receiving second dose of moderna COVID 19 vaccine on 6/4/21, this illness lasted approximately until 6/12/21 when his URI symptoms seemed to resolve. However he had persistent shortness of breath, lightheadedness, and palpitations starting around 6/12-6/13 which ultimately brought him to the emergency department on 6/15/21.
Preexisting Conditions: Described palpitations through adolescence into adulthood, but never formally diagnosed with anything. No other past medical history to date.
Allergies: No allergies to medications
Diagnostic Lab Data: Initial lab work and tests upon presentation notable for EKG with AFIB and rates in 160-200s. D Dimer 4829, troponin 0.059, CT angio of the chest demonstrating pulmonary edema. CRP 19.1, BNP 7500, WBC 13.27. COVID 19 PCR test negative. Further work up still pending.
CDC Split Type:

Write-up: Patient received second dose of Moderna COVID 19 vaccine on 6/4/21. During this same time, patient also had URI diagnosed as bronchitis at an urgent care and provided albuterol inhaler. Cough and URI symptoms subsided on approximately 6/12/21 but developed SOB, lightheadedness, and palpitations thereafter prompting presentation to ED on 6/15/21. Patient was started on digoxin, heparin, and furosemide by cardiology team. Work up in progress.


VAERS ID: 1401709 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049B214 / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic shock, Pharyngeal swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Anaphylactic Shock about 1 hour post vaccination; Hives all over the body; Swollen Throat; Itching all over the body; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ANAPHYLACTIC SHOCK (Anaphylactic Shock about 1 hour post vaccination) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049B214) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 04-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Jun-2021, the patient experienced URTICARIA (Hives all over the body), PHARYNGEAL SWELLING (Swollen Throat) and PRURITUS (Itching all over the body). On 04-Jun-2021 at 1:00 PM, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced ANAPHYLACTIC SHOCK (Anaphylactic Shock about 1 hour post vaccination) (seriousness criteria hospitalization and medically significant). The patient was treated with EPINEPHRINE (EPIPEN) on 04-Jun-2021 for Anaphylactic shock, at a dose of 2 dosage form and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) on 04-Jun-2021 for Hives, at a dose of 25 milligram every six hours. At the time of the report, ANAPHYLACTIC SHOCK (Anaphylactic Shock about 1 hour post vaccination) and PHARYNGEAL SWELLING (Swollen Throat) outcome was unknown and URTICARIA (Hives all over the body) and PRURITUS (Itching all over the body) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. It was reported that as of 07 JUN 2021, the patient still had hives and itchiness. Company comment: Based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded.


VAERS ID: 1402126 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-26
Onset:2021-06-04
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 6022C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Breast enlargement, Breast tenderness
SMQs:, Lipodystrophy (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: OTC: Gabapentin, Imuran, Cardizem CD, Baby ASA, Flexeril, Ropinerol, Vit B Complex, Vit D, Levothyroxine, Colace, Senna PRN: Ambein, Xanax, Norco, LCtaid, Doxylamine Succunate
Current Illness: See below
Preexisting Conditions: MCTD, jupus, RA, OA, Raymauds, Hypothyroidism, Bone Marrow Suppression, Thrombocytopenia, Metatarsalgia, Plantar Fasciitis, PGAD, POD, s/p vol shoulder surgeries, s/p R TKR, s/p partial hysterectomy
Allergies: Cymbalta, Lyrica, Zofran, Morphine, Benadryl, Topamax, Tetracycline, Tiazidine, Bactroban
Diagnostic Lab Data: Due to see doctor on the 26th. Did not feel that this was a life threatening event that my appointment needed to be changed. Tests to be determined by physician on 6/26/2021.
CDC Split Type:

Write-up: 9 days s/p 2nd vaccine, in the arm that received the vaccine, noted the left breast was twice the size of the right breast. No redness, tenderness, not nipple discharge. The left axcilla soft, nontender, no palpable lymph nodes noted. 10 days s/p 2nd vaccine, left breast, still enlarged, then tender to palpation. Injection site is fine. No fevers, chills, nor sweats. Warm compressed applied to left axcilla, keeping left arm in motion, continuing to try to support the left breast.


VAERS ID: 1402139 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-28
Onset:2021-06-04
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue
SMQs:

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: aspirin 81 mg tablet atorvastatin (LIPITOR) 20 mg tablet blood sugar diagnostic (ONETOUCH ULTRA BLUE TEST STRIP) strip carvediloL (COREG) 6.25 mg tablet cyclobenzaprine (FLEXERIL) 5 mg tablet diclofenac sodium (VOLTAREN GEL) 1 % gel glipiZI
Current Illness: None
Preexisting Conditions: Nervous Cervical radiculopathy Shoulder joint pain Respiratory Obstructive sleep apnea Acute bronchitis due to 2019 novel coronavirus Circulatory Essential hypertension Sinus tachycardia Digestive Severe obesity (BMI 35.0-39.9) with comorbidity (CMS/HCC) Other constipation Vitamin D deficiency Genitourinary Irregular menstruation Musculoskeletal Costochondritis Osteoarthritis of glenohumeral joint, left Loose body in joint of shoulder region Primary localized osteoarthrosis of shoulder region Sagittal band rupture at metacarpophalangeal joint, initial encounter Endocrine/Metabolic Pure hypercholesterolemia Uncontrolled type 2 diabetes mellitus with hyperglycemia, with long-term current use of insulin (CMS/HCC) Other Recurrent major depressive disorder, in partial remission (CMS/HCC) Noncompliance with medications Other specified eating disorder Preop cardiovascular exam Vivid dream PTSD (post-traumatic stress disorder) Adjustment disorder with mixed anxiety and depressed mood History of endometrial ablation
Allergies: HydrochlorothiazideMyalgia / Muscle Pain
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue


VAERS ID: 1402231 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-19
Onset:2021-06-04
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Epistaxis, Haemoglobin decreased
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (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: nose bleed, decrease in hemoglobin by 0.7 in 1 day 6/4 Nose bleed, 6/8 another nosebleed, hgb dropped from 12.8 to 12.1 in 1 day, needed TXA to stop the nosebleed in the clinic, sent home with Afrin, hold aspirin due to bleeding


VAERS ID: 1402430 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-18
Onset:2021-06-04
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Anticoagulant therapy, Catheterisation cardiac, Stent placement
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (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: clonazepam 1 mg, buproprion 150 mg BID, dexamthasone 2 mg BID, metoprolol succinate 25 mg, rosuvastatin 40 mg
Current Illness:
Preexisting Conditions: HTN, HLD, osteoarthritis, degenerative joint disease
Allergies: bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: NSTEMI went to cardiac cath and received stent in LAD. Started on prasugrel 10 mg daily, lisinopril 2.5 mg daily, and aspirin 81 mg daily discharged home


VAERS ID: 1402610 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Had food poisoning that began on 04-14-2021 and was symptomatic for two weeks afterward. My first COVID-19 vaccine was on 5/13/2021 and only symptom from that was a slightly sore arm at injection site. The reaction I''m reporting followed the second vaccination I received on 6-2-2021 in which I had vertigo.
Preexisting Conditions: None.
Allergies: Topical vitamin E
Diagnostic Lab Data:
CDC Split Type:

Write-up: Just as I was going to get into bed to sleep on the night of 06-04-2021, I experienced vertigo. I found one position I could be in that gave me relief, but any movement of my head beyond that one position resulted in severe vertigo. It was severe all day on 6-5-2021. My doctor on call advised me to take Claritin and Dramamine during the day and Benadryl at night. I did not take the Benadryl and did not seem to get any relief from the Claritin and Dramamine. Late in the day, I tried an exercise for vertigo and could not complete the exercise because it exacerbated the vertigo to a point I thought I would pass out had I continued. On 6-6-2021, symptoms were lessening and I was able to get back on my feet but could not fully function without vertigo. On 6-7-2021 I felt fairly normal and resumed all my regular activities without incident..


VAERS ID: 1402669 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-27
Onset:2021-06-04
   Days after vaccination:69
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Deep vein thrombosis, Myocardial strain, Pulmonary embolism, Scan with contrast abnormal, Thrombophlebitis superficial, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, loratadine, losartan, magnesium oxide, melatonin, meloxicam, omeprazole
Current Illness: none
Preexisting Conditions: GERD, hypertension, osteoarthritis
Allergies: Shellfish (anaphylaxis), tetracycline (angioedema)
Diagnostic Lab Data: 6/9/2021: Ultrasound Venous Duplex Lower extremity R: IMPRESSION: Right lower extremity deep vein thrombosis involving the proximal femoral vein through to the posterior tibial veins. Associated superficial thrombophlebitis involving the proximal to mid lesser saphenous vein. 6/9/2021 CT chest with IV contrast: Significant bilateral pulmonary emboli involving the distal main pulmonary arteries, both lower lobar pulmonary arteries and segmental branches, the left upper lobe are pulmonary artery, and the origins of the right middle lobar and right upper lobe are pulmonary arteries. No pulmonary infarct. There is slight convexity of the intraventricular septum towards the left, suggesting right heart strain.
CDC Split Type:

Write-up: Acute bilateral pulmonary embolus and right lower extremity DVT. No typical risk factors such as recent trauma or surgery and no personal history of DVT/PE. Received Moderna COVID-19 vaccination series in February and March of this year.


VAERS ID: 1402798 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Headache, Chills, Nausea


VAERS ID: 1403278 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: PALPITATIONS AND SHORTNESS OF BREATH, PT WILL SEEK TREATMENT AT LOCAL WALK IN CLINIC FOR EVALUATION.


VAERS ID: 1403508 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: not sure which one but pt''s parent explained pt has fainted post vaccination before
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt fainted shortly after vaccination (within 5 minutes). Pt regained consciousness within few seconds. Pt lied down with feet higher on a chair. Pt was monitored for 30 minutes and recovered fully.


VAERS ID: 1403614 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-12
Onset:2021-06-04
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: I was diagnosed with a blood clot ( Deep Vein Thrombosis) in my left leg after the event of my vaccine. No family history and clean bill of health. Am now on Eliquis blood thinners to ease the pain and reduce my blood clot. Seeing a hematologist in a few days


VAERS ID: 1403695 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: On 6/4/2021 patient received her third dose of the COVID 19 vaccine. Per phone conversation with the patient, patient arrived to vaccine clinic with a written letter by physician requesting to receive an additional dose. Patient received first dose 3/20/2021 and second dose 4/10/2021. Vaccine is currently only approved for a two dose series. Patient denied any unexpected or prolonged side effects.


VAERS ID: 1404003 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-26
Onset:2021-06-04
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Insomnia, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

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

Write-up: I''m experiencing extreme fatigue where I will take involuntary naps during the day and sleeping more than 8 hours a night. Normally I struggle with not sleeping enough and am not sure if it''s directly related to the vaccine but I wanted to give the data in case it was.


VAERS ID: 1404794 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram normal, Musculoskeletal stiffness, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: 6/15 follow up with pediatrician - EKG normal. No further side effects after 6/5.
CDC Split Type:

Write-up: Fever 18 hours after second dose injection. Stiff neck, tightness in chest approx. 30 hours after second dose injection.


VAERS ID: 1405860 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC2021651512

Write-up: Allowance of covid vaccination that resulted in adverse lasting side effects. Developed breasts. Ongoing issues.; Test: Nasal Swab Result: Positive; Test: Nasal Swab Result: Positive; This is a spontaneous report from a contactable consumer (patient). This 18-year-old non-pregnant female patient received bnt162b2, via an unspecified route of administration, administered in arm right on an unspecified date (Batch/Lot number was not reported) as unknown, single for covid-19 immunisation. Medical history included allergy/known allergies: yes. The patient''s concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Allowance of covid vaccination that resulted in adverse lasting side effects. Developed breasts. Ongoing issues. Developed breasts resulted in: Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care, Hospitalization, Life threatening illness (immediate risk of death from the event), Disability or permanent damage. Hospitalization for 10 days. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19. Covid test post vaccination: covid test type post vaccination was Nasal Swab on 04Jun2021, result was positive. Treatment of event was unknown. The event outcome was not recovered. Information on Lot/Batch number has been requested.


VAERS ID: 1405864 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021655093

Write-up: swelling; join pain; This is a spontaneous report from a contactable consumer (Patient). A 70-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), dose 1 via an unspecified route of administration on 01Jun2021 as 1ST DOSE, SINGLE DOSE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced swelling and join pain on 04Jun2021. It was reported that patient received first dose of the vaccine on 01Jun2021 and today is the first day she experienced the AE. She also stated that she experienced joint pain. Caller wanted to know if the swelling AE that she experienced would be a contraindication in getting the 2nd dose of the Pfizer BioNTech Covid-19 Vaccine and it was reported that Caller wanted to know if it would be fine for her to take aspirin or aleve after getting the Pfizer BioNTech Covid-19 Vaccine. The outcome of events was unknown.


VAERS ID: 1405866 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Body temperature increased, Chest discomfort, Circumstance or information capable of leading to medication error, Confusional state, Ear discomfort, Erythema, Feeling hot, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), 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: AMLODIPINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Elevated blood pressure reading without diagnosis of hypertension (she was diagnosed with elevated blood pressure in February or March this year.)
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: elevated blood pressure; Result Unstructured Data: Test Result:148/90 mmHg; Test Date: 2021; Test Name: elevated temperature; Result Unstructured Data: Test Result:100.2 Fahrenheit
CDC Split Type: USPFIZER INC2021655777

Write-up: When I went to get the vaccine, it was already drawn from the vial. The vial placed on the table was Moderna. I am not sure which vaccine I received; confused; a slightly elevated temperature which went from 99. to 100.2; Her ears were also red/Her ears are burning red; her whole face is red, ears are red, neck is starting to get red and front of chest is red; chest was purple; She felt hot; a rash all over her body/rash around the head and chest/She got a huge rash on her face, neck, and chest, forehead, cheeks, and nose; This is a spontaneous report from a contactable consumer (patient) reported for herself. A 52-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EW0217, Expiration date: unknown) via an unspecified route of administration, administered in right arm on 04Jun2021 around 15:30 or 15:45 pm (age at vaccination was 52 years) as 1st dose, single dose for COVID-19 immunization. The patient medical history included elevated blood pressure. The caller stated that she was diagnosed with elevated blood pressure in February or March this year. Stated her blood pressures was 138 or 140''s or something like that. 148/90 or over 88. Sometimes it was 139. Concomitant medications included amlodipine with dose 5 mg 1x/day via oral route for elevated blood pressure. The patient took the Pfizer COVID vaccine because everyone required it. The patient experienced a rash all over her body and wanted to know if that was vaccine side effect or she needs to contact her HCP. On PRD 04Jun2021, it was reported that the caller wanted to know the expiry date and confirm the product under the lot number provided. She received the response stating that confirmed the product was a Pfizer COVID-19 vaccine. They also provided the expiration date: 30Sep2021. The caller had gone to the pharmacy to receive a COVID-19 vaccine. All her friends had received the Pfizer COVID-19 vaccine. Moderna caused many side effects. Her doctor also said it''s belter she gets the Pfizer COVID-19 vaccine because she had elevated blood pressure. When she went to get the vaccine, it was already drawn from the vial. The vial placed on the table was Moderna. She was not sure which vaccine she received. The lady who gave her the vaccine told her it was the Pfizer COVID-19 vaccine. She can''t trust them because the vaccine was not drawn from the vial in front of her. She had called the pharmacy three times already. They have been giving her different information each time. First, they said they don''t have the Pfizer COVID-19 vaccine and then they said they do. She asked that why doesn''t Pfizer create a policy to ensure that the vaccine should be drawn from the vial in front of the patient. She was not sure what they gave. They may be made her part of a study. She was very confused. There were two syringes filled in. She was not sure which vaccine did she receive. The caller reported rash around the head and chest right after receiving the vaccine. She also noticed few minutes post vaccination a slightly elevated temperature which went from 99. to 100.2. Her ears were also red. She received the response stating that they cannot verify which vaccine she had received as they had not witnessed the administration. Fever and rash had been reported with the Pfizer COVID-19 vaccine. The reaction could occur anywhere from minutes to a few days post vaccination. A reaction such as ears turning red has not been listed as side effect in the prescribing information. They didn''t have the list of all the possible side effects associated with the vaccine. The asked her to speak to her HCP if the symptoms persist or didn''t go away. Informed caller to contact someone at the pharmacy and report the event. Pfizer cannot control the policy and procedure of the pharmacy. It''s best to report to ensure they don''t repeat such mistakes again. On PRD 04Jun2021, it was reported that the caller called about the Pfizer vaccine EW0217. Caller stated she just got the vaccine at and the pharmacy refused to let her see the vial it was drawn out of. The guy had a bottle that said Moderna and wouldn''t let her go to the back. When she asked to see the Pfizer covid vaccine vial they told her they threw it out. She asked that why was the pharmacy refusing to let her see what they were giving her. She stated she honestly thought they did something but told her that they drew it in the back. She asked how she was supposed to know she got the Pfizer covid vaccine. She was told she was to get her second dose in 4 weeks, and the caller questioned 4 weeks stating the Pfizer second dose should be 3 weeks after first dose. Then stated getting the second dose 4 weeks after first dose was for Moderna, not Pfizer. She just got the vaccine. She reported her whole face was red, ears were red, neck started to get red and had a huge rash on the front of her chest. She got a huge rash on her face, neck, and chest, forehead, cheeks, and nose, it was all red. She didn''t know if it was going to get worse. Her ears were burning red. Received vaccine half hour ago about 2:45. Her card did not say anything about the date of when she should get the second dose. She did not receive any treatment as it just happened half hour ago. She stated her ears were burning and were purple, red. She had never had purple ears before. The caller wanted to know if that was normal and whether she should go to her doctor''s office because it was Friday. There was a Product complaint. The description of complaint included the caller received COVID-19 Vaccine Lot# EW0217. Caller was concerned she did not receive the Pfizer COVID vaccine. Vaccine facility refused to show her the vial stating it was discarded. Product strength and count size dispensed was not provided. No sample of the product was available to be returned as the vial was discarded. Packaging sealed and intact was not provided. On PRD 04Jun2021, it was reported that the caller just received the Pfizer Covid-19 Vaccine. She had a huge rash on her head and chest. Her ears are red. The caller had really called because she didn''t like the way of administering the vaccine. The caller saw a Moderna vial on the table where she was vaccinated. She wanted to see the vial to the vaccine that she received. Did not produce the vial. The caller was concerned that she may have received the Moderna vaccine instead of the Pfizer. The agent also referred caller to the state department of health because they are the ones who distributed the vaccine. The caller stated that she was really not sure if she got the Pfizer vaccine. She believed it was the Moderna or whatever was in that syringe. There were 2 syringes. She didn''t know what she was given. When she went to get the vaccine, she walked up to get the paper that had the vaccine information on it. She told them that was not what she wanted. She wanted the vaccine Pfizer made. She told them to provide her with Pfizer''s information. She told him to use her right arm. She wanted to see the vial they drew the vaccine from because she saw a Moderna vial on top of the table half filled in. Someone at the pharmacy told the caller they drew up the vaccine in the back. He told the caller she had to trust him. The caller went to the back and asked the lady where the vial was, she drew the vaccine from. The caller stated they did not have the vial they drew her vaccine from but used another vial to show her how the vaccine looks. Caller was told this was the Moderna. They drew it and threw it away. Caller stated how was she supposed to know what they gave her. She simply asked could she see the vial the vaccine was in. The caller stated they gave the vaccine, and she walked out. Caller stated that the pharmacy could have given her a quadruple dose. She didn''t see the lady. The lady could have put a random number on there. The caller stated that her ears got really red. Her chest was purple. It was kind of strange. She felt hot. When she got in the car, she looked really red. For the first 5 minutes, it looked like something was growing on her arm. Her face was red. She had to drink water to calm down. The caller confirmed that she told the previous Pfizer safety agent that she had the reaction. The safety agent told her that she should call Medical Information. The caller asked if the side effects were normal whether they really gave her a vaccine. She measured her temperature. Right now, the temperature was 99.3 at 4:15. 3 minutes later it was 99.2. Now it''s 100.2. Her head was just hot after an hour and a half. When she checked her forehead it was 99.4. The caller stated shouldn''t they have a blue top on the Pfizer vial. He showed her a small vial. He told her it was from the same lot. He asked the lady. The lady drew up the vaccine but said she didn''t have it. The lady put the vial in the sharps box. The caller called last week, and they only had Moderna vaccines at that time. Her friend said Pfizer was better and it has less side effects. Caller stated her vaccination card does not say when she has to come back for her second dose. The lady told her to come back in 28 days. Caller knew that they come back in 28 days for the Moderna vaccine. The Pfizer vaccine was 21 days. Caller confirmed she received the first dose of the Pfizer Covid-19 Vaccine today around 2:30 or 2:45. Caller stated that Pfizer provides for guidelines. As a patient, she should see what vial the vaccine was drawn from. She has blood pressure and weight issues. Caller stated she took Amlodipine for blood pressure. Caller stated she hopeed they didn''t give her a different kind of vaccine and she turned into a mutant or something. On PRD 04Jun2021, it was reported that the caller was concerned that she might not have been administered the Pfizer COVID 19 vaccine that she had requested. There was a Moderna vial on the table and they couldn''t produce the Pfizer vial that my dose came from. She had an adverse reaction to the Pfizer COVID 19 vaccine. She had a huge rash on her face and chest, her ears were red. I received the shot at Walgreens and there was a Moderna vial on the table. She was not sure they gave her Pfizer or if they gave her some kind of experimental drug. They couldn''t produce the Pfizer vial that her dose came from. The vaccine card that they gave her said Pfizer on it, but she didn''t know that they were from her vial. She took high blood pressure medication. The outcome of the events was unknown. Follow up#01 (04Jun2021), Follow up#02 (04Jun2021), Follow up#03 (04Jun2021) andcFollow up#04 (04Jun2021): New information received from a contactable consumer (patient) reported for herself included: Updated the lot number (EW0217), details regarding the adverse events, concomitant medication (Amlodipine), medical history (elevated blood pressure) and details of product complaint.


VAERS ID: 1405871 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO191 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: ELIQUIS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arrhythmia; COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021658014

Write-up: Severe headaches never get headaches; Whole body aches; Fever; Diarrhea; This is a spontaneous report received from a contactable consumer or other non hcp(patient). A 66-years-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number: EWO191) via an unspecified route of administration in Arm Left on 04Jun2021 at 10:30 AM (66-years-old age at vaccination) as 1ST DOSE, SINGLE DOSE for covid-19 immunisation. Medical history included Heart arithmia from an unknown date and unknown if ongoing, covid-19 from Jan2021 to an unknown date. Concomitant medications included apixaban (ELIQUIS) taken for an unspecified indication, start and stop date were not reported. Patient had no known allergies. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was diagnosed with COVID-19. Since the vaccination, patient has not been tested for COVID-19. On 04Jun2021 at 13:00, the patient experienced severe headaches never get headaches, whole body aches, fever and diarrhoea. I had covid in january and felt like I have it all over again. Treatment was received for the events. I called Dr and got advise on meds to take. The events was reported as non serious. The outcome of the events was reported as not recovered. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1405879 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Dyspnoea, Inflammation, Joint swelling, Musculoskeletal discomfort, Musculoskeletal stiffness, Oedema peripheral, Pain, Pain in extremity, Peripheral swelling, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: AMLODIPIN (BESILAT) DEXCEL; METFORMIN; ATENOLOL; OLMESARTAN; CINNARIZINE; VALIUM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Blood pressure high; Diabetes; Vertigo
Allergies:
Diagnostic Lab Data: Test Date: 20210422; Test Name: TSH; Result Unstructured Data: Test Result:Unknown
CDC Split Type: USPFIZER INC2021664021

Write-up: My whole thighs is hurting; I couldn''t move my arm for 2 days, it was stiff I couldn''t move my hand; Joint discomfort and inflammation; Joint discomfort and inflammation; Even inhaling, exhaling is not comfortable; Whole right side where I got the shot from my neck to my ankle is swollen, my back, my arm, my neck, my thighs everything is swollen and it hurts extremely; Whole right side where I got the shot from my neck to my ankle is swollen, my back, my arm, my neck, my thighs everything is swollen and it hurts extremely; Whole right side where I got the shot from my neck to my ankle is swollen, my back, my arm, my neck, my thighs everything is swollen and it hurts extremely; Whole right side where I got the shot from my neck to my ankle is swollen, my back, my arm, my neck, my thighs everything is swollen and it hurts extremely; Whole right side where I got the shot from my neck to my ankle is swollen, my back, my arm, my neck, my thighs everything is swollen and it hurts extremely; This is a spontaneous report from a contactable consumer (patient). A 41-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot Number: EW0179), via an unspecified route of administration on 03Jun2021 (at the age of 41-year-old) at single dose for COVID-19 immunization. The patient medical history included blood pressure high, asthma, diabetes and vertigo. The patient concomitant medications included amlodipine besilate (AMLODIPIN (BESILAT) DEXCEL) taken for blood pressure high, metformin taken for diabetes, atenolol, olmesartan taken for blood pressure, cinnarizine taken for vertigo and diazepam (VALIUM). Patient did not receive any other vaccine prior to Covid vaccine. The patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: EW0162), via an unspecified route of administration, administered at arm right on 13May2021 (at the age of 41-year-old) as single dose for COVID-19 immunization. The patient experienced my whole thighs is hurting, I couldn''t move my arm for 2 days, it was stiff I couldn''t move my hand, joint discomfort and inflammation on an unspecified date. On 04Jun2021, the patient had whole right side where I got the shot from my neck to my ankle is swollen, my back, my arm, my neck, my thighs everything is swollen and it hurts extremely, even inhaling, exhaling is not comfortable. Patient stated, I think I am having some kind of reaction with the shot (COVID-19 vaccine) because my whole entire body from my knee up to my neck is swollen. My whole right side where I got the shot from my neck to my ankle is swollen, my back, my arm, my neck, my thighs everything is swollen and it hurts extremely. Even inhaling, exhaling is not comfortable. Patient further stated, the next day the middle of the day almost every day my right arm started swelling up and next day my neck started swelling up. My whole thighs was hurting and was swollen. When I take vaccine I dont take any other medication, so I am not sure what is actually causing any problems. I havent taken anything else other than Tylenol. So, first time I didnt take anything I just took Tylenol but my arm swell up the same day. I couldn''t move my arm for 2 days, it was stiff I couldn''t move my hand. I put some heating pad and ice pad like stuff on it and about on the third day it started to get better but then 2 days after that I woke up swollen and I couldnt move. This was freaking me out. Under my arm and all the way down I don''t think it should swell up like that and it is on whole body. The patient underwent lab tests and procedures which included TSH was unknown on 22Apr2021. The patient received Tylenol as a treatment medication for relief joint discomfort and inflammation. Outcome of the events was unknown. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1405941 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021671136

Write-up: also been experiencing a migraine which doesn''t seem to be going away/ Intractable migraine, pain in his head; pain in his head and neck; Fever; chills; This is a spontaneous report from a contactable consumer (patient''s mother). A 16-years-old male patient received second dose of bt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: EW0181), via an unspecified route of administration, administered in deltoid left on 04Jun2021 at 10:25 (at the age of 16-years-old) as single dose for COVID-19 immunization. The patient did not had ant medical history. The patient''s concomitant medications were not reported. The patient previously received the first dose of bt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0182), administered in left deltoid muscle on 14May2021 as single dose for COVID-19 immunization. The patient did not receive any other vaccine within four weeks prior to the first administration date of the suspect vaccine. The patient did not administer any additional vaccines on same date of the Pfizer suspect. On 04Jun2021 at 18:25 (within 8 hours of being administered the second dose of Pfizer Covid-19 Vaccine), the patient experienced fever and chills. On 05Jun2021 at 20:00, the patient been experiencing a migraine which doesn''t seem to be going away/ intractable migraine, pain in his head, and pain in his neck. The patient received treatment for the fever and chills which included Tylenol. The patient was also treated for the migraine and pain in his head and neck. Duration of the fever and chills was about 36 hours, after which patient recovered completely. The consumer explained that the fever and chills were the normal, expected side effect. The intractable migraine, pain in head and neck was persistent. The patient did not require a visit to emergency room or physician office but they were waiting to hear back from his doctor. The patient was not hospitalized and did not underwent relevant tests. The consumer wanted to know if that was normal and how long she should expect the headache to last. The outcome of the events fever and chills was resolved on 06Jun2021, and migraine and pain in his head and neck was not resolved.


VAERS ID: 1405983 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Dizziness, Headache, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Protein allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021673100

Write-up: headaches with dizziness; headaches with dizziness; felt feverish; itchiness we''re I got my 2nd shot; Diarrhea; stomachache; This is a spontaneous report from a contactable consumer (patient). A 17-year-old non-pregnant female patient received bnt162b2 (BNT162B2), dose 2 (Age at vaccination: 16 years) via an unspecified route of administration, administered in Arm Right on 03Jun2021 12:00 (Batch/Lot Number: EW0179 and Expiry date:Unknown) as 2ND DOSE, SINGLE for Covid-19 immunization. Medical history included allergy of big amounts of biotin. The patient concomitant medications was not reported. Historical vaccination included previously the patient received bnt162b2 (BNT162B2), dose 1 (Age at vaccination (years): 16) via an unspecified route of administration, administered in Arm Right on 13May2021 12:30 PM (Batch/Lot Number: EW0179 and Expiry date:Unknown) as 1st DOSE, SINGLE for Covid-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. On 04Jun2021, after second dose, first day diarrhea and stomachache. On 05Jun2021 (2nd day) she felt feverish but was not too bad and also itchiness where she got her 2nd shot. On 06Jun2021,(on the 3-4 day) the patient had headaches with dizziness .The patient did not received treatment for the events. The outcome of the events was resolved on an unspecified date in 2021. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1406699 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Fatigue, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Woke up with several stomach pain, diarrhea, headache, muscle aches and tiredness.


VAERS ID: 1407067 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-27
Onset:2021-06-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Injection site erythema, Injection site indentation, Injection site oedema, Nodule, Pyrexia, Skin mass
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: losartan 50mg daily, atorvastatin 40mg daily, Amlodipine 10 mg daily, Carvedilol 25 mg BID, Gabapentin 300 mg BID, Xeralto 20 mg daily.
Current Illness: Atrial fibrilation, SVT, cardiomyopathy, neuropathy, hyperlipidemia, HTN, pacemaker.
Preexisting Conditions: Atrial fibrilation, SVT, cardiomyopathy, neuropathy, hyperlipidemia, HTN, pacemaker.
Allergies: NKA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Left arm edema a week after the vaccine, with induration and erythema, he was treated on 6/9/21 with Augmentin 875/125mg BID x 7days, then she started to have erythematous painful nodules in the arms, legs and abdomen, multiple joint pain, generalized weakness and suggestive fever.


VAERS ID: 1407189 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-05-27
Onset:2021-06-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Blood glucose abnormal, Chest pain, Dizziness, Exposure during pregnancy, Headache, Peripheral swelling, Protein urine present, Stillbirth
SMQs:, Acute renal failure (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Chronic kidney disease (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitimen, Operazole, cepalexin,Tyelenol,
Current Illness: Hep c Hypertension Asthma UTI Bladder infection
Preexisting Conditions: Kidney stones UTI Hep c
Allergies: Sulfa, bactrim, gentmuzine, tramodol
Diagnostic Lab Data: 3 HR glucose test
CDC Split Type:

Write-up: Positive glucose test Protein in urine Swollen feet and hands Headaches Abdominal pain Dizziness Chest pain Baby was 3lbs 2.9 oz 29 weeks pregnant baby stillbirth Positive glucose test 6/4 6/7 3hour glucose test 2hr was high protein in urine


VAERS ID: 1407542 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-18
Onset:2021-06-04
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: 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? No
Previous Vaccinations:
Other Medications: Vit D3, CoQ-10, Turmeric, fish oil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Woke up one morning with a slight rash on several areas of my body. Neck, side of torso, shoulder, and chest. First believed to be chigger bites or poison ivy/oak because I work and play around both. But it did not look like the chigger bites or poison ivy/oak I had previously experienced. This was a single red spot up to several red spots on areas not usually affected by chiggers or poison ivy/oak. I used OTC creams to treat. Then, I saw a couple of doctors discussing the side effects of the C-19 vaccine. They mentioned Shingles as one side effect. So I researched Shingles and because of the odd red spots and the areas, mianlhy neck and side of torso, I am thinking this was a very slight infection of Shingles.


VAERS ID: 1407553 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Pain, Pruritus, Pyrexia, Skin discolouration, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hot, swollen, sore, itchy, black and blue, fever


VAERS ID: 1407622 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Angiogram cerebral abnormal, Cerebral venous thrombosis, Jugular vein thrombosis, Platelet count increased, Platelet factor 4 increased, Thrombocytopenia, Transverse sinus thrombosis
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: metformin 1000mg qD atorvastatin 40mg qD amlodipine 5mg qD
Current Illness: None
Preexisting Conditions: Diabetes Hypertension Hyperlipidemia
Allergies: ACE inhibitor -- $g angioedema
Diagnostic Lab Data: PF4 antibody w/ 2.239 OD Platelets 67 from normal baseline CT angio of head showing thrombosis of left transverse sinus, left sigmoid sinus, and left internal jugular vein
CDC Split Type:

Write-up: VITT: cerebral venous thrombosis and thrombocytopenia with positive PF4 antibody and no heparin exposure. Symptom onset on 6/4/21 which was 2 days after 2nd dose moderna vaccine (6/2/21) and diagnosed on 6/17/21. Started on bivalrudin. Clinically stable.


VAERS ID: 1407704 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-10
Onset:2021-06-04
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NA / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Cough, Electrocardiogram abnormal, Fatigue
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Clindamycin lotion, adapalene-benzoyl peroxide
Current Illness: None
Preexisting Conditions: Acne
Allergies: Bee pollen
Diagnostic Lab Data: ECG 6/4/21
CDC Split Type:

Write-up: When he got up to use restroom his symptoms were very mild, though when he woke up the symptoms persisted for ~ 1 week. Does not recall any illnesses, but mother felt that patient seemed a little more fatigued ~ 1 week prior. Went to ER 6/4/21 with tightness in his chest worse with deep breathing, cough, laughing, worse laying down and better sitting upright. Got Pfizer COVID19 vaccine 4/10/21, which is ~ 8 weeks prior to symptoms starting. ECG showing diffuse ST elevation concerning for pericarditis. Troponin was negative, chest x-ray was negative. He was given the instructions to take ibuprofen for 1-2 weeks and just stopped the ibuprofen yesterday. His symptoms resolved after 4 days of using ibuprofen.


VAERS ID: 1407743 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Atypical pneumonia, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Elderberry
Current Illness: None
Preexisting Conditions: Asthma - chronic cough
Allergies: Penicillin Latex Perfumes Non-hypoalergenic laundry detergent Fabric softener
Diagnostic Lab Data: I don''t have health insurance or the money to get lab tests done. I went to a homeopathic doctor who helped me with my symptoms.
CDC Split Type:

Write-up: After shot I became very weak. All my joints hurt, even the joints in my fingers. I had a fever of 101 for 2 days. As those symptoms reduced, I came down with walking pneumonia &a rash has broken out on my stomach (rash is still active 2 weeks after shot)


VAERS ID: 1407787 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-14
Onset:2021-06-04
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Full blood count, Laboratory test abnormal, Metabolic function test, Platelet count decreased, Purpura, Thrombotic thrombocytopenic purpura
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, arterial (narrow), Renovascular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Loratadine, Aceaminophen, Naproxen, Tums. Yasmin
Current Illness: Chest Pain, Headache, Shortness of Breath.
Preexisting Conditions: No long standing health conditions identified.
Allergies: NKA,NKDA
Diagnostic Lab Data: 04JUN2021 CBC,CMP
CDC Split Type:

Write-up: Patient was seen at hospital on 04JUN2021 for a Purpuric Rash at and was refereed to Medical Center on 04JUN2021 time 1704, upon arrival to the patients labs were collected. Lab results confirmed Thrombotic Thrombocytopenic Purpura due to platelet count of four. Patient has been hospitalized since that date receiving treatment.


VAERS ID: 1407822 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B and D, Multivitamin, Tramadol, Tylenol, Inhaler
Current Illness: N/A
Preexisting Conditions: Fibromyalgia and arthrithis
Allergies: Lortab, penicillin, sulfa, trees, seasonal allergy, lobster, pet dander, cockroach.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: The following evening pt started itching on LA and found band aide still intact from the vaccine given the previous day. A quarter size redness and swelling at the site of injection with itching was noticed for 3 days. On fourth day almost gone. After nine days the swelling and itchiness re-appeared on LA. Today there is a rectangle shape dull purplish red area with slight edema and no itching.


VAERS ID: 1407924 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chest X-ray normal, Chest discomfort, Discomfort, Dyspnoea, Electrocardiogram normal, Hypertension, Muscular weakness, Tension
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)

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

Write-up: Right after the vaccination, within 10 minutes I started to feel pressure in my left arm down to my wrist. I also felt weakness in both legs. I went home and symptoms lingered and remained for over a week. Muscle weakness will come and go . I was driving in my car and I felt anxious and my chest very heavy and difficulty breathing. I stopped the car and was fortunate to be parked next to a fire department. They put me in an ambulance and checked my blood pressure which was high. They monitored me until my bp went down to the normal range and they allowed me to go home. For the next 6 days, I felt a constant pressure in my arm . I went to Urgent Care to seek care for the pressure on my arm. They did chest x ray and EKG- everything came back normal and to follow up with PCP. I have an appt to see my PCP. Currently I still have pressure/tension originating from left armpit to underneath arm all the way to wrist.


VAERS ID: 1408195 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Chills, Diarrhoea, Hallucination, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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: Xarelto 15mg once daily Effexor 300 mg once daily
Current Illness: Blood disorder. Factor 5 Ladin Fibromyalgia
Preexisting Conditions: Factor 5 Ladin Stage 3 colon cancer in remission (2013) Asthma Fibromyalgia past history of DVT 2017 Past history PE 2015
Allergies: Keflex Penicillin
Diagnostic Lab Data: Patient went to Emergency Room on 6/14/2021.
CDC Split Type:

Write-up: Patienr reports low fever, chills, sore throat and diarrhea onset approximately 5:00 PM on 6/3/2021 lasting approximately 2 days. States watery diarrhea 3 or more times daily since 6/3/2021. Patient states hallucinations began on approximately 6/5/2021. States multiple episodes occurring most days. Reports memory loss as well.


VAERS ID: 1408201 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-01
Onset:2021-06-04
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

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: Multi-vitamin supplement, curcumin, magnesium citrate
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: No tests, confirmation by doctor with discussion of symptoms and pictures
CDC Split Type:

Write-up: Shingles has developed on the right half of the torso from the navel to the spine.


VAERS ID: 1409491 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Eye pruritus, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210629788

Write-up: EXTREMELY ITCHY EYES; BLURRED VISION; This spontaneous report received from a patient concerned a 60 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 04-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 04-JUN-2021, the subject experienced extremely itchy eyes. On 04-JUN-2021, the subject experienced blurred vision. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from extremely itchy eyes, and blurred vision. This report was non-serious.


VAERS ID: 1409777 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AMLODIPINE BESILATE; ATORVASTATIN; PANTOPRAZOLE 40
Current Illness: Acid reflux (oesophageal) (Verbatim: Acid reflux diagnosed at the end of Feb2021 or beginning of Mar2021.); Blood pressure high (Verbatim: High blood pressure diagnosed at the end of Feb2021 or beginning of Mar2021.); Chronic kidney disease stage 3 (Verbatim: Stage 3 chronic kidney disease); High cholesterol (Verbatim: High cholesterol diagnosed at the end of Feb2021 or beginning of Mar2021.)
Preexisting Conditions: Medical History/Concurrent Conditions: Immune system disorder NOS; Kidney disorder; Pneumonia
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021702465

Write-up: very tired; headache; Arm was very sore; This is a spontaneous report from a contactable consumer (patient). A 64-years-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735), via an unspecified route of administration, administered in arm left in the morning on 04Jun2021 as a single dose for COVID-19 immunisation. Medical history included stage 3 chronic kidney disease from May2021 and was ongoing; High blood pressure diagnosed at the end of Feb2021 or beginning of Mar2021 and was ongoing; High cholesterol diagnosed at the end of Feb2021 or beginning of Mar2021 and was ongoing; Acid reflux from unspecified date in 2021 was ongoing and acid reflux diagnosed at the end of Feb2021 or beginning of Mar2021; pneumonia from on an unknown date in Jan2021. He reported that he was in the hospital the first week of Jan2021, on 07Jan2021 or 08Jan2021 the time, he didn''t know that it shut down his immune system and his kidneys took a bigger hit than they already had, and he had pneumonia. He reported that he was in the hospital for a good 8 or 9 days and shortly after he was discharged and after that he started the medications for blood pressure, cholesterol, and acid reflux. He reported that the biggest thing was that he had to wait until his doctor cleared him to get the Covid-19 vaccine as he has some other medical issues and once his doctor said to get the Covid-19 vaccine, he got it. Concomitant medications included amlodipine besilate (Film-coated tablet) taken 10 mg once daily for blood pressure from 2021 and ongoing; atorvastatin taken 20mg once daily for Cholesterol abnormal from 2021 and was ongoing; pantoprazole sodium sesquihydrate (PANTOPRAZOLE 40) taken 40mg once daily for acid reflux from an unspecified start date and was ongoing. The patient''s arm was very sore on 04Jun2021. The patient was very tired on 05Jun2021 and had headache on 05Jun2021. The outcome of the events was recovered on an unknown date in Jun2021. Follow up activities has been raised.


VAERS ID: 1409941 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Chills, Electrocardiogram, Fibrin D dimer, Full blood count, Myocardial necrosis marker, Nausea, Pain, Palpitations
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithium, olanzapine, zyrtec, Lexapro, singulair
Current Illness: None
Preexisting Conditions: Asthma, mild Depression Anxiety SVT, single post-op episode
Allergies: Minocycline
Diagnostic Lab Data: 6/5/2021 Hospital Ecg x2, ddime, ct chest, xray chest, cardiac enzymes, cbc
CDC Split Type:

Write-up: Initial symptoms at 12hr post-vaccine typical chills & aches & nausea.; duration 6 hr. At 24hr mark, chest pains started with palpitations. Worse with exertion. Subsided and returned. Sought treatment at 48hr post-vaccine. Clear ekg, chest xray, and chest ct. Aspirin 325mg calmed the symptoms.


VAERS ID: 1409967 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: DIZZY, SWEATY, FINGERS TINGLING


VAERS ID: 1410027 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: NONE
Preexisting Conditions: Elevated LDL Cholesterol Level Overweight
Allergies: N/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: PATIENT WAS GIVEN A VACCINE THAT WAS OUTSIDE OF THE ALLOWABLE TIMEFRAME OF A RECONSTIUTED VACCINES. WHICH MAY HAVE AFFECTED THE EFFICACY. PATIETN WAS INFORMED , INCEDNT REPORTS WERE SUBMITTED. PATIENT VOICED UNDERSTANDING. WILL RETURN ON 6/18/2021 TO REPEATED DOSE 2 VACCINE.


VAERS ID: 1410044 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       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: Ergocalciferol 1,250 mcg taken by mouth once daily Vitamin D 2000 to 4000 units daily
Current Illness: none
Preexisting Conditions: Vitamin D deficiency Pre-Diabetes Low Serum vitamin B12 Thrombocytopenia
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: PATIENT WAS GIVEN A VACCINE THAT WAS OUTSIDE OF THE ALLOWABLE TIMEFRAME OF A RECONSTIUTED VACCINES. WHICH MAY HAVE AFFECTED THE EFFICACY. PATIETN WAS INFORMED , INCEDNT REPORTS WERE SUBMITTED. PATIENT VOICED UNDERSTANDING. WILL RETURN ON 6/18/2021 TO REPEATED DOSE 2 VACCINE.


VAERS ID: 1410052 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       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: none
Current Illness: none
Preexisting Conditions: none
Allergies: Pollen
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT WAS GIVEN A VACCINE THAT WAS OUTSIDE OF THE ALLOWABLE TIMEFRAME OF A RECONSTIUTED VACCINES. WHICH MAY HAVE AFFECTED THE EFFICACY. PATIETN WAS INFORMED , INCEDNT REPORTS WERE SUBMITTED. PATIENT VOICED UNDERSTANDING,BUT HAS DECIDED TO HOLD OFF ON GETTING DOSE 2 REDONE, READ AN ARTICLE ABOUT HEART INFLAMMATION IN YOUNG MEN AND WOULD LIKE TO THINK ABOUT IT.


VAERS ID: 1410167 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH RW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Dyspnoea, Fatigue, Headache, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Burpropion HCL XL 300mg, Desvenlafaxine Succnt ER 150mg
Current Illness:
Preexisting Conditions:
Allergies: demerol, dilaudid
Diagnostic Lab Data: Chest X-Ray, blood test (lab results were not given to me) 6/4/2021
CDC Split Type:

Write-up: Fever, severe shortness of air, fatigue, chest pain, headache


VAERS ID: 1410258 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH GW0180 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ecitalopran 10mg once a day, Vitamin D
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: yes inflammation around her heart 6/6/201
CDC Split Type:

Write-up: Same day as the shot she was having chest pains, hard time sleeping


VAERS ID: 1410260 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-17
Onset:2021-06-04
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chest pain, Dyspnoea, Hypoaesthesia, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: - Chest pain after 1.5 months from the second shot - Left arm numbness - Shortness of breadth - Hard to stay asleep - Lack of energy


VAERS ID: 1410316 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-24
Onset:2021-06-04
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Biopsy endometrium, Heavy menstrual bleeding, Postmenopausal haemorrhage, Ultrasound abdomen, Ultrasound scan vagina
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Armour Thyroid, Labetalol, Escitolopram, Amlodopine
Current Illness: No
Preexisting Conditions:
Allergies: no
Diagnostic Lab Data: Endrometrial Biopsy Trans Abdominal Ultrasound Trans Vaginal Ultrasound
CDC Split Type:

Write-up: Heavy post-menopausal bleeding


VAERS ID: 1410431 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-25
Onset:2021-06-04
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Alopecia, Stress
SMQs:

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

Write-up: 10 days after the first shot of Pfizer Covid-19 vaccine, around June 4th 2021, patient started to notice accelerated hair loss. A few days later, she noted a bald patch on the right side of her head, behind her ear. Today (June 18) hair loss continues and hair seems to be thinning out. She is stressed out. Not sure what to do and would like some guidance before we get the second shot. Multiple people on VAERS have reported accelerated hair loss post second shot. Patient had developed Pneumonia last year when she had been diagnosed with covid-19 (around April-May 2020)


VAERS ID: 1411316 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Hypoaesthesia, Immediate post-injection reaction, Injection site erythema, Injection site swelling, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Novolog, clonazepan
Current Illness:
Preexisting Conditions: Type 1 diabetic
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately after vaccine was administered, entire arm went numb and tingled. Lasted for 2 hours. Days following had random minor muscle aches, weakness, and tingling (fingers), in forearm, palm; arm feels very tired. On day 9, arm began to ache continuously, felt very weak, swelling and redness at site, and tingling in hand and last two fingers.


VAERS ID: 1411750 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-28
Onset:2021-06-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / UNK LA / IM

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

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

Write-up: WENT TO HOSPITAL 1 WEEK LAER AFTER FIRST DOSE D/T HEART PALPITATION


VAERS ID: 1412052 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Heart rate increased, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fainting after flu shot
Other Medications: Melatonin
Current Illness: None
Preexisting Conditions: Mild asthma; constipation
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fatigue starting approx. 12 hours after second pfizer covid vaccine shot and lasting 24 hours; reduced appetite; fever from approx 24 hours after shot (maybe sooner) until approx. 36 hours after shot. Highest recorded temp was 102.2 at approx. 30 hours after shot. Fatigue interfered with daily activities from 12 hours after shot to 36 hours after shot. Mild soreness in arm where shot was given. Pulse and blood oxygen were checked each time temp was taken (approx 3 times between 24 and 36 hours after shot) and were within normal ranges each time; although pulse was on the higher end of the normal range for a 12 year old boy. Quick recover starting 36 hours after shot, when temp reduced to approx. 100. Appetite returned at this time. Fever was gone by 48 hours after shot and all other side effect seemed to have subsided by this point. No mediation was taken by the vaccine recipient. Vaccine recipient was offered usual foods and he consumed milk and water in smaller amounts than usual but also more frequently than usual to stay hydrated.


VAERS ID: 1412075 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: 1st night numbness in right arm (not the vaccinated arm) spreading to the entire right side of the body with the next 2 hours. Numbness similar to the numb feeling from Novacaine. By next morning, entire body was numb from toes to scalp. Full body numbness for 3-4 days, then both arms started to feel more normal, then in the next 2-3 days remaining body parts started to come back to normal, except for the scalp. After another week, the numbness faded and felt normal again. After the numbness subsided, started having difficulty falling asleep, taking up to 3-4 hours to fall asleep. Still having difficulty now falling asleep. Not sure if the sleep issues are vaccine related.


VAERS ID: 1412302 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-06
Onset:2021-06-04
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Gait disturbance, Parkinson's disease, Sitting disability
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: RYTARY; ROPINIROLE; MEMANTINE; BUPROPION HCL XL; LISINOPRIL; TAMSULOSIN; ADVAIR; PROVENTIL [SALBUTAMOL]; BABY ASPIRIN; VITAMIN D NOS; MULTIVITAMIN [VITAMINS NOS]
Current Illness: Asthma; Blood pressure fluctuation; COPD; Depression; Heart disorder; Memory impaired; Parkinson''s disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Parkinson''s disease was so severe; Couldn''t walk; When sitting in the chair he couldn''t even sit good inside the chair; This spontaneous case was reported by a consumer and describes the occurrence of PARKINSON''S DISEASE (Parkinson''s disease was so severe) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Parkinson''s disease, Depression, Memory impaired, Blood pressure fluctuation, COPD, Asthma and Heart disorder. Concomitant products included BUPROPION HYDROCHLORIDE (BUPROPION HCL XL) for Antidepressant therapy, SALBUTAMOL (PROVENTIL [SALBUTAMOL]) for Asthma, LISINOPRIL for Blood pressure management, FLUTICASONE PROPIONATE, SALMETEROL XINAFOATE (ADVAIR) for COPD, ACETYLSALICYLIC ACID (BABY ASPIRIN) for Heart disorder, MEMANTINE for Memory impaired, CARBIDOPA, LEVODOPA (RYTARY) and ROPINIROLE for Parkinson''s disease, TAMSULOSIN, VITAMIN D NOS and MULTIVITAMIN [VITAMINS NOS] for an unknown indication. On 06-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Jun-2021, the patient experienced PARKINSON''S DISEASE (Parkinson''s disease was so severe) (seriousness criterion medically significant) and GAIT DISTURBANCE (Couldn''t walk). 04-Jun-2021, the patient experienced SITTING DISABILITY (When sitting in the chair he couldn''t even sit good inside the chair). On 05-Jun-2021, PARKINSON''S DISEASE (Parkinson''s disease was so severe), GAIT DISTURBANCE (Couldn''t walk) and SITTING DISABILITY (When sitting in the chair he couldn''t even sit good inside the chair) had resolved. Concomitant product use Tamsulosin used for unspecified prostate disease. Patient received the second Moderna vaccine dose around 3pm. No treatment medications provided by the reporter. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Additionally, patient''s past medical history of Parkinson''s disease is a confounding factor that may play a possible contributory role. Further information has been requested.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Additionally, patient''s past medical history of Parkinson''s disease is a confounding factor that may play a possible contributory role. Further information has been requested.


VAERS ID: 1412429 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Eye 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLEGRA ALLERGY
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: No
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021655054

Write-up: On Friday June 4th I woke up at 12:00am after going to sleep at 11:pm on June 3rd. When I woke up I found that my right eye was almost swollen shut. I took Benadryl and used ice to reduce the swelling; This is a spontaneous report from a contactable consumer (patient) reported for herself. A 27-years-old female patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Left on 02Jun2021 14:30 (Batch/Lot Number: Ew0186) as 1st DOSE, SINGLE for covid-19 immunization, at the age at vaccination of 27 years old. Patient was not pregnant. Medical history reported as no. No known allergies. Concomitant medications included fexofenadine hydrochloride (ALLEGRA ALLERGY) and Excedrine migrane (as reported). Reported Event: On Friday 4th Jun patient woke up at 12:00am after going to sleep at 11:pm on 3Jun. When she woke up she found that her right eye was almost swollen shut. She took Benadryl and used ice to reduce the swelling. It was now 12:38pm on 4Jun and the eye was still a bit swollen but it was better than when she first woke up. The patient experienced the event (serious as medically significant) on 04Jun2021 12:00 AM with outcome of recovering. AE treatment: took Benadryl and used ice to reduce swelling. No other vaccine in four weeks. No covid prior vaccination. No covid tested post vaccination. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1412434 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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 INC2021655231

Write-up: the son felt like he was gonna pass out and was pale; the son felt like he was gonna pass out and was pale; This is a spontaneous report from a contactable consumer. A 15-year-old male patient (reporter''s son) received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration at age of 15-years, on 03Jun2021 18:25 (Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Historical Vaccine included the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on an unknown date as single dose for covid-19 immunisation. The patient experienced felt like he was gonna pass out and was pale on 04Jun2021 01:00. Events outcome was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1412446 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone disorder
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: Medical History/Concurrent Conditions: Heart disorder; Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021656479

Write-up: I feel like I am having my pregnancies miscarriage''s all over again / My pelvic, back, legs, spine, neck, head and all my bones are killing me.; This is a spontaneous report from a contactable consumer (patient). A 52-year-old female patient (110 pounds) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in Arm Left on 03Jun2021 18:00 (Batch/Lot number was not reported) as 2ND DOSE, SINGLE for covid-19 immunisation in Pharmacy or Drug Store. Medical history included heart condition and known allergies: Sulfa. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. No medications the patient received within 2 weeks of vaccination. The patient previously took bnt162b2 for covid-19 immunisation at Left arm on 13May2021 18:00. The patient reported that she felt like she was having her pregnancies miscarriage was all over again / her pelvic, back, legs, spine, neck, head and all her bones are killing her on 04Jun2021 12:00 with outcome of unknown. It was unknown if any treatment was received. The patient was just wondering if the same dose or different doses of this vaccine should be the same. Her husband was 200 pounds and she was 110 pounds. She was a smaller person. Should she had a smaller does? She felt like she had been overdosed with Pfizer. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19.


VAERS ID: 1412447 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-13
Onset:2021-06-04
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Heart rate increased, Viral test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Adenoidectomy; Choanal atresia; Tonsillectomy
Allergies:
Diagnostic Lab Data: Test Date: 20210605; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021656509

Write-up: Labored breathing; chest pains; fast heart rate; This is a spontaneous report from a contactable consumer reported for himself. A 16-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration, administered in Arm Right on 13May2021 11:30 AM as unknown, single (at age of 15-years-old) for covid-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. No other medications the patient received within 2 weeks of vaccination. Medical history included choanal atresia, tonsils and adenoids removed, ear tags. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medications were none. On 04Jun2021 09:00, the patient experienced labored breathing, chest pains, fast heart rate. The adverse events resulted in emergency room/department or urgent care, hospitalization for 2 days. The adverse events received treatment included Aspirin, Ibuprofen. The patient underwent lab tests and procedures which included Nasal Swab: negative on 05Jun2021. Outcome of the event was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1412453 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021656559

Write-up: Hives all over torso/back, arms/under arms, legs/behind the knees, neck and chin. NO wheezing or shortness of breath.; itching; This is a spontaneous report from a contactable consumer (patient). A 13-year-old male patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm left on 04Jun2021 at 08:00 (Batch/Lot number was not reported) (at the age of 13-year-old) as single dose for COVID-19 immunisation. The patient medical history included COVID-19 from an unknown date to an unknown date. No known allergies. Since the vaccination the patient has not been tested for COVID-19. The patient''s concomitant medications were not reported. On 04Jun2021 at 10:00, the patient experienced hives all over torso/back, arms/under arms, legs/behind the knees, neck and chin with itching. No wheezing or shortness of breath. The events were serious, medically significant. The events required doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Therapeutic measures were taken as a result of the events and included treatment with BENADRYL. The patient outcome of the events was recovering. Information about lot/batch number has been requested.


VAERS ID: 1412599 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021711611

Write-up: Itching; Had hives the same day as she had her vaccine; This is a spontaneous report received from a contactable consumer (Patient). A 22-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, batch/lot number: EP7533, expiration date: Jul2021) via an unspecified route of administration, administered in arm left on 04Jun2021 at a dose of 0.3 ml as single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. Patient had the Pfizer vaccine on 04Jun2021. She had hives the same day 04June2021. Since 04Jun2021, patient has had hives and itching. Patient was due for her second dose in one and a half weeks. She wanted to know if she should get her second dose. The outcome of events was unknown.


VAERS ID: 1412736 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-24
Onset:2021-06-04
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Back pain, Cardiomegaly, Chest X-ray, Chest discomfort, Chest pain, Dyspnoea, Electrocardiogram, Laboratory test, Lethargy, Palpitations, Peripheral coldness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), 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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: 6/16/21 Chest 2V - PA/Lat (X-ray - two chest views ) Lab draw Electrocardiogram Impression: The lungs are clear but there is cardiomegaly without congestive heart failure
CDC Split Type:

Write-up: Tightness and pain n the chest, shortness of breath, aching feeling in the upper back, lethargy/loss of energy, heart palpitations. cold feet and hands.


VAERS ID: 1412849 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-28
Onset:2021-06-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Muscle spasms, Pain in extremity, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Termination of pregnancy and risk of abortion (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal vitamins; low dose aspirin
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: June 4th - ultrasounds; glucose tests; blood tests; etc June 15th - ultrasounds; glucose test; blood tests; rogam tests (my blood was compatible with baby''s)
CDC Split Type: vsafe

Write-up: I just had my second shot yesterday morning. For the first dose, I didn''t have any of the typical side effects other than sore arm. On June 4th, I started having vaginal bleeding. I called the on call triage and the bleeding was significant enough to go to ER. Was there and almost had a DNC at that point because the doctor felt the bleeding was so significant. But there was a wait in ER, had an ultrasound, by that time bleeding slowed down and I went home with the caveat that if the bleeding returned to go to ER again. The doctor''s were saying that a miscarriage was going to happen....so we were taking it day by day. 10 days later, I started bleeding again and then I miscarried on Tuesday of this week. I started cramping at 1;:00 in the morning and felt the water break and then started bleeding heavily again at 03:00 in morning. Follow up with OB''s on June 7th. And I went to ER and once we got there and they checked the ultrasound and they couldn''t see the baby any more and they had me go in to a D&E. Pregnancy - 3rd pregnancy - one live birth (my son); the first pregnancy was an elective abortion; Estimated date of delivery was going to be December 1 (I was 15 weeks)


VAERS ID: 1412964 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-05-21
Onset:2021-06-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Dyspnoea, Echocardiogram, Electrocardiogram, Fatigue, Full blood count, Metabolic function test, Myocardial necrosis marker, Neck pain, Pericardial effusion, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Invokana 300 mg tablet, Janumet 50-1000 mg, Lisinopril 10 mg, Pravastatin 40 mg
Current Illness: None
Preexisting Conditions: Diabetes mellitus type 2; Hypertension, Hyperlipidemia Covid-19 Infection with Infusion of Regeneron (Jan 2021) - fully recovered
Allergies: Sulfa
Diagnostic Lab Data: CBC, CMP, Cardiac enzymes, Chest Xray, EKG, Echocardiogram
CDC Split Type:

Write-up: Symptoms: Chest pain radiating to neck starting on June 4, 2021 with fatigue and slight shortness of breath Seen at Urgent Care and sent to Hospital and found to have PERICARDITIS and PERICARDIAL EFFUSION. Given medications and hospitalized for 24 hours.


VAERS ID: 1413009 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Parosmia, 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: Sumatriptan 100mg D3 Rosuvastatin 10mg Tramadol 50mg
Current Illness: None
Preexisting Conditions: High cholesterol
Allergies: None
Diagnostic Lab Data: CT Scan - 6/17/21
CDC Split Type:

Write-up: Rotten Meat smell and taste.


VAERS ID: 1413140 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Hunger, Peripheral coldness
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Noteworthy: hands become ice cold before feeling hungry and this symptom remains Odd: lump under rib cage? blockage? congested area? on left side of heart seems to have disappeared and/or no longer feel like it is there


VAERS ID: 1413165 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 64AC214 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chest pain, Heart rate increased, Menstruation delayed, Sleep disorder, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Fertility disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Pepcid
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: spoke to my doctor many times he recommended taking Benadryl and told me to keep monitoring my heart rate
CDC Split Type:

Write-up: Significant higher heart rate, been monitoring heart rate daily. Average before vaccine about 70 BPM, now 2 weeks later 89 BPM daily average Chest pain, tight feeling in my throat, anxiety feeling on edge, terrible sleep Late menstrual cycle, I am always on a schedule period was 9 days late.


VAERS ID: 1413298 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / IM

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

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

Write-up: Rash, itchy on right arm and next couple days get more and more on body and legs until present day. Taking Benadryl


VAERS ID: 1413339 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-01
Onset:2021-06-04
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Borrelia test, Herpes virus test, Lumbar puncture, Magnetic resonance imaging head, West Nile virus test
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: antecedent non-Hodgkin''slymphoma
Preexisting Conditions:
Allergies: Past sensitivity to penicillin
Diagnostic Lab Data: lumbar puncture with Lyme titer, West Nile virus titer, herpes titer on June 19, 2021 MRI of the brain June 19, 2021
CDC Split Type:

Write-up: patient developed right-sided Bell''s palsy which subsequently evolved bilateral Bell''s palsy


VAERS ID: 1413840 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram normal, Confusional state, Dizziness, Full blood count normal, Metabolic function test, Monoplegia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Gabapentin, meloxicam, trazodone, tizanidine
Current Illness: None
Preexisting Conditions: Depression, hypertension
Allergies: None
Diagnostic Lab Data: CT scan head 6/20/21 - normal; CBC, CMP - normal on 6/20/21
CDC Split Type:

Write-up: Arm pain, dizziness, intermittent confusion


VAERS ID: 1414029 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Pruritus, Skin abrasion
SMQs:, Anaphylactic reaction (broad), Accidents and injuries (broad), Hypersensitivity (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: Sleeping pill and triamcilone cream
Current Illness:
Preexisting Conditions:
Allergies: sulfa and alvalox
Diagnostic Lab Data: Sores on arms and legs from scratching, PCP prescribed a steroid to help with itching
CDC Split Type:

Write-up: 2 days after immunization started to have itching all over her legs, chest, arms and back. No visible rash no other signs/symptoms.


VAERS ID: 1414136 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest discomfort, Condition aggravated, Dyspnoea, Electrocardiogram, Exposure during pregnancy, Palpitations, Troponin
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: bystolic thermotabs prenatal multi prenatal DHA ca, mg, vitamin D
Current Illness: none
Preexisting Conditions: MVP dysautonomia
Allergies: azithromycin
Diagnostic Lab Data: ekg- 6/18/2021 troponin - 6/18/2021
CDC Split Type:

Write-up: high risk pregnancy due to maternal age, 36, but otherwise normal healthy pregnancy without any complications- 8/4/2021 history of tachycardia and palpitations that had been well controlled on bystolic since at least 2016 1 day post pfizer vaccination began to experience frequent episodes of palpitations throughout the day, sometimes accompanied by chest tightness and SOB, which has persisted intermittently since


VAERS ID: 1414596 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054621A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram, Lymphadenopathy, Muscular weakness, Pain in extremity, Peripheral swelling, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril; Amlodipine; Pantoprazole; Tamsulosin ;vitamin, Ibuprofen, Tylenol; cyclobenzaprine
Current Illness: Urine stream being weak; Arthritis in shoulder and back pain
Preexisting Conditions: Arthritis in shoulder and back pain.
Allergies: Allergic to cephalosporin (Taken at the time of vaccination but no longer taken)
Diagnostic Lab Data: EKG (TNC)
CDC Split Type: vsafe

Write-up: My arms swell and I had a fever. My glands were swollen and the fever lasted 4 days. On the 4th day, the swelling went down but it didn''t look right so that''s when I went to the Emergency room where they did the EKG. They let me go and got in touch with my doctor which I got an appointment on the 29th. I am experiencing heightened senses and pain. The pain is really bad in my forearm and elbow. It feels like it is weaker than what it was. I can''t lift my arms over my head. It is more intense after the vaccine was administered.


VAERS ID: 1414719 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1414945 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415109 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415110 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415140 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Mobility decreased
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amloipine Bsylate 5 mg Atorvastatin 40 mg Hydrochlorothiazide 25 mg Metroprolol Tartrate 25 mg Asprin 81 mg Lumigan0.01 eye drops
Current Illness: none
Preexisting Conditions: none
Allergies: Lisiniprol
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Severe pain in left shoulder to the point it''s difficult to move. At times I have numbness in my fingers. This started about 4 hours after my shot.


VAERS ID: 1415192 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415201 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415219 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415351 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-27
Onset:2021-06-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Gait disturbance, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ateenol,bp med,pottasium garlic gingerroot vit c vit B-12
Current Illness:
Preexisting Conditions: high Blood pressure
Allergies:
Diagnostic Lab Data: have DR. App as soon as possible. App for 6/12
CDC Split Type:

Write-up: Palsey type hand shaking, unsteady walking gate,Pain in both knees


VAERS ID: 1415423 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

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

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

Write-up: Shingles


VAERS ID: 1415443 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levetiracetam 1000mg 3xs a day, Oxcarvazetien 600mg 4xs a day, Propranolol 10mg 2xs a day, Primidone 50mg, HCTZ 160-12.5mg, Fluticasone Protionate 50mcg,
Current Illness: seizures and high blood pressure
Preexisting Conditions: seizures and high blood pressure
Allergies: Erythromycin, Lincomycin, and Theophylline
Diagnostic Lab Data: no
CDC Split Type:

Write-up: Healthcare facility told pt to call and report that after taking the first shot he stop having seizures. Before getting the shot he was having multi seizures a day or at least 2 a week and now after the shot he hasn''t had any.


VAERS ID: 1416000 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Influenza like illness, Muscle spasms, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (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: Sprintec (birth control)
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Aripiprazole, Remeron, Topiramate, Cyclobenzaprine, Sertraline, Pineapple, Banana, Latex.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Since the first dose, I have had heavy menstrual bleeding. I initially thought it was spotting in between the sugar pills in my birth control, but this problem has consisted for the last two weeks since the shot. I am not trying to get pregnant and I have not had this kind of issue before. I felt sick (like the flu and cramps) the first 24 hours after the shot as well as both my arms hurting despite only my left arm getting the shot, then felt normal other than the menstrual bleeding and persistent arm pain.


VAERS ID: 1416486 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-31
Onset:2021-06-04
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Blood pressure measurement, Body temperature, Decreased appetite, Dizziness, Dyspnoea, Feeling abnormal, Gait disturbance, Hypotension, Oxygen saturation, Pulse abnormal, Respiratory rate, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: BLOOD PRESSURE; Test Result: Inconclusive ; Result Unstructured Data: 170-71; Test Name: BODY TEMPERATURE; Test Result: Inconclusive ; Result Unstructured Data: 98.4 F?; Test Name: Oxygen saturation; Test Result: Inconclusive 99 %; Result Unstructured Data: Oxygen saturation; Test Name: Pulse; Test Result: Inconclusive ; Result Unstructured Data: Pulse; Test Name: respiration RATE; Result Unstructured Data: decreased
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: can''t walk; feeling very bad/brain is not working correctly/ head is wrong/feeling like a zombie; He vomit everything he eats, he cannot eat, he vomit even water/he have been throwing up; very dizzy, cannot walk because dizzy and vomit/woke up dizzy; pressure was down; short of breath; stomach was tight near the heart; he don''t have appetite; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of GAIT DISTURBANCE (can''t walk) and FEELING ABNORMAL (feeling very bad/brain is not working correctly/ head is wrong/feeling like a zombie) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 31-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Jun-2021, the patient experienced GAIT DISTURBANCE (can''t walk) (seriousness criterion hospitalization), FEELING ABNORMAL (feeling very bad/brain is not working correctly/ head is wrong/feeling like a zombie) (seriousness criterion hospitalization) and DECREASED APPETITE (he don''t have appetite). On 07-Jun-2021, the patient experienced DIZZINESS (very dizzy, cannot walk because dizzy and vomit/woke up dizzy), HYPOTENSION (pressure was down), DYSPNOEA (short of breath) and ABDOMINAL DISCOMFORT (stomach was tight near the heart). On an unknown date, the patient experienced VOMITING (He vomit everything he eats, he cannot eat, he vomit even water/he have been throwing up). At the time of the report, GAIT DISTURBANCE (can''t walk), FEELING ABNORMAL (feeling very bad/brain is not working correctly/ head is wrong/feeling like a zombie), DIZZINESS (very dizzy, cannot walk because dizzy and vomit/woke up dizzy), HYPOTENSION (pressure was down), DYSPNOEA (short of breath), ABDOMINAL DISCOMFORT (stomach was tight near the heart), DECREASED APPETITE (he don''t have appetite) and VOMITING (He vomit everything he eats, he cannot eat, he vomit even water/he have been throwing up) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: blood pressure (Inconclusive) 170-71. On an unknown date, Body temperature: 98.4 (Inconclusive) 98.4 F?. On an unknown date, Oxygen saturation: 99 % (Inconclusive) Oxygen saturation. On an unknown date, Pulse abnormal: 60 (Inconclusive) Pulse. On an unknown date, Respiratory rate: 18 (Low) decreased. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. No treatment medication was reported. Company Comment Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Most recent FOLLOW-UP information incorporated above includes: On 08-Jun-2021: Lab data were updated. Product and event tab were updated. On 08-Jun-2021: Seriousness criteria hospitalization was added.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1416522 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / OT

Administered by: Work       Purchased by: ?
Symptoms: Deafness unilateral, SARS-CoV-2 test, Tinnitus
SMQs:, Hearing impairment (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (diagnosed prior to vaccination)
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: COVID-19 Rapid Nasal Swab; Test Result: Negative ; Test Name: SARS-CoV-2 test; Test Result: Positive ; Comments: prior to vaccination
CDC Split Type: USPFIZER INC2021662006

Write-up: ringing in left ear and some hearing loss in left ear; ringing in left ear and some hearing loss in left ear; This is a spontaneous report from a contactable other health professional (patient). A 39-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), intramuscular, administered in the left arm, on 03Jun2021 12:00 (batch/lot number: Ew0181), as 2nd dose, single, at age 39 years old, for COVID-19 immunisation, at a workplace clinic. The patient was not pregnant at the time of vaccination. Medical history included COVID-19 on an unknown date (diagnosed prior to vaccination). There were no concomitant medications. Historical vaccine included the 1st dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), intramuscular, administered in the left arm, on 05May2021 10:00 (batch/lot number: Ew0173), at age 39 years old, for COVID-19 immunisation. On 04Jun2021 13:00, the patient started to have ringing in left hear and some hearing loss in left ear. No treatment was given for the events. The patient underwent laboratory tests which included SARS-CoV-2 test: Positive on an unspecified date (prior to vaccination), and COVID-19 Rapid Nasal Swab: Negative on 04Jun2021. The outcome of the events was not recovered. Follow-up attempts are needed. Further information is expected.; Sender''s Comments: The patient had COVID-19 infection prior to vaccination with BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE). Based on information available, the reported event ringing in left hear and hearing loss in left ear was unlikely causally related to BNT162B2. The case will be reassessed should additional information become available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics committees and Investigators, as appropriate.


VAERS ID: 1416735 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1416743 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1416750 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1416754 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1416800 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-07
Onset:2021-06-04
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bursitis, Injected limb mobility decreased, Joint range of motion decreased, Pain, Pain in extremity, Product administered at inappropriate site, Shoulder injury related to vaccine administration, X-ray limb abnormal
SMQs:, Drug abuse and dependence (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: After I got my second Moderna shot my right arm hurt but I thought it was normal but it has been almost 3 weeks and 3days ago it started to hurt really bad and now I can?t use my right arm because I have so much pain and I have no range of motion I can?t lift my right arm over my head or even out to my side I went to the emergency room and waited 3 hours to be seen and finally they took xrays and said I have bursitis in my right arm from getting the vaccine or how it was given to me I don?t think the girl gave me the shot in the right place and she gave it to me to high or to deep in my arm causing really bad pain now to wear my arm is in a sling!


VAERS ID: 1416877 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Pt. stated she felt her throat closing after receiving the Moderna vaccine at 10:28 A.M. - has multiple food allergies - similiar episode occurred after she received the first vaccine. Exam by CRNP who administered Benadryl 50 mg. p.o. at 10:42. H/R 105 - PO2 99% - Lungs clear to auscultation - HR regular. Observed and discharged home without event.


VAERS ID: 1417155 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-28
Onset:2021-06-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Cardiac disorder, Condition aggravated, Confusional state, Feeling abnormal, Peripheral coldness
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Flare up of Arthritic conditions Heart issues, cold left arm when left above the head for over a minute. confusion, swimming head


VAERS ID: 1417589 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-27
Onset:2021-06-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Blood glucose normal, Blood test normal, Bradyphrenia, Feeling abnormal, Hypertension, Hypoaesthesia, Hypoaesthesia oral, Metabolic function test, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Usually get a swollen and raised and redspot where I get an injection - for any vaccine (flu, MMR, Dtap) but not the COVID vacc
Other Medications: No
Current Illness: No
Preexisting Conditions: Vitiligo - lightening of the skin (auto immune disorder)
Allergies: No
Diagnostic Lab Data: Fasting blood panel - Bloodwork - ruled out diabetes; June 12 at doctor''s office - clear
CDC Split Type: vsafe

Write-up: I woke up on 4th with pins and needles in my hands and I called the doctor''s office. They said that I was crazy and nothing was going on with me and call back in a week even though the receptionist at the office had just said they were getting all kinds of calls about it.. For the next week, my hands and my feet were tingling intermittently. I went to the doctor on Friday, June 11th. They did a full metabolic panel - all came back fine. The next morning, June 12th, I felt my face was numb. I called doctor and she said it was anxiety. So my hands were pins and needles. The face numbness was new. I see a naturopath and I told her and she said it was call for concern and she looked at labs and told me to call doctor back and she mentioned that she had seen all kinds of people with these symptoms. My anxiety is super high. I''m not usually an anxious person. I have high blood pressure. I have joint pain in my hands - if I take Naproxen. If I take Aleve the joint pain goes away. I feel like my face is dragging but when I call in the mirror it looks fine. That''s the feeling of numbness says my naturopath - and that''s the same with my lips. I feel like I have some brain fog and I''ve been stumbling over words. That happens about once a day. I have a doctor''s appt on Friday for blood pressure. I did not have blood pressure before this. Usually my blood pressure is 126/90 (when normal) and it''s tracking at 143/103 and 140/100 ever since I had the vaccine.


VAERS ID: 1417653 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1417685 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1417705 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1417754 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Myalgia, Oral discomfort, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I took Amour, Clear luster, Clorphil complex, DHEA, Ammuno Pad, Baicalin, melatonin, 5HTP, Fish Oil, Digestive Enzyme.
Current Illness: none
Preexisting Conditions: Just the food allergies. I have Hypothyroidism.
Allergies: I am allergic to acidic foods, gluten and dairy.
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: I had pain in your left shoulder on the 4th same day as dose, on the 5th I had a fever till 11pm. A lot of fatigue and achy muscles. My mouth was burning on 06/05/2021 till the present time. I have been to my dentist for this and also going to an ENT soon. My dentist sent me to an oral surgeon and he did nothing.


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