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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 238 out of 5,069

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VAERS ID: 1417921 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Arthralgia, Atelectasis, Atrial enlargement, C-reactive protein increased, Cardiac monitoring, Chest pain, Diastolic dysfunction, Discomfort, Dyspnoea, Echocardiogram, Ejection fraction normal, Electrocardiogram abnormal, Lung consolidation, Lung opacity, Myalgia, N-terminal prohormone brain natriuretic peptide increased, Pericarditis, Pleuritic pain, Red blood cell sedimentation rate increased, Supraventricular tachycardia, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: One month earlier had norovirus symptoms with nausea, vomiting, diarrhea and chills for 24 hours.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 6/20/21: - NT Pro BNP 320 - High sensitivity troponin 195, 2 hours later 212, 18 hours later 268 - CRP 15.90 - ESR 50 - CTA chest without evidence of PE though with consolidation of the inferior lingular segment and LLL felt to be reactive inflammatory change and atelectasis. - TTE with normal LV function, EF 70%. Diastolic dysfunction. Mild biatrial enlargement. No hemodynamically significant valvular disease. No visible pericardial effusion. - EKG NSR, EKG #2 paroxysmal with rate of 142.
CDC Split Type:

Write-up: Developed myalgias and joint pains approximately 48 hours after the injection, then improved. Then about a week after the injection, developed severe myalgias and joint pains. Treated with Medrol dose pack (6 days) with improvement. 3 days later developed pleuritic chest pain as well as shortness of breath. Presented 48 hours after this started for medical care and was diagnosed with acute pericarditis. Started on ibuprofen 600 mg TID and colchicine 0.6 mg BID with significant improvement in discomfort. Discharged from the hospital after 48 hours of observation. Did develop paroxysmal SVT which was felt to be 2/2 to the acute pericarditis. Started on metoprolol tartrate 50 mg BID to help with rate control and sent home with zio patch for additional cardiac monitoring.


VAERS ID: 1418012 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Delaware  
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: 1418040 (history)  
Form: Version 2.0  
Age: 21.0  
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 / 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: 1418072 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-13
Onset:2021-06-04
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Body temperature increased, Discomfort, Dizziness, Ear discomfort, Paranasal sinus discomfort, Sinus congestion, Sinusitis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Protonix; inhaler; Allerflow; Glucosamine chondroitin; Allerclear; vitamin D3; Cleave oil; grape seed extract; centrum silver adults 50 +; Fiber well gummies; digestive gummies; Truvani immune support; turmeric; PreserVision Areds 2 vitamin
Current Illness: None
Preexisting Conditions: Chronic respiratory condition
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: I had dizziness, head congestion, pressure particularly on the cheekbones, lightheadedness. stuffiness in my ears, and my temperature was very slightly elevated just enough to feel uncomfortable. I scheduled a health visit on 06/04/2021. They prescribed Augmentin. They said it was as sinus infection. I felt better after 72 hours.


VAERS ID: 1418344 (history)  
Form: Version 2.0  
Age: 50.0  
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: 1418356 (history)  
Form: Version 2.0  
Age: 20.0  
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 (MODERNA)) / MODERNA 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: 1418422 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
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: 1418608 (history)  
Form: Version 2.0  
Age: 14.0  
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: 1418631 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-02-04
Onset:2021-06-04
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Deafness
SMQs:, Hearing impairment (narrow)

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

Write-up: loss of hearing


VAERS ID: 1419900 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Loss of consciousness
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), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLONASE [FLUTICASONE PROPIONATE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Covid-19 prior vaccination); Myotonia congenita (Paramyotonia-congenita)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021665173

Write-up: Passed out 12 hours after receiving the vaccine.; This is a spontaneous report from a contactable consumer(patient). This 16-year-old female patient (not pregnant) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number EW0175) at single dose via an unknown route in left arm on 04Jun2021 08:30 at 16-year-old for Covid-19 immunization. Medical history included Paramyotonia-congenita. Prior to vaccination, was the patient diagnosed with COVID-19. Patient had no known allergies. Concomitant drug included fluticasone propionate (FLONASE). The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 04Jun2021 08:00 PM, patient passed out "12 hours" (as reported) after receiving the vaccine. No treatment was received. Outcome of the event was resolved. Since the vaccination, the had not patient been tested for COVID-19. The report was assessed as non-serious.


VAERS ID: 1419920 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-06-04
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Appendicitis, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: FISH OIL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (Penicillin as a child)
Allergies:
Diagnostic Lab Data: Test Date: 20210609; Test Name: covid-19 test; Test Result: Negative
CDC Split Type: USPFIZER INC2021701442

Write-up: diagnosed with appendicitis; abdominal pain; This is a spontaneous report from a contactable consumer (patient). A 40-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection) via an unspecified route of administration, administered in right arm on 17May2021 at 14:15 (at age of 40 years old, Batch/Lot number was not reported) as a single dose for covid-19 immunization. Medical history included Penicillin allergy as a child. Concomitant medications included Daily Immunity Vitamin and fish oil. Prior to vaccination, the patient was not diagnosed with COVID-19. Starting around 04Jun2021, the patient started feeling abdominal pain. The pain slowly increased over the next few days. It became severe by 09Jun2021. He saw the primary care Dr in the morning of 09Jun2021. Dr sent he home with pain meds & ultrasound apt for the next day. The pain got so bad he went to ER 3:00 pm afternoon of 09Jun2021. At 10:30 pm on 09Jun2021, the patient was diagnosed with appendicitis. He had emergency appendectomy on morning of 10Jun2021. The events result in Doctor or other healthcare professional office/clinic visit and Emergency room/department or urgent care. Seriousness criteria reported as Life-threatening. The patient was hospitalized 2 days in Jun2021. The patient underwent lab tests and procedures which included covid-19 test: negative on 09Jun2021. The outcome of the events was recovering. Information about batch/lot number has been requested.


VAERS ID: 1420157 (history)  
Form: Version 2.0  
Age: 1.5  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-22
Onset:2021-06-04
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

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

Write-up: My son is breastfeed I received the vaccine 5/21/2021 on 6/4/2021 a rash suddenly appeared all Over his neck that was extremely itchy we treated it with steroids three days later the rash came back all over his scalp ( tiny little bumps ) again extremely itchy it went away again for theee days then returned all Over his body from head to toe , tiny pimples that were extremely itchy . This has been two for two weeks coming and going.


VAERS ID: 1420158 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1420182 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Echocardiogram normal, Electrocardiogram ST-T change, Fatigue, Inflammatory marker increased, Lethargy, Pain, Pericarditis, Red blood cell sedimentation rate increased, Troponin normal
SMQs:, Systemic lupus erythematosus (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma, but well controlled, on no medications, with no inhaler use in several years.
Allergies: None
Diagnostic Lab Data: Elevated ESR on 6/19, over 2 weeks post-vaccine. Elevated ESR and CRP on 6/22 with normal troponins. Normal ECG and echocardiogram and physical exam with pediatric cardiology on 6/22. Signs and symptoms with elevated inflammatory markers on 6/22 consistent with pericarditis that was resolving at the time of cardiology evaluation on 6/22.
CDC Split Type:

Write-up: Pericarditis: severe chest pain worse with being supine, lethargy, fatigue, starting day after vaccine, peaked in pain 3 days post-vaccine, lingering chest pain for at least 2 weeks (still present over 2 weeks later) after vaccine.


VAERS ID: 1420287 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1420424 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Injection site swelling, Musculoskeletal stiffness, Neck pain, Pain in extremity, Paraesthesia, Peripheral swelling, Ultrasound scan, X-ray
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: I woke up the 2nd day after recieving the Janssen Vaccine with a stiff neck and my shoulder hurt. I thought that I slept wrong. The pain did not go away that day or any day after that. My whole arm started hurting, and tingling. My neck hurt and my shoulder hurt severely. It''s been 3 weeks agl that I had gotten the vaccine, and it all still hurts. My whole arm is swollen, and there''s a big bump swelling at the injection site of my left arm. I went to my doctor on 6/14/2021. He ordered Xrays and gave me a muscle relaxer, and an extended release medicine like aleve. The medicine did not help at all so I went back to the clinic. He perscribed Tramadal 50mg. and it helps a small amount but doesn''t really help that much. He ordered an Ultrasound.


VAERS ID: 1420426 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood iron normal, Full blood count normal, Headache, Immune system disorder, Loss of personal independence in daily activities, Migraine
SMQs:, Dementia (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: ibuprofen, certirizine, miralax, allergy shots
Current Illness: seasonal allergies
Preexisting Conditions: asthma, allergies, restless leg syndrome, autism, precocious puberty, mild migraines frontal forehead
Allergies: sensitive to paxil
Diagnostic Lab Data: cbc and iron checked are within normal guidelines
CDC Split Type:

Write-up: ongoing, prolonged headache migraine started within 24 hours of vaccine, to date 19 days of headaches out of 20, same spot on forehead between eyes above, requires multiple doses of pain medication to subside the pain and has required migraine ( headache) cocktail of Benadryl/ ibuprofen/ Compazine on occasion to relieve pressure and pain of headaches, than it returns. Extenuating headaches after Pfizer vaccine, seems the vaccine has triggered a prolonged immune response we have yet been able to stop. Constant daily headache same area requiring more medication and lasting longer, some days after first does of tylenol he will need a 2nd dose of ibuprofen 4/5 hours later as the headache with first does of pain meds did not remove the headache. , achy pressure pain same with each headache, not sever pain but moderate and affects daily movements and activities as to not escalate the pain further, drinking multiple bottles of water and trying to stay hydrated along with medications trying to remedy the prolonged headache from the vaccine . Drs have very limited information on how to treat or handle prolonged headaches from vaccination, information on these events or recommended treatments not easily found.


VAERS ID: 1420515 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

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

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

Write-up: No known adverse health events associated with this vaccine administration. VAERS report is being filed in order to follow CDC Interim Clinical Considerations for Use of COVID-19 Vaccines, which states that this administration error (unauthorized age group) should be reported


VAERS ID: 1420567 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Taste disorder
SMQs:, Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: VERY DIZZY DAY AFTER 2ND VACCINE. HEADACHE ALL DAY. FELT LIKE SOMEONE SPRAYED MY MOUTH WITH SOME TYPE OF CHEMICAL. ABOUT 12 HOURS AFTER SHOT GOT THE CHILLS.


VAERS ID: 1420605 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022E21A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Electrocardiogram
SMQs:, Anaphylactic reaction (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: None
Diagnostic Lab Data: I had a ECG test done.
CDC Split Type: vsafe

Write-up: My first shot was May 4, 2021. After the first shot I had chest pains but they went away. After the second vaccine I was okay for about a day. June 2-3 I experienced strong chest pains. It was very severe that I felt pressure close to my heart, and this is why I went and sought care from a doctor. I have been having chest pains for about three weeks now.


VAERS ID: 1421116 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-20
Onset:2021-06-04
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood test, Hypoaesthesia, Inflammation
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin 40 mg Multi vitamin Baby aspirin Vitamin D3
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood work
CDC Split Type:

Write-up: Numbness in hands and feet Inflammation all over Back pain


VAERS ID: 1421128 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1421358 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia
SMQs:, Taste and smell 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: None
Preexisting Conditions:
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Metallic taste in mouth within hours of injection, lasted several days.


VAERS ID: 1421363 (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: 2021-06-23
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: 1421422 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1421443 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1421523 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-30
Onset:2021-06-04
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram, Dizziness, Fall, Feeling drunk, Magnetic resonance imaging normal, Urine analysis normal, Vertigo
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin a day; Vitamin B12; calcium; Cyclobenzaprine; Iron; Adver - inhaler; Furosemide; Gabapentin; Glimepiride; Spiriva; Levothyroxine; Vit D; Multivitamin; Pantoprazole; Potassium; Pravastatin; Insulin Injection - Toujeo; Vit C
Current Illness: no
Preexisting Conditions: Diabetes; Emphysema; Enlarged heart; ear condition -Dehiscence of inner circle ear - circle
Allergies: Penicillin; Sulfa antibiotics; Chantix -it''s an anti-depressant but I used it to try to stop smoking; Actose - diabetic medicine
Diagnostic Lab Data: CAT SCAN - clear MRI - head and neck - nothing showed up that there was anything wrong Bloodwork - all okay Urine Samples - okay
CDC Split Type: vsafe

Write-up: Had fallen asleep on the couch and I went to get up and I fell. I stood up and tried to walk again and fell again. I was very dizzy. And when I woke up in the morning, I still was very dizzy and it felt like I was super, super drunk - bouncing off the walls when I try to move. I waited to see if it would clear up. It didn''t. My daughter took me to ER at 1:00 pm. Diagnosed as Vertigo . They gave me two medications - Meclizine and Promethazine - I''m still taking those. That has helped. Two days I was good, I was back to normal. But yesterday, it was back again (the dizziness) - it''s like I''m drunk but not falling into the walls - just dizzy. It''s still here today. (Dizziness). Upcoming appointments in July - one with a Neuro doc and one with a new primary care doctor.


VAERS ID: 1421816 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1421835 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1421846 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / UNK - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Fluid retention, Peripheral swelling, Renal impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (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), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: DM, HTN
Allergies: Diclofenac
Diagnostic Lab Data: At the hospital kidney function was low compared to last year that was normal.
CDC Split Type:

Write-up: Swelling of the legs and bloating of stomach, fluid retention


VAERS ID: 1422025 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1422062 (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: 2021-06-23
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: 1422073 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1422091 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1422560 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1422747 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
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: 1422792 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
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: 1422826 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
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: 1423038 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-26
Onset:2021-06-04
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 648B21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dyskinesia, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: convulsions; Uncontrollable movement on her face / Uncontrollable movement of entire body; This spontaneous case was reported by a consumer and describes the occurrence of SEIZURE (convulsions) in a 26-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 648B21A and 037C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 26-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-May-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 SEIZURE (convulsions) (seriousness criterion medically significant) and DYSKINESIA (Uncontrollable movement on her face / Uncontrollable movement of entire body). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at a dose of 25 mg. At the time of the report, SEIZURE (convulsions) and DYSKINESIA (Uncontrollable movement on her face / Uncontrollable movement of entire body) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. It was reported that the patient started experiencing uncontrollable movement on her face and entire body, it like convulsions almost. The pharmacist was not sure what she could use to help it but she was told to use Benadryl 25mg. She is still having the symptoms bad. This case concerns a 26-year-old female with a serious unexpected event of seizure, and non-serious dyskinesia. Event latency 7 days after second dose mRNA-1273. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: This case concerns a 26-year-old female with a serious unexpected event of seizure, and nonserious dyskinesia. Event latency 7 days after second dose mRNA-1273. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1423256 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
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: 1423373 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Multivitamin, mirena iud.
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Strong menstrual cramps and bleeding for 4 days. I have had an IUD in place for years and do not get a period anymore. This was abnormal for me.


VAERS ID: 1423518 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-06-04
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020821A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Headache, Migraine
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Asthma, herniated disc (L5)
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Acutely Migraines, Prolonged Headaches, 5/4/2021 Until present (6/24/2021)


VAERS ID: 1423697 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 RA / IM

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

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

Write-up: Patient experienced weakness post vaccination, recovered and released


VAERS ID: 1423709 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Nausea, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: NKA
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient experienced syncope, nausea and vomiting, transported to hospital via EMS


VAERS ID: 1423858 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Dizziness, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 800 mg Ibuprofen, 450 mg turmeric curcumin, 50 mg Ginger
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish
Diagnostic Lab Data: N/A at this time.
CDC Split Type:

Write-up: 1. Severe headaches daily starting every night. Treatment for the headache is taking two 200 mg Ibuprofen. 2. Light headiness/dizzy spells. Treatment for it is rest. 3. Pain in left arm pit. No treatment other than the 200 mg Ibuprofen in item number one. 4. Blurred vision.


VAERS ID: 1424107 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / IM

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

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

Write-up: 17 year old patient received 1st dose of the Moderna vaccine at a previous clinic on 5/7/2021 despite the vaccine only being approved for use in patients 18 years and older. Based on CDC guidance and information from the manufacturer it was recommended to vaccinate patient with a second dose of the Moderna vaccine and follow the vaccine dosing schedule. No adverse effects were reported from the patient.


VAERS ID: 1424214 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-05-10
Onset:2021-06-04
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Deafness unilateral, Magnetic resonance imaging head, Sudden hearing loss, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Famotadine 40mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: On 6/4/21 at 11:30 am, I went deaf in my right ear suddenly. It started with tinnitus and I went deaf over the course of a few minutes. 6/4/21 Urgent care visit : hearing test, no sound detected in right ear 6/7/21 ENT specialist visit: Hearing test for baseline, diagnosed sudden onset hearing loss 6/14/21 ENT specialist visit: Hearing test shows no significant improvement: 6/22/21 MRI of head done: (results not in yet)
CDC Split Type:

Write-up: On 6/4/21 at 11:30 am, I went deaf in my right ear suddenly. It started with tinnitus and I went deaf over the course of a few minutes. 6/4/21 Urgent care visit: no sound detected in right ear 6/4/21 Emergency room visit: Oral steroid prescribed. 6/7/21 ENT specialist visit: Hearing test for baseline, diagnosed sudden onset hearing loss and additional oral Steroids prescribed. 6/14/21 ENT specialist visit: Hearing test shows no significant improvement: Steroid injections into ear prescribed and done in office 6/21/21 ENT specialist visit: 2nd steroid injection into ear done. 6/22/21 MRI of head done: (results not in yet) Future 6/25/21: ENT specialist visit: 3rd steroid injection into ear scheduled.


VAERS ID: 1424327 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Headache, Neck pain, Pain in jaw, Tinnitus, Vertigo
SMQs:, Hearing impairment (narrow), Vestibular disorders (narrow), Osteonecrosis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benazepril 40MG, Amlodipine Besylate 5MG, Alegra 24hr allergy
Current Illness: none
Preexisting Conditions: Asthma and allergies
Allergies: none
Diagnostic Lab Data: Hearing test done on June 23rd 2021 confirms loss of hearing in right ear.
CDC Split Type:

Write-up: Vertigo, Ringing in Right ear, loss or muffled sound in right ear, headaches, jaw soreness right side, neck pain right side


VAERS ID: 1424351 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram, Fatigue, Inflammation, Insomnia, Lymphadenopathy, Nausea, Presyncope
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None. I think I may be allergic to something in shot but unsure.
Diagnostic Lab Data: Blood pressure, EKG
CDC Split Type: vsafe

Write-up: 05/04/2021 around 8:30 AM I started feeling effects like nausea and fatigue. The typical symptoms. They lasted for about a week and a half. It lasted until about 06/14/2021 and then I noticed the lymph node protrusion on Sunday and I went to the urgent care Clinic on Monday 06/14/2021and they just said it would go away. At the Doctor they did blood pressure test and an EKG and they did EKG because I had vasovagal response after touching lymph node. There was a few nights in a row about a week after the vaccine, where I had insomnia and I couldn''t fall asleep at all and had to take sleep aid. Lymph node swelling did go down and isn''t inflamed anymore.


VAERS ID: 1424395 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

Write-up: extremely sore arm for 4 days


VAERS ID: 1424841 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Chest pain for a week. Still joint pains everywhere. A little blurry vision.


VAERS ID: 1425858 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Hypokinesia, Insomnia, Muscle spasms, Pain in extremity
SMQs:, Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sulfonamide allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Aortic bypass (ROUGHLY 2 YEARS AGO.); Leg cramps; Poor peripheral circulation
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210651143

Write-up: MUSCLE CRAMPS IN LEGS, ARMS, FEET; COULD NOT MOVE ARM /HAVE DIFFICULTY MOVING ARM; DISRUPTING SLEEP; RIGHT ARM BEING SORE EVERY OTHER DAY; This spontaneous report received from a patient concerned a 61 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included major surgery - aorta bypass, legs cramping prior to the surgery, and almost no blood circulating towards legs, and concurrent conditions included sulfa allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A expiry: 23-JUN-2021) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-JUN-2021, the subject experienced muscle cramps in legs, arms, feet. On 04-JUN-2021, the subject experienced could not move arm /have difficulty moving arm. On 04-JUN-2021, the subject experienced disrupting sleep. On 04-JUN-2021, the subject experienced right arm being sore every other day. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from muscle cramps in legs, arms, feet, right arm being sore every other day, disrupting sleep, and could not move arm /have difficulty moving arm. This report was non-serious.


VAERS ID: 1426127 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Visual impairment
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: NKDA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Pt complains of eye swelling and altered vision. States she has been seeing black spots in her vision and has some swelling around her right eye. Refrained from giving second shot due to these effects


VAERS ID: 1426453 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-28
Onset:2021-06-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Aphasia, Hemiparesis, Transient ischaemic attack
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

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

Write-up: Exactly a week after the first dose of Pfizer pt had a TIA. Was taken by ambulance to the hospital. Lost usage of right side and couldn''t speak for roughly 30 mins. Pt states hospital found no reason for the TIA.


VAERS ID: 1426941 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysuria, Pollakiuria
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: AMLOPRES
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021693828

Write-up: Painful and frequent urination; Painful and frequent urination; This is a spontaneous report from a contactable consumer(patient). A 38-years-old female patient received BNT162B2 (BNT162B2, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 02Jun2021 (at the age of 38-year-old) as 2nd dose, single dose for covid-19 immunization. Medical history included high BP. Concomitant medication included amlodipine besilate (AMLOPRES) 5 mg taken for hypertension, start and stop unknown. The patient previously took Varicella for chicken pox in the left shoulder near the armpit on 22Apr2021, BNT162B2 (BNT162B2, solution for injection, Batch/Lot: EW0173) administered in left arm on 09May2021 as 1st dose, single dose for covid-19 immunization. On 04Jun2021, after 2 days of vaccination actually patient experienced side effect of painful and frequent urination. She wanted to understand is this normal, how long the side effects be like that only or she has to check with her doctor. Lab tests: patient stated, "Not recently, last month actually, before the vaccination, before the first shot, just preventive checkups, like to check our immunity.". Outcome of the events was unknown. Follow up attempts are needed. Further information has been requested.


VAERS ID: 1427050 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash macular
SMQs:, 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: Systemic: Developed spots on hand of vaccine arm. No itch. Getting better-Mild


VAERS ID: 1427208 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-26
Onset:2021-06-04
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Laboratory test, Lymphadenopathy, Red blood cell sedimentation rate, X-ray
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Sickness (father got sick on second dose of vaccine)
Allergies:
Diagnostic Lab Data: Test Name: Labs; Result Unstructured Data: Test Result:good; Comments: Nothing showed inflammation and nothing was elevated at all; Test Name: sedimentation rate; Result Unstructured Data: Test Result:fine; Test Name: X-ray; Result Unstructured Data: Test Result:good
CDC Split Type: USPFIZER INC2021725691

Write-up: 3 lymph nodes on collar bone; This is a spontaneous report from a contactable consumer (patient''s mother). A 14-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: EW0164), via an unspecified route of administration, administered in Arm Left on 26May2021 around 5pm (at the age of 14 years old) as 1st dose, single dose, dose 2 via an unspecified route of administration, administered in Arm Right on 16Jun2021 around 5:30pm as 2nd dose, single dose for COVID-19 immunization. No patient history. Patient medical history: None. Family medical history relevant to adverse event was father got sick on second dose of vaccine. The patient''s concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. Relevant Tests: None. No additional Vaccines Administered on Same Date of the Pfizer Suspect. No other products. The reporter stated that the patient got vaccine on 26May2021. On 04Jun2021, they noticed lymph nodes on his collar bone. They went to the pediatrician because he had never been sick or anything. After the first dose, he had labs taken and they were perfect. Nothing showed inflammation and nothing was elevated at all. The sedimentation rate was fine. There was nothing. His labs were good, and the X-ray was good. The reporter and her husband did a lot of research and thought that it was the vaccine. The pediatrician did not think that it was the vaccine. There were no cases of teenagers or men getting swollen lymph nodes, only adult women. Now, they want to do surgery on him. One pediatrician wanted to do surgery and the other said to let it wait out. The reporter stated that nobody had heard of any cases of this and asked had anyone else reported lymph nodes on teenagers. The reporter stated that she just got the second shot yesterday on 16Jun2021, so she was not letting him do anything. She was making him sit down all day. The reporter stated that she contacted Pfizer yesterday after she saw the surgeon. She did not know how to contact them. So, she sent an email asking for cases. She confirmed that she did not go through a report she just sent an email. The reporter would just like to know if anyone else, any other teenage boys had this issue. She clarified that he had 3 lymph nodes on his collar bone. She remembered exactly when it was because she freaked out. It was 04Jun2021, at 9:30 at night. He came into the living room, saying he had these knots on his neck. The reporter stated that it was different then mosquito bites because they did not itch. 2 of the lymph nodes had stayed the same and one had gotten harder and was getting firm. Treatment was started on antibiotics yesterday, that the surgeon wanted him on. It was Cephalexin 500mg, twice a day. The adverse event did not require a visit to emergency room because she thought it was the vaccine so she just took him to the pediatrician, and he could not find any reports of it. The adverse event required a visit to physician office, since getting the vaccine, he had gone to the pediatrician, and then to saw the surgeon. The patient underwent lab tests and procedures which included Labs: good, red blood cell sedimentation rate: fine, x-ray: good. The clinical outcome of the event was unknown.


VAERS ID: 1427276 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-06-04
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Foreign body in throat, Oropharyngeal discomfort, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Hypersensitivity (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 INC2021734051

Write-up: Something is in her throat and was wondering if that was it closing up/some trouble with her throat; Something is in her throat and was wondering if that was it closing up/some trouble with her throat; Something is in her throat and was wondering if that was it closing up/some trouble with her throat; This is a spontaneous report from a contactable consumer (the patient). A 64-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot Number: EW0151), via an unspecified route of administration on 07Apr2021 (at the age of 64-years-old) as a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot Number: EN6207) on 10Mar2021 for COVID-19 immunisation. On 04Jun2021, the patient experienced something is in her throat and was wondering if that was it closing up/some trouble with her throat. The patient stated the last dose she received was in April and she wanted to know would she be still having side effects because it seems like something was in her throat and was wondering if that was it closing up. She further stated she was having some trouble with her throat and she was wondering if that is a side effect from the Covid. She stated it was the week when (withheld) had all that rain, about 2 weeks ago and she started having trouble with it and its lasted quite some time. The patient stated she scheduled to see her regular primary care doctor next week on a Thursday. The patient stated it was worse the morning when she first called and as the day went on it got better. The outcome of events was resolving. Information on lot/batch number was available. Additional information has been requested.


VAERS ID: 1427431 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: nothing
Current Illness: no acute illness
Preexisting Conditions: Celiac disease
Allergies: celiac disease omnicef
Diagnostic Lab Data: None
CDC Split Type:

Write-up: pins and needles sensations that came and went in the fingers and toes, mostly the fingers. getting better, but was "constant" and now a couple times a day.


VAERS ID: 1427711 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Acne, Cough, Dyspnoea, Erythema, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Sudden cough, wheezing and shortness of breath daily one time during 24 hours for 20-40mins. Red acne on arm stayed for 10 days.


VAERS ID: 1427879 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-10
Onset:2021-06-04
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Breast tenderness, Ear discomfort, Ear pain, Ear swelling, Erythema, Fatigue, Hypoaesthesia, Lymph node pain, Lymphadenopathy, Menstruation irregular, Nausea, Paraesthesia, Pruritus, Rash, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Thyroid condition but it is under control
Allergies: Penicillin; sulfa; Ketek
Diagnostic Lab Data: Physical exam
CDC Split Type: vsafe

Write-up: New worsening symptoms started on 06-04-2021, I woke up with my ear itching, were painful, felt like my ears were on fire. My ears were swollen also developed redness, rash on my chest. I ordered Benadryl through delivery for what looked like hives to me. On 06-14-2021 I also developed new allergies that I did not have. My face swelled up and went numb, had tingling sensation to my hands. I went to see my PCP who referred me to an allergist doctor. I also had an allergic reaction to a skin care product that I use. I went to HCF to see a doctor who performed a physical exam. The doctor at the HCF felt my breasts which are so tender to touch, the doctor also could feel the swelling of my lymph nodes in my breasts and also my menstrual cycle is 6 days early this month. To this day the swelling in my lymph nodes are still present and painful. I still continue with fatigue, nausea as before but now I feel its more constant. I do not have my lot# to provide.


VAERS ID: 1427961 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-17
Onset:2021-06-04
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: False positive investigation result
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: Multivitamin Calcium 300mg Gabapentin Fiber capsule
Current Illness: None
Preexisting Conditions: None
Allergies: Codeine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Giving blood. Notified that my donation?s initial screening test for anti HCV was reactive. They also did more testing and the results of the extra tests did not confirm the initial reactivity. It does not show that I have a HCV infection. It also said I can not donate blood anymore.


VAERS ID: 1428067 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-06
Onset:2021-06-04
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Fatigue, Hypersomnia
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad)

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

Write-up: Constant fatigue and hypersomnia. Blood tests normal, waiting to see sleep specialist.


VAERS ID: 1428459 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 RA / IM

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

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

Write-up: Patient received one dose of Moderna and one dose of Johnson and Johnson''s Janssen vaccine. Patient did not report any adverse reactions/side effects.


VAERS ID: 1428466 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Chest pain, Electrocardiogram normal, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms: low fever, back and chest pain, mild nausea - started 6/4/21 and get worse over 4 days. Urgent care seeked on 6/8/21, EKG shown normal, no treatment received. Symptoms abruptly disappeared on 6/10/21


VAERS ID: 1429480 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Injection site erythema, Injection site pruritus, Injection site swelling, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Tachycardia-Severe


VAERS ID: 1429528 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-23
Onset:2021-06-04
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A22A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac monitoring, Computerised tomogram, Echocardiogram, Laboratory test, Magnetic resonance imaging, Transient ischaemic attack
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid, iron, calcium, multi vitamin, collagen,
Current Illness:
Preexisting Conditions: Thyroid cancer 2007, type 2 diabetes very controlled, past sleep apnea
Allergies: Sulfa, advair, codene,
Diagnostic Lab Data: Cat scan, heart echo, mri, lab work and now heart monitoring
CDC Split Type:

Write-up: Started having TIA?s not sure if related but seems suspect when I have never had anything like that before the vaccine


VAERS ID: 1429687 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Intermenstrual bleeding, Migraine
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Migraine lasting 48 hours, Menstrual spotting


VAERS ID: 1429722 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Cognitive disorder, Disturbance in attention, Fatigue, Feeling abnormal, Hypoaesthesia, Loss of personal independence in daily activities, Muscle tightness
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (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: penicillin
Diagnostic Lab Data: Blood work normal 6/25/2021
CDC Split Type:

Write-up: While I had several seemingly minor and/or expected symptoms, I want to emphasize the extreme fatigue and brain fog that lasted 17 days, and greatly effected my ability to function in daily life. June 4-8: Mild fatigue and brain fog. June 9-11: Increased severity of brain fog/ mental cloudy-ness and decreased cognition. I was unable to get my head right and focus and stay on task. I needed to lay down and sleep. June 12 - In addition to my mental cloudy-ness and decreased cognition I lost sensation to the left side of my face. I felt numb, although I still had feeling and muscle control. June 13-15 - Regained sensation in face, had tight jaw, still extreme fatigue and brain-fog. Slept all day. June 15-17 - Fatigue and decreased cognition continued. June 18-21 - Experienced moments clarity throughout the day June 22-26(today) - Felt like myself again


VAERS ID: 1429829 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-30
Onset:2021-06-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

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

Write-up: Per daughter: feeling tired and week, he went to the ER and was sent home. He went back due to worseing of weakness and was eventually sent to Pittsburgh hospital for further testing. His condition escalated to paralysis. Guillain-Barre syndrome was a possible diagnosis.


VAERS ID: 1429988 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-01
Onset:2021-06-04
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ENG6204 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO153 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: elouquis,simvastin dialetizem
Current Illness: none
Preexisting Conditions: none
Allergies: penecillian
Diagnostic Lab Data: 06/14/2021,ekg 135 p /minutes
CDC Split Type:

Write-up: rapid heart rate


VAERS ID: 1430319 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-14
Onset:2021-06-04
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Eye movement disorder, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, Advil, Allegra, Vitamin B, Vitamin D, Vitamin C
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Diagnosed with Bells Palsy
CDC Split Type:

Write-up: Sought treatment on June 5th for drooping right side of mouth and inability to independently operate right eye (unable to close/blink)


VAERS ID: 1430372 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0173 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Dehydration, Dizziness, Electrolyte imbalance, Headache, Incoherent, Loss of consciousness, Persistent depressive disorder, Swelling face, Syncope, Urine analysis, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: Chest xray, urine, blood, and cognitive were all given. Results are available
CDC Split Type:

Write-up: 18 hours after the 1st vaccine shot... healthy female while in the shower....blacked out, couldn''t see, called for mother who she knew was not home, passed out, and was not coherent, felt dizzy, had a bad headache, and face was swollen, Called her doctor''s office, told them about the vaccine and the incident, they said to go to the emergency room. Went to emergency room. She had a full list of tests. Was given a saline drip, hydration unit. Level V emergency code. Name vasovagal syncope, reaction to vaccine, electrolyte abnormalities, dehydration, dysthymia


VAERS ID: 1430426 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Neck pain, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: back of neck pain, shoulder pain and swelling above left clavicle since first vaccine (over 3 weeks) 7/10 pain


VAERS ID: 1430571 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-27
Onset:2021-06-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001T21A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Electrocardiogram, Intensive care, Stent placement
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: Having a slight pain in chest didn''t thing anything of it , it went away until a few days later on June 4th the pain didn''t go, went into the bathroom and almost passed out go the ambulance rushed to the hospital where they had to put a stint in the leg and stayed 4 days in the ICU before being able to come home. Has to take medicine everyday now for heart.


VAERS ID: 1431045 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-27
Onset:2021-06-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Amnesia, Memory impairment
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: As stated, Multiple Chemical Sensitivity (Syndrome)
Allergies: Yes, I''m chemically sensitive, have Multiple Chemical Sensitivity and react to many, especially molds and yeasts which I think this may be related to. Also have reacted to dyes, various additives & fillers.
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I began noticing very noticeable memory problems about a week after my 2nd dose. This is similar to yeast/fungal reactions I''ve had, so I started taking nutritional-supplement anti-yeast/anti-fungals. This only helped a little, but I still have significant memory loss. I also noticed it in others and told them I thought it was from their Covid Vaccine . Everyone thought I was crazy, so I didn''t report it. I planned to tell my PCP when I saw her, but I forgot. (She''s out of town now and I plan to email her after she returns.) Last week I was shocked to hear this symptom on the news. (With Chemical Sensitivities, I''ve been viewed as crazy, so I didn''t go further than telling friends.) This symptom is REAL. With proteolytic enzymes this symptom has lessened over time, but I still have memory loss that I hadn''t had prior. As an FYI, I had a similar memory problem decades ago after applying an over-the-counter topical for corns (on my foot). I believe it had salicylic acid. I stopped immediately and the symptom remedied. This on has not, completely and it''s bee a month now. Hope he damage is not permanent. I checked the box that it isn''t


VAERS ID: 1431463 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest discomfort, Chest pain, Dyspnoea, Electrocardiogram normal, Myocarditis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? 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: flu like symptoms, no fever
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG 6/28/2021 Normal Chest X-Ray 6/28/2021 Normal
CDC Split Type:

Write-up: Difficulty breathing, chest pressure and chest pain, suspected myocarditis


VAERS ID: 1431496 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-26
Onset:2021-06-04
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / UNK - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril 10 mg Vitamin D3 25 mcg Blisovi Fe 1/20
Current Illness:
Preexisting Conditions:
Allergies: prednisone vicodin Pepcid Omeprozole
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA Covid Arm - Red patch that got larger, was hot to the touch as well as sore and swollen. Treated at home with cortisone creme and ice packs.


VAERS ID: 1431732 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-26
Onset:2021-06-04
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0216 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Injection site pain, Menstruation irregular, Pain, Pain in extremity, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Fertility disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: intolerance to NSAIDS (itchy throat, ears)
Diagnostic Lab Data: N/A. called vaccine line for assistance, the wait time was 3+ hours to speak to someone so i hung up.
CDC Split Type:

Write-up: The day following the shot I had a very sore arm (which was to be expected) this went away in a day or two and felt completely fine after. On day 9/10 following the vaccine, I woke up with severe pain in the same arm at the injection point and pain with mobility of the same shoulder. Later the same day I unexpectedly began my menstrual cycle. It was 7 days early. It''s never early, ever. My cycle is down to the day and regular, always. No usual menstrual cycle indicators/symptoms prior to it beginning either. The day after my cycle started, I noticed my heartbeat was pounding very loudly at night in bed, this lasted for 3 days with moments of minor chest tightness in the center of the chest, which was concerning, I almost opted to go to ER. this sensation subsided on the 4th day and has not returned.


VAERS ID: 1433127 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-06-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Cardiac flutter, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow)

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

Write-up: Excessive fluttering/palpitation like beating


VAERS ID: 1433150 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-06-04
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction
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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I21.4 - Non-STEMI (non-ST elevated myocardial infarction) (CMS/HCC)


VAERS ID: 1433229 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-30
Onset:2021-06-04
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: N17.9 - Acute kidney failure, unspecified


VAERS ID: 1433306 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Feeling abnormal, Hypoaesthesia, Impaired work ability, Myalgia, Pain in extremity, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: x rays (mri on next visit)
CDC Split Type:

Write-up: muscle ache, simple jobs were impossible, joint pain, leg pain, arm feels numb and weird. walking causes chest pains. dr says do not take 2nd vax.


VAERS ID: 1433397 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests, Angina pectoris, Deafness, Inflammation, Tinnitus, Vertigo
SMQs:, Other ischaemic heart disease (narrow), Hearing impairment (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: shellfish
Diagnostic Lab Data: Several hearing tests were performed. Anti inflammatory was given to help with the inflammation. I now have a severe ear problem that leads to vertigo and hearing loss. I also have a heart problem I never had before.
CDC Split Type:

Write-up: SAhortly after taking the shot, I have had non stop static buzzing noise in both my ears that does not go away. After several weeks the volume of the static buzzing noise increased. I went to my primary doctor and then an ENT (ear specialist) and was diagnosed with Tinnitus. Previously before the vaccine I was completely healthy and had no history of any ear related medical issues. I also have been having heart pain on my chest. It is due to my heart valve being inflamed. Anti inflamatory were prescribed but did not help much. I am scheduled to see a cardiologist.


VAERS ID: 1433398 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-01
Onset:2021-06-04
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction
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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I21.4 - NSTEMI (non-ST elevated myocardial infarction) (CMS/HCC)


VAERS ID: 1433558 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-01
Onset:2021-06-04
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH GR8733 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary mass, Axillary pain, Mammogram, Ultrasound scan
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: mammogram, ultrasound were completed on 06/29/2021 and had no results, and now the pt is waiting on a biopsy apt
CDC Split Type:

Write-up: woke up with pain under left arm and felt a lump by left breast, mammogram and ultrasound was done and the doctor does not know what it is. there is now an biopsy scheduled because the doctor does not know what the lump is.


VAERS ID: 1433960 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-03-19
Onset:2021-06-04
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Diplopia, Facial paralysis, Myasthenia gravis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Ocular motility disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rosuvastatin 20 mg oral tablet pantoprazole 20 mg oral delayed release tablet Tadalafil (Eqv-Cialis) 20 mg oral tablet Xarelto 20 mg oral tablet
Current Illness: none
Preexisting Conditions: none
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: drooping of right eyelid; double vision Diagnosed from blood test as myasthenia gravis No treatment as yet--waiting for appointment end of July


VAERS ID: 1434032 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

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

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

Write-up: Vaccine given outside recommended dosing interval, second dose was administered 15 days following the first dose which was given on 5/20/2021


VAERS ID: 1435898 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A, / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac arrest, Carotid artery occlusion, Electrocardiogram
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (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: BRILINTA; ASPIRIN (E.C.); CARVEDILOL PHOSPHATE; ROSUVASTATIN CALCIUM
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: EKG; Result Unstructured Data: Normal
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Block; cardiac arrest; This spontaneous case was reported by a nurse and describes the occurrence of CARDIAC ARREST (cardiac arrest) and CAROTID ARTERY OCCLUSION (Block) in a 57-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 050C21A,) for COVID-19 vaccination. Concomitant products included TICAGRELOR (BRILINTA), ACETYLSALICYLIC ACID (ASPIRIN (E.C.)), CARVEDILOL PHOSPHATE and ROSUVASTATIN CALCIUM for an unknown indication. On 03-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Jun-2021, the patient experienced CARDIAC ARREST (cardiac arrest) (seriousness criterion medically significant). On an unknown date, the patient experienced CAROTID ARTERY OCCLUSION (Block) (seriousness criterion medically significant). At the time of the report, CARDIAC ARREST (cardiac arrest) had resolved and CAROTID ARTERY OCCLUSION (Block) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Electrocardiogram: normal (normal) Normal. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment medications were 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. Patients age, and concomitant medication with ticagrelor, aspirin, rosuvastatin suggest an underlying cardiovascular disease that is a potential confounder. Additional 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. Patients age, and concomitant medication with ticagrelor, aspirin, rosuvastatin suggest an underlying cardiovascular disease that is a potential confounder. Additional information has been requested.


VAERS ID: 1437575 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Arteriovenous fistula, Cavernous sinus thrombosis, Cellulitis orbital, Jugular vein thrombosis, Magnetic resonance imaging head abnormal, Parophthalmia, Platelet count normal, Scan with contrast abnormal, White matter lesion
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Ocular infections (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cognitive delay
Allergies: no known allergies
Diagnostic Lab Data: JUN 11 05:15 140 | H 109 | 12 / _____________________ 129 L 3.3 | 24 | 0.76 / JUN 11 09:08 / L 10.9 / H 17.1 ---------- 227 / L 32.4 / MRI brain/orbits: (06/10/2021 02:22 EDT MRI Brain wo w Contrast) IMPRESSION: 1. Inflammatory changes in the right orbit. 2. Consider thrombosis of the right cavernous sinus and enlargement of the superior ophthalmic vein or a carotid cavernous fistula on the right with enlargement of the superior ophthalmic vein. 3. Atrophy and chronic white matter changes. [1] (06/10/2021 02:22 EDT MRI Brain wo w Contrast) IMPRESSION: Question thrombosis left sigmoid sinus and internal jugular bulb. [2]
CDC Split Type:

Write-up: Patient had orbital cellulitis and cavernous venous sinus thrombosis accompanied by IJ thromboses. She has significant cognitive delay and was not able to give much details; she lives in a group home so I was told that she had 2nd Moderna vaccine on 6/1, but I was unable to confirm. Her platelets were normal and she improved despite treatment with heparin.


VAERS ID: 1437684 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-21
Onset:2021-06-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Chest X-ray, Computerised tomogram
SMQs:, Hearing impairment (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: Verapamil 120mg citalopram 20 mg Bupropion XL 300mg Bayer aspirin 81mg multi vitamin gummie osteo biflex calcium chew fiber gummie B12 1000mcg D3 25 mcg Aleve
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Trip to ER where they performed CAT scan, chest x-ray, and blood work follow up tests scheduled: MRA scan, echo ultrasound, and carotid scan
CDC Split Type:

Write-up: Developed Bell''s Pasly two weeks after injection


VAERS ID: 1437907 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / SYR

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

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

Write-up: Mother completed document stating child''s age was 12 years old. DOB= 11 years. Advised mother that the 2nd dose can be given after the child''s 12th birthday. No adverse reaction following vaccine was reported by the parent.


VAERS ID: 1439858 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Chest X-ray, Musculoskeletal chest pain, Neck pain, Painful respiration, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UBRELVY; ZOLMITRIPTAN; EMGALITY [GALCANEZUMAB]; GABAPENTIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Adhesive tape allergy; Allergic to cats; Allergy to intravenous contrast media; Cervical dystonia; Drug allergy; Migraine; Thoracic disc degeneration
Allergies:
Diagnostic Lab Data: Test Name: Blood work; Result Unstructured Data: Test Result:Unknown result; Test Name: chest x-rays; Result Unstructured Data: Test Result:Unknown result; Test Date: 20210529; Test Name: COVID-19 nasal swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021713814

Write-up: Pain from neck down to bottom of rib cage on right side/extreme pain; Pain from neck down to bottom of rib cage on right side/extreme pain; A deep breath caused extreme pain; Pain continued across the stomach; This is a spontaneous report from a contactable consumer (patient). A 59-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the right arm, on 04Jun2021 16:30 (Batch/Lot Number: EW0182), as dose 2, single, at age 59 years old, for COVID-19 immunisation, at a pharmacy/drug store. The patient was not pregnant at the time of vaccination. Medical history included migraine, thoracic disc degeneration, cervical dystonia, known allergies: cats, IV dye, tegaderm and "trednisone" (as reported), all from unknown dates. The patient was not diagnoswed with COVID-19 prior to vaccination. The patient did not receive any other vaccines within 4 weeks prior to BNT162B2. Concomitant medications included ubrogepant (UBRELVY); zolmitriptan; galcanezumab (EMGALITY); gabapentin, and "tiza" (as reported), all taken for unspecified indications, start and stop dates were not reported. The patient previously took imipramine and experienced allergy. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), administered in the left arm, received on 14May2021 16:30 (batch/lot number: EW0167), as dose 1, single, at age 59 years old, for COVID-19 immunisation and the patient had no reaction. On 04Jun2021 21:00, the patient experienced pain from neck down to bottom of rib cage on right side/extreme pain, a deep breath caused extreme pain, and pain continued onto the left side from the neck down to the bottom of the rib cage and across the stomach with the same symptoms. The patient used heat, flu and cold medicine, with Benadryl at night. Treatment was also reported as "doctor''s visit, blood work and chest x-rays". The events resulted to physician''s office visit. The patient had COVID-19 nasal swab on 29May2021 which was negative. The patient underwent blood work and chest x-rays on an unspecified date with unknown results. The outcome of the events was recovering. The reporter assessed the events as non-serious. Follow-up attempts are needed. Further information is expected.


VAERS ID: 1440077 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-26
Onset:2021-06-04
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Cardiomegaly, Heart rate, Heart rate increased, X-ray
SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ATORVASTATIN CALCIUM; LEVOTHYROXINE SODIUM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: High cholesterol; Thyroidectomy
Allergies:
Diagnostic Lab Data: Test Name: blood pressure; Result Unstructured Data: Test Result:110/55; Test Name: pulse rate; Result Unstructured Data: Test Result:50-60; Comments: normal pulse; Test Date: 20210604; Test Name: pulse rate; Result Unstructured Data: Test Result:over 180; Comments: 9 days after shot; Test Date: 20210606; Test Name: X-ray; Result Unstructured Data: Test Result:slight enlarged heart
CDC Split Type: USPFIZER INC2021766664

Write-up: slight enlarged heart; went to ER for heart rate of over 180; This is a spontaneous report from a contactable consumer (patient). A 55-year-old female patient received bnt162b2, via an unspecified route of administration, administered in left arm on 26May2021 10:30 (Lot Number: Ew0177) as dose 2, single at the age of 55-year-old for covid-19 immunisation. The patient was not pregnant. 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 had not been tested for COVID-19. Medical history included high cholesterol from an unknown date, thyroid removal in 2011. The patient had no known allergies. Historic vaccine was bnt162b2, via an unspecified route of administration, administered in left arm on 06May2021 10:30 (Lot Number: Ew0167) as dose 1, single at the age of 55-year-old for covid-19 immunisation. Concomitant medications included atorvastatin calcium 10 mg, levothyroxine sodium 100, all taken for an unspecified indication, within 2 weeks of vaccination. 9 days after shot (04Jun2021) the patient went to ER for heart rate of over 180, sent home and had to go to ER 3 more than mrs within a 7 day period the last time they admitted her for 2 days. The patient did not have heart issues nor high blood pressure or any heart disease. She ran 110/55 normal pulse 50-60. The patient now had to see a cardiologist and he wanted to do a monitor. The patient had never had to go through this ever until this shot. They took X-rays and it showed an slight enlarged heart (06Jun2021 03:30 as reported). The patient was so upset the shot had done this to her. The patient underwent lab tests and procedures which included 9 days after shot (04Jun2021) heart rate of over 180; blood pressure: 110/55, normal pulse: 50-60 on an unknown date; x-ray: an slight enlarged heart on 06Jun2021. The adverse events resulted in emergency room/department or urgent care and physician office visit. The seriousness of events was hospitalization for 2 days from Jun2021. Therapeutic measures were taken as a result of events which included a pill to regulate to restart her heart. The outcome of events was unknown.


VAERS ID: 1440240 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1096 / 1 LA / IM

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

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

Write-up: Site: Swelling at Injection Site-Medium


VAERS ID: 1440430 (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: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 RA / IM

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

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

Write-up: Mother called the local Health Department on 7/1/21 to report that her son received the 1st dose of the Pfizer vaccine (Lot# ER8735) on 5/24/21 and the 2nd dose of Pfizer on 6/4/21 (Lot# ER8735) which is less than the recommended 21 day interval. She reported her son had no adverse effects and feels "fine."


VAERS ID: 1440585 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Heart rate irregular, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: My son started complaining of chest pain about 11 hours after receiving the 2nd dose of his vaccine. Throughout the night his heart rate was very erratic, reaching as high as 138 and he had palpitations. The symptoms resolved by the next morning. There were no other adverse outcomes. I was not aware of the heart rate and palpitations until a few days later when he showed me the data from the night of the vaccine on his fitbit heart rate tracker. Since the symptoms had already resolved, I did not bring him to the doctor for any testing.


VAERS ID: 1440757 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-14
Onset:2021-06-04
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ophthalmological examination abnormal, Scar, Uveitis, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Ocular infections (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tirosint 112 mcg, Vitamin D3 1000 IU
Current Illness:
Preexisting Conditions: Psoriasis, Hashimoto''s Thyroiditis, movement disorder of unknown cause
Allergies:
Diagnostic Lab Data: I saw an optometrist on 6/5/21 to rule out the possibility of a retinal detachment. Then I saw ophthalmologist and retina specialist on 6/15/21 to seek further consultation of the cause of all of the many new black dots and black squiggly lines that started appearing in my vision on 6/4/21. Dr. said I had a lot of debris in the middle part of my eye (but NOT in the vitreous cavity). He also noted that I have scarring in my left eye. I suspect that it may be vaccine-induced uveitis, due to the fact that I already have at least two other autoimmune diseases, the proximity of appearance of this problem to my 2nd vaccination dose, and the nature of the debris in my eye.
CDC Split Type:

Write-up: On 6/4/21 I noticed the appearance of many black dots and black squiggly lines in both of my eyes, with the left eye being worse. I have never experienced this problem previously. I continue to experience this, and it appears that the number of black lines and dots may be increasing or remaining constant.


VAERS ID: 1440799 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-23
Onset:2021-06-04
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Computerised tomogram head normal, Echocardiogram normal, Hypoaesthesia, Infection, Magnetic resonance imaging head normal, SARS-CoV-2 test positive
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Type 2 Diabetes, Hypertension, Restless Leg Syndrome, Generalized anxiety disorder
Allergies: Unknown
Diagnostic Lab Data: COVID 19 Positive test - 6/4/2021 CT Scan of the head Negative - 6/4/2021 MRI Negative for acute stroke - 6/4/2021 Echocardiogram unremarkable - 6/4/2021
CDC Split Type:

Write-up: Breakthrough infection, includes hospital admission that appears unrelated to COVID 19. Patient reported to the hospital with right sided numbness of the face. Patient had an MRI that was negative for acute stroke.


VAERS ID: 1440955 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-06-04
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / UNK UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Psychotic disorder
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had several visits to the ED within 6 weeks of receiving COVID vaccination. She presented to the ED on 6/4/2021 for paranoid psychosis. She presented to the ED on 06/09/2021 and was subsequently hospitalized for amphetamine dependence.


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