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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 245 out of 8,010

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VAERS ID: 1760699 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Unknown  
Location: Foreign  
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 214008 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dizziness, Fatigue, Headache, Heart rate increased, Hypotension, Injection site pain, Limb discomfort, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma; Hypertension; Type 2 diabetes mellitus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEMODERNATX, INC.MOD20213

Write-up: This case was received via regulatory authority (Reference number: DE-PEI-202100188636) on 27-Sep-2021 and was forwarded to Moderna on 27-Sep-2021. This regulatory authority case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN , DIZZINESS , LIMB DISCOMFORT , MYALGIA , FATIGUE , HEADACHE , PYREXIA , ASTHENIA (weakness), HYPOTENSION (low blood pressure ) and HEART RATE INCREASED (high pulse ) in a 49-year-old patient of an unknown gender who received mRNA-1273 (Spikevax) (batch no. 214008) for Prophylactic vaccination. Concurrent medical conditions included Type 2 diabetes mellitus, Asthma and Hypertension. On 08-Sep-2021, the patient received second dose of mRNA-1273 (Spikevax) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Spikevax) (unknown route) 1 dosage form. On 08-Sep-2021, the patient experienced INJECTION SITE PAIN (seriousness criterion hospitalization prolonged) and FATIGUE (seriousness criterion hospitalization prolonged). On 09-Sep-2021, the patient experienced LIMB DISCOMFORT (seriousness criterion hospitalization prolonged), MYALGIA (seriousness criterion hospitalization prolonged), HEADACHE (seriousness criterion hospitalization prolonged) and PYREXIA (seriousness criterion hospitalization prolonged). On 10-Sep-2021, the patient experienced DIZZINESS (seriousness criterion hospitalization prolonged), ASTHENIA (weakness) (seriousness criterion hospitalization), HYPOTENSION (low blood pressure ) (seriousness criterion hospitalization) and HEART RATE INCREASED (high pulse ) (seriousness criterion hospitalization). On 10-Sep-2021, INJECTION SITE PAIN and LIMB DISCOMFORT had resolved. On 11-Sep-2021, MYALGIA , HEADACHE and PYREXIA had resolved. At the time of the report, DIZZINESS and FATIGUE was resolving and ASTHENIA (weakness), HYPOTENSION (low blood pressure ) and HEART RATE INCREASED (high pulse ) outcome was unknown. No concomitant was provided. Treatment details at hospital are not mentioned. Patient experienced Dizziness and weakness due to low blood pressure and high pulse, Aching limbs, Fever. Patient have allergy with diclofenac and pollen. Patient also have Asthma, elevated HB values (blood too thick), type II diabetes (diet), high blood pressure. Patient required treatment in the emergency room in the hospital in particular due to the sudden low blood pressure and high pulse despite resting, incipient myocarditis was suspected. After ECG, blood values, etc., the hospital diagnosed it as severe vaccination reactions. Company comment: This case concerns a 49-year-old, patient with relevant medical history of Type 2 diabetes mellitus, Asthma and Hypertension, who experienced the unexpected events of injection site pain, fatigue, limb discomfort, myalgia, headache, pyrexia, dizziness asthenia, blood pressure decreased and heart rate increased which caused hospitalization. The events occurred approximately on the same day, up to two days after the second dose of Moderna COVID-19 Vaccine. The rechallenge was not applicable as events occurred after second dose and no further dosing was reported or planned, based on information provided. Patient''s medical history of diabetes mellitus, Asthma and Hypertension remains a confounder. The benefit-risk relationship of Moderna COVID-19 Vaccine is not affected by this report. Event seriousness assessed as per Regulatory Authority reporting. Most recent FOLLOW-UP information incorporated above includes: On 27-Sep-2021: Translation received on 29-Sep-21 and updated with event verbatim. Senders Comment with historical condition update.; Sender''s Comments: This case concerns a 49-year-old, patient with relevant medical history of Type 2 diabetes mellitus, Asthma and Hypertension, who experienced the unexpected events of injection site pain, fatigue, limb discomfort, myalgia, headache, pyrexia, dizziness asthenia, blood pressure decreased and heart rate increased which caused hospitalization. The events occurred approximately on the same day, up to two days after the second dose of Moderna COVID-19 Vaccine. The rechallenge was not applicable as events occurred after second dose and no further dosing was reported or planned, based on information provided. Patient''s medical history of diabetes mellitus, Asthma and Hypertension remains a confounder. The benefit-risk relationship of Moderna COVID-19 Vaccine is not affected by this report. Event seriousness assessed as per Regulatory Authority reporting.


VAERS ID: 1760713 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3380 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Inappropriate schedule of product administration
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: RIGEVIDON [ETHINYLESTRADIOL;LEVONORGESTREL]; FLUOXETINE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC202101243130

Write-up: Painful periods; Heavy periods; Inappropriate schedule of vaccine administered; This is a spontaneous report from a contactable consumer received from the Regulatory Agency (RA). The regulatory authority report number is GB-MHRA-WEBCOVID-202109172135569740-QSOKO. Safety Report Unique Identifier [GB-MHRA-ADR 25961668]. An 18-year-old female patient second dose of bnt162b2 (Pfizer BioNTech covid-19 vaccine), via an unspecified route of administration on 08sep2021 (batch/lot number: fe3380) as dose 2, single for covid-19 immunization. Historical vaccine included first dose of bnt162b2 (Pfizer BioNTech covid-19 vaccine), via an unspecified route of administration on 30jun2021 (batch/lot number: v1220) as dose 1, single for covid-19 immunization. The patient medical history was not reported. Concomitant medication(s) included ethinylestradiol, levonorgestrel taken for an unspecified indication, start and stop date were not reported; fluoxetine taken for an unspecified indication, start and stop date were not reported. Patient has not had symptoms associated with covid-19. Not had a covid-19 test. Patient is not pregnant; patient is not currently breastfeeding. Patient has not tested positive for covid-19 since having the vaccine. Patient is not enrolled in clinical trial. On 15Sep2021 patient experienced heavy periods, on 08Sep2021 inappropriate schedule of vaccine administered, on an unspecified date painful period. Therapeutic measures were taken as a result of painful periods (dysmenorrhoea). The outcome of heavy periods was recovering, painful periods, inappropriate schedule of vaccine administered was unknown Note: Patient had a very heavy and painful period, various painkillers didn''t help, was in significant amount of pain and unable to do much; had heavy and painful periods when not on the pill, pill reduces this significantly although this period not at all. Only had this side effect after my second vaccine, not first. It is the combined pill- rigevidon. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1760814 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-06
Onset:2021-09-08
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Vertigo
SMQs:, Vestibular disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Steroid therapy (Taking regular steroid treatment (e.g. orally or rectally))
Allergies:
Diagnostic Lab Data: Test Date: 20210706; Test Name: COVID-19 virus test; Test Result: Negative ; Comments: No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC202101243210

Write-up: Vertigo; This is a spontaneous report from a contactable consumer received from the regulatory authority report number GB-MHRA-WEBCOVID-202109202042366790-ORNJW, Safety Report Unique Identifier GB-MHRA-ADR 25970743. A 39-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 06Aug2021 (Batch/Lot number and expiry date were not reported) as DOSE 2, SINGLE for COVID-19 immunisation; and citalopram, nasal from an unspecified date (Batch/Lot number was not reported) to an unspecified date, at 10 mg, unknown frequency for an unspecified indication. Medical history included steroid therapy (taking regular steroid treatment (e.g. orally or rectally)). Concomitant medications were not reported. Historical vaccine included BNT162B2 on an unspecified date as dose 1, single for COVID-19 immunization. The patient experienced vertigo on 08Sep2021 with outcome of not recovered. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 06Jul2021, No - Negative COVID-19 test. The event was reported as serious, disabling by the health authority. Narrative case summary and further information: Case narrative. Patient was not enrolled in clinical trial No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender''s Comments: Linked Report(s) : GB-MHRA-ADR 25970743 MHRA


VAERS ID: 1760886 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Foreign  
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 - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Limb discomfort, Malaise, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Type 2 diabetes mellitus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEMODERNATX, INC.MOD20213

Write-up: er; This case was received (Reference number: DE-PEI-202100186787) on 27-Sep-2021 and was forwarded to Moderna on 27-Sep-2021. This regulatory authority case was reported by a consumer and describes the occurrence of NAUSEA in a 31-year-old female patient who received mRNA-1273 (Spikevax) for Prophylactic vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Type 2 diabetes mellitus. On 08-Sep-2021, the patient received second dose of mRNA-1273 (Spikevax) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Spikevax) (unknown route) 1 dosage form. On 08-Sep-2021, the patient experienced NAUSEA (seriousness criterion hospitalization), LIMB DISCOMFORT, DIZZINESS, MALAISE, MYALGIA, CHILLS and PYREXIA. The patient was hospitalized on sometime in September 2021 due to NAUSEA. On 09-Sep-2021, MALAISE, CHILLS and PYREXIA had resolved. At the time of the report, NAUSEA, LIMB DISCOMFORT and DIZZINESS was resolving and MYALGIA had not resolved. Concomitant medications were not reported . Treatment information was not provided. It was reported that patient had type 1 diabetes mellitus, blood sugar was very high one day after vaccination. It was difficult to adjust despite repeated insulin administration. Company Comment: This case concerns a 31-year-old, female patient with previous relevant medical history of Type 2 diabetes mellitus, who experienced the unexpected event of nausea. The event occurred on the same day after the second dose of Spikevax.The rechallenge was not applicable, as is not expected another dose. The medical history of diabetes mellitus remains a confounder. The benefit-risk relationship of Spikevax is not affected by this report. Most recent FOLLOW-UP information incorporated above includes: On 27-Sep-2021: Translated document received on 30-Sep-2021 as live follow up contained updated inarrative.; Reporter''s Comments:; Sender''s Comments: This case concerns a 31-year-old, female patient with previous relevant medical history of Type 2 diabetes mellitus, who experienced the unexpected event of nausea. The event occurred on the same day after the second dose of Spikevax.The rechallenge was not applicable, as is not expected another dose. The medical history of diabetes mellitus remains a confounder. The benefit-risk relationship of Spikevax is not affected by this report.


VAERS ID: 1761107 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-08
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Dehydration, Dizziness, Tachycardia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: AUPFIZER INC202101242866

Write-up: Bradycardia; dehydration; dizziness; Tachycardia; This is a spontaneous report from a contactable other health professional via the Regulatory Authority. Regulatory authority report number is 623856. A 58-years-old male patient received bnt162b2 (COMIRNATY mRNA, formulation: solution for injection, lot number and expiration date were not reported), via an unspecified route of administration on an unspecified date as dose number unknown, single for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. On 08Sep2021, the patient experienced bradycardia, dehydration, dizziness, tachycardia. The outcome of all the events were recovered on unspecified date in 2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1761149 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-03
Onset:2021-09-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (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: AUPFIZER INC202101244150

Write-up: Pulmonary embolism; This is a spontaneous report from a contactable other health professional via the Regulatory Authority. Regulatory authority report number is 626614. A 67-year-old male patient received bnt162b2 (COMIRNATY, Solution for injection, lot/batch number was not reported), via an unspecified route of administration on 03Sep2021 as a dose number unknown, single for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced pulmonary embolism on 08Sep2021. The outcome of event was not recovered. No follow-up attempts were possible, information about lot/batch number could not be obtained. No further information was expected.


VAERS ID: 1763030 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:2021-09-02
Onset:2021-09-08
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2153 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Burning sensation, Dyspnoea, Electrocardiogram, Myocarditis, Palpitations, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210918; Test Name: Blood tests; Result Unstructured Data: Test Result:raised protein levels linked to my heart; Comments: raised protein levels linked to my heart; Test Date: 20210918; Test Name: ECG; Result Unstructured Data: Test Result:Unknown result; Comments: Unknown result; Test Name: COVID-19 virus test; Test Result: Negative ; Comments: No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC202101258871

Write-up: Breathlessness; Burning sensation; Palpitations/ Felt heart palpitations; Myocarditis; This is a spontaneous report from a contactable consumer received from the Agency Regulatory Authority. The regulatory authority report number is GB-MHRA-WEBCOVID-202109221914035990-M2IMP and Safety Report Unique Identifier GB-MHRA-ADR 25980131. A 34-year-old patient of an unspecified gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via an unspecified route of administration on 02Sep2021 (Lot Number: FF2153) as dose 2, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient was unsure had symptoms associated with COVID-19. Patient was not enrolled in clinical trial. The patient experienced myocarditis on 08Sep2021. The patient experienced breathlessness, burning sensation, palpitations/ felt heart palpitations on an unspecified date. The patient went into hospital, self-admitted into on 18Sep2021 4:45, they booked an ECG (electrocardiogram). The patient had blood tests which showed raised protein levels linked to her heart. On 18Sep2021, the patient lab test which included blood test was raised protein levels linked to my heart and electrocardiogram was unknown result, on an unspecified date COVID-19 virus test was no-negative COVID-19 test. Since the vaccination, the patient was not tested positive for COVID-19. Timeframe between vaccination and starting of the event myocarditis was 6 days. After strenuous exercise it took hours before the patient felt normal again. Breathlessness, that lasted for ages. The outcome of the events breathlessness, burning sensation, palpitations/ felt heart palpitations was resolved on an unknown date 2021. The outcome of the event myocarditis was resolving. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1763176 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG9019 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Loss of consciousness, Movement disorder, Musculoskeletal stiffness, Myalgia, Neck pain, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), 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? 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: IEPFIZER INC202101278018

Write-up: he said he was in significant pain in the muscle at the back of his neck & then he collapsed & passed out; he said he was in significant pain in the muscle at the back of his neck & then he collapsed & passed out; he said he was in significant pain in the muscle at the back of his neck & then he collapsed & passed out; neck locking & he was unable to move it neck locking / stiffness in his neck; neck locking & he was unable to move it neck locking / stiffness in his neck; Constant headache; Temperature; Tiredness; This is a spontaneous report from a contactable consumer downloaded from the Agency Regulatory Authority-WEB. This is a report received from the Regulatory Authority, Regulatory authority report number IE-HPRA-2021-084095. A 15-year-old male patient received bnt162b2 (COMIRNATY, solution for injection, Batch/Lot Number: FG9019), dose 2 via an unspecified route of administration on 07Sep2021 as DOSE 2, SINGLE for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. Historical vaccine included first dose of Comirnaty, Concentrate for dispersion for injection on 15Aug2021 as dose 1, single for covid-19 immunisation. The patient experienced constant headache, temperature, tiredness on 08Sep2021; he said he was in significant pain in the muscle at the back of his neck & then he collapsed & passed out, neck locking & he was unable to move it neck locking / stiffness in his neck (musculoskeletal stiffness) on 09Sep2021. Event loss of consciousness were considered as serious-medically significant, rest of events were considered as non-serious. Event loss of consciousness, musculoskeletal stiffness, pyrexia and fatigue were recovered in Sep2021, rest of events were not recovered, headache, neck pain, myalgia, Movement disorder and Musculoskeletal stiffness was not recovered. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1763214 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-04
Onset:2021-09-08
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG4493 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Angioedema, Blood test, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: blood test; Result Unstructured Data: Test Result: unknown results.
CDC Split Type: ITPFIZER INC202101237009

Write-up: systemic giant urticaria; persistent urticarial reaction; This is a spontaneous report from a contactable physician from the Regulatory Authority [IT-MINISAL02-787438]. A 12-year-old male patient received the first dose of BNT162B2 (COMIRNATY, Lot Number: FG4493; Expiration Date: 30Nov2021) via intramuscular at 0.3 mL single in left arm on 04Sep2021 10:00 for covid-19 immunisation. Medical history and concomitant medications were not reported. The patient experienced systemic giant urticaria and persistent urticarial reaction on 08Sep2021 with seriousness criteria medically significant. The patient received therapy with cortisone and antihistamines, and underwent blood tests, unknown results. The outcome of event was not recovered. Persistent urticarial reaction


VAERS ID: 1763651 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Foreign  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG7372 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Malaise, Pain in extremity, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210919; Test Name: COVID-19 antigen test; Test Result: Negative ; Test Date: 20210922; Test Name: COVID-19 antigen test; Test Result: Positive ; Test Date: 20210922; Test Name: COVID-19 PCR test; Test Result: Positive
CDC Split Type: NOPFIZER INC202101180384

Write-up: COVID-19 antigen and PCR test positive; positive COVID-19 test with symptoms; general feeling of sickness; tenderness in the upper arm; This is a spontaneous report from a contactable consumer (parent). A 15-year-old male patient received bnt162b2 (COMIRNATY), via an unspecified route of administration on 07Sep2021 (Batch/Lot Number: FG7372) at the age of 15-years-old as dose 1, single for covid-19 immunisation. The patient had no relevant medical history. There were no concomitant medications and patient had not received any other vaccine within 4 weeks. On 08Sep2021, the patient felt so ill that he did not go to school. The tenderness in the upper arm was not the reason he stayed at home; it was the general feeling of sickness. During the evening he was improving and in Sep2021 he felt good and went to school. On 22Sep2021, the patient tested positive for covid-19 antigen and pcr test. The patient was being tested by the school. He does not experience anything else other than mild cold late evening Sep 21st and then two positive tests Sep 22nd, first "quick-test" at school and later a PCR-test. Now 23Sep2021, patient also had headache and more than mild cold symptoms. No fever. The patient underwent lab tests and procedures which included COVID-19 antigen test: negative on 19Sep2021 and positive on 22sep2021 and COVID-19 PCR test positive on 22Sep2021. The event general feeling of sickness and tenderness in the upper arm recovered on 09Sep2021; all other events was not recovered. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1763716 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
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: 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Concomitant elements: good
Allergies:
Diagnostic Lab Data: Test Date: 20210908; Test Name: SARS-CoV-2 RT-PCR test; Result Unstructured Data: Positive Iu international unit(s)
CDC Split Type: PTJNJFOC20211001705

Write-up: Vaccination failure; COVID-19; This spontaneous report received from a physician by a Regulatory Authority (Vaccines, PT-INFARMED-B202109-1358) on 01-OCT-2021 and concerned a 28 year old of unspecified gender, race and ethnic origin. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: Concomitant elements: good. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 21C13-01 expiry: unknown) 0.5 ml, 1 total ,administered on 30-JUL-2021 for covid-19 immunisation(Drug start period 40 days, Drug last period 40 days). No concomitant medications were reported. On 08-SEP-2021, the patient experienced vaccination failure and covid-19. Laboratory data included: SARS-CoV-2 RT-PCR (reverse transcription?polymerase chain reaction) test (NR: not provided) Positive LU international unit (s). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from covid-19 on 16-SEP-2021, and the outcome of vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint.


VAERS ID: 1765803 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
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: Chills, Myalgia, Pericarditis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEJNJFOC20211008262

Write-up: Pericarditis; Myalgia; Pyrexia; Chills; This spontaneous report received from a consumer via a Regulatory authority (regulatory authority, DE-PEI-CADR2021185839) on 05-OCT-2021 and concerned a 58 year old female. The patient''s weight was 62 kilograms, and height was 172 centimeters. 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: Unknown and expiry: Unknown) dose was not reported, 1 total, administered on 07-SEP-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 08-SEP-2021, the patient experienced myalgia, pyrexia and chills. On 20-SEP-2021, the patient experienced pericarditis. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from myalgia, pyrexia, and chills on 10-SEP-2021, and was recovering from pericarditis. This report was serious (Other Medically Important Condition).


VAERS ID: 1766352 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-03
Onset:2021-09-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2153 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Diabetic ketoacidosis, SARS-CoV-2 test, Thirst, Type 1 diabetes mellitus, Weight, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetic ketoacidosis
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:No - Negative COVID-19 test; Test Name: Weight; Result Unstructured Data: Test Result:loss
CDC Split Type: GBPFIZER INC202101266361

Write-up: Type 1 diabetes mellitus; Weight loss and thirst; Weight loss and thirst; diabetic ketoacidosis; This is a spontaneous report from a contactable consumer. This is a report received from the regulatory authority. Regulatory authority report number GB-MHRA-WEBCOVID-202109250935505960-INLKY, Safety Report Unique Identifier GB-MHRA-ADR 25994609. A 17-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 via an unspecified route of administration on 03Sep2021 (at the age of 17-year-old) (Batch/Lot Number: Ff2153) as a single dose for COVID-19 immunisation. Medical history included diabetic ketoacidosis. No relevant medical history. No family history of type 1 diabetes. Patient has not had symptoms associated with COVID-19. The patient''s concomitant medications were not reported. Patient was not enrolled in clinical trial. Patient was not pregnant. The patient experienced type 1 diabetes mellitus on 08Sep2021 with outcome of not recovered, diabetic ketoacidosis in 2021 with outcome of unknown, weight loss and thirst on an unknown date with outcome of unknown. The course of events was as follows: In 2021 (as reported as 16Oct2021, future date) patient was taken to A&E and diagnosed with type 1 diabetes and diabetic ketoacidosis. The event 1 diabetes mellitus was reported as hospitalization, medically significant, life threatening. The event diabetic ketoacidosis was medically significant. The patient underwent lab tests and procedures which included: Sars-cov-2 test: no - negative covid-19 test, weight: loss. Patient has not tested positive for COVID-19 since having the vaccine. Adverse reactions did not occur as a result of an exposure during pregnancy. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1769630 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE8037 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Axillary pain, Fatigue, Lymph node pain, Lymphadenopathy, Pain in extremity, SARS-CoV-2 test
SMQs:, Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:Negative; Comments: No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC202101266473

Write-up: Swollen lymph node/Lymph node pain; Tiredness; Swollen lymph nodes; Left armpit start hurting; Hand pain; This is a spontaneous report from a contactable consumer or other non hcp received from the Regulatory Agency. The regulatory authority report number is GB-MHRA-WEBCOVID-202109241759481940-WROSY, Safety Report Unique Identifier GB-MHRA-ADR 25991250. A 37-years-old non-pregnant female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: FE8037), via an unspecified route of administration on 08Sep2021 (at the age of 37-years-old) as single dose for COVID-19 immunization. The patient''s medical history included asthma from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. Unsure if patient had symptoms associated with COVID-19. Patient was not pregnant. Patient was not currently breastfeeding. Patient has not tested positive for COVID-19 since having the vaccine. Patient was not enrolled in clinical trial. On an unspecified date, the patient experienced swollen lymph node/lymph node pain and tiredness. On 08Sep2021, had hand pain and on 23Sep2021 had swollen lymph nodes and left armpit start hurting. She had normal arm pain reaction and tiredness for a few days after injection (left arm) on 8Sep2021. Yesterday, 23Sep2021 her left armpit start hurting and she discovered swollen lymph node. Today (24Sep2021) she got another swollen lymph node (not as big or painful yet) in her right armpit. She has no other physical side effects. The patient underwent lab tests and procedures which included Covid-19 vaccine test: negative (No - Negative COVID-19 test) on an unspecified date. The reporter considered the events as serious (medically significant). Suspect Reactions: Please provide details of any relevant investigations or tests conducted: She have been tested twice for COVID before, tests were negative but because of her work she had always a very high risk of infection. The outcome of events hand pain was resolved on 11Sep2021, lymph node pain, tiredness, swollen lymph nodes was not recovered, and armpit pain was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1770992 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3005695 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Superficial vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: ESMODERNATX, INC.MOD20213

Write-up: Thrombosis of leg superficial venous; This case was received via regulatory authoriy (Reference number: ES-AEMPS-1010291) on 30-Sep-2021 and was forwarded to Moderna on 30-Sep-2021. This regulatory authority case was reported by a physician and describes the occurrence of THROMBOPHLEBITIS SUPERFICIAL (Thrombosis of leg superficial venous) in a 14-year-old female patient who received mRNA-1273 (Spikevax) (batch no. 3005695) for COVID-19 immunisation. The patient''s past medical history included COVID-19 on 05-Jul-2021. On 08-Sep-2021, the patient received first dose of mRNA-1273 (Spikevax) (Intramuscular) .5 ml. On 08-Sep-2021, the patient experienced THROMBOPHLEBITIS SUPERFICIAL (Thrombosis of leg superficial venous) (seriousness criterion hospitalization). At the time of the report, THROMBOPHLEBITIS SUPERFICIAL (Thrombosis of leg superficial venous) was resolving. mRNA-1273 (Spikevax) (Intramuscular) was withdrawn on 08-Sep-2021. For mRNA-1273 (Spikevax) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. No treatment information was provided. Company Comment: This case concerns a 14-year-old, female patient with relevant medical history of COVID-19, who experienced the serious unexpected event of Thrombophlebitis Superficial. The event occurred the same day after the first dose of Spikevax. The medical history of COVID-19 remains a confounder. The rechallenge assessed as unknown since the Patient experienced AE after the first dose which is resolving at the time of report but no information about second dose is available. The benefit-risk relationship of Spikevax in not affected by this report. Most recent FOLLOW-UP information incorporated above includes: On 30-Sep-2021: Translated document contains significant information of dose details (Dose-1).; Sender''s Comments: This case concerns a 14-year-old, female patient with relevant medical history of COVID-19, who experienced the serious unexpected event of Thrombophlebitis Superficial. The event occurred the same day after the first dose of Spikevax. The medical history of COVID-19 remains a confounder. The rechallenge assessed as unknown since the Patient experienced AE after the first dose which is resolving at the time of report but no information about second dose is available. The benefit-risk relationship of Spikevax in not affected by this report.


VAERS ID: 1777512 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-09
Onset:2021-09-08
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Abortion spontaneous, Dysmenorrhoea, Heavy menstrual bleeding, Menstruation delayed
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Termination of pregnancy and risk of abortion (narrow), Fertility 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: FIPFIZER INC202101272932

Write-up: Menorrhagia; Early miscarriage; Menstruation delayed; Abdominal cramps; Dysmenorrhoea; This is a spontaneous report from a contactable consumer (patient) downloaded from the Regulatory Agency (A) -WEB, regulatory authority number FI-FIMEA-20214923. A 29-year-old female patient received bnt162b2 (COMIRNATY), dose 2 via an unspecified route of administration on 09Aug2021 (Batch/Lot Number: UNKNOWN) as DOSE 2, SINGLE for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced menorrhagia, early miscarriage, menstruation delayed, abdominal cramps and dysmenorrhoea on 08Sep2021 with outcome of recovered on an unspecified date. Further ADR description stated that menstruation following the second dose of vaccine began three days later than expected and was exceptionally painful and profuse. Her stomach cramped for three days so that she needed painkillers in order to be able to work in the sitting position. The patient mentioned that normally, her menstrual cycle was very regular 28.5 days (+/- 1), she only got stomach cramps on the first day of her period and she usually do not need painkillers for the pain. She mentioned that it was also possible that this was an early miscarriage. The mother reported she became pregnant while taking bnt162b2. Therapeutic measures were taken as a result of abdominal cramps. No follow-up attempts are possible. No further information expected. Information on batch/lot number cannot be obtained.


VAERS ID: 1777796 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-06
Onset:2021-09-08
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH J07BX03 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Abortion spontaneous, SARS-CoV-2 test, Ultrasound abdomen
SMQs:, Termination of pregnancy and risk of abortion (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Abortion induced
Allergies:
Diagnostic Lab Data: Test Name: SARS-CoV-2 test; Test Result: Negative ; Test Name: USG; Result Unstructured Data: Test Result:did not find any embryonic cardiac activity
CDC Split Type: FRPFIZER INC202101273302

Write-up: miscarriage at 12 WA + 5 days; This is a spontaneous report from a contactable physician downloaded from the Regulatory Agency (RA)-WEB, regulatory authority number FR-AFSSAPS-TS20214703. A 33-year-old female patient received bnt162b2 (COMIRNATY), intramuscular on 06Aug2021 (Lot Number: J07BX03) as DOSE 1, SINGLE for COVID-19 immunisation. Medical history included voluntary termination of pregnancy, haemorrhagic abortion and emergency curettage followed by transfusion in 2019. The patient''s concomitant medications were not reported. On 08Sep2021 (12 WA + 5 days) (D33 from the vaccination), the dating ultrasound did not find any embryonic cardiac activity. Diagnosis of interrupted pregnancy (craniocaudal length corresponding to 7 WA + 2 days). The patient is referred to the emergency room for further treatment. In total, miscarriage at 12 WA + 5 days. The mother reported she became pregnant while taking bnt162b2. The mother was 12 Weeks pregnant at the onset of the event. The mother was pregnant with 1 baby. The mother was due to deliver on 01Apr2022. The mother delivered the pregnancy on 08Sep2021 resulted in spontaneous abortion. The fetal outcome is intrauterine death. The patient underwent SARS-CoV-2 test: negative on unspecified date. The patient was hospitalized due to event and the outcome was unknown. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1778506 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Body temperature, Presyncope
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Malaise (blood test showed malaise, the patient had rested in bed.)
Allergies:
Diagnostic Lab Data: Test Date: 20210908; Test Name: BP; Result Unstructured Data: Test Result:low at 70-80s; Test Name: blood test; Result Unstructured Data: Test Result:malaise; Test Date: 20210908; Test Name: body temperature; Result Unstructured Data: Test Result:36.6 Centigrade; Comments: before vaccination
CDC Split Type: JPPFIZER INC202101184523

Write-up: Vasovagal reflex/vagal reflex; This is a spontaneous report from a contactable physician received from the regulatory authority. Regulatory authority report number is v21126349. A 15-year and 10-month-old male patient received on 08Sep2021 in the afternoon (at 15 years) the first dose of bnt162b2 (COMIRNATY, Solution for injection, Lot number was unknown, Expiration date was unknown) via an unspecified route of administration as single dose for COVID-19 immunization. Body temperature before vaccination on 08Sep2021 was 36.6 degrees Centigrade. The patient had no family history. Medical history included malaise (blood test done on an unknown date showed malaise, the patient had rested in bed). Concomitant drugs were unknown. On 08Sep2021 at about 19:00 (same day after the vaccination) the patient experienced vagal reflex. The course of the event was as follows: On 08Sep2021 in the afternoon (the day of vaccination), the patient received the first dose of bnt162b2. After the vaccination, the patient had vasovagal reflex and visited the emergency room. Blood pressure reading low at 70-80s persisted even after giving fluid replacement (500ml) after the emergency outpatient department (with emergency transportation). Improvement was confirmed during the day and the patient returned home after observation in hospital.The final outcome of vasovagal reflex was recovered on 08Sep2021 with treatment of fluid replacement.The reporting physician classified the event as non-serious and assessed that the causality between the vaccine and the event was unassessable for the same symptoms also occurred when other injection (Blood sampling) was performed.No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected. Follow up (28Sep2021): New information received from the contactable physician includes: event details, clinical course and reporter assessment updated (from unrelated to unassessable) .


VAERS ID: 1783370 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3716 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: DKPFIZER INC202101285128

Write-up: Fainting; This is a spontaneous report from a contactable consumer downloaded from a regulatory authority-WEB, regulatory authority number is DK-DKMA-WBS-0088046 and Safety Report Unique Identifier was DK-DKMA-ADR 25918431. A 15-year-old male patient received bnt162b2 (COMIRNATY), dose 1 via an unspecified route of administration on 08Sep2021, at the age of 15 years, (Batch/Lot Number: FG3716) as dose 1, single for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient has not reported any other health issues. The patient experienced fainting on 08Sep2021. The event is serious (medically significant). The outcome for the event fainting was recovering. No follow-up attempts possible. No further information expected.


VAERS ID: 1784454 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-08
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: KRJNJFOC20211014894

Write-up: ACUTE PARALYSIS; This spontaneous report received from a health care professional via a Regulatory Authority concerned a 5 decade old male. 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, intramuscular, batch number: 207A21A, expiry: 21-SEP-2021) dose was not reported, 1 total, administered on 26-AUG-2021 on deltoid for an drug use for unknown indication. No concomitant medications were reported. On 08-SEP-2021, the patient experienced acute paralysis and was hospitalized. The patient received inpatient treatment. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of acute paralysis was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0 20211014894-COVID-19 VACCINE AD26.COV2.S-acute paralysis. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1676795 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-01
Onset:2021-09-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Feeling abnormal, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (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: No medicine or anything is being taking
Current Illness: None
Preexisting Conditions: None
Allergies: Flaygel antibiotic
Diagnostic Lab Data:
CDC Split Type:

Write-up: Burning and tingling in my legs feet arms and hands my whole body has had this weird feeling all day today


VAERS ID: 1676797 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-02
Onset:2021-09-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

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

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

Write-up: Swollen lymph nodes in armpit of right arm (injection sight)


VAERS ID: 1678511 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No past illnesses
Preexisting Conditions: No chronic health problems
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Urticarial rash of arms, legs and trunk which occurred the next day, no anaphylaxis


VAERS ID: 1678515 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-04
Onset:2021-09-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 4 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Patient completed Moderna COVID series 4/27/2021 and 5/24/2021. Patient then received Pfizer on 8/14/2021 Lot#- FC3181 and then received another Pfizer dose on 9/4/2021 Lot number listed on this report.


VAERS ID: 1678582 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-05
Onset:2021-09-07
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered
SMQs:, Medication errors (narrow)

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

Write-up: Patient received Pfizer COVID vaccine dose on 4/25/2021, 6/23/2021 and 8/5/2021. Lot number for 8/5/2021 dose #3 listed on this report.


VAERS ID: 1678601 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-09-07
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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

Write-up: Patient received J+J COVID vaccine on 5/23/2021 and received Pfizer vaccine on 8/10/2021 as documented on this report.


VAERS ID: 1678609 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

Administered by: Public       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: Topomax, Wellbutrion, Clonidine, Methadone, GAbapentin
Current Illness: NA
Preexisting Conditions: Migraine, Anxiety
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Pt reported to feel dizzy. BP: 124/80, After 15min monitoring pt reports feeling better. Pt left the facility, symptoms resolved.


VAERS ID: 1678675 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial spasm, Hypoaesthesia, Injection site reaction, Muscle spasms, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Tingling sensation all extremities. Hand and forearm cramps in left arm (injection site) now affecting left leg (calf) Left side of face has spasms and numbness.


VAERS ID: 1678677 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-22
Onset:2021-09-07
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Inappropriate schedule of product administration, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Patient received Moderna Vaccine on 1/10/2021. Then received Pfizer COVID vaccine on 8/1/2021. Lot #- EW0178. Then patient received another dose of Pfizer vaccine on 8/22/2021 as documented on this report.


VAERS ID: 1678704 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Consumer states she has a swollen lump under armpit in same are that was vaccinated. It did not appear until 2 days after injection


VAERS ID: 1678710 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (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: spectazole percocet norvasc celebrex melatonin
Current Illness: follow up of IFS, controlled medication, HTN and Hyperlipidemia
Preexisting Conditions: Neurology Cervical radiculopathy Fibromyalgia Cervicalgia Pain in right shoulder Cardiovascular Essential hypertension Hypertriglyceridemia Pulmonary Sleep apnea Chronic rhinitis Gastrointestinal Gastroesophageal reflux disease Fatty liver Nephrology CKD (chronic kidney disease) Stage 3, GFR 30-59 ml/min Genetics/Metabolics Impaired fasting glucose Rheumatology Osteoarthritis of cervical spine Cervical disc disorder Cervical spondylosis without myelopathy Musculoskeletal Rotator cuff tear, right Incomplete tear of right rotator cuff Psychiatry Adjustment disorder with mixed anxiety and depressed mood Other Low testosterone Thoracic outlet syndrome High risk medication use Controlled substance agreement signed Obesity, Class I, BMI 30-34.9
Allergies: Lisinopril
Diagnostic Lab Data: none
CDC Split Type:

Write-up: itchy throat, cough, tickle in throat, throat felt tight administered Fexofenadine 60 mg tablet by mouth observed patient additional 30 minutes. patient states symptoms subsided after 10 minutes of receiving Fexofenadine 60 mg talet


VAERS ID: 1678725 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-06
Onset:2021-09-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin (not pregnant) Apple cider vinegar supplement Turmeric supplement Cymbalta 30mg PO QD Synthroid 100mcg PO QD
Current Illness: None that I am aware of.
Preexisting Conditions: Polycystic ovarian syndrome (PCOS) Hashiomotos thyroiditis Autoimmune myositis Seasonal allergies Depression Chronic pain and fatigue
Allergies: Tomatoes
Diagnostic Lab Data:
CDC Split Type:

Write-up: My skin is burning diffusely, primarily my legs. It feels similar to getting burned when talking something out of the oven. I?m also having diffuse joint and muscle pain that is at least a 6 on the 0-10 pain scale. I have taken ibuprofen and my Cymbalta with limited relief. Cool air helps decrease the overall burning sensation but does not take it away.


VAERS ID: 1678735 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Crying, Pharyngeal swelling, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Patient stated she had been sick 12 hours after a flu shot. When asked to define sick, she said it was hard to breathe.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient sent to the ER.
CDC Split Type:

Write-up: A few minutes after the patient was vaccinated, she informed me that her eyes were starting to be blurry. I asked her if this had just started of if she thought it was because she was crying. I offered her some water and asked her to let me know if anything changes or gets worse. While drinking her water she said that she thinks her throat was starting to swell. I gave her benadryl and had the person I share an office with call the nurse practitioner in case the situation got worse. While she was calling the NP I got the epi pen ready and offered to call the ambulance to get her emergency care right away. Patient refused an ambulance and said her friend who was with her during her vaccination would take her to the ER. I recommended to call the ambulance again for their safety. The NP arrived and epinephrine was administered. I offered to call the ambulance one more time, she refused again. I told the patient''s friend to get her to the nearest emergency room right away. I called to check on her a few hours later and she said she is still being monitored and received more benadryl and epinephrine.


VAERS ID: 1678738 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-09-07
   Days after vaccination:129
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Condition aggravated, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Protonix Cymbalta Abilify Hydrocodone
Current Illness: None
Preexisting Conditions: Deteriorating lumbar disk
Allergies: Bactrim Brintelex
Diagnostic Lab Data: Blood draw Cat scan
CDC Split Type:

Write-up: Patient has a history of pulmonary embolisms poat 5 years. Tgere was no type of screening for this. Patient is currently hospitalized for Pulmonary Embolisms


VAERS ID: 1678743 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-05
Onset:2021-09-07
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Hypoxia
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cozaar, aspirin, atorvastatin
Current Illness: none
Preexisting Conditions: copd, asthma, cabg, HTN, high cholesterol
Allergies: no known allegies
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient diagnosed with COVID-19 and is hospitalized with hypoxia, requiring oxygen


VAERS ID: 1678767 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-01
Onset:2021-09-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

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

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

Write-up: Facial swelling


VAERS ID: 1678768 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-03-22
Onset:2021-09-07
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Inappropriate schedule of product administration, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Patient has had 4 doses of Moderna documented as well as 1 dose of Pfizer. Dates of Moderna are: 2/18/2021, 3/01/2021, 3/22/2021, 3/28/2021. Facility administered the dose on 3/22/2021 and charted it as 2nd dose. Pfizer dose given on 9/04/2021. There is no location given as to where other vaccines were given. I have tried to contact patient, left a voice message and have not heard back from her.


VAERS ID: 1678772 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Fatigue, Nausea, Stridor, Throat tightness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)

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

Write-up: 20 minutes after vaccine administration the patient reported throat tightness, dyspnea, nausea and vomited. She felt generally weak. EMS reported stridor. No rash or itching. No abdominal pain or diarrhea. No reported hypotension. She received 50mg of benadryl and 0.5mg of epinephrine. By arrival to the emergency room the symptoms had largely resolved. She was hemodynamically stable. Still complained of feeling tired though. she was observed for several hours and then discharged after progressive improvement of symptoms.


VAERS ID: 1678778 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Public       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: BP: 130/80 HR: 61 RA: 99% RR:18
CDC Split Type:

Write-up: Patient stated that he feels lightheaded.


VAERS ID: 1678805 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-11
Onset:2021-09-07
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / 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? 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: Breakthrough case. Confirmed positive covid results on 9/7/21 by PCR testing


VAERS ID: 1678824 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-06
Onset:2021-09-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness: ALMOST 24 HOURS AFTER VACCINE I HAVE NECK PAIN, HEADACHE AND VERY TIRED
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: STIFF NECK, HEADACHE, VERY TIRED


VAERS ID: 1678833 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-09-07
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

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

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

Write-up: Patient received dose #1 of Pfizer vaccine on 8/13/2021 from a different vendor and received dose #2 11 days later on 8/24/2021 as documented on this report.


VAERS ID: 1678856 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysphagia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (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: amlodinpine, benazepril, esomeprazole, flonase, folic acid, metaglip, hctz, loratadine, lorazepam, metoprolol, crestor, sulfasalazine
Current Illness: None
Preexisting Conditions: DM, HTN, GERD, Hyperlipidemia, Obesity, Anxiety, Interstitial pulmonary disease, NASH
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt had feeling of throat tightness and difficultly swallowing. No rash or hive. No wheezing or stridor. She was given 0.3 Epi via epipen IM to the right thigh. Symptoms subsided in 2-3 minutes. Monitored patient for 1:15 minutes total without return of symptoms. She was released to home with script for epipen and directions to call 911 for EMS if symptoms returned.


VAERS ID: 1678883 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Exposure during pregnancy, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine in 2019. reacted w/ rash on arm; resolved after a few days.
Other Medications: denies
Current Illness: denies
Preexisting Conditions: denies
Allergies: denies
Diagnostic Lab Data:
CDC Split Type:

Write-up: nausea; then vomiting small amount of liquid 30 minutes after vaccination. Reports that she just found out she was pregnant yesterday; estimated gestation 5 weeks. Does not know EDD


VAERS ID: 1678885 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

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

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

Write-up: fainted


VAERS ID: 1678888 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: PCN
Diagnostic Lab Data: Blood Pressure normal - Benedryl 25mg administered
CDC Split Type:

Write-up: Patient described feeling tingling in the ears and nose. After 15-20 minutes the feeling subsided. Blood pressure was check and was normal


VAERS ID: 1678890 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: N/A
CDC Split Type:

Write-up: Patient says she experienced blurry vision. EMS attended and released. Patient recovered.


VAERS ID: 1678912 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 - / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Painful respiration
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Pt complained of mild SOB and chest pain within about 10 min post vaccination. Chest pain with breathing, A&Ox3, VS on EMS arrival T-N/A, P- 110-120, R 14-16, BP-157/88. Taken to EMD.


VAERS ID: 1678927 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-09-07
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Patient completed Moderna COVID-19 vaccine series 4/7/2021 and 5/7/2021. Patient then received Pfizer dose as documented on this report on 8/4/2021.


VAERS ID: 1678932 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Musculoskeletal stiffness, Peripheral swelling, Rash, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 45 minutes after receiving the vaccine, she developed a systemic rash followed by jives. Her right arm developed some swelling and then some numbness and stiffness. She states she developed a headache behind her eyes. BP 131/75 at 1232 with HR 102 and Pulse Ox95. At 1237 BP 127/77, HR 104 and Pulse Ox 95. SHe was taken to the ED to be evaluated


VAERS ID: 1678949 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Fluzone vaccine-hives
Other Medications: unknown
Current Illness: NA
Preexisting Conditions: CVA Pacemaker
Allergies: fluzone latex hydrocodone codeine erythromycin iodine tomato egg aspirin Toradol morphine
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: 17 minutes after vaccination, patient started having itching and tightness to face. Started with a few hives to right cheek. Benadryl 25 mg IM given and patient sent to emergency department


VAERS ID: 1678959 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Injection site pain
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Mild, Additional Details: about 10 minutes after pfizer covid vaccine administration, pt reported feeling slight dizzy. I said I would call 911 and asked if she has touble breathing. pt said no it is not serious. another 2 to 3 minutes later, pt got up and said she is feeling completely fine. I asked her to stay a little longer, but she said is no longer dizzy and she is able to go home and did not want to stay in the store any longer. I did call her about half hour later and she is completely fine.


VAERS ID: 1678966 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

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

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

Write-up: anxiety, tingling. monitored bp and pulse for 40 mins. temp 98


VAERS ID: 1678967 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Medium, Additional Details: Patient fainted due to anxiety relatd to the vaccination. Patient fainted approximately 10 minutes after it was given when trying to stand up. Was given water after the vaccination as well as laid down post fainting spell.


VAERS ID: 1678976 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Confusional state, Dizziness, Nausea, Tinnitus, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Chills-Mild, Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Nausea-Medium, Systemic: Shakiness-Mild, Systemic: Tinnitus-Mild, Additional Details: ems called - taken for monitoring


VAERS ID: 1678983 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Headache, Pain
SMQs:

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

Write-up: Pt presented to COVID Clinic at 1220 after receiving the vaccine at 1030 complaining of headache and body aches , but denied wanting to go to the ER.


VAERS ID: 1678988 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-02-09
Onset:2021-09-07
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID-19 Sofia antigen with a positive result.
CDC Split Type:

Write-up: Patient received the Pfizer COVID-19 vaccine on 1/18/2021 and 2/9/2021 (fully vaccinated), but tested positive for COVID-19 on 9/7/2021.


VAERS ID: 1678996 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Dizziness, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: Dizziness, Tachycardia


VAERS ID: 1678997 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #FF2587 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chills, Dizziness, Dysphagia, Erythema, Headache, Heart rate increased, Throat irritation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Patient had informed healthcare worker of a previous anaphylaxis reaction to Toradol prior to vaccine. the patient was informed to wait 30 minutes after injection. 15-20 minutes after the patient received the Pfizer covid vaccine, the patient was experiencing headache, dizziness, chills and increased heart rate. Patient was assessed by healthcare worker and was walked down to the ER. As the patient was walking the patient stated her throat was itchy and it was hard to swallow. Once the health care worker and patient reached the ER, the patients face turned red and was given EPI and treated in the ER.


VAERS ID: 1678999 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135AB / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Patient says cheek felt swollen;no viual swelling-Mild, Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: Patient stated left cheek/jaw felt swollen/left leg felt numb/tingly


VAERS ID: 1679003 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose normal, 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: Patient refers taking Methotrexate and Prednisone
Current Illness: N/A
Preexisting Conditions: Patient reports suffering from Arthritis, Cholesterol, Sclerosis and Osteoporosis
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Female patient 77 years old refers to a paramedic approximately 20 minutes after the vaccine administration, feeling dizzy. Patient is evaluated at 10:15am BP: 140/80, SPO2 98%, Glucose: 74, pulse : 87 per minute. We consult with Doctor R who orders 4z of juice for the patient and to keep her in observation for approximately 30 minutes. Vitals are evaluated BP 130/70, Dextrose 96, Spo2: 99, pulse :84. Patient refers feeling better and not dizzy.


VAERS ID: 1679005 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Patient reported swelling on left hand. EMS evaluated and cleared patient.


VAERS ID: 1679044 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
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: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Client got vaccinated with JJ at facility who previously got 2 Moderna before at pharmacy. Vaccine Record: 1st Moderna: 06/07/2021 Lot #049C21A 2nd Moderna: 07/09/2021 Lot #052C21A Janssen: 09/07/2021 Lot #201A21A We found out that she got the vaccine when her sister came over to tell she''s vaccinated already. We checked in system during registration. She used a different name in pharmacy that''s why her record did not show . She didnt know that the vaccine she got from pharmacy was COVID vaccine.


VAERS ID: 1679050 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

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

Write-up: throat tightening


VAERS ID: 1679052 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-01
Onset:2021-09-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 06ZEZIA / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Intermenstrual bleeding, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Abnormal bloody/clotted vaginal discharge mid cycle.


VAERS ID: 1679061 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-25
Onset:2021-09-07
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / IM

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

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

Write-up: pt is hospitalized with covid + pna


VAERS ID: 1679066 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad)

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

Write-up: Pt with early pregnancy. Reports hx anaphyllaxis with flu shot in past. Pfizer covid lot #FE3592 given at 2:24pm. At 2:45 c/0 lightheadedness and feeling "weird". vs 121/72 hr 92 and reg o2 sat 100%. Rapid resonse team attended and pt taken to ER via stretcher. No difficulty breathing.


VAERS ID: 1679071 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 - / -

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

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

Write-up: Fainting


VAERS ID: 1679073 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Agitation, Crying, Feeling cold, Heart rate increased, Hyperhidrosis, Muscle tightness, Paraesthesia, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: About 5 mins after vaccine administration, patient complained of a tingling sensation in her face, hands and fingers and mild throat tightening. No breathing issues identified. She remains alert and oriented to name, place and time; communicated coherently verbally. Pt continue to lie on the cot during assessment. A few minutes later, she started to show some symptoms of sweatiness, agitated, crying and trembling. After another 15 mins, the client started to feel muscle tightening in her LE and UE; continues to cry, tremble. Body feels cool to touch. BP: 120/60, HR 30-40s; comfort measures provided; encouraged relaxation breathing, Pulse Ox- range 95-99%. Continued assessment done; 911 called. Arrived at 2:45 pm and client d''cd to ER via stretcher and remains alert and oriented. HR increased 130 and BP remains stable.


VAERS ID: 1679075 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Condition aggravated, Dizziness, Electrocardiogram, Feeling abnormal, Panic attack
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: States has anxiety and panic attacks
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: EKG by EMS
CDC Split Type:

Write-up: 1:30 pm Patient states was feeling light headed, dizzy but has passed, patient stated has anxiety and panic attacks. Skin cool and dry to touch, color pink, respirations 20. nurse instructed to continue to sit in waiting room take deep breathes will check on her in a few minutes. 1:40 pm nurse check on patient was doing ok but states still felt funny. remains alert, oriented and without distress 1:49 Pt states feels heaviness in chest BP156/102 HR 84 Resp 20, called 911. 1:54pm BP 144/100 HR 89 Resp 16. Patient remains alert, orient and without diaphoresis. States it could be anxiety. EMS arrived 2:00 patient able to walk to ambulance for assessment and EKG. EMS state EKG normal recommend waiting 5 more minutes in lobby and if unable to drive call for assistance and follow up with private medical doctor.


VAERS ID: 1679077 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: difficulty breathing, fever, fatigue
Preexisting Conditions: fatigue, continuing cognitive fog'', still with at times difficulty breathing
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: fatigue, fevers, SOB


VAERS ID: 1679081 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood pressure decreased, Loss of consciousness, Nausea, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: B/P bottomed, nausea, vomiting, extreme weakness, loss of consciousness


VAERS ID: 1679082 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Headache, Neck pain, Oropharyngeal pain
SMQs:, Anaphylactic reaction (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), Arthritis (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: Prenatel
Current Illness: none
Preexisting Conditions: currently being monitored for a lung conditions, unknown indicator. Follow-up with PCP is in One Month
Allergies: eggs, OxyContin
Diagnostic Lab Data: epi pen and kenelog
CDC Split Type:

Write-up: headache, neck pain, throat pain, unable to take full breath while mouth closed due to tightness, pain and burning in lungs


VAERS ID: 1679101 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

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

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

Write-up: Pt experienced symptoms of syncope after leaving the pharmacy area about 10 minutes after the 2nd dose was provided.


VAERS ID: 1679105 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: Patient walked into the vaccination room to receive J&J COVID-19 vaccine. Patient was counselled on side effects. Patient looked slightly pale and mentioned he did not like vaccines. Patient was administered the J&J vaccine in left deltoid. Immediately after administering the vaccine, a band-aid was placed on the injection site and as the band-aid was being placed, the pharmacist heard the patient exhale and noticed the patient''s head dropped to the side. Pharmacist caught the patient''s head and held it while repeating his name until he woke up. Patient lost consciousness for about 15-20 seconds. When patient awoke, he was asked if he was okay and he replied "I went to sleep". He mentioned this has happened to him recently when he had to give blood work and another time he asked to leave the hospital room after feeling queasy when his wife had to be given an epidural. Patient denied any shortness of breath/difficulty breathing, chest pains, or itching. He was provided with water and an ice pack to apply to the back of his neck. The color immediately came back to his face after drinking some water and applying the ice pack. While observing him, we discussed he has a 3 month old baby and has not been getting any sleep lately and the only ?symptom? he felt was sleepy. He was observed for 15 additional minutes inside the vaccination room without any further events.


VAERS ID: 1679119 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-01
Onset:2021-09-07
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Nasal congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: unknown
Allergies: morphine
Diagnostic Lab Data: rapid COVID test, molecular, NG swab
CDC Split Type:

Write-up: cough, runny nose and congestion


VAERS ID: 1679128 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: Female patient 25 years old refers to nurse with feeling dizzy and blurry vision after the vaccine administration. She gets transferred to the evaluation area. We take her vitals 110/70, 98% Spo2, 103 pulse and 76 glucose. We consult with Doctor R. and she indicates to leave patient in the observation area for 30 minutes and to reevaluate vitals. After 30 minutes we retake her vitals BP 120/70, Spo2 99%, 97 pulse and 90 of glucose. Patient refers feeling better and free of dizziness. Patient leaves the cent of vaccines.


VAERS ID: 1679146 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Migraine, Photophobia
SMQs:, Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (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: ADVIL
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Dizziness, light sensitive, migraine, aches in joints


VAERS ID: 1679184 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Neck pain, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (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 known
Current Illness: none noted
Preexisting Conditions: none noted
Allergies: none noted
Diagnostic Lab Data: none known
CDC Split Type:

Write-up: Syncope approximately 10minutes post-vaccination. Came to upon prompting, but quite violent response. Arms thrashed out, but standing upright within seconds asking ''Did I pass out?''. Claimed he has in the past, specifically when donating blood. Pale and perspiring for several minutes. Stated neck somewhat sore, but no head discomfort. Stayed in the recovery area around 30 minutes. Fully recovered before leaving. Refused call to relative or emergency services. Suggested he follow up with provider.


VAERS ID: 1679187 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SINGULAIR 10MG AND LORATIDNE 10 MG
Current Illness: UNKOWN
Preexisting Conditions: URTICARIA
Allergies: PREVIOUS HISTROY OF URTICARIA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PT STARTED TO HAVE ITCHING ALL OVER HER BODY APPROXIMATELY 8-10 MINUTES AFTER THE VACCINATION


VAERS ID: 1679193 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-18
Onset:2021-09-07
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / 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? 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: Breakthrough case. Confirmed with positive PCR test on 9/7/21


VAERS ID: 1679195 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: n/a
CDC Split Type:

Write-up: Patient arrived for her first dose appointment for the Pfizer vaccine. After receiving the vaccine, the vaccinator found on that the patient record matched with a patient who had previously received 1 dose of the Moderna vaccine on May 10th. The patient insisted that the vaccine she received today was her first vaccine and that she had been struggling over the last four months to combat an identify theft incident involving her bank accounts, vehicles, and other accounts tied to the contents of her wallet. Patient was grateful to have received the vaccine and had no adverse reactions to the vaccine. Patient was observed for 15 minutes after her vaccination and left the location without incident. Patient was advised to call 311 to attempt to reconcile and correct her vaccination record.


VAERS ID: 1679200 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure increased, Heart rate irregular
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Cardiac arrhythmia terms, nonspecific (narrow)

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

Write-up: Patient reported in the past of itchiness after receiving the first dost. After the second shot was administer, the patient took benadryl. Patient left after a bit to the doctor appointment where she was told that she have elevated blood pressure and irregular heart rate. Patient was prescribe blood pressure medication to take and follow up


VAERS ID: 1679206 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: dose given outside of recommended window. dose given 6 months after 1st dose


VAERS ID: 1679207 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-05
Onset:2021-09-07
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Vaccine breakthrough infection
SMQs:

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

Write-up: Breakthrough case


VAERS ID: 1679219 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-02
Onset:2021-09-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Medications tamsulosin 0.4mg 1 tablet qam olopatadine 0.2mg 1 gtt ou qd PRN lorazepam 1 mg tablet ? tablet bid tadalifil 5mg 1 tablet qam trazodone 100 mg tablet 1 tablet qhs bupropion SR 200 mg tablet, 1 tablet qam zolpidem 10mg 1 tabl
Current Illness: None
Preexisting Conditions: BPH, Asthma, anxiety/depression/insomnia, PVC''s
Allergies: PEN PK, Dried Fruit-Apricots
Diagnostic Lab Data: EKG 09/07/2021. Tachycardia, occasional PVC''s, with no signs of Myocarditis or endocarditis.
CDC Split Type:

Write-up: Tachycardia. Normal my resting heart rate is 50, heart rate at rest between 100-135 sustained for hours.


VAERS ID: 1679223 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-06
Onset:2021-09-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Eczema
SMQs:, Hypersensitivity (narrow)

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

Write-up: Flared patient''s eczema


VAERS ID: 1679271 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient fell after 10 minutes getting the Pfizer vaccine, claimed felt nausea, light headed, no other symptoms reported. Got up by himself and sat on bench for another 30 minutes, check every 5 minutes with him, he claimed symptoms were getting better.


VAERS ID: 1679273 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Echocardiogram normal, Electrocardiogram normal, Red blood cell sedimentation rate increased, Troponin increased, White blood cell count normal
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: - daily multivitamin - methylphenidate 30 mg daily
Current Illness: - none
Preexisting Conditions: - none
Allergies: - none
Diagnostic Lab Data: High sensitivity troponin: 93-128-154 CRP: 14.9 ESR: 13 WBC: 5.67
CDC Split Type:

Write-up: Chest pain with elevated troponin but normal EKG and echo 3 days after second COVID 19 vaccine.


VAERS ID: 1679278 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-04
Onset:2021-09-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Echocardiogram, Electrocardiogram, Myocarditis, Troponin
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Obesity BMI 32
Allergies: Vicodin - allergy not specified
Diagnostic Lab Data: Echo ECG Troponins CXR
CDC Split Type:

Write-up: Myopericarditis diagnosed 9/7/21


VAERS ID: 1679281 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 1 RA / IM

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

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

Write-up: Vaccine was administered. After vaccine form was reviewed. Patient seemed anxious, but received the vaccine without any issue. At the end of the 15 minute way period, patient was brought to counsel window stated that "itchy spots" appeared on patient wrist and arm. She was not experiencing any shortness of breath and spots were not spreading. Recommended patient take some Benadryl and patient said that this happens to her from time to time. Offered, but parent declined did not feel it was medically necessary to administer Benadryl as patient just had 2 spots on arm.


VAERS ID: 1679282 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-05
Onset:2021-09-07
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lovastatin; CoQ10; aspirin; vitamin D
Current Illness: None
Preexisting Conditions: Diabetes; stage 3 kidney damage
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: It started out with pimples. I thought they were spider bites. They would go away in a few hours. That continued for like 3 weeks. Then I started having some blisters in my legs, bottom area, arms. They looked like water blisters. They itched terribly. I took some Benadryl for a couple of days. After a week or so I thought I should see a doctor. I made an appointment and they said they did not know what it was. They told me to buy an over the counter medication. They come back daily. I have another appointment with my doctor on 09/22/2021.


VAERS ID: 1679284 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Gingival bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gingival 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: unknown
Current Illness: unknown
Preexisting Conditions: Hashimotos
Allergies: unknown
Diagnostic Lab Data: none known
CDC Split Type:

Write-up: Patient reports that, as she was walking home from the vaccine clinic, about half an hour after receiving vaccine, she started to have bleeding from her gums, in between two teeth (not generalized). Reports bleeding stopped then restarted a couple of times. Reports no recent injury to gums and no recent dental work. Reports no history of easy bleeding or bruising. Denies any other symptoms. Denies any signs or symptoms concerning for allergic reaction (denies swelling/ rash/ light headedness/ GI distress/ respiratory distress/confusion). Due to time of day when this conversation occurred, this provider suggested client visit Urgent Care is symptom was concerning to her. Also advised that she could watch and wait to see if symptom resolved spontaneously. Advised her to seek care if bleeding did not resolve or worsened.


VAERS ID: 1679286 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Feeling hot, Hyperhidrosis, 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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Given vaccine @ 14:15 and taken to observation area, no acute issues reported. ~14:25 pt asked for water, c/o temporary LOC. Pt laid down and feet elevated, LOC less than 7secs. Pt very diaphoretic, cool and pale. Pt reports feeling very hot and clammy. EMS called and arrived within 10mins. HR 100, SBP 115s. Pt continued to improve over time, reporting feeling hot but less lightheaded. Upon arrival of EMS pt HR still in the low 100s and SBP 112, no abnormal rhythm found. EMS advised to take pt to ED for observation d/t reports of feeling dizzy and lightheaded. Pt reports he has passed out from blood draws before and did not eat lunch prior to arriving for vaccination.


VAERS ID: 1679298 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Loss of consciousness, Nausea, Salivary hypersecretion, Seizure, Skin warm
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: patient received the first dose of the pfizer covid vaccine in her left arm IM. Within 30 seconds of the shot being given, patient lost consciousness for about 30 seconds, and began to convulse and slide off her chair. Her father held her up so she didn''t fall, and patient regained consciousness when her father was asking what was going on. Patient''s blood pressure was checked, and it was at 84/45 with a heart rate of 55. Patient became diaphretic and extremely hot to the touch. Ice packs were given to cool the patient down. Blood pressure was taken again and her pressure went up to 165/110 with a heart rate of 103. 911 was called at this time. Patient could barely maintain consciousness, but was able to remember where she was and what happened during her shot. Patients airways remained open, and patient complained of nausea. Patient had extra salivation at this time and remained hot to the touch and continued to get hotter. Pharmacist administered .15mg of Epinepherine via epiPen at 3:53. EMS and fire arrived shortly after and transported patient to Hospital


VAERS ID: 1679300 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

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

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

Write-up: Per CDC guidelines, Moderna vaccines are only recommended for 18 years or older patients. Technician accidently vaccinated this 12 year old patient without prior consent from pharmacist. Technician thought CDC guidelines allowed for Moderna vaccines to be vaccinated to 12 years or older. Technician was confused with Pfizer vaccines guidelines. No adverse effects are noted and pharmacy is closely monitor patient daily for 2 weeks. If any adverse effects happen, we will notify VAERS of the change. Technician was reprimanded and re-educated for the guidelines and re-trained on vaccinations.


VAERS ID: 1679305 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Paraesthesia oral, Throat irritation, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Patient reported an itchy throat following first dose.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported itchy throat, dizziness, tongue feeling weird and blurry vision shortly after administration of vaccine. Patient was administered 50 mg of diphenhydramine and laid on the floor for 45 minutes. Blood pressure and pulse were monitored. After 45 minutes of little to no improvement, EMS was notified. She was taken to the ER, observed and discharged.


VAERS ID: 1679326 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: 5 minutes after she got the shot she started sweating, feeling hot around her neck. Her mom told us she had POTS. We got her a bottle water , she started drinking it and then said she felt dizzy. She wanted something salty so we got her some plain chips. once she ate that she started feeling better. We had her remain seated for 30 min. After that, she stood up and said she was no longer dizzy or hot feeling.


VAERS ID: 1679328 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-04
Onset:2021-09-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Chills, Cyanosis, Diarrhoea, Discomfort, Dizziness postural, Dyspnoea exertional, Feeling abnormal, Feeling cold, Headache, Hot flush, Hyperhidrosis, Lip discolouration, Malaise, Maternal exposure during breast feeding, Muscle spasms, Myalgia, Nausea, Neck pain, Pain, Palpitations, Paraesthesia, Sleep disorder, Toothache
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Neonatal exposures via breast milk (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pristiq
Current Illness: None, healthy
Preexisting Conditions: None, currently breastfeeding
Allergies: None
Diagnostic Lab Data: My doctor''s office closes on Friday, Saturday, Sunday, and Monday (due to a holiday) and I just reached out to them today and left a message with the medical assistant and am waiting to hear back. I have been hydrating and eating as healthy as I can but still feel terrible. I am trying to manage the pain with ibuprofen and tylenol (one of each taken at the same time) and it is barely "touching" the pain or managing it. I also cannot sleep throughout the night because of the pains and discomfort. I cannot take care of my children, my husband is caring for them at this time while I am in bed most of the day.
CDC Split Type:

Write-up: The symptoms came on around 5pm the same day I received the COVID-19 vaccine, which was at 1:40pm. I also received the flu vaccine (Flucelvax ) at the same time in my right arm. That evening at 5pm, I started having severe symptoms of chills and body pain. I had to take 5 baths throughout the night to get warm enough. I''ve been consistently experiencing severe headache, and now odd hot flashes with feeling uncomfortable with sweats, brain fog, full body pain - joint and muscular, neck pain, tingling in legs and feet, nausea, diarrhea, general unwell feeling. I get easily short of breath when walking. My muscles feel like they are about to cramp up after walking. I feel anxious because of these symptoms and been having anxiety attacks. I have had heart palpitations and dental pain (in all of my teeth) and dizziness when ambulating. My lips have been blueish purple or white (which is also why I need to bathe to stay warm, yet our house is at 80 degrees temperature because we do not have air conditioning. But then I subsequently have sweats at the same time.


VAERS ID: 1679333 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-22
Onset:2021-09-07
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, Fertility disorders (broad)

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

Write-up: Irregular menstruation


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