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

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



Case Details (Reverse Sorted by Onset Date)

This is page 242 out of 8,010

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VAERS ID: 1732324 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-05
Onset:2021-09-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vit D, multi vit
Current Illness: cold 2 weeks before
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash all over her body per patient


VAERS ID: 1734020 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-02
Onset:2021-09-08
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 06F21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Paraesthesia, Vaccination site swelling
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: Minor pins and needles all over the body/Random pins and needles all over the body; Right arm pit got fat; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (Minor pins and needles all over the body/Random pins and needles all over the body) and VACCINATION SITE SWELLING (Right arm pit got fat) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 06F21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Sep-2021, the patient experienced VACCINATION SITE SWELLING (Right arm pit got fat). On 17-Sep-2021, the patient experienced PARAESTHESIA (Minor pins and needles all over the body/Random pins and needles all over the body). At the time of the report, PARAESTHESIA (Minor pins and needles all over the body/Random pins and needles all over the body) outcome was unknown and VACCINATION SITE SWELLING (Right arm pit got fat) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided.


VAERS ID: 1734040 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Chest pain, Fatigue, Feeling of body temperature change, Headache, Hypoaesthesia, Miosis, Mobility decreased, Myalgia, Nausea, Paraesthesia, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AMBIEN; ESTRADIOL; METOPROLOL; LYRICA; NORCO; AMLODIPINE
Current Illness: Blood pressure fluctuation (Emergency blood pressure); Heart disorder (have heart problems); Knee replacement; Neuropathy; Sleep disorder
Preexisting Conditions: Medical History/Concurrent Conditions: Hysterectomy
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: BLOOD PRESSURE; Result Unstructured Data: blood pressure was 110/60 when headache started; Test Date: 20210909; Test Name: BLOOD PRESSURE; Result Unstructured Data: within 45 minutes,shot up to 155/99.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: chest pain; numbness in left ear and left cheek; tingling in left ear and left cheek; could not close joints / could not use her hand; nausea; fatigue; weird headache starts in back of head and is burning / The headache completely incapacitates her when it starts. She feels it move to the frontal lobe, and it vanishes just as quickly as it comes; body aches severe on left arm; severe burning/cooling sensation; hazy vision starts in left eye and it moves to the right eye; pupils constricted; This spontaneous case was reported by a consumer and describes the occurrence of FEELING OF BODY TEMPERATURE CHANGE (severe burning/cooling sensation), VISION BLURRED (hazy vision starts in left eye and it moves to the right eye), MIOSIS (pupils constricted), HYPOAESTHESIA (numbness in left ear and left cheek) and PARAESTHESIA (tingling in left ear and left cheek) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Hysterectomy. Concurrent medical conditions included Heart disorder (have heart problems), Sleep disorder, Neuropathy, Knee replacement and Blood pressure fluctuation (Emergency blood pressure). Concomitant products included METOPROLOL for Blood pressure fluctuation, AMLODIPINE for Blood pressure high, HYDROCODONE BITARTRATE, PARACETAMOL (NORCO) for Knee replacement, PREGABALIN (LYRICA) for Neuropathy, ZOLPIDEM TARTRATE (AMBIEN) for Sleep disorder, ESTRADIOL for an unknown indication. On 08-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Sep-2021, the patient experienced FEELING OF BODY TEMPERATURE CHANGE (severe burning/cooling sensation), VISION BLURRED (hazy vision starts in left eye and it moves to the right eye), MIOSIS (pupils constricted), NAUSEA (nausea), FATIGUE (fatigue), HEADACHE (weird headache starts in back of head and is burning / The headache completely incapacitates her when it starts. She feels it move to the frontal lobe, and it vanishes just as quickly as it comes) and MYALGIA (body aches severe on left arm). On 09-Sep-2021, the patient experienced MOBILITY DECREASED (could not close joints / could not use her hand). On 16-Sep-2021, the patient experienced HYPOAESTHESIA (numbness in left ear and left cheek) and PARAESTHESIA (tingling in left ear and left cheek). On an unknown date, the patient experienced CHEST PAIN (chest pain). At the time of the report, FEELING OF BODY TEMPERATURE CHANGE (severe burning/cooling sensation), VISION BLURRED (hazy vision starts in left eye and it moves to the right eye), MIOSIS (pupils constricted), HYPOAESTHESIA (numbness in left ear and left cheek), PARAESTHESIA (tingling in left ear and left cheek), CHEST PAIN (chest pain), MOBILITY DECREASED (could not close joints / could not use her hand), NAUSEA (nausea), FATIGUE (fatigue), HEADACHE (weird headache starts in back of head and is burning / The headache completely incapacitates her when it starts. She feels it move to the frontal lobe, and it vanishes just as quickly as it comes) and MYALGIA (body aches severe on left arm) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 09-Sep-2021, Blood pressure measurement: 110/60 (normal) blood pressure was 110/60 when headache started and 155/99 (High) within 45 minutes,shot up to 155/99.. Patient experiences nausea, 12 hours later followed by fatigue, weird headache that starts in back of the head, and burning, with a severe burning cooling sensation. Patient feels headache moving to the frontal lobe, and disappearing just as quickly as it comes. Patient also have hazy vision which started in the left eye, moving to the right eye. Numbness and tingling in the left ear and left cheek, in the 8th day after the third dose of vaccine . This case was linked to MOD-2021-323605.


VAERS ID: 1734169 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-05
Onset:2021-09-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Rash
SMQs:, Severe cutaneous adverse reactions (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101198671

Write-up: Rash and Blisters on arms and face; Rash and Blisters on arms and face; This is a spontaneous report from a contactable consumer (patient) . A 42-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: Fc3184), via an unspecified route of administration in Arm Left on 05Sep2021 (at 42 years) at 13:15 as single dose for covid-19 immunisation . The patient medical history was not reported. There were no concomitant medications. Prior to vaccination the patient was not diagnosed with COVID-19; since the vaccination she has not been tested for COVID-19. On 08Sep2021 the patient experienced rash and blisters on arms and face. Events required doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Treatment received for the adverse events included prednisone.Outcome of the event was recovering.No follow-up attempts are needed. No further information is expected.


VAERS ID: 1734178 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210908; Test Name: Blood Pressure; Result Unstructured Data: Test Result:178/90 mmHg; Test Date: 20210909; Test Name: Blood Pressure; Result Unstructured Data: Test Result:Normal mmHg; Test Date: 20210908; Test Name: Heart rate; Result Unstructured Data: Test Result:90 beats per minute; Test Date: 20210909; Test Name: Heart rate; Result Unstructured Data: Test Result:Normal
CDC Split Type: USPFIZER INC202101200929

Write-up: Blood pressure was 178/90 mmHg; Heart rate went up/resting heart rate was 90 beats per minute; This is a spontaneous report from a contactable consumer (patient) A 56-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 08Sep2021 (Batch/Lot Number: FD8448) as DOSE 2, SINGLE for covid-19 immunisation . Age at vaccination :56 years.The patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) for covid-19 immunization (Anatomical Location: left shoulder). There were no concomitant medications and medical history. The clinical course was reported as follows: on 08 Sep2021 he received his second Covid 19 vaccine last Wednesday at around 9:00AM-9:30AM in the morning. His Covid 19 record card says FD8448. He works nights so after he received the vaccine he went home and slept because he had to work that night. He reports probably about 13 hours after he received the vaccine, around 10:00PM-11:00PM that night, he was sitting at his desk at work and his heart rate went up. His resting heart rate was 90 beats per minute. His blood pressure was 178/90 mmHg and it stayed that way for about 3 hours. He left work and was on his way home when he had to stop and call paramedics. The paramedics came to where he was stopped, and the paramedics checked him out. The paramedics put an ice bag on the back of his neck and he sat there for about 15 minutes. His symptoms calmed down enough that he felt safe enough to finish his drive home although his heartrate and blood pressure were still elevated. It probably lasted a total of about 5 hours and after that his heartrate and blood pressure returned to normal. While he was on his way home and if he was feeling bad when he passed by the emergency department close to his house, he would stop. But he didnt have to stop. He arrived home and he sat down and maybe within a couple hours everything was back to what he would call normal.Therapeutic measures were taken as a results of the events.The outcome of the events was recovered.No emergency room/phiscian office visit.Additional information : Vaccination Facility Type :Pharmacy/Drug Store;No prior vaccination within 4 weeks Follow-up attempts are completed. No further information is expected.


VAERS ID: 1734439 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-28
Onset:2021-09-08
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine present, Burning sensation, Computerised tomogram normal, Electrocardiogram normal, Feeling jittery, Full blood count normal, Haematuria, Heart rate abnormal, Metabolic function test, Migraine, Muscular weakness, Paraesthesia, Urine analysis, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, E, C, Zinc, folic acid Ivermectin 0.2mg/kg (12mg twice a week)- prophylaxis prescribed regimen
Current Illness: none
Preexisting Conditions: none
Allergies: Pcn, bactrim, cefdinir, omnicef, keflex, vancomycin, gentamycin, clindamycin latex mango
Diagnostic Lab Data: (9/8/21)Day 11, appt w urologist, ruled out uti , xray and ct scan to rule out kidney stones, all negative, positive for blood in urine. 9/13- CBC & CMP all normal 9/15 saw PCP , exam, lab work, ekg. All normal.
CDC Split Type:

Write-up: Starting Day 11, started experiencing 3 days of gross hematuria. Day 12- bilateral weakness in upper and lower extremities. Day 13, migraine, internal jitteriness, bilateral weakness in muscles, tingly feet, burning finger tips omn Day 14- heart rate while sitting fluctuating from 150s- 50s.


VAERS ID: 1734576 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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: None


VAERS ID: 1734678 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Facial discomfort, Facial paralysis, Incorrect dose administered, Laboratory test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hearing impairment (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: allergies to antibiotics (unknown all of them definitely penicillin)
Diagnostic Lab Data: 9/11/21 total ER workup
CDC Split Type:

Write-up: the evening after receiving both vaccines patient experience shortness of breath but thought it was related to her asthma. Patient reports the next couple days she thought her face felt funny and "droopy" but when asking other family/friends they said she did not have any visible changes. Patient noticed visible facial change on 9/11/21 and went to ER for complete workup where they ruled out TIA, lyme disease etc. Patient was given valtrex and prednisone tapers for treatment she is currently completing


VAERS ID: 1734811 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-06
Onset:2021-09-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

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

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

Write-up: Blood clot


VAERS ID: 1735107 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-02-22
Onset:2021-09-08
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Positive test results
CDC Split Type:

Write-up: The employee tested positive for COVID-19


VAERS ID: 1735618 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-09-08
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Breast swelling, Peripheral swelling, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: swelling of arms and breast, rash


VAERS ID: 1735824 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-05
Onset:2021-09-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Brain scan normal, Epistaxis, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: na
Current Illness: not known
Preexisting Conditions: dialysis patient
Allergies: not known
Diagnostic Lab Data: We do not have this information
CDC Split Type:

Write-up: Patient stated that 3 days after getting the Pfizer vaccine that she blew her nose and had clots. This caused her concern and so she went to the ER seeking medical care. They ran test and ruled out other possibilities of what could have caused the clots and came up with the vaccine as the main cause of the clots. She stated that they did a brain scan and said that she was fine. Her md is aware of what happened and wanted her to receive the second shot which was given today on 9/26/21, but since she had COVID already as well that she will not need to get a 3rd dose. We have only given her vaccine and have not filled any regular medications for her so we do not have her medical md on file.


VAERS ID: 1736137 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-21
Onset:2021-09-08
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Echocardiogram, Electrocardiogram ambulatory, Heart rate increased, Supraventricular tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: sertraline, cannabis, flonase
Current Illness: GERD
Preexisting Conditions: GERD
Allergies: keflex causes comiting
Diagnostic Lab Data: echo heart monitor metoprolol regimen
CDC Split Type:

Write-up: proximal Supraventricular tachycardia random heart acceleration for extended periods of time


VAERS ID: 1736144 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-03
Onset:2021-09-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Diarrhoea, Illness, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Elderberry cold and flu, mexnex DM, and ibprohen
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Postive test results for 7 people ( unvaccanted) after 1 person who had just got vaccined on the 3rd came down sick.
CDC Split Type:

Write-up: My son got his vaccine on the 3rd, by wensday the 8th ( of September 2021, this is all in the same month) but by wensday the 8th he started to have. Runny nose and sneezing, and a slight cough. ( Mind you he gas seasonal allergies) so that is what we thought it was. By Friday the 10th our roommate Davey took sick, chills, cough, body aches, dirrieha, vomiting, and low grade fever with lose of taste. On the 11th that is when myself took ill all with the same symptoms except no dirrieha, vomiting and I lost both smell and taste. And by this time my son got worse. On Sunday the 12th is when my husband took sick, with the same symptoms as me. We all got covid test that came back postive. Now NO ONE in my house goes anywhere unless that have a mask. The schools here make kids stay 6ft apart and a mask at all times, my roommates work is very careful as well. Me and my husband don''t leave unless of a doctor''s appointment and even then we try to keep them vitural I have sezuiers, my 7yr old who s autistic, and has sezuiers. And my 15yr old who has asthma they all got it a couple days later. Luckly they are doing better. I myself am allergic to the flu shot, so I have been staying home because I''m scared to death on getting the covid vaccine and now that no sooner than my son gets his vaccine everyone in my house is suddenly sick? This worries me even more. No one that my children at school have came down with it. And they were all check for being in close contact with my kids, and same with our roommates work. Everyone came back negtive that worked around him and kids that were around mine. Now I''m not agaisnt the vaccine. But this alone scared the crap out of me. And three weeks later my roommate is still testing postive, and I keep getting random low grade fevers still. My son is doing. Bit better, my husband better, and my other 4 children better. But my roommate is still sick with the postive test results, and coughing. And I with the low grade fever still.


VAERS ID: 1736807 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-02
Onset:2021-09-08
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After first vaccine, got a bad case of hives
Other Medications: Do not have a listing of medicines currently taking
Current Illness: Hives subsequent to 1st vaccine
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Nurse practitioner took a swab of several pustules and reportedly sent them to a lab to be analyzed.
CDC Split Type:

Write-up: Red itchy rash covering most of my torso. The rash had fluid filled pustule''s and continued to develop to the extremities over the next several days.


VAERS ID: 1736869 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-16
Onset:2021-09-08
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal X-ray, Anaemia, Blood cortisol, Blood creatinine increased, Blood sodium decreased, Blood thyroid stimulating hormone, COVID-19, Cardiomegaly, Chest X-ray abnormal, Condition aggravated, Fatigue, Gastrointestinal haemorrhage, Haematochezia, Haemoglobin decreased, Laboratory test abnormal, Nucleic acid test, Oesophagogastroduodenoscopy, Polymerase chain reaction, Pseudomonal bacteraemia, Pulmonary congestion, SARS-CoV-2 test positive, Urine output decreased, Weight increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Gastrointestinal haemorrhage (narrow), Hyponatraemia/SIADH (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Sepsis (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, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ammonium lactate (LAC-HYDRIN) 12 % EXTERNAL Lotion apply to affected area twice daily. Med Note (Tue Feb 16, 2021 12:45 AM) atorvastatin (LIPITOR) 40 MG PO Tab take 1 Tab by mouth once every night at bedtime. Med Note (Tu
Current Illness: A-fib ? Ankle sprain ? Asthma pt denies ? Cancer 2008 cervical and uterine ? CHF exacerbation 07/17/2019 ? Chronic back pain fractured L1, 2, 5 ? Chronic renal failure ? Concussion as teenager from sport ? Dementia ? Fractures ? Gait abnormality ? GERD (gastroesophageal reflux disease) ? Heart abnormality ? Heart failure with preserved ejection fraction ? Hypertension ? Hypothyroidism ? Knee pain ? Low back pain ? Lymphedema ? Nerve disorder ? Neuropathy ? Numbness of foot ? Poor circulation ? Septic arthritis of knee, left ? Vascular disease
Preexisting Conditions: A-fib ? Ankle sprain ? Asthma pt denies ? Cancer 2008 cervical and uterine ? CHF exacerbation 07/17/2019 ? Chronic back pain fractured L1, 2, 5 ? Chronic renal failure ? Concussion as teenager from sport ? Dementia ? Fractures ? Gait abnormality ? GERD (gastroesophageal reflux disease) ? Heart abnormality ? Heart failure with preserved ejection fraction ? Hypertension ? Hypothyroidism ? Knee pain ? Low back pain ? Lymphedema ? Nerve disorder ? Neuropathy ? Numbness of foot ? Poor circulation ? Septic arthritis of knee, left ? Vascular disease
Allergies: No Known Allergies
Diagnostic Lab Data: Covid detected 9/8/2021 CXR shows cardiomegaly w/ mild pulmonary vascular congestion. Plain film of abdomen shows no acute process. Patient is admitted to Internal Medicine with consult to Gastroenterology. Status: Final result Visible to patient: Yes (not seen) Next appt: None Specimen Information: Nasopharyngeal; Swab 0 Result Notes Ref Range & Units SARS-CoV-2 (COVID-19) by NAA, Micro Not Detected Detected Abnormal Narrative The SARS-CoV-2 (COVID-19) by NAA test is for in vitro diagnostic use under the FDA Emergency Use Authorization (EUA) for laboratories certified to perform high complexity testing. This test has not been FDA cleared or approved. Methodology: Nucleic Acid Amplification (NAA)/Polymerase Chain Reaction (PCR). Specimen Collected: 09/08/21 12:27 PM Last Resulted: 09/08/21 1:51 PM
CDC Split Type:

Write-up: This is a 60y.o. female with PMHx of HFpEF, Afib, and chronic lymphedema who presents to ED for abnormal labs. Patient has a home healthcare worker who draws scheduled labs and was notified today of Hgb 7.1 with instructions to go to the ED. This morning, patient had x1 episode of red blood with a bowel movement. She denies any prior episodes aside from this one, denies black tarry stools, denies coffee-ground emesis. Patient was previously admitted to this facility 2 months ago for anemia, though was found to have Bacteremia due to Pseudomonas and was treated accordingly. At the time, she also underwent EGD with gold prob cautery for suspected GI bleed. Patient states that she has been more fatigued lately, though attributes this to her mother''s recent cancer diagnosis. Since discharge, she has been gaining weight, approximately 15-20lbs. She has also had decreased urine output, measuring approximately ~2L/day, from her normal ~3-4L/day. She denies fevers, chills, changes in vision, chest pain, SOB, abdominal pain, N/V/D, constipation, difficulty urinating, or weakness. Patient previously had Covid approximately 1 year ago, has been fully vaccinated with Pfizer vaccine. ED Course: BP 106/76, HR 63, RR 20, T 97.9F, SpO2 97% on RA. Labs remarkable for Na 133, Cr 1.46, Hgb 7.4, Cortisol 22.5, TSH 6.52, Covid detected. CXR shows cardiomegaly w/ mild pulmonary vascular congestion. Plain film of abdomen shows no acute process. Patient is admitted to Internal Medicine with consult to Gastroenterology.


VAERS ID: 1737258 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3591 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Axillary pain, Contusion, Injection site erythema, Injection site pain, Injection site swelling, Lymphadenopathy, Pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: The 2nd COVID19 vaccine by Pfizer/BioNTech
Other Medications: Stelara, Mercaptopurine
Current Illness:
Preexisting Conditions: Crohn''s Disease, Auto-Immune Hepatitis, Entero-Arthritis
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fever of 103, body aches, pain, swelling and redness at injection site. Swollen, painful lymph nodes under the left (injection site) arm. Also many bruises all over legs and thighs. All symptoms lasted 4 days.


VAERS ID: 1737452 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

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

Write-up: Within 15 minutes of receiving vaccine, c/o tingliing in right upper extremity. Hand strength equal, color pink and warm. Overall color pink, and denies any other symptom.


VAERS ID: 1737492 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial flutter, Dyspnoea, Electrocardiogram, Fatigue, Headache, Hypoaesthesia, Musculoskeletal stiffness, Pain, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Supraventricular tachyarrhythmias (narrow), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Olmesartan, escitalopram, atorvastatin, pantoprazole
Current Illness: None
Preexisting Conditions: Hypertension, hyperlipidemia, GERD
Allergies: Amlodipine
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: Patient presents to clinic with complaint of fatigue. Pleasant demeanor and ambulates without assistance. Precordial flutters felt 3-4x/day and he is unable to lay flat or on his left/right side without having difficulty breathing. Began after administration of Covid vaccine 2nd week of August. This lasted for 2 weeks and dissipated. 2nd Covid vaccine September 8th and the flutters returned. EKG completed. Orthopnea: Intermittent dyspnea when in the supine and lateral recumbent position. This started 2-3 days after his second Covid vaccination. Currently not in respiratory distress. Neck stiffness started 3 days ago. Limited movement in neck without pain. Pain 5 on pain scale of 0-10. The pain is constant and relieved with standing. Aggravated with lying supine and lateral recumbent. HA: Pain started while lying supine and increased when he changed position for supine to standing. Pain described as throbbing, squeezing, pressure pain. Pain unrelieved lasting 4 hrs. Normally pt takes Excedrin for HA relief. Heart: EKG completed precordial flutters felt 3-4x/day. Began after administration of Covid vaccine 2nd week of August. This lasted for 2 weeks and dissipated. 2nd Covid vaccine September 8th and the flutters returned. Flutters described as light tapping in the precordial region that is not painful. Numbness and tingling: Bilat upper ext numbness and tingling usually starts in the hands and radiates to forearm. Lower ext bilat tingling and numbess. This started days after 1 Covid vaccine.


VAERS ID: 1737809 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Feeling abnormal, Heart rate increased, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

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

Write-up: After my first dose of the Pfizer vaccination I had problems with my chest and heart beat only a few hours after the initial shot. Along with the normal sore arm, I had chest pain, fast heart rate and trouble breathing. As someone who is very athletic and could run up the stairs on a normal basis, this was extremely abnormal. I could be sitting or laying down completely still, having not done any movement, and these symptoms of rapid heart rate, chest pain, and shortness of breath would return.


VAERS ID: 1738029 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Lethargy, Loss of consciousness, Pallor
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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient lost consciousness for few seconds, sweat, pale, lethargic,


VAERS ID: 1738065 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-03
Onset:2021-09-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain lower, Arthralgia, Blood urine present, Bone pain, Contusion, Culture urine negative, Electrocardiogram abnormal, Headache, Heart rate increased, Hypoaesthesia, Pain, Pain in extremity, Palpitations, Sleep disorder, Spinal pain, Urinary tract inflammation, Urine analysis abnormal
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid Vit D
Current Illness: None
Preexisting Conditions: Hashimoto''s and Celiac disease
Allergies: None
Diagnostic Lab Data: Urine analysis (3times)- 16 Sept, 24 Sept and 25 Sept. All Show blood in urine and sign of inflammation.
CDC Split Type:

Write-up: Started with pain in hips and headache. The pain in the hips developed into pain up and down spine and into base of skull. The headache has not gone away in two weeks. Heart palpitations and speeding heart beat started around 10 September. The pain progressed to its worse on 17 September. All of the above plus heavy lower abdominal pain. Went to Urgent care on 16 September for ekg and urine analysis. The ekg was done three times because first showed abnormalities and they kept moving proves until they got a normal reading. Urine analysis showed blood in urine and inflammation markers. Was put on antibiotics for a uti but was called back to stop antibiotics as the uti culture came back negative. No explanation for blood in urine. 20 September started excruciating pain in right foot, both shins and arms. I would wake up from the pain at night. Over the counter pain medication did not help alleviate pain. Noticed bruises on both arms, legs and right armpit/shoulder blade as well. 23 September - shooting pain from base of skull down both arms. This has been continues until this report on 27 September. 25 September my left thigh went numb for 30 mins. Saw pcp twice more urine analysis and blood work was ordered . Waiting for the results.


VAERS ID: 1738488 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-27
Onset:2021-09-08
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Decreased appetite, Fatigue, Nasal congestion, Oropharyngeal pain, Pain in extremity
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Chest pain, sore throat, nasal congestion, fatigue, sore right arm, loss of appetite. Normal cardiac exam with no friction rub or pain when leaning forward. Treatment included aspirin 81 mg QD and rest., avoid sports. Patient recovered by 9/21/21 (13 days).


VAERS ID: 1740016 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21 / 1 - / OT

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

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

Write-up: Dose administered after exposure to room temperature $g24 hours/administered with the vaccine that was supposed to be thrown away yesterday, 07Sep2021; This spontaneous case was reported by a consumer and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose administered after exposure to room temperature $g24 hours/administered with the vaccine that was supposed to be thrown away yesterday, 07Sep2021) in a 30-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 058E21) for COVID-19 vaccination. No Medical History information was reported. On 08-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose administered after exposure to room temperature $g24 hours/administered with the vaccine that was supposed to be thrown away yesterday, 07Sep2021). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Dose administered after exposure to room temperature $g24 hours/administered with the vaccine that was supposed to be thrown away yesterday, 07Sep2021) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was given by reporter. No treatment medication was given by reporter Most recent FOLLOW-UP information incorporated above includes: On 08-Sep-2021: Added reporter information: first name, last name, occupation, reporter type, address, postal code.added patient detail: Date of birth, pregnancy status no. On 14-Sep-2021: Non-significant follow-up appended; Sender''s Comments: This case concerns 30 -year-old female patient with no medical history, who experienced the unexpected event of Expired product administered. First dose of mRNA-1273, Moderna COVID-19 was administered after exposure to room temperature more than 24 hours. Event seriousness assessed as per Regulatory Authority reporting. The rechallenge was considered unknown. The reporter did not provide a causality assessment. The benefit-risk relationship of mRNA-1273, Moderna COVID-19 Vaccine is not affected by this report.


VAERS ID: 1740017 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-05
Onset:2021-09-08
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Product administration error, Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling, Vaccination site urticaria
SMQs:, Hypersensitivity (narrow), 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: PROLIA; PANTOPRAZOLE; VITAMIN B12 [HYDROXOCOBALAMIN ACETATE]; VITAMIN D [COLECALCIFEROL]; CALCIUM
Current Illness: Allergy (allergic to sulpha-swelling redness pain); Allergy (allergic to several antibiotics-face and neck rash - at time on the trunk and back); Breast cancer (multiple surgeries due to implant rejection-- 4 surgeries); Hives (numerous issues with hives thought the years- giant hives-- cause in determined - treated with steroids); Immunocompromised; Leukopenia (Remains chronic---- in depth invertigation finds no direct cause); Osteoporosis (Prolia stopped due to severe bone and muscle pain 10/01/2020)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Hives; Lump; Redness; Itch that is driving her crazy; Dose did not go into the deltoid muscle, it went into the tissue; This spontaneous case was reported by a nurse (subsequently medically confirmed) and describes the occurrence of MASS (Lump), ERYTHEMA (Redness), PRURITUS (Itch that is driving her crazy), URTICARIA (Hives) and PRODUCT ADMINISTRATION ERROR (Dose did not go into the deltoid muscle, it went into the tissue) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 066D21A, 029K20A and 039K20A) for COVID-19 vaccination. The patient''s past medical history included Hives (numerous issues with hives thought the years- giant hives-- cause in determined - treated with steroids) since 10-Jan-1990, Breast cancer (multiple surgeries due to implant rejection-- 4 surgeries) since 12-Jan-2016, Osteoporosis (Prolia stopped due to severe bone and muscle pain 10/01/2020) since 15-Feb-2005 and Leukopenia (Remains chronic---- in depth invertigation finds no direct cause) since 10-Mar-2000. Concurrent medical conditions included Immunocompromised, Allergy (allergic to several antibiotics-face and neck rash - at time on the trunk and back) since 10-Jan-1980 and Allergy (allergic to sulpha-swelling redness pain) since 15-Jan-1990. Concomitant products included DENOSUMAB (PROLIA) from 15-Feb-2005 to 01-Oct-2020 for Osteoarthritis NOS, PANTOPRAZOLE from 15-Jan-2021 to an unknown date, HYDROXOCOBALAMIN ACETATE (VITAMIN B12 [HYDROXOCOBALAMIN ACETATE]) from 01-Jun-1995 to an unknown date, COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) from 06-May-2006 to an unknown date and CALCIUM from 01-Jun-2006 to an unknown date for an unknown indication. On 05-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Subcutaneous) dosage was changed to 1 dosage form. On 08-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PRODUCT ADMINISTRATION ERROR (Dose did not go into the deltoid muscle, it went into the tissue). On 09-Sep-2021, the patient experienced MASS (Lump), ERYTHEMA (Redness) and PRURITUS (Itch that is driving her crazy). On an unknown date, the patient experienced URTICARIA (Hives). At the time of the report, MASS (Lump), ERYTHEMA (Redness), PRURITUS (Itch that is driving her crazy) and URTICARIA (Hives) outcome was unknown and PRODUCT ADMINISTRATION ERROR (Dose did not go into the deltoid muscle, it went into the tissue) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. treatment medication includes steroids Most recent FOLLOW-UP information incorporated above includes: On 15-Sep-2021: Follow-up received includes- Patient route of administration-Subcutaneous tissue On 16-Sep-2021: ADR Received on 16 Sep 2021,include Patient details, Medical History and concomitants mediations added


VAERS ID: 1740152 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-21
Onset:2021-09-08
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: ADHD (Other medical history: ADHD, depression, seasonal allergies); Depression (Other medical history: ADHD, depression, seasonal allergies); Seasonal allergy (Other medical history: ADHD, depression, seasonal allergies)
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: Nasal Swab; Test Result: Positive ; Comments: covid test type post vaccination=Nasal Swab, covid test name post vaccination=R apid Antigen Test
CDC Split Type: USPFIZER INC202101197804

Write-up: I had a breakthrough case of Covid-19. I was exposed on Sunday 05Sep2021 and noticeable symptoms began on Wednesday 08Sep2021.; I had a breakthrough case of Covid-19. I was exposed on Sunday 05Sep2021 and noticeable symptoms began on Wednesday 08Sep2021.; This is a spontaneous report from a contactable consumer. A 32-year-old non-pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: ER8736), via an unspecified route of administration, administered in left arm as dose 2, single on 21Apr2021 (at the age of 31-year-old) for covid-19 immunisation and first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: EP7533), via an unspecified route of administration, administered in left arm as dose 1, single on 30Mar2021 (at the age of 31-year-old) for covid-19 immunisation. Facility type vaccine was Pharmacy or Drug Store. Medical history included attention deficit hyperactivity disorder (ADHD), depression, seasonal allergies all from an unknown date and unknown if ongoing and no known allergies. Concomitant medications included cetirizine hydrochloride (ZYRTEC); fluticasone propionate (FLONASE) and bupropion hydrochloride (WELLBUTRIN) at 300 mg all taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine and received other medications within 2 weeks: wellbutrin XR 300mg, Zyrtec (OTC) and Flonase. Patient was not pregnant at the time of vaccination. As reported, the patient had a breakthrough case of Covid-19 and was exposed on 05Sep2021 (at the time of the report on Sunday) with noticeable symptoms began on 08Sep2021 (at the time of the report on Wednesday). Symptoms included nasal congestion, sinus pressure, mild chest congestion, and aches in the neck and shoulders. All the adverse events resulted in doctor or other healthcare professional office/clinic visit. The patient underwent lab tests and procedures which included SARS-COV-2 test: via Nasal Swab (Rapid Antigen Test) resulted positive on 10Sep2021. Therapeutic measures were taken as a result of OTC nasal and chest decongestants. At the time of this report, the outcome of all events was recovering. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1740962 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Chest X-ray, Chills, Decreased appetite, Diarrhoea, Electrocardiogram, Extra dose administered, Fatigue, Headache, Impaired work ability, Influenza virus test, Nausea, Pain, Pneumonia bacterial, Pyrexia, SARS-CoV-2 test negative, Staphylococcus test, Ultrasound Doppler, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid, Humira, Lexapro
Current Illness: None
Preexisting Conditions: Ulcerative Colitis w/o complications, anxiety, hypothyroidism
Allergies: None
Diagnostic Lab Data: EKG, chest x ray, 9/12 saline IV, 9/12 - 9/15 IV antibiotics, 9/12 - 9/15 daily blood draws, 9/12 - 9/15 NEGATIVE covid, flu, MRSA test, 9/12 ultrasound for blood clots, 9/13 blood thinners, 9/13 - 9/15 at home antibiotics 9/16
CDC Split Type:

Write-up: Had no issues with shots 1 and 2 I received 3/2021. Received shot 3 (booster) 9/8/21. Felt normal all day 9/8. Woke up 9/9 with severe body ache, headache, fever (close to 102 F), chills. Missed work 9/9. Did not improve despite rest, fluids and tylenol. Woke up on 9/10 even worse. Fever was over 102. Same symptoms from day before but they were worse. 9/11, fever was well into 102 F range. Had same symptoms, but also had nausea, vomiting, diarrhea, fatigue and loss of appetite. Fever was between 102 and 103. On 9/12, went to hospital. Had fever close to 104. Admitted to hospital and spent three nights. Was diagnosed with bacterial pneumonia, cause unknown. Not sure if related to covid shot. Dr''s were unsure if shot caused infection, or if infection was already present and the shot temporarily lowered my immune system.


VAERS ID: 1741343 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-06
Onset:2021-09-08
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Endotracheal intubation, Gastrointestinal haemorrhage, Haemorrhage, Liver disorder, Malaise, Respiratory disorder
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Ischaemic colitis (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Carvedilol, ondansetron ODT, dulaglutide, glipizide, rosuvastatin, olmesartan, clonidine, tamsulosin, amlodipine, apixaban, sildenafil, spironolactone, ergocalciferol
Current Illness: None
Preexisting Conditions: Atrial fibrillation Class 2 obesity CPAP dependence Essential hypertension Liver cancer Type 2 diabetes
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received both vaccine doses in early 2020. On 9/8/2021 patient presented with symptoms of COVID-19 and a GI bleed. Patient was eventually intubated during hospital admission more for bleeding issues than respiratory issues. Patient needed multiple trips to IR to fix bleeding. Patient was ultimately transferred on 9/28/2021 from our facility to another hospital. Patient has been waiting for liver transplant for awhile and because of continued bleeding transferred to a higher level of care for hepatobiliary surgery.


VAERS ID: 1741441 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Inconsistent chest pressure. Slight difficulty breathing.


VAERS ID: 1741586 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Blood pressure increased, Blood test, Chest pain, Dizziness, Dyspepsia, Dyspnoea, Electrocardiogram, Fatigue, Insomnia, Myalgia, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), 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), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Ibuprofen
Current Illness: N/A
Preexisting Conditions: Hypertension, UVEITIS Eye disease
Allergies: N/A
Diagnostic Lab Data: 9/10/2021 and 9/17/2021
CDC Split Type:

Write-up: Within 2 hours of receiving the vaccine my blood pressure increased to 187/97. I couldn''t sleep overnight due to difficulty breathing. The next day I went to work and felt dizziness, weakness, muscle pain, tiredness and joint pain. The same symptoms the next 1/2 day followed by chest pain, shortness of breath. Feeling of having a fast-beating, heartburn and pounding heart. Around 4.30 PM I have called Dr.''s office asking for advice. I was advised to take Tylenol and Ibuprofen and if the symptoms persist to go to ER. Around 6.00 PM I went to ER and was checked having blood work and EKG. I was released 4 hours later and followed up a week after. At the time of visit I was checked up and had blood work again. I was advised to go again for more testing since I still had difficulty breathing.


VAERS ID: 1741645 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / IM

Administered by: Private       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: XYZAL, PATADAY, ALBUTEROL NEB SOLN., ZITHROMAX,MEDROL DOSE PAK, PROMETHAZINE DM, ALBUTEROL INH, TRIAMCINOLONE
Current Illness: PATIENT HAD COVID, AND RECEIVED MONOCLONAL INFUSION ON 08/16/2021, SOONER THAN THE 90 DAY RECOMMENDED TIME INTERVAL FOR VACCINATION
Preexisting Conditions: OBESE
Allergies: CIPRO
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT WAS GIVEN THE COVID VACCINE TOO SOON AFTER RECEIVING MONOCLONAL INFUSION


VAERS ID: 1741747 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-05
Onset:2021-09-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Raynaud's phenomenon, Superficial vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: worsening raynauds, superficial thrombosis


VAERS ID: 1741801 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-01
Onset:2021-09-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

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

Write-up: 1 week after vaccination, started to have pain in the middle of chest for a few days.


VAERS ID: 1741932 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F218 / 3 LA / IM
FLUA4: INFLUENZA (SEASONAL) (FLUAD QUADRIVALENT) / SEQIRUS, INC. - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood electrolytes decreased, Blood potassium decreased, Blood sodium decreased, Cystocele, Dysstasia, Incontinence, Mobility decreased, Rectocele
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Hypokalaemia (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: gabapentin, duloxetine, losartan ,simvastatin, zolpidem, Caltrate, oxycodone
Current Illness:
Preexisting Conditions: osteo Arthritis advanced ,Fibromyalgia, bladder issues ,SVT, acute vasculitis , Copd ,Back problems
Allergies: antibiotics penicillin cephalon sporins sulfa blood thinner
Diagnostic Lab Data: 2 ER visits. Electrolytes, Sodium and potassium very low
CDC Split Type:

Write-up: Trouble standing , trouble using arms and leg . possible Guillain Barre. Cystocele went in and Retocele appaered. incontience


VAERS ID: 1742387 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-24
Onset:2021-09-08
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Back pain, Laboratory test abnormal, Pain in extremity, Stent placement, Thrombectomy, Thrombosis
SMQs:, Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: birth control
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Transfer of three hospitals to meet patient needs. Labs - thrombectomy - stents placement - lifetime medication
CDC Split Type:

Write-up: Paint to back and leg - Showered blood clots - result hospitalization with continuous heparin drip - daily thrombectomy- stents placed - on Xarelto for lifetime


VAERS ID: 1744137 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Headache, Nodule
SMQs:

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: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme headache when laying down to go to sleep. Large knot popped up on right side of face in front of right ear just below right temple.


VAERS ID: 1744395 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Headache, Impaired work ability, Pain
SMQs:, Dementia (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: Full body aches, extreme fatigue, chills, head ache, had to leave work early, felt "horrible" for 2 days, around 48 hours


VAERS ID: 1744648 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Migraine, Sleep disorder
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: Mobic 15 mg, Potassium CL ER 10 MEQ capsule, Furosemide
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Gabapentin, Penicillins, Promethazine, Tramadol, Zolpidem Tartrate
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed a severe migraine, patient has had the migraine every day since the injection of the vaccine. Also patient has had trouble sleeping since the injection of the vaccine.


VAERS ID: 1745273 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FP8448 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Bursitis, Impaired work ability, Joint range of motion decreased, Movement disorder
SMQs:, Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Inability to move arm day after administration, missed one day of work, shoulder pain with certain movements, limited range of motion, diagnosed by occupational health doctor with subacromial bursitis of left shoulder joint.


VAERS ID: 1745290 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Fatigue, Musculoskeletal stiffness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad)

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

Write-up: Patient received his first dose of Pfizer Covid 19 on 9/7/21. The next day he started experiencing nausea and fatigue. He contacted the pharmacy after speaking to his primary care doctor. After 2 weeks of experiencing nausea, fatigue, lightheadedness, and chills with no fever, he went to urgent care. At that time, he was told try to get more rest. After 3 weeks with no changes, he saw his primary care doctor. He has also complained of the back of his neck feeling stiff and shoulders feeling weak. His primary care physician has prescribed steroids at this time. She recommended he notify us so we could report.


VAERS ID: 1745333 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: got weaker day by day, nausea, diarrhea


VAERS ID: 1746202 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort
SMQs:, Anaphylactic reaction (broad)

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

Write-up: Per client he experienced chest pressure 4hrs after receiving vaccine that lasted 4hrs. Per client no shortness of breath during this time, did not take medication, and did not seek medical help.


VAERS ID: 1747713 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / OT

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

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

Write-up: administered with expired vaccine; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (administered with expired vaccine) in a 49-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. No Medical History information was reported. On 08-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 ml. On 08-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (administered with expired vaccine). On 08-Sep-2021, EXPIRED PRODUCT ADMINISTERED (administered with expired vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment medications were provided. This case was linked to MOD-2021-314567, MOD-2021-314793, MOD-2021-314468, MOD-2021-314545, MOD-2021-314540, MOD-2021-314570, MOD-2021-314517, MOD21-141641, MOD21-141642, MOD-2021-314555, MOD-2021-314573, MOD-2021-314805, MOD-2021-314810, MOD-2021-314573 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 15-Sep-2021: Follow-up information included no new information On 15-Sep-2021: Follow up information contains no new information.


VAERS ID: 1747749 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

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

Write-up: Severe chest pains. Started at 9:00a, lasting until 7:30-8:00p. Pain came in waves, high pain waves followed by aches.


VAERS ID: 1747764 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-11
Onset:2021-09-08
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 9399D2 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Eye pain, Fatigue, Feeling abnormal, Flushing, Hypoaesthesia, Muscular weakness, Musculoskeletal stiffness, Oral discomfort, Pain, Pain in jaw, Pyrexia, Tinnitus, Yawning
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hearing impairment (narrow), Osteonecrosis (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (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; LEXAPRO
Current Illness:
Preexisting Conditions: Comments: The medical history was not provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: yawning so much (over 50 times) her jaw hurt; yawning so much (over 50 times) her jaw hurt; mouth would open so wide it was like a monster coming out; body would get tight it wanted to stretch and then everything would release; whole body pain; feel worse/this vaccine ruined my life; her eyes hurt their sockets; ear ringing as I talk to you; legs felt numb and weird,arms felt numb and weird; body was radiating heat; worst chills she has ever had; exhausted; whole body started flushing (~2min after injection); legs felt weak; This spontaneous case was reported by a patient and describes the occurrence of FLUSHING (whole body started flushing (~2min after injection)), MUSCULAR WEAKNESS (legs felt weak), YAWNING (yawning so much (over 50 times) her jaw hurt), PAIN IN JAW (yawning so much (over 50 times) her jaw hurt) and ORAL DISCOMFORT (mouth would open so wide it was like a monster coming out) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 85DE21A and 9399D2) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The medical history was not provided by the reporter. Concomitant products included THYROID and ESCITALOPRAM OXALATE (LEXAPRO) for an unknown indication. On 11-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Other) dosage was changed to 1 dosage form. On 08-Sep-2021, the patient experienced FLUSHING (whole body started flushing (~2min after injection)) and MUSCULAR WEAKNESS (legs felt weak). On an unknown date, the patient experienced YAWNING (yawning so much (over 50 times) her jaw hurt), PAIN IN JAW (yawning so much (over 50 times) her jaw hurt), ORAL DISCOMFORT (mouth would open so wide it was like a monster coming out), MUSCULOSKELETAL STIFFNESS (body would get tight it wanted to stretch and then everything would release), PAIN (whole body pain), FEELING ABNORMAL (feel worse/this vaccine ruined my life), EYE PAIN (her eyes hurt their sockets), TINNITUS (ear ringing as I talk to you), HYPOAESTHESIA (legs felt numb and weird,arms felt numb and weird), PYREXIA (body was radiating heat), CHILLS (worst chills she has ever had) and FATIGUE (exhausted). On 10-Sep-2021, PYREXIA (body was radiating heat) had resolved. At the time of the report, FLUSHING (whole body started flushing (~2min after injection)), MUSCULAR WEAKNESS (legs felt weak), YAWNING (yawning so much (over 50 times) her jaw hurt), PAIN IN JAW (yawning so much (over 50 times) her jaw hurt), ORAL DISCOMFORT (mouth would open so wide it was like a monster coming out), MUSCULOSKELETAL STIFFNESS (body would get tight it wanted to stretch and then everything would release), PAIN (whole body pain), FEELING ABNORMAL (feel worse/this vaccine ruined my life), EYE PAIN (her eyes hurt their sockets), TINNITUS (ear ringing as I talk to you), HYPOAESTHESIA (legs felt numb and weird,arms felt numb and weird), CHILLS (worst chills she has ever had) and FATIGUE (exhausted) outcome was unknown. No treatment medication was reported This case was linked to MOD-2021-325400 (Patient Link).


VAERS ID: 1749406 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Musculoskeletal discomfort, Restless legs syndrome, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (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: Hepatitis B, projectile vomiting
Other Medications: Sertraline, Vitamin D,
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Was given my first shot in the series of 2 on 9/7/21 in my left arm. Went home and did some light cleaning around my house. That night or the next night, I can?t remember I started getting restless legs. I could not go to sleep. My legs would not let me relax. It sometimes gets so bad it goes up into my back.


VAERS ID: 1749517 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: chest congestion/tightness, nonproductive cough, shortness of breath


VAERS ID: 1749635 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-03
Onset:2021-09-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Ultrasound antenatal screen abnormal
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (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: Prenatal, Compound Thyroid, Vitamin D, Omega 3
Current Illness: N/A
Preexisting Conditions: Auto-Immune Thyroid
Allergies:
Diagnostic Lab Data: I had an ultrasound on 9/10/21 that confirmed my baby was no longer growing.
CDC Split Type:

Write-up: I started cramping and when the ultrasound was done on September 10 2021, I measured 5 weeks 2 days and I should have been 6 weeks 2 days. My baby stopped growing the day I received the second vaccination, which then resulted in a miscarriage.


VAERS ID: 1749793 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE 3592 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Mouth swelling, Pruritus, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Hives, swollen face and mouth, puritis, urticaria. Treatment was Benadryl, famotidine, prednisone (deltasone)


VAERS ID: 1749918 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site paraesthesia, Joint swelling, Loss of personal independence in daily activities, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: MMR, around 18 months of age or so
Other Medications: none
Current Illness: UTI the month before but had cleared up and no meds at the time
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: About 30-40 minutes later after the vaccine, she was feeling tingling and nerve stimulation in her left arm. Later, her knee began hurting and swelling but we thought it was unrelated since she had hurt her knee in gymnastics the day before. I gave her Tylenol and Claritin just in case. She started having some joint pain a few hours later and then some hives/redness formed around the knee. I gave her 25 mg Benadryl. Around 7pm, all of her joints starting swelling, including wrists, ankles, and her ring finger which was odd to us. Later on, her wrists, hands, fingers, ankles, and knees increased in swelling and pain. I gave her more Benadryl, Pepcid AC, and some Aleve. The next day she broke out in hives all over her body except for her face. She had some hives on her right ear and neck also. She missed school. The joint swelling lasted throughout the day and finally subsided late that night along with the pain. The hives for the most part disappeared and reappeared in the next day briefly, then were gone. She did completely recover.


VAERS ID: 1750017 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

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

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

Write-up: Pt felt dizzy post vaccine, Vital signs were BP 117/66, Po2 98%, Pulse 106and finger stick 101. Patient was observed by medical staff as per protocol.


VAERS ID: 1750057 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-30
Onset:2021-09-08
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anosmia, Back pain, COVID-19, Cough, Dyspnoea, Fatigue, Nausea, Oropharyngeal pain, Paranasal sinus discomfort, Pyrexia, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: food allergies - dairy and nuts
Diagnostic Lab Data: COVID test - CVS urgent department - walk in - Sept 9th. I think I went to that on Monday and the PCP on Tuesday. COVID test 14th - positive result
CDC Split Type: vsafe

Write-up: I had a really severe sore throat and a lot of sinus pressure. I had a super low fever for only a day or two. I lost my sense of smell. I had really, really bad back pain. A little bit nauseous, cough and some shortness of breath. I had a lot of fatigue and still feel really fatigued. I initially tested negative for COVID - I had gotten an antibiotic thinking a strep throat and a sinus infection. But I wasn''t getting better, so 3 or 4 days after that, I went to doctor my PCP - because of my cough - I couldn''t sleep at night because of it. He retested me for COVID and I tested positive for COVID. He gave me a cough syrup to address the cough. He said I wasn''t eligible for the infusion. I still have some symptoms but I''m definitely better. I still have a cough and shortness of breath. I am just starting to get sense of smell back and I feel very fatigued still.


VAERS ID: 1750117 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Heart rate increased, Hypoaesthesia, Hypoaesthesia oral, Neck pain, Paraesthesia, Peripheral coldness, Speech disorder, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: EMGEL and ELIDEL topical
Current Illness:
Preexisting Conditions:
Allergies: Propranolol
Diagnostic Lab Data: O@ sat 100% at urgent care, HR normal
CDC Split Type:

Write-up: Within 5 minutes dizziness, right arm numb extend to digits, cold arm, then progressed to left arm, As walked to car perioral numbness and on tongue, Went to urgent care - Dizzy, head under water feel, Speech not making sense, lateral neck pain, sense of increased heart rate, tongue felt swollen, O2 100%, Treated with benadryl and felt better within 15 min., Legs tingly the next day with some dizziness and arm symptoms resolved after 2 days.


VAERS ID: 1750189 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

Write-up: lump nods under arm swollen and sore left side of chest sore for 3 weeks


VAERS ID: 1750512 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-20
Onset:2021-09-08
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Cardiac stress test
SMQs:, Other ischaemic heart disease (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: I have had Stress Tests multiple times.
CDC Split Type:

Write-up: Later that night I got a pain in my heart that lasted 20 minutes.


VAERS ID: 1751878 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / UNK RA / OT

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

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

Write-up: Dose given past the 12 hour post puncture time; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 22-Sep-2021 and was forwarded to Moderna on 22-Sep-2021. This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose given past the 12 hour post puncture time) in a 21-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. No Medical History information was reported. On 08-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose given past the 12 hour post puncture time). On 08-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Dose given past the 12 hour post puncture time) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication details was reported. No treatment medication details was reported. This case was linked to MOD-2021-327879.


VAERS ID: 1752015 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Limb discomfort, Lung disorder, Lymphadenopathy, Movement disorder, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (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), 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: Pfizer, Inc. EUA 027034
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101182554

Write-up: Right Axillary Lymphadenopathy; Difficulties raising right arm above the head with associated swelling discomfort; Difficulties raising right arm above the head with associated swelling discomfort and difficulty expanding the lungs to breath and; Difficulties raising right arm above the head with associated swelling discomfort; difficulty expanding the lungs to breath; difficulty expanding the lungs to breath; right side chest discomfort; This is a spontaneous report from a contactable other hcp. A 41-years-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for Injection, Batch/Lot number: FF2589), via an unspecified route of administration, administered in Arm Right on 07Sep2021 13:30 as DOSE 2, SINGLE (at the age of 41-year-old) for covid-19 immunisation. Medical history included hypothyroidism. Concomitant medications included levothyroxine sodium (SYNTHROID). The patient previously took avelox and experienced drug hypersensitivity, biaxin and experienced drug hypersensitivity, bnt162b2 for covid-19 immunisation. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient received dose 1 of bnt162b2 on 10Aug2021 03:30pm, Lot number: EW987. On 08Sep2021 02:15, the patient experienced right axillary lymphadenopathy within 13h of vaccine administration, difficulties raising right arm above the head with associated swelling discomfort and difficulty expanding the lungs to breath and right side chest discomfort. AE resulted in doctor or other healthcare professional office/clinic visit. The patient did not received any treatment for the events. The outcome of the events was not resolved. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1752066 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-09-08
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dust allergy; Hyperlipidemia; Mite allergy; Shellfish allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101225588

Write-up: Bell''s Palsy left face; This is a spontaneous report from a contactable physician. A 50-year-Old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (Lot number and expiration date was not reported) as dose 2, single, and via an unspecified route of administration on an unspecified date (Lot number and expiration date was not reported) as dose 1, single for COVID-19 immunization. Medical history included hyperlipidaemia, dust mites allergy, shrimp allergy. The patient''s concomitant medications were not reported. The patient did not receive any other vaccine within 4 weeks prior to COVID vaccine. The patient experienced Bell''s palsy left face on 08Sep2021. The event resulted in emergency room/physician''s office visit. The patient received treatment with prednisone and valacyclovir. The outcome of event was not recovered. Information on lot/batch number has been requested.; Sender''s Comments: Considering the temporal association, a causal association between administration of bnt162b2 and the onset of Bell''s palsy left face cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1752157 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gout
SMQs:, Arthritis (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: IBUPROFEN; EMERGEN C.
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Gout flare (Have had 1 gout flare up the month prior.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101240914

Write-up: Gout flare; This is a spontaneous report from a contactable consumer, the patient. A 35-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3182) via an unspecified route of administration in the right arm on 08Sep2021 at 12:45 (at the age of 35-years-old) as a single dose for COVID-19 immunisation. Medical history included gout flare on an unspecified date in Aug2021 (reported as had 1 gout flare up the month prior). Concomitant medications included ibuprofen (MANUFACTURER UNKNOWN) and ascorbic acid, calcium carbonate, calcium pantothenate, calcium phosphate, chromium, cyanocobalamin, folic acid, magnesium carbonate, magnesium hydroxide, manganese gluconate, nicotinic acid, potassium bicarbonate, potassium carbonate, potassium phosphate dibasic, pyridoxine hydrochloride, quercetin, riboflavin sodium phosphate, sodium bicarbonate, sodium phosphate, thiamine hydrochloride, thioctic acid, zinc ascorbate (EMERGEN-C); both for unknown indications from an unknown date and unknown if ongoing. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 08Sep2021 at 17:00, (also reported as approximately 3 hours after 1st dose of the vaccine), the patient had a gout flare and noticed the left toe joint in his foot began to swell and turn red. He stated that he had 1 gout flare up the month prior and he was sure that it was another flare up happened. The next day he could hardly put pressure on the joint and it was very painful, which lasted about 4 days. Reportedly, it was during a low purine diet period, being active and usually that happens after alcohol or unhealthy food intake. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event gout flare was resolved on an unspecified date in 12Sep2021.


VAERS ID: 1753369 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood magnesium, Blood thyroid stimulating hormone, COVID-19, Dizziness, Dyspnoea, Feeling abnormal, Full blood count normal, Hypoaesthesia, Immediate post-injection reaction, Metabolic function test, Palpitations, Paraesthesia, SARS-CoV-2 test positive, Sensory disturbance, Ultrasound Doppler, Urine analysis, White blood cell count, White blood cell count abnormal
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Progesterone contraceptive implant
Current Illness: Red left eye
Preexisting Conditions: Recurrent yeast infections
Allergies: Barley, Gluten, other foods
Diagnostic Lab Data: COVID 19 (+) 9/14/21 --- Emergency Room - 9/24 urinalysis positive, 1 hyaline cast, WBC clumps, small bacteria, moderate leukocyte, moderate blood, hazy appearance Normal CBC, CMP, Mg, TSH Lower extremity venous doppler normal, no DVT.
CDC Split Type:

Write-up: 20 yo female had first Pfizer off which is reflected in database. A minute after she began have heart palpitations. Then she began fighting for air. Immediately felt her hands and arms were like foot falls asleep numb, tingling. Nurse had her wait and she stayed about 45 minutes due to 130s heart rate. Eventually did improve and cleared to work but thought she might pass out so sent home. On the 9th awoke but didn''t feel good and felt like she ran a mile, out of breath. Nurse advice line sent her to the ER. Sense that heart was twitching even in her leg beating through her skin ''weirdest thing.'' Reports no prior anxiety toward the vaccination. Her heart rate was 180 in the ER. Multiple ER visits since then. First vaccine was at another clinic.


VAERS ID: 1753413 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Headache, Injection site discomfort, Injection site pain, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (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: severe discomfort/pain from the shot area all the way up to the neck/head on the left side lasting several days. slight chest pain (2x). headache for 1-2 days.


VAERS ID: 1753868 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041AZ1A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Contusion, Hypoaesthesia, Immediate post-injection reaction, Injection site pain, Limb discomfort, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Sexual dysfunction (broad)

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

Write-up: Immediately after the shot, I experienced discomfort in my left arm. The discomfort continued to increase over time. It began to feel like a bruise from receiving a blow to my arm. Now, I feel pain that extends from the injection site up, down, and around my arm. Sometimes I feel a numbness or tingling. Symptoms have worsened rather than dissipating. I have never had this issue after other vaccines.


VAERS ID: 1753935 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-13
Onset:2021-09-08
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cycle threshold 26.1 on admission.
CDC Split Type:

Write-up: Patient admitted to the hospital for COVID 19. Reporting per Janssen COVID vaccine EUA.


VAERS ID: 1754216 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Diplopia, Fatigue, Myalgia, Vomiting, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Ocular motility disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot, (20+yrs ago) flu-like symptoms
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of Moderna 09/08/2021, started experiencing symptoms of vomiting, muscle aches, loss of appetite, loose stool, double vision, and extreme fatigue. (Lost 9lbs in 4 days) Primary communications ER visit treated with Zofran. Primary visit 09/13/2021. Still continuing to experience symptoms.


VAERS ID: 1754240 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-06
Onset:2021-09-08
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Parosmia
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: basaglar, zetia, enalapril, aspirin, allopurinol, tramadol, glyb-metformin, metoprolol succinate
Current Illness:
Preexisting Conditions: Type 2 Diabetes
Allergies: sulfa drugs, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: He continually smells burning oil after the second shot


VAERS ID: 1754303 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-16
Onset:2021-09-08
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 RA / IM

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

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

Write-up: Breakthrough COVID after full vaccination


VAERS ID: 1754755 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-03
Onset:2021-09-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Headache, Musculoskeletal stiffness, Neck pain
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin Vitamin D Probiotic Vitamin B
Current Illness: Tonsillitis in July 2021
Preexisting Conditions: None
Allergies: Dairy Yeast Soy Gluten Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Persistent headache - Going on 4 weeks Chest pain and tightness - Intermittent and still occurring Neck pain and stiffness - Newly developed at 4 weeks


VAERS ID: 1755744 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-09-08
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Headache
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211000435

Write-up: STOMACH UPSET; CHILLS; HEADACHE; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 08-SEP-2021 09:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 08-SEP-2021, the patient experienced stomach upset. On 08-SEP-2021, the patient experienced chills. On 08-SEP-2021, the patient experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from headache, stomach upset, and chills. This report was non-serious.


VAERS ID: 1755758 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:0000-00-00
Onset:2021-09-08
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Alopecia, Body temperature, Chest pain, Chills, Decreased appetite, Dizziness, Eczema, Electrocardiogram, Feeling of body temperature change, Fungal infection, Migraine, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Food allergy; Penicillin allergy
Preexisting Conditions: Comments: The patient was very healthy, never had any health issues.
Allergies:
Diagnostic Lab Data: Test Date: 20210908; Test Name: Body temperature; Result Unstructured Data: 105.0 F; Test Date: 20210911; Test Name: Electrocardiogram; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20211001154

Write-up: A TYPICAL YEAST INFECTION; HAIR STARTED TO FALL OUT IN THE SHOWER AND WITH BRUSHING; ECZEMA ON BOTH HANDS AND ARMS; HEADACHES ON/OFF LIKE MIGRAINES; CHEST PAIN; LOST APPETITE COMPLETELY AND READY TO PASS OUT FROM HUNGER/NOT EATING.; LIGHTHEADED; EXTREME CHILLS; FEVER; HOT/COLD SENSATIONS; This spontaneous report received from a patient concerned a 44 year old female. The patient''s weight was 196 pounds, and height was 66 inches. The patient''s concurrent conditions included: sesame seeds allergy, and penicillin allergy, and other pre-existing medical conditions included: The patient was very healthy, never had any health issues. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A expiry: 21-SEP-2021) dose was not reported, administered on 07-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-SEP-2021, the patient experienced hot/cold sensations. On 08-SEP-2021, the patient experienced extreme chills. On 08-SEP-2021, the patient experienced fever. Laboratory data included: Body temperature (NR: not provided) 105.0 F. On 09-SEP-2021, the patient experienced lost appetite completely and ready to pass out from hunger/not eating. On 09-SEP-2021, the patient experienced lightheaded. On 10-SEP-2021, the patient experienced chest pain. On 11-SEP-2021, the patient experienced eczema on both hands and arms. On 11-SEP-2021, the patient experienced headaches on/off like migraines. Laboratory data included: Electrocardiogram (NR: not provided) Normal. On 18-SEP-2021, the patient experienced hair started to fall out in the shower and with brushing. On 19-SEP-2021, the patient experienced a typical yeast infection. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chest pain, hot/cold sensations, extreme chills, and fever on SEP-2021, was recovering from eczema on both hands and arms, and a typical yeast infection, had not recovered from hair started to fall out in the shower and with brushing, and the outcome of lost appetite completely and ready to pass out from hunger/not eating., headaches on/off like migraines and lightheaded was not reported. This report was non-serious. This case, from the same reporter is linked to 20211000473.


VAERS ID: 1756084 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Balance disorder, Immunisation, Nausea, Off label use
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Crohn''s (have CROHNS for 52 years.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101240845

Write-up: balance problems where I have to hold on to walls, door knobs, or any fixed item; nausea; I my THIRD Booster Covid Vaccine; I my THIRD Booster Covid Vaccine; the shoulder was sore; This is a spontaneous report from a contactable consumer (patient) via Pfizer. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration, administered in left arm on 08Sep2021 (Lot number was not reported) as dose 3 (booster), single for covid-19 immunisation. Medical history included crohn''s disease for 52 years. The patient''s concomitant medications were not reported. Immediately after third booster covid vaccine on 08Sep2021, patient''s left arm at the shoulder was sore and no problem. But, after 5 days on 13Sep2021 and continuing to date of 19Sep2021, when patient got up in the morning (slowly), patient had balance problems where patient had to hold on to walls, doorknobs, or any fixed item to hold on to, to get to the bathroom. At the same time, patient had bad nausea which continues for hours, or until a 20mg Nausea Pill was taken as a treatment. The outcome of all events was unknown. The lot number for BNT162B2 was not provided and will be requested during follow up.


VAERS ID: 1756894 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Eye pain, Fear, Headache, Photophobia, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dietary supplements: Vitamins B Complex, C, E, Purity Gold Pack, Biotin, MSM Chondroitin, Turmeric Prolia Injections twice yearly
Current Illness: None
Preexisting Conditions: None known other than osteopenia/osteoporosis
Allergies: Sulfonamides Zithromax Dosepak Clindamycin
Diagnostic Lab Data: On September 14th I was scheduled with Optometrist, OD, on referral from my Opthalmologist. Routine visual tests were completed and Dr. sent me back to the office of Opthalmologist for further testing of visual fields. All tests were reported to be normal. The eye aches behind my eyes with extreme light sensitivity and also headaches have persisted since this event and are not previously experienced by me.
CDC Split Type:

Write-up: The morning after the CoVid Moderna injection at 8:30 I was sitting in room at home and at one point when I blinked my eyes, I could see nothing but dark gray. I closed my eyes and repeated, nothing but gray. No sight. I did this numerous times breathing deeply for 20-30" approximately between eye opening. This continued for approximately 6 minutes. The experience was terrifying. At one point, I opened my eyes and my sight was returning. I lay down and slept for approximately 3 hours. I had eye aches and significant headaches following this event which were new and sought the advice of an Optometrist since I could not get an appointment with my ophthalmologist for weeks.


VAERS ID: 1756956 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-18
Onset:2021-09-08
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19 pneumonia, Dyspnoea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (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? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Came to the emergency room with shortness of breath. and was diagnosed with COVID-19 pneumonia. Then patient was started on remdesivir and steroids. Patient started feeling better and patient started breathing on room air. Patient also had acute kidney injury that was also resolved. Since patient was stable enough, patient was discharged home on dexamethasone.


VAERS ID: 1756961 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-22
Onset:2021-09-08
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary normal, COVID-19 pneumonia, Chills, Echocardiogram, Ejection fraction decreased, Fibrin D dimer increased, Headache, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (narrow), Angioedema (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Came to the emergency room with a headache, fever, and chills and was diagnosed with COVID-19 pneumonia. Patient was started on remdesivir and steroids. Patient was breathing on room air. Since the patient completed remdesevir course, the patient is feeling better. Patient also has a positive D-dimer, probably secondary to COVID-19 pneumonia. CTA chest was negative for PE. There was a question of CHF. Echo shows EF of 55% to 60% and left systolic function normal. Patient had a complaint of lower extremity swelling. The patient was given oral Lasix, also given 1 dose of IV Lasix. The lower extremity swelling resolved. Since patient was stable enough, patient was discharged to a group home.


VAERS ID: 1756996 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Glossitis, Glossodynia, Lymphadenopathy, Muscle spasms, Myalgia, Oral pain, Soft tissue swelling, Swollen tongue
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: One A Day Women''s
Current Illness: No Acute or Chronic medical conditions
Preexisting Conditions: none
Allergies: No Known Drug Allergies
Diagnostic Lab Data: I reported these symptoms to my occupational health office the very next morning with no support or advice.
CDC Split Type:

Write-up: Swollen neck glands, entire soft tissue under my tongue/lingual frenulum was swollen, tender and inflamed, muscle aches/cramps, joint pain. Only the mouth and glands have resolved to date, the other symptoms still persist today. I have NEVER had these symptoms before and am not being treated for any medical conditions.


VAERS ID: 1757079 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF3319 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blood test, Cholecystitis, Computerised tomogram, Guillain-Barre syndrome, Hypoaesthesia, Immunoglobulin therapy, Intensive care, Lumbar puncture abnormal, Magnetic resonance imaging head, Magnetic resonance imaging spinal, Muscular weakness, Musculoskeletal disorder, Pain, Ultrasound scan, Urinary incontinence, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Infectious biliary disorders (narrow), Gallbladder related disorders (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Microgestin 1/20
Current Illness: None, fully healthy
Preexisting Conditions: PSC Primary Sclerosing Cholangitis
Allergies: None
Diagnostic Lab Data: September 8th to 14th Numerous Blood tests, and Ultra Sounds September 14th MRI Brain and Spine, then Spinal Tap
CDC Split Type:

Write-up: Wednesday Sept 8th, 24 hours after the 2nd shot , started to feel weak and pain in the right side and vomiting. went to hospital was given pain medication and sent home. Next day more pain and weakness in the Legs. More pain. a CT scan was done and Dr suspected cholecystitis. That day Friday the 10th more weakness and loss control of urine. ON Saturday September 11th, could not use legs and no control of urine. fly and check into Hospital. condition continue to get worst and by Tuesday September 14th legs numb, and MRI is performed, the a Spinal Tap, the Tap confirmed the GBS Guillain-Barre Syndrome. Immediately moved to ICU. Given two IVIG treatments in 48 hours. Recover started and PT and OT worked to help. now doing PT 3 times per week and making recovery.


VAERS ID: 1757461 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test, Chills, Dysstasia, Gait inability, Pyrexia, SARS-CoV-2 test, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxin 150 mg
Current Illness: None
Preexisting Conditions: Graves'' Disease, Charcot-Marie-Tooth, microscopic colitis
Allergies: gluten, penicillen, NSAIDS, pineapple, lactose
Diagnostic Lab Data: Blood, urine, and Covid (both PCR and slower test)
CDC Split Type:

Write-up: Severe chills/rigors, fevers up to 102.8, extreme weakness during the night. Unable to stand or walk the next day. via ambulance to ER on afternoon of 9/9/2021. Four days in hospital.


VAERS ID: 1757492 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-01
Onset:2021-09-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Gastrointestinal disorder, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, vitamin D, buspar, Crestor
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: My heart is racing since the second shot and my heart rate doesn?t come down for hours after easy exercise like walking. Rapid heart rate even after a month. Left back pain, shoulder pain. No appetite and stomach pain. Digestion issues


VAERS ID: 1757584 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-05
Onset:2021-09-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lorsartan and hydrochlothiazide
Current Illness: Nonr
Preexisting Conditions: High blood pressure and asthma
Allergies: None
Diagnostic Lab Data: None as of yet
CDC Split Type:

Write-up: Constant raised hives itching under my arms, breaststroke, trunk, thighs they come and go and move to different locations. They are very large patchy areas and I have not had one good day since taking the 2nd dose of the covid vaccine. Regardless of what is done there is no relief.


VAERS ID: 1758646 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-01
Onset:2021-09-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Extra dose administered
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), 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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Effexor XR 150mg, Gabapentin 600mg, Quetiapine 100mg & 300mg, clonazepam 1mg, Temazepam 30mg, Amitriptyline 150mg, Clopidogrel 75mg, Plavix 75mg, Imodium AD, Metformin 500mg, Trulicity 0.75mg/mL, Imitrex 100mg, methocarbamol 750mg, lisin
Current Illness: n/a
Preexisting Conditions: chronic thoracic & lumbar back pain, mood disorder, hypertension, diabetes type 2, migraine, COPD, hyperlipidemia, bipolar disorder
Allergies: Lamictal, Haldol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Moderna COVID dose #3 at his work on 9/1/2021. 9/8/2021 he was admitted to the hospital for a CVA


VAERS ID: 1758876 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 1 RA / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Hyperhidrosis, Hypoaesthesia, Pain, Paraesthesia, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: I had two days fevers after second shot of moderna Covid vaccine, and after two days of the fever, then my chest pain like I had a pneumonia for another three days, then my right arm and my body especially my back starting breaking out like big rashes for two days, then my right head right are and right leg starting feels numbness, tingling, and hurting. I am sweating all the time now, when I am not a sweating person before I had the moderna Covid vaccine.


VAERS ID: 1759156 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Unknown  
Location: Georgia  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1759283 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-14
Onset:2021-09-08
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1759384 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-23
Onset:2021-09-08
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Headache, Myalgia, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Novel Coronavirus PCR- Detected (9/8/2021)
CDC Split Type:

Write-up: 58 yo female s/p Pfizer COVID19 vaccination: dose 1 on 3/2 and dose 2 on 3/23. PMH of alpha-1 antitrypsin deficiency s/p bilateral lung transplant on mycophenolate, tacrolimus, and prednisone 5 mg daily, atrial fibrillation, HTN, HLD, and recent diagnosis of COVID-19 infection on 9/8 who presents to the ED for evaluation of ongoing fever. She received monoclonal AB infusion on 9/9 prior to admission, but had ongoing fevers, myalgias and headache. ID recommended initiation of Remdesivir. She desaturated with exertion and was also started on Decadron. She completed 4 days of Remdesivir prior to discharge. She was doing well without hypoxemia, fevers or myalgias, therefore, discharged prior to completion of... the fifth dose of Remdesivir. She was discharged to home on 9/14 in stable conditions.


VAERS ID: 1759539 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-09
Onset:2021-09-08
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1759602 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-17
Onset:2021-09-08
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 LA / IM

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

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

Write-up: Tested Positive for Covid on 09/10/2021


VAERS ID: 1759645 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-03
Onset:2021-09-08
   Days after vaccination:67
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chest discomfort, Chest pain, Chills, Cough, Dyspnoea, Electrocardiogram normal, Fatigue, Headache, Malaise, Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, X-ray normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: pre diabetic
Allergies: no
Diagnostic Lab Data: Covid - Positive Xray - normal ECG - normal
CDC Split Type: vsafe

Write-up: 8sep2021 I had a stuffy nose, nothing more. 9sep2021, I started having sore throat and got worst. 10 sep2021 I had fever and chills. I got tested. Positive for covid. The 4th was 101 fever and it was the worst. Shortness of breath. I checked my oxygen dropped to 95. I felt really tired. for a week. I took Tylenol every 4 hrs for the fever. Then I had really bad headache which lasted for 2 more days. Then I coughing, dry cough. I was sick for total 6 days then my fever went away and chills. That Tuesday I didn''t have the fever any more. The headache was still there and everything started improving. On Thursday the sore throat went away. on Friday. On 19 sep2021 i lost a sense of taste of smell I called my doctor 16September2021 and got prescribed for a cough medication Denzonatate . Felt like a was recovering from a bad cold. I went to see the doctor 25 sep2021 -urgent care , I had pressure in my chest and lungs and was painful. was told to take ibuprofen. I still haven''t get completely my sense of taste and smell.


VAERS ID: 1760012 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Arthralgia, Back pain, Balance disorder, Crying, Dizziness, Fatigue, Gait disturbance, Gait inability, Hypoaesthesia, Mobility decreased, Pain, Pain in extremity, Retching, Walking aid user, X-ray
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: FLU SHOT MADE ME VERY SICK IN 2009. WENT OT EMERGENCY ROOM
Other Medications: VITAMIN C, D, ZINC, VYVANSE
Current Illness: N/A
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data: XRAY
CDC Split Type:

Write-up: 9/7: VACCINATION AT STORE PHARMACY @ 4PM 9/8: LESS THAN 24 HRS AFTER 1ST SHOT: NUMBNESS IN MY RIGHT LEG MOST OF THE DAY FROM MY HIP DOWN. COULD NOT FEEL LEG. FELT OFF BALANCED 9/9: ALMOST 47 HOURS AFTER 1ST SHOT: SAT AT MY DESK FOR MOST OF THE DAY WORKING. APPROX. 3PM EXTREME PAIN AND COULD NOT WALK. COULD NOT MOVE FROM CHAIR. MOST INTENSE PAIN. PAIN SO SEVERE I WAS DRY HEAVING & CRYING. I CAN NOT EXPRESS HOW SEVERE THIS PAIN WAS- I HAD A LONG HARD LABOR AND LABOR WAS NOTHING COMPARED TO THIS. IT WAS SCARY. COULD NOT WALK FOR A FEW ( 3 ) HOURS. SON CALLED HUSBAND AND I WAS TAKEN TO THE MED. GOT SHOT TO HELP WITH THE PAIN AND AN XRAY. PRESCRIBED PAIN PILLS AND TOLD TO REST. PAIN WAS MOST INTENSE AT MY HIP AND RADIATED DOWN MY LEG & LOWER BACK. IT WAS THE WORST PAIN AND AFRAID I WOULD NOT BE ABLE TO WALK EVER. PHYSICALLY COULD NOT WALK FOR A COUPLE HOURS. ONCE I WAS ABLE TO ATTEMPT WALKING, COULD ONLY DO SO WITH A LIMP AND CANE. LIMPING LASTED THE REST OF THE NIGHT AND NEXT DAY. UP MOST OF THE NIGHT WITH PAIN. 9/10: HAD TO WORK FROM BED. EXTREME DIZZINESS AND SICK TO STOMACH. RIGHT HIP/LEG AND RIGHT SIDE LOWER BACK DULL/ NAGGING PAIN. EVERY TIME I GOT UP, I GOT SICK TO MY STOMACH AND DIZZY. 9/11-9/12: DIZZINESS BOTH DAYS AND EXTREMELY TIRED. 9/11: HIP PAIN BETTER. FOOT ONLY NUMB. TRIED TO GET HAIRCUT AND HAD TO HAVE A FAN PUT ON ME UNTIL BETTER AND LEFT SALON TO GO BACK HOME DUE TO DIZZINESS. 9/12: TRIED TO REPORT ONLINE TO CDC AND GOT KICKED OUT 2X. 10/1: DR APPOINTMENT TO REPORT ISSUES AND DISCUSS 2ND SHOT POSSIBLE REACTIONS.


VAERS ID: 1760683 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Diarrhoea, Dyspnoea, Fatigue, Influenza like illness, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After 1st dose of Hepatitis B in 2009: Had tingly skin. Didn''t complete shots 2 or 3.
Other Medications: Vitamin B12, C, D, Zinc, Tumeric
Current Illness: None prior.
Preexisting Conditions: stiff joints, tendonitis in arms/legs
Allergies: none known
Diagnostic Lab Data: After 2nd Vaccine (9/8/21): - again, starting 6 hours after the shot (approx. 8 pm): full body fatigue, weakness. - This time, this expanded into flu-like symptoms: 48 hours of significant fatigue, fever, queasiness, headache, body aches. - I didn''t work the next 2 days; I slept over 30 hours (like 19 the first night/day, and 14 the 2nd night/day). - 1 week later, I got full-on flu symptoms (diarrhea, vomiting, fever for 3 days. Again, slept over 30 hours the first 2 nights/days -- a virtual repeat, but worse. Took 2 more days from work, in addition to my normal day off. - Now, almost 4 weeks later: still suffering from fatigue; plus shortness of breath when I try to stand up quickly. - No heart/chest pain or tightness this time. No general difficulty breathing this time.
CDC Split Type:

Write-up: After 1st Vaccine (8/11/21): - starting 6 hours after the shot (approx. 8 pm): full body weakness - During the night (approx. 15 hours after the shot): tightness in left chest/heart area; difficulty breathing deeply - 2 days later, 8/13, afternoon (i.e. 48-52 hours later): re-occurrence of tightness in left chest/heart area; difficulty breathing deeply.


VAERS ID: 1761198 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-24
Onset:2021-09-08
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1761210 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-03
Onset:2021-09-08
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022M20A / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1761243 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Influenza like illness, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multi vitamin, calcium, vitamin D
Current Illness: none
Preexisting Conditions: vasculitis
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I very quickly began having flu like symptoms which increased dramatically as the day went on. I received the vaccine at 12:30 and began feeling progressively worse to the point where by 8 PM I had a fever of 104 which lasted throughout the night. I went from having a normal temperature to having the 104 fever in a span of 30 minutes. Horrific shaking and chills accompanied the fever. We were using a Forehead thermometer Wand which is approved for accuracy. The fever lasted throughout the night and was only mildly and temporarily reduced with tylenol. I continued to feel lousy the next day although the fever and shaking had largely subsided. 48 hours after receiving the vaccine I felt pretty muc recovered.


VAERS ID: 1761301 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-01
Onset:2021-09-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK LA / -

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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pain in left calve
Preexisting Conditions:
Allergies: Pain in left calve
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in left calve


VAERS ID: 1761397 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-30
Onset:2021-09-08
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, Arthralgia, COVID-19, Respiratory tract congestion, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Taste and smell disorders (narrow), Arthritis (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: shingles
Other Medications: lisinopryl, amlodapine, metopryl, doxazosin, montelekast, levoceterizene, garlic
Current Illness:
Preexisting Conditions: high blood pressure, no spleen, 1 kidney, artificial hip
Allergies: penicillun
Diagnostic Lab Data: Positive for Covid 9/13/21
CDC Split Type:

Write-up: sinus congestion/drainage 2 weeks, no treatment positive covid test 9/13/21 no taste/smell, ongoing breathing problems/chest congestion, 3 weeks, Mucinex/ joint pain, ongoing


VAERS ID: 1761762 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-01
Onset:2021-09-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: obese, high blood pressure, sessile lifestyle
Allergies: none known, lactose intolerance?
Diagnostic Lab Data: none. I get regular COVID testing through my college and have not tested positive yet
CDC Split Type:

Write-up: I had periodic chest pain when lying down after my first shot that I had never previously experienced. About a week after my second shot, i became... acutely aware of the movement of my heart and occasional twinging pain in my chest no matter my body orientation. I wrote it off then, but it has been nearly a month and the pain / discomfort in my chest makes itself known at least once a day . I''ve adjusted and gotten used to it, but every once in a while a strong twinge will scare me


VAERS ID: 1761909 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA D04F21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Confusional state, Cough, Hypersensitivity, Pain, Pain in extremity, Pruritus, Rhinorrhoea
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Mental confusion, itchy nose, pain in the bones behind the back when getting up, pain in the knees, itchy arm 2 days, pain in the arm, runny nose, pain in evacuation, one night with persistent cough, allergy follows.


VAERS ID: 1764100 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / UNK - / OT

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

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

Write-up: Expired vaccine used; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) in an 83-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006C21A) for COVID-19 vaccination. No Medical History information was reported. On 08-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine used). On 08-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication information provided by the reporter. No treatment information provided. Time from first puncture-14 days Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 28-Sep-2021: follow up document document contains non significant information; Sender''s Comments: This report refers to a case of Expired vaccine used for mRNA-1273, Lot# 006C21A with no associated AEs. Causality for this medication error is not applicable.


VAERS ID: 1764103 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / UNK - / OT

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

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

Write-up: Expired vaccine used; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) in a 90-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037C21A) for COVID-19 vaccination. No Medical History information was reported. On 08-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine used). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. After 29 days of puncturing the vial, dose was administered No concomitants were reported by reporter No treatment medications were reported by reporter Most recent FOLLOW-UP information incorporated above includes: On 28-Sep-2021: Follow up received on 29-Sep-2021 contains non significant information.


VAERS ID: 1764178 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-09-08
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Medication error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BNT 162
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211007410

Write-up: MEDICATION ERROR; This spontaneous report received from a pharmacist concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included bnt 162 for prophylactic vaccination. On 08-SEP-2021, the patient experienced medication error. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of medication error was not reported. This report was non-serious.


VAERS ID: 1764302 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

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

Write-up: Day after 2nd dose/fully vaccinated severe hives over body.


VAERS ID: 1764918 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-03-29
Onset:2021-09-08
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Angioedema, Decreased appetite, Hypersensitivity, Hypoaesthesia, Hypoaesthesia oral, Lip swelling, Nausea, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (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: 10,000 IU of Vit D - twice a week; occasionally take a melatonin or Benadryl (mainly for sleep); Claritin - in the spring as needed
Current Illness: no
Preexisting Conditions: no
Allergies: had allergies when I was a kid - moderate to severe; nothing significant now except Hay Fever
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: While sleeping in the middle of the night, I was awakened at 01:00 am with symptoms of allergic reaction - I had mild nausea; intense itching in my palms and in my buttocks and swelling in my lips and numbness (severe swelling of lips - almost couldn''t close my mouth) an numbness in my lips and face. Giant hives: buttocks, armpits. The symptoms persisted severely for about 6 hours and then gradually got better over the next 6 hours. I took 2 Benadryl almost immediately and two more at 03:30 am and two more around 6 am. That helped to finally get the symptoms under control. My last meal had been around 07:30 that evening - many hours since eating. The symptoms persisted another 6-8 beyond those initial 6 hours. It was another 6-8 beyond those initial 6 for my face to be back to normal. My lips were swollen as big as my thumbs. I did not have any breathing difficulty. Just that one time occurrence of this. I saw the doctor a couple days later. I have an appt with an allergist coming up on the 15th of October. I have a booster shot scheduled on the 18th of this month. Had a flu shot in August 3, 2021 - NOTE - Pharmacy - Locatoin


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