National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

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



Case Details (Reverse Sorted by Onset Date)

This is page 246 out of 5,069

Result pages: prev   147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345   next


VAERS ID: 1383617 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm felt tingly right away. Within 5 minutes chin felt numb. Within 2 hours left side of face was tingly and numblike.


VAERS ID: 1384287 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Body temperature, Discomfort, Dry throat, Feeling cold, Feeling of body temperature change, Headache, Musculoskeletal stiffness, Ophthalmic fluid drainage, Paranasal sinus discomfort, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (narrow), Arthritis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Protein allergy; Sulfonamide allergy
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (around 27-FEB-2021); Infusion
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: Body temperature; Result Unstructured Data: 100.4
CDC Split Type: USJNJFOC20210609223

Write-up: FEELING HEAVY; NECK IS STIFF; SLIGHT DRAINAGE; FEELING WEAK; FEVER OF 100.4; HEADACHE; SPREADING COLD THEN TURNS TO SPREADING HOT OVER WHOLE BODY; SINUS PRESSURE; THROAT IS DRY AND THROBBING; VERY COLD; This spontaneous report received from a patient concerned a 76 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included covid-19, and antibody infusion, and concurrent conditions included sulfa allergy, and myosin allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and expiry: UNKNOWN) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUN-2021, the subject experienced spreading cold then turns to spreading hot over whole body. On 03-JUN-2021, the subject experienced sinus pressure. On 03-JUN-2021, the subject experienced throat is dry and throbbing. On 03-JUN-2021, the subject experienced very cold. On 03-JUN-2021, the subject experienced fever of 100.4. On 03-JUN-2021, the subject experienced headache. Laboratory data included: Body temperature (NR: not provided) 100.4. On 04-JUN-2021, the subject experienced feeling heavy. On 04-JUN-2021, the subject experienced neck is stiff. On 04-JUN-2021, the subject experienced slight drainage. On 04-JUN-2021, the subject experienced feeling weak. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from very cold, spreading cold then turns to spreading hot over whole body, sinus pressure, feeling heavy, neck is stiff, slight drainage, headache, and feeling weak, and the outcome of throat is dry and throbbing and fever of 100.4 was not reported. This report was non-serious.


VAERS ID: 1384298 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Body temperature, Fatigue, Headache, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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: Abstains from alcohol; Cigarette smoker (Consumer is a daily smoker.); Dermoid cyst (Getting ready for surgery.); Food allergy; Latex allergy; Penicillin allergy; Shellfish allergy
Preexisting Conditions: Comments: Patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: Body temperature; Result Unstructured Data: 101.2 F
CDC Split Type: USJNJFOC20210611911

Write-up: PAIN IN THE RIGHT ARM (FEELING OF LIKE BEING PUNCHED IN THE ARM); FEVER OF 101.2 DEGREE F; TIREDNESS (OVERWHELMINGLY TIRED); DULL HEADACHE; BODY WEAKNESS; This spontaneous report received from a patient concerned a 39 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included dermoid cyst, penicillin allergy, latex allergy, shellfish allergy, non alcohol user, cigarette smoker, and green peppers allergy, and other pre-existing medical conditions included patient had no drug abuse or illicit drug usage. The patient experienced drug allergy when treated with morphine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, and batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUN-2021, the subject experienced body weakness. On 03-JUN-2021, the subject experienced dull headache. On 03-JUN-2021, the subject experienced tiredness (overwhelmingly tired). On 04-JUN-2021, the subject experienced pain in the right arm (feeling of like being punched in the arm). On 04-JUN-2021, the subject experienced fever of 101.2 degree f. Laboratory data included: Body temperature (NR: not provided) 101.2 F. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from body weakness, dull headache, pain in the right arm (feeling of like being punched in the arm), fever of 101.2 degree f, and tiredness (overwhelmingly tired). This report was non-serious.


VAERS ID: 1384307 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Iowa  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Influenza like illness, Pain in extremity, Spinal pain
SMQs:, Arthritis (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210612016

Write-up: FEELING ILL, COUGHING, SHARP HEADACHE PAIN AND MUSCLE ACHE; PAIN IN SPINE; VERY UPSET; SORE ARM; This spontaneous report received from a patient concerned a 59 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 03-JUN-2021, the subject experienced feeling ill, coughing, sharp headache pain and muscle ache. On 03-JUN-2021, the subject experienced pain in spine. On 03-JUN-2021, the subject experienced very upset. On 03-JUN-2021, the subject experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sore arm, and the outcome of feeling ill, coughing, sharp headache pain and muscle ache, pain in spine and very upset was not reported. This report was non-serious.


VAERS ID: 1384733 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021649481

Write-up: swollen eye; This is a spontaneous report from a contactable consumer (patient). A male patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number: not reported), via an unspecified route of administration on 02Jun2021 as 1ST DOSE, SINGLE DOSE for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. On 03Jun2021, the patient woke up with swollen eye. Something similar had never happened to him and he wants to know if it is something reported with the vaccine. Referred to his physician for treatment recommendation. The outcome of the event was unknown. Information about lot/batch no has been requested.


VAERS ID: 1384743 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Pain, Vaccination site haemorrhage
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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: Medical History/Concurrent Conditions: Idiopathic thrombocytopenic purpura
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021650407

Write-up: redness; soreness; quite a bit or 2 to 3 drops of still wet, coagulated blood; This is a spontaneous report from a contactable consumer (patient) or other non HCP A 65-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: unknown, Expiration date: unknown), via unspecified route of administration, on 02jun2021 as 2nd dose, single dose for COVID-19 immunization. The patient medical history included ITP (Idiopathic thrombocytopenic purpura). concomitant medications were not reported. On 03jun2021, 1 day after the vaccination, the patient experienced quite a bit or 2 to 3 drops of still wet, coagulated blood after removing bandage (after wiping it away, her arm wasn''t actively bleeding), redness and soreness. She enquired regarding explaining the medical conditions including bleeding disorder or blood thinners to vaccination provider which was mentioned in the fact sheet. In response to her history of Idiopathic thrombocytopenic purpura she was informed that When vaccinating Persons with Increased Bleeding Risk, providers often avoid giving intramuscular injections or choose alternative routes because of the risk for hematoma formation after injections. The outcome of the events was unknown. Information on the lot/batch number has been requested


VAERS ID: 1384746 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021650442

Write-up: possibly experienced was a severe allergic reaction; This is a spontaneous report from a contactable consumer. The consumer (patient''s mother) reported for patient (reporter''s daughter). A 55-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection: Lot number: unknown), via an unspecified route of administration on 03Jun2021 as a single dose for COVID-19 immunization. The patient also given Benadryl and other premeds (other premeds not specified), 2 hours before taking the 2nd dose. The patient''s medical history was not reported. The patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection: Lot number: unknown), on 02Apr2021 for COVID-19 immunization. The caller stated that, 5 hours after the first dose, her daughter''s throat started to close. The caller Immediately called 911 and 911 mentioned that the patient did not require an EpiPen and was not advised to go to the ER. Immediately after receiving the 2nd dose on 03Jun2021, the patient had the same reaction (throat started to close) and her heart seemed to be beating out of her body. The caller stated that her daughter went to urgent care and was currently on oxygen. The caller stated that her daughter has been in the urgent care unit for over 1 hour and 1/2 now. The caller stated that, prior to receiving the second dose, her daughter consulted an allergist, but her allergist urged her to get the 2nd dose. The patient was even prescribed Benadryl and other premeds (other premeds not specified), 2 hours before taking the 2nd dose. The patient also did called CDC to report this event, but CDC did not advise them otherwise. Caller was complaining why should her daughter''s doctors (an allergist and immunologist) advised her to get the second dose given the reaction her daughter experienced. The caller was informed as per general pharmacy/medical knowledge, what her daughter could have possibly experienced was a severe allergic reaction post vaccination. The caller enquired about what are the risks of the vaccine and it was reported that, there was a remote chance that the Pfizer-BioNTech COVID-19 Vaccine could cause a severe allergic reaction. A severe allergic reaction would usually occur within a few minutes to one hour after getting a dose of the Pfizer-BioNTech COVID-19 Vaccine. Signs of a severe allergic reaction can include: Difficulty breathing and A fast heartbeat (similar to what her daughter could possibly experience). The caller was also asking if the vaccinators on the site were employed by Pfizer and why do they not have this information and advised her daughter not to take the 2nd dose given the above-mentioned reactions post vaccination of 1st dose. Caller wanted to know whether her daughter was going to be okay, and she can give her an assurance that this was not going happen when her daughter comes back to home because her daughter was living alone in her apartment. The outcome of the event was unknown. Follow up attempts are needed, information about lot/batch number cannot be obtained.


VAERS ID: 1384758 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Fatigue, Headache, Malaise
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021654613

Write-up: I have been feeling very dizzy; Having shortness of breathe; Head hurts; I am really tired; Feeling ill; This is a spontaneous report from a contactable consumer or other non HCP (patient). A 26-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8736), intramuscular in left arm on 02Jun2021 at 13:30 (at the age of 26-years-old) as 2nd dose, single for COVID-19 immunization. The patient had no medical history. The patient''s concomitant medications were not reported. The patient previously took first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735), via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunization. The patient did not receive any vaccination 4 weeks prior. On 03Jun2021, patient experienced feeling very dizzy, shortness of breathe, head hurt, really tired, and feeling ill. The patient did not take any treatment for the events. The outcome of the events was not recovered. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1384762 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Rectal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021654750

Write-up: rectal bleeding; lower abdominal cramps; This is a spontaneous report from a contactable consumer or other non hcp (reported herself). A 27-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number: unknown), via an unspecified route of administration on 03Jun2021 at single dose for COVID-19 immunisation. The patient took 1st dose of BNT162B2, PFIZER-BIONTECH COVID-19 VACCINE solution for injection) for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 03Jun2021, the patient experienced rectal bleeding (medically significant and lower abdominal cramps (abdominal pain) (non-serious). At the time of reporting, the outcome of the events were unknown. Information about the Lot/batch number has been requested


VAERS ID: 1384775 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Myalgia, Neuralgia, Pain in extremity, Restless legs syndrome, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Eosinophilic pneumonia (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: ELIQUIS; DILTIAZEM; ATENOLOL; JANUVIA [SITAGLIPTIN]; MELATONIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Atrial fibrillation; COVID-19; Hay fever (known allergies: Hay fever); Hypertension; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021656596

Write-up: Minor muscle aches; Sore arm; Minor chills second night; Sig increase in neuropathic leg/feet pain plus restless leg interrupting sleep frequently.; Sig increase in neuropathic leg/feet pain plus restless leg interrupting sleep frequently.; Sig increase in neuropathic leg/feet pain plus restless leg interrupting sleep frequently.; This is a spontaneous report received from a contactable consumer(patient). A 68-year-old male patient received second dose of bnt162b2 (BNT162B2 PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number: EW0185), via an unspecified route of administration in left arm on 03Jun2021 at 14:30(at the age of 68-years-old) 2ND DOSE SINGLE DOSE as single dose for COVID-19 immunization. The medical history of the patient included diabetes II, hypertension, a-fib and COVID-19 on Dec2020. The patient allergic reactions included hay fever. The concomitant medications of the patient included apixaban(ELIQUIS), diltiazem(DILTIAZEM), atenolol(ATENOLOL), sitagliptin(JANUVIA) and melatonin(MELATONIN). The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: ER8736), via an unspecified route of administration in left arm on 14May2021 at 14:00 as a single dose for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the covid vaccine. Prior to vaccination, the patient was diagnosed with covid-19. Since the vaccination, the patient not been tested with covid-19. After the second dose the patient experienced minor muscle aches, sore arm, minor chills second night and sig increase in neuropathic leg/feet pain plus restless leg interrupting sleep frequently on 03Jun2021 at 18:00. The patient stated that notes from his initial infection with COVID last December show the same intensification of neuropathy symptoms for several nights. It was reported that no treatment was received. The outcome of all the events was reported as resolving.


VAERS ID: 1384798 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: Fever; Result Unstructured Data: Test Result:High
CDC Split Type: USPFIZER INC2021659131

Write-up: She had a high fever; This is a spontaneous report from a non-contactable consumer or other non hcp patient''s mother). A 13-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 2 via an unspecified route of administration, administered in arm right on 02Jun2021 (Batch/Lot Number: EW0177) as a Single dose for covid-19 immunization. The patient medical history and concomitant medication was not reported. The patient previously took BNT162B2 on 12May2021 for COVID-19 Immunization (Dose: 1st, Batch/lot number: EW0179, anatomical site of injection for first vaccination: Left arm). On 03Jun2021, She had a high fever and the fever recorded 24 hours after the shot. The patient mother was interesting to patient about the fever was recorded 24 hours after the shot. So first she thought the patient didn''t go to have any side effects at all but then she did get side effects 24 hours after the shot." The patient did not take any vaccination prior to second vaccination. The patient took Ibuprofen for fever reducing medicine. The outcome of the event was recovered in Jun2021. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1384845 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Hyperhidrosis, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient no known drug allergies and no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210607415

Write-up: SEIZURE; VOMITING; DIAPHORESIS; TIRED; This spontaneous report received from a consumer concerned a 24 year old white, Not Hispanic or Latino male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non alcoholic, and non smoker, and other pre-existing medical conditions included the patient no known drug allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, expiry: 31-OCT-2021) dose was not reported, one total administered in Left arm on 03-JUN-2021 at 13.25 for prophylactic vaccination. No concomitant medications were reported. On 03-JUN-2021 (within 5 mins of the post-vaccination, 13.30), consumer reported that patient received the Janssen COVID-19 vaccine and began to seizure, of the post-vaccination and 20 mins later (13.45), patient vomited. Diaphoretic. EMS was called to assist the patient. Patient refused to go to ER (emergency room), but was given an ice pack. Patient was now fine, and was picked up to go home. Currently patient felt tired. The patient recovered from seizure, vomiting, and diaphoresis on 03-JUN-2021, and was recovering from tired. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0.20210607415-covid-19 vaccine ad26.cov2.s -seizure. 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: 1384869 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Tremor, 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), Parkinson-like events (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, Systemic: Shakiness-Medium


VAERS ID: 1384876 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute respiratory failure, Aggression, Agitation, Allergy to vaccine, Blood culture negative, Blood pH normal, Bundle branch block right, C-reactive protein increased, Carbon dioxide increased, Chest X-ray normal, Computerised tomogram normal, Condition aggravated, Confusional state, Disturbance in attention, Dyspnoea, Electrocardiogram abnormal, Fibrin D dimer, Hypercapnia, Hypertension, Hyporesponsive to stimuli, Intensive care, Liver function test normal, Mechanical ventilation, Metabolic encephalopathy, Muscle contractions involuntary, Pyrexia, Red blood cell sedimentation rate increased, Renal function test normal, Respiratory distress, Sinus tachycardia, Systemic inflammatory response syndrome, Tachycardia, Tremor, Troponin increased, Urine analysis normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hostility/aggression (narrow), Hypertension (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Sepsis (broad), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen-codeine 300-30 mg Oral per tablet albuterol 90 mcg/actuation Inhl inhaler azithromycin 250 MG Oral tablet budesonide-formoteroL 160-4.5 mcg/actuation Inhl inhaler diltiazem (TIAZAC) 300 MG 24 hr capsule ibu
Current Illness: Admitted from 5/9/21-5/10/21 for COPD exacerbation treated with antibiotics and steroids.
Preexisting Conditions: COPD oxygen and steroid dependent, HTN, hyperlipidemia, DM-2, obesity BMI 41
Allergies: roflumilast, atorvastatin, gentamycin, tetracycline
Diagnostic Lab Data: as above
CDC Split Type:

Write-up: Patient is a 70 yo F with PMHx COPD chronically on 3L O2, CHF, DM Type II, Hypothyroidism, HTN, CAD, GERD and OSA not on bipap anymore at home presenting to the ER with difficulty breathing on 6/3/21. Due to acuity of condition limited history able to be obtained from patient and limited history obtained from patient''s sign other on admit, who reported patient was having difficulty breathing earlier the day of admit and patient''s boyfriend called EMS. Patient''s boyfriend did report she was at baseline and denied any changes in management except she received her second dose of the COVID vaccine the day prior 6/2/21. EMS found the patient in respiratory distress and placed on non-rebreather and given 10mg Decadron. Once in the ER patient continued to appear in respiratory distress despite 3 treatments with Duo-nebs and patient was placed on NIPPV. Due to aggressive behavior of hitting staff and agitation in which patient appeared confused and attempted to continuously pull out IV lines and oxymask patient was given two separate doses of IV 0.5mg Ativan. pt arrived with a fever of 101.1, tachycardia 148, hypertension 190/144, respiratory rate of 38 she was admitted with severe SIRS response/possible sepsis with acute hypoxic respiratory failure without septic shock: - CXR negative for acute pathology/CT neg for acute pathology - ESR 64, CRP 5.5, D-dimer 540 - no leukocytosis present on lab work, renal and hepatic function WNL - EKG showed sinus tachycardia at rate 133 with RBBB - UA negative for acute infection - Blood cultures negative - Patient was started on IV Vancomycin and Zosyn which was discontinued the following day as infection ruled out - HS troponin 18, 1hr 15, delta -3 - ABG showed normal pH with hypercapnia at 58 she was also admitted for Acute metabolic encephalopathy: - Patient became agitated and was hitting staff in the ER - Unable to focus or respond more than a couple short words in ER without closing eyes - Given Ativan 0.5mg IV twice in ER as attempting to pull off lines and oxygen she was admitted to the ICU. the following day she was doing better but had body wide tremulousness and muscle fasciculations. she was eventually transferred to the medical floor. IV fluids were discontinued. Her fever defervesced. Eventually oxygen was weaned down to her baseline and she was discharged on 6/8/21 back home with home health services. She was felt to have severe SIRS response following covid 19 vaccination and it is now listed as an allergy. To her knowledge she has never been infected with covid-19


VAERS ID: 1384926 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chest pain, SARS-CoV-2 test negative
SMQs:, Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient received two Pfizer-BioNTech vaccines; dates and lot information and administration site of vaccines are not available at the time of this report. The patient presented to Hospitial on 6/3/2021 complaining of weakness and left sided chest pain occuring over several days. She was tested for C19 via rapid test and found to be positive. She was isolated and treated for C19 symptoms. She has been discharged to a Nursing Home setting.


VAERS ID: 1385090 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Back pain, Chills, Dizziness, Fatigue, Headache, Heavy menstrual bleeding, Muscle spasms, Pain, Polymenorrhoea, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 1 hour after- light headed, headache 7 hours after- body chills, body ache, fatigue 14 hours later- fever 21 hours later- cramps, back ache 23 hours later- started period (last regular period stopped a week prior) heavy than usual flow


VAERS ID: 1385122 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-30
Onset:2021-06-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-CV-2 RAPID JUNE 3, 2021
CDC Split Type:

Write-up: TESTED POSITIVE WHEN FULLY VACCINATED


VAERS ID: 1385142 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-01
Onset:2021-06-03
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-CV-2 RAPID JUNE 3, 2021
CDC Split Type:

Write-up: TESTED POSITIVE WHEN FULLY VACCINATED


VAERS ID: 1385148 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-09
Onset:2021-06-03
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-CV-2 RAPID JUNE 3, 2021
CDC Split Type:

Write-up: TESTED POSITIVE WHEN FULLY VACCINATED


VAERS ID: 1385180 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-20
Onset:2021-06-03
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-CV-2 RAPID JUNE 3, 2021
CDC Split Type:

Write-up: TESTED POSITIVE WHEN FULLY VACCINATED


VAERS ID: 1385191 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-20
Onset:2021-06-03
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-CV-2 RAPID JUNE 3, 2021
CDC Split Type:

Write-up: TESTED POSITIVE WHEN FULLY VACCINATED


VAERS ID: 1385199 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-15
Onset:2021-06-03
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-CV-2 RAPID JUNE 3, 2021
CDC Split Type:

Write-up: TESTED POSITIVE WHEN FULLY VACINATED


VAERS ID: 1385209 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-13
Onset:2021-06-03
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Catheterisation cardiac, Chest X-ray, Chest pain, Computerised tomogram thorax, Echocardiogram, Magnetic resonance imaging heart, Myocarditis, Troponin increased, Ultrasound Doppler
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Trazodone, Wellbuterin, Zoloft,ginko bilboa, airborne
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: June 3,2021- chest x-ray, ECHO of the heart, venus dopplar, blood tests for increased level of troponin June 4, 2021, heart caterization, CT scan of chest, blood tests June 7, 2021- heart MRI, blood tests
CDC Split Type:

Write-up: Had Chest pain early on June 3. Went to Emergency Room, transferred to other hospital, Did blood tests, chest x-ray, heart ECHO, Venus Doppler. June 4- blood tests, heart catherization. June 7- heart MRI. Diagnosed with myocarditis. I have no history of heart issues prior to this.


VAERS ID: 1385224 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Patient complained of nausea, coughing after receiving Pfizer vaccine dose 2. Observed by provider on site and discharged to home.


VAERS ID: 1385241 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-01
Onset:2021-06-03
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039AZ1A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Chest pain, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (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: Flo- Nase, B-12, vitamin D, multi-vitamin, iron
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Angiogram
CDC Split Type:

Write-up: Chest pain on left side. Eventually diagnosed as pericarditis after weeks of tests and hospitalization. Currently on multi-week course of Indomethacin


VAERS ID: 1385255 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-01
Onset:2021-06-03
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW017 / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Vein disorder
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: I already had some feeling of blood cloths being clogged in my leg. I believe I was exposed to covid prior to the vaccine, but never had more than one symptom at a time, so I never got tested. I believe I had COVID toe. But that went away, the nail fell and the only sympton that lingered for a while was the feeling of few arteries being clogged. Those symptons were gone by the time I took the vaccine. With the vaccine, I had the same type of problem, however it was my very small veins that felt clogged, and a lot more painful, because it involved a lot more little veins. very painfull when it occurred.
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: After 10 days, my feet and hands developed a feel that the very small veins in my hands and feet are dying, are being clogged. Very painful, happens when i rest my hands and feet usually.


VAERS ID: 1385277 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-21
Onset:2021-06-03
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, B12, D3, probiotics
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Medical professionals diagnosed
CDC Split Type:

Write-up: Shingles


VAERS ID: 1385288 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: Pt developed a rash on both forearms. Hydrocortisone cream was applied and the rash went away after approximately 24 hours.


VAERS ID: 1385357 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: vaccine was administered outside of storage recommendations. Notified pt to return for re-vaccination


VAERS ID: 1385369 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: vaccine was administered outside of storage recommendations. Notified pt to return for re-vaccination


VAERS ID: 1385372 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-23
Onset:2021-06-03
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK - / -

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

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

Write-up: U07.1 - Lab test positive for detection of COVID-19 virus


VAERS ID: 1385384 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / SYR

Administered by: School       Purchased by: ?
Symptoms: Back pain, Dizziness, Hypopnoea, Musculoskeletal chest pain, Pain, Respiratory rate increased
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (narrow), Vestibular disorders (broad), Respiratory failure (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: xulane birth control patch (every Friday)
Current Illness:
Preexisting Conditions: scoliosis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: first it was minimal dizziness, like I just had to take it easy and sit down. then later that evening I had horrible aches and pains throughout my body, predominantly in my arms, back and head. that lasted until the following evening. while experiencing this my breathing was very fast and shallow and I suspect that ro be the reason I was sore in a select few places in my back and rib cage for a few days after the pain subsided.


VAERS ID: 1385394 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: vaccine was administered outside of storage recommendations. Notified pt to return for re-vaccination


VAERS ID: 1385400 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-29
Onset:2021-06-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Blood test normal, Cold sweat, Colitis, Computerised tomogram abnormal, Diarrhoea, Diarrhoea haemorrhagic, Injection site pain, Nausea, Tremor
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Gastrointestinal haemorrhage (narrow), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Started taking Zoloft within last 2 weeks. Cont next pg
Current Illness: n/a
Preexisting Conditions: frequent sinus infections
Allergies: caffeine
Diagnostic Lab Data: Blood tests taken 6/4 normal. CT scan 6/4 showed inflammation diagnosis Colitis. Awaiting results from stool sample submitted on 6/5
CDC Split Type:

Write-up: Initially after injection, the site on my arm was sore for several days. I am not sure that what follows is related to the vaccine, but my mother received the vaccine at the same time I did at the same location and she fell ill on June 4 June 3 around 1pm. I had abdominal pain. During a bowel movement I broke out into a cold sweat with shaking of limbs. That bowel movement turned into diarrhea. Then finished with nothing but dark blood. I rested for a bit as I was having abdominal pain and still having dark blood as a bowel movement. 2-3 times. When I got a change, I phoned my Primary Care Physician''s office. It was after hours and I spoke with a colleague that suggested I go to the ER to get checked out.


VAERS ID: 1385431 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-20
Onset:2021-06-03
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Menstruation delayed
SMQs:, Fertility disorders (broad), Opportunistic infections (broad)

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

Write-up: Delayed menstrual cycle by 10 days and shingles developed exactly two weeks after second shot injection.


VAERS ID: 1385472 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: vaccine was administered outside of storage recommendations. Notified pt to return for re-vaccination


VAERS ID: 1385488 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: vaccine was administered outside of storage recommendations. Notified pt to return for re-vaccination


VAERS ID: 1385491 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: vaccine was administered outside of storage recommendations.


VAERS ID: 1385503 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: vaccine was administered outside of storage recommendations.


VAERS ID: 1385511 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

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

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

Write-up: The patient was administered a dose with an incorrect ratio of diluent. The vial was mixed with 0.8ml of diluent instead of 1.8ml.


VAERS ID: 1385538 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

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

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

Write-up: Patient was administered a pfizer covid vaccine at the wrong concentration. The initial vial was mixed with 0.8ml of diluent instead of 1.8ml of diluent.


VAERS ID: 1385817 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect dose administered, Product preparation issue
SMQs:, Medication errors (narrow)

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

Write-up: Patient was administered a covid 19 vaccine at the wrong concentration. The vial was mixed with 0.8ml of diluent instead of 1.8ml of diluent.


VAERS ID: 1385839 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injury associated with device
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: The patient was receiving a vaccine with another patient. This patient sustained a needle stick from the other patient.


VAERS ID: 1385862 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-06-03
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Constipation, Nausea, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: It was Wed night and she said her stomach hurt so she couldn''t sleep. She woke up at 4 and had to throw up. It was yellow. She went back to bed but then woke up and at 06:00 am threw up again. She said she hadn''t been able to poop for 2-3 days. Docusate for constipation on Friday and she went twice but she told me yesterday that she hasn''t gone again since that time. Has not received more than the one dosage of the Docusate. Dr. gave her sublingual med for throwing up but we haven''t filled it as her nausea is gone. She says her stomach doesn''t hurt and she doesn''t feel nauseous - she just hasn''t been able to have a BM again.


VAERS ID: 1385921 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Fatigue, Flushing, Headache, Heart rate increased, Joint stiffness, Migraine, Myalgia, Pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, potassium, postnatal vitamin, hair, skin, and nails vitamin, sunflower lecithin
Current Illness:
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Same day-severe muscle soreness in arm, dizziness/lightheaded, fast pulse, flushed, headache Next day-fever, full body muscle and joint ache and stiffness, tiredness, migraine


VAERS ID: 1385980 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Contusion, Gait disturbance, Migraine, Musculoskeletal stiffness, Pain in extremity, Pyrexia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot 2013 got very very sick
Other Medications: Ibuprofen
Current Illness: Probably allergies
Preexisting Conditions: Regular headaches
Allergies: Whiskey, stawberry cake, 5 gum
Diagnostic Lab Data:
CDC Split Type:

Write-up: Night of I got the regular fever and chills. I then went to sleep and woke up with a throbbing migraine and my legs were so sore I wanted to cut them off. I could barely walk they were so tight. I have now been getting bruising on my legs. I don''t know if it is due to the shot though. I shaved my legs and I usually get some bruising after that. My arms have been slightly tense and sore as well. I have reasons outside of the shot to believe that it may not be the vaccine, but I thought I should report it.


VAERS ID: 1385996 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Pain, Rash, Throat irritation, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions:
Allergies: Compazine, Demerol, sulfa antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported while at home to have developed body aches, rash to neck area, itchy throat, headache and vomiting. Patient sought care at an urgent care where they reportedly received Solumedrol and a steroid taper pack. Patient reports that the rash is improving, has scheduled follow up with Urgent care tomorrow. Verbalized they will call 911 if symptoms acutely worsen.


VAERS ID: 1386003 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Haematuria, Metabolic function test, Nephritis, Proteinuria, Urine analysis
SMQs:, Acute renal failure (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Proteinuria (narrow), Tubulointerstitial diseases (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Acn?
Allergies: Berries
Diagnostic Lab Data: BMP Urine studies
CDC Split Type:

Write-up: Hematuria Acute nephritis Proteinuria 1.5 grams


VAERS ID: 1386038 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension, Sleep Apnea, Anxiety
Allergies: Lisinopril, Amlodipine, Morphine, NSAIDS
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received a mixed series of COVID-19 mRNA vaccine. On 5/5/21 he received a dose of Moderna COVID-19 vaccine. On 6/3/21 he inadvertently received a dose of Pfizer COVID-19 vaccine for his second dose.


VAERS ID: 1386059 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test normal, Chest X-ray normal, Chest discomfort, Chest pain, Computerised tomogram normal, Decreased appetite, Dysarthria, Dysphemia, Electrocardiogram normal, Inflammation, Laryngitis, Malaise, Pneumonitis
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Good
Allergies: NKA
Diagnostic Lab Data: Pnt stated he had CT Scan, Bloodwork, EKG and chest x-ray that all showed ok and was sent home
CDC Split Type:

Write-up: Pnt called Saturday 6/6 stating he developed tightness in chest within hours and laryngitis, a stutter, hard to articulate thoughts and generally didn''t feel well by that evening. I advised to go to ER for evaluation. I followed up on Tues 6/8/21 and he stated the ER said he has inflammation of the heart and lungs but sent him home. Also none of the previous symptoms had resolved and he also has pain in left upper chest, decreased energy and loss of appetite. The patient said he doesn''t have a PCP so I advised to go to ER again.


VAERS ID: 1386169 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cheilitis, Condition aggravated, Headache, Paraesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Wasp sting as a young adult
Other Medications: Amlodipine 2.5mg daily
Current Illness: Recently diagnosed Hypertension. Acute URI
Preexisting Conditions: Cardiac, Asthma
Allergies: Wasps, Codeine
Diagnostic Lab Data: None available
CDC Split Type:

Write-up: 5:22PM Developed headache followed by tingling in tongue. 5:25PM BP 192/90, P 92. Administered Benadryl 25mg PO. 5:35PM 182/94, P 88 Symptoms persist. 5:44PM BP 182/90, P84. 5:50PM BP188/98, P 84 Second dose of Benadryl 25mg PO. 6:00PM BP 204/106, P88 C/O headache worsening, Lips feel "funny" Called for ambulance for assistance 6:10PM BP 222/98, P 88. Transport to Health Center via ambulance.


VAERS ID: 1386206 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Headache, Heart rate increased, Pyrexia, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Multi-Vitamin; Fish oil - both the night before
Current Illness: no
Preexisting Conditions: no
Allergies: No
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: The night of the vaccine, towards the middle of the night she had a fever 103.2; little bit of a headache. Her fever went down through the night. In a.m., she was at 100 degrees. She started shaking and fainted when getting ready to go downstairs; Pulsometer - 147 for heart rate. She shook just a little. I thought she was going to have a seizure and I yelled for my husband and she regained consciousness. She hasn''t had a fever since but we can''t keep her heart rate down -it shoots up from 130- to low 150''s. Still like that today. we took her to Dr. - he said it was reaction to vaccine. He referred her to cardiologist with an urgent designation. She''s never had nay problems like this before. She will see cardiologist tomorrow. Rest and hydration is the current treatment. It hasn''t gone away in the two or three days that they thought it would.


VAERS ID: 1386232 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3, Vitamin B Complex
Current Illness: none
Preexisting Conditions: none
Allergies: amoxicillin/penicillin
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Tinnitus, hearing loss in left ear since two days after receiving COVID vaccine in left arm. Symptoms began on 6/3/21 and I am still experiencing symptoms today, 6/9/21.


VAERS ID: 1386264 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 RA / IM

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

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

Write-up: Patient received undiluted dose of Pfizer vaccine (0.3 mL undiluted dose) IM


VAERS ID: 1386336 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: PHARMACY LEFT PFIZER VACCINE VIALS IN THE FREEZER FOR LONGER THEAN 2 WEEKS AT A TEMPERATURE (-25 AND -15 DEGREES C). WE GAVE DOSES OUT OF THESE VIALS, RENDERING THEM POSSIBLY LESS EFFECTIVE.


VAERS ID: 1386361 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: PHARMACY LEFT PFIZER VACCINE VIALS IN THE FREEZER FOR LONGER THAN 2 WEEKS AT TEMPERATURE (-25 AND -15 DEGREES C). WE GAVE DOSES OUT OF THESE VIALS, RENDERING THEM POSSIBLY LESS EFFECTIVE


VAERS ID: 1386376 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia, Night sweats, Oropharyngeal pain, Pain in extremity, Palatal swelling, Pyrexia, Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOW Neptune Krill Oil (500mg) 2 Soft gels daily. Nature Made D3 1000IU (25 mcg) 1 Tablet daily. Careone Sentry Senior Multivitamin & Multimineral Supplement (Gluten Free). 1 Tablet daily.
Current Illness: None
Preexisting Conditions: None
Allergies: None that I am aware of.
Diagnostic Lab Data: None as of this report.
CDC Split Type:

Write-up: Sore arm. Sore throat. fever. Night sweats. Loss of sleep. Swollen and enflamed roof of mouth.


VAERS ID: 1386399 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Chills, Diarrhoea, Headache, Hypoaesthesia, Injection site bruising, Injection site pain, Nausea, Oropharyngeal pain, Pain, Paraesthesia, Pyrexia, Sinus congestion, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: COVID exposure in May. Son positive beginning of May, husband positive mid-May 2021. I lost sense of taste and smell.
Preexisting Conditions: DM. No meds or problems since gastric sleeve surgery in 2014.
Allergies: None
Diagnostic Lab Data: None done at this time
CDC Split Type:

Write-up: Started with bruising and pain at injection site (left deltoid). By 10hrs post injection, fever (103-103.5). body aches, chills, headache, sinus congestion, sore throat, n/v/d and abdominal pain. Left arm (site of injection) still has significant bruising, pain with movement, numbness and tingling going all the way from deltoid to hand. Taking Zinc, Vit D, Vit C, Tylenol, Motrin. Today, NP prescribed Tessalon perles and Flonase, ASA.


VAERS ID: 1386584 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Hypertension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypertension (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: No illnesses
Preexisting Conditions: No chronic health conditions
Allergies: No Allergies
Diagnostic Lab Data: Patient used the blood pressure machine at (ranging from 125 -135 systolic blood pressure).
CDC Split Type:

Write-up: Chest tightness and higher blood pressure (ranging from 125 -135 systolic blood pressure) than normal day after receiving the vaccine.


VAERS ID: 1386591 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 vaccine that was expired. Vaccine was drawn from a vial that was opened on 4/8/21. Patient informed on 6/4/21. Patient has not experienced any symptoms.


VAERS ID: 1386843 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Cough, Fatigue, Headache, Injection site erythema, Injection site pain, Nausea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Atorvastatin, Tresiba, Humalog, Ketoconazle, Prolia, Estroven, Fish Oil, Calcium Citrate Magnesium and Zinc, D3, Ocuvite, Centrum Silver, Aspirin, Probiotic 10, Tylenol
Current Illness: None
Preexisting Conditions: Breast Cancer - remission, Diabetes, High Blood Presssure
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA Pain in upper arm at ejection site & slight redness. Started same day some residual (5+ days) Compete exhaustion with severe headache. Started day after on 6-4-2021 some residual still occurring 6/9/2021 (6 + days) Nausea. Started day after on 6-4-2021. Some traces on 6-5-2021 (2 days) Cough. Started three days after on 6-5-2021 some residual still occurring (5+ days) Feeling of heaviness in chest. Started on 6-5-2021. (lasted 1/2 day)


VAERS ID: 1387214 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Discomfort, Influenza like illness, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna covid 1 month prior
Other Medications: multivitamin, Co-Q10, Vitamin D
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Chills, fever, body aches, muscle aches, flu like symptoms, loss of apatite, extreme discomfort lasting ~ 2 days


VAERS ID: 1387329 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-14
Onset:2021-06-03
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: Certain metal pieces are sticking to my arm.


VAERS ID: 1387382 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Blood pressure measurement, Heart rate, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 325 mg Acetaminophen 5mg Lisiniprol
Current Illness: None
Preexisting Conditions: Pre-Hypertension and seasonal asthma.
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Racing heart and anxiety attack at 0400. Woke up in the middle of the night with BP of 150/90 and heart rate of 180. Ambulance was called and diagnosed with heart palpitations from the vaccine.


VAERS ID: 1387479 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Pain in extremity
SMQs:, Dementia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210609135

Write-up: LIL BRAIN FOG; ARM SORENESS; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 02-JUN-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 03-JUN-2021, the subject experienced lil brain fog. On 03-JUN-2021, the subject experienced arm soreness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the lil brain fog and arm soreness was not reported. This report was non-serious.


VAERS ID: 1387807 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021648917

Write-up: redness and hives on her neck.; redness and hives on her neck.; Caller states they are starting to spread on her neck and the other side and she is starting to see dots all over her body; This is a spontaneous report from a contactable consumer (Patient). A 33-years-old female patient received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration, administered in Arm Left on 01Jun2021 12:00 (Batch/Lot Number: EW0179) as 2ND DOSE, SINGLE for covid-19 immunization. Medical history included allergic to Penicillin. The patient''s concomitant medications were not reported. The patient previously took bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Left on 11May2021 (Batch/Lot Number: EWO175 or EW0175) as 1st DOSE, SINGLE for covid-19 immunization. For AE(s) following prior vaccinations, stated none and stated last vaccines were as a child. On 03Jun2021, the second day after her shot, the patient when she woke up, she had developed redness and hives on her neck which started to spread on her neck and the other side, and she was starting to see dots all over her body. She would like to know if this was normal, and what to do next. The outcome of the events was not recovered. Follow up needed, further information has been requested.


VAERS ID: 1387822 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021653185

Write-up: I''ve had trouble with my stomach; This is a Pfizer-sponsored program spontaneous report from a contactable consumer or other non hcp (Patient). A 61-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as unknown, single dose for covid-19 immunization. The patient medical history was not reported. Suspect Product: Ibrance 125 mg. On 03Jun2021 after the vaccination the patient experienced trouble with her stomach. The outcome of the event was Unknown. No follow-up attempts are needed; Information about lot/batch number cannot be obtained.


VAERS ID: 1387831 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METOPROLOL; DULOXETINE; OLANZAPINE; AMLODIPINE BESYLATE; POTASSIUM; ASPIRIN [ACETYLSALICYLIC ACID]; ATORVASTATIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high (Verbatim: High blood pressure); Heartbeats irregular (Verbatim: Irregular heart beats); High cholesterol (Verbatim: High Cholesterol)
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: pulse rate; Result Unstructured Data: Test Result:90
CDC Split Type: USPFIZER INC2021655122

Write-up: This is a spontaneous report from a contactable consumer (patient). A 67-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EW0169), via an unspecified route of administration, administered in Arm Right on 02Jun2021 (at the age of 67-year-old) as a single dose for COVID-19 immunization. The patient''s medical history included high blood pressure, high cholesterol from 1980, irregular heartbeats started this year ago but had not been told by a doctor. The patient stated she was in her 40s and going through menopause when they diagnosed her. The patient''s family history was reported as none. The patient''s concomitant medications included metoprolol ER 25 mg every day taken for Blood Pressure abnormal, Duloxetine 30 mg a day and 60 mg a day, olanzapine 10 mg a day at bedtime, amlodipine besylate 5 mg day taken for Blood Pressure abnormal, Potassium 20 mg, acetylsalicylic acid (ASPIRIN) 81 mg and atorvastatin 80 mg taken for cholesterol abnormal. No AEs was reported prior vaccinations. The patient was not administered with vaccine at Military facility. The patient was not administered with any other vaccine on same date of the Pfizer suspect. The patient was not administered with any other vaccine 4 weeks prior to suspect vaccine. The patient stated that after receiving the Pfizer COVID-19 vaccine on 02Jun2021 (Wednesday) she was experiencing an elevated heart rate /noticed her heart rate was elevated this morning. She would like to know if this was a normal side effect. The patient stated her heart races when she gets up and when she sits it goes back down. She stated it has not worsened but it''s scary. On 04Jun2021, the patient''s heart rate a little faster than normal. After the COVID-19 vaccine her pulse was too low to take her blood pressure medication. The reporter stated this was yesterday (03Jun2021). She stated she does not know when she started taking any of her medications. She stated that, she didn''t take her blood pressure medication yesterday as she can''t take it if her pulse was below 60. This morning it was in the 90s. The patient had not visited emergency room/physician office. The patient''s relevant medical tests were reported as none. The reporter stated that her next vaccine was scheduled for 26Jun2021. She stated that, she cannot find her card for the vaccine and it was in her purse and now she can''t find it. She later clarifies that she found the card. The outcome of the events was unknown. Information on Lot/Batch number is available; Further information has been requested.


VAERS ID: 1387833 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: WARFARIN; BENICAR; BYSTOLIC; DILTIAZEM CD; CLONAZEPAM
Current Illness: Anxiety (2 years ago); Atrial fibrillation; Blood pressure (10 years ago)
Preexisting Conditions: Medical History/Concurrent Conditions: Hip surgery (few years ago)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021655188

Write-up: Mild chills; Feel tired; This is a spontaneous report from a contactable consumer or other non hcp. A 87-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 2 via an unspecified route of administration, administered in Arm Left on 01Jun2021 (at the age of 87-years-old) (Batch/Lot Number: EW0185) as single dose for covid-19 immunisation. Medical history included ongoing high blood pressure (10 years ago), ongoing anxiety (2 years ago), ongoing atrial fibrillation and hip surgery from an unknown date and unknown if ongoing (few years ago). The patient did not emergency room and physician office visit. Prior Vaccinations (within 4 weeks): None. Concomitant medication included warfarin taken for atrial fibrillation, start and stop date were not reported; olmesartan medoxomil (BENICAR) taken for blood pressure, start and stop date were not reported; nebivolol hydrochloride (BYSTOLIC) taken for blood pressure start and stop date were not reported; diltiazem hydrochloride (DILTIAZEM CD) taken for blood pressure, start and stop date were not reported; clonazepam taken for an unspecified indication, start and stop date were not reported. The patient previously took first dose of bnt162b2 on 04May2021 (Batch/lot number EW017) administered in, Left arm for covid-19 immunisation and experienced tired. The patient previously took Flu shot and experienced Sort of bothered my face (40-50 years ago). The reporter stated that second dose received 28 days after first dose. she had her second dose of the Pfizer COVID-19 vaccine 01Jun2021 and on 03Jun2021 started to feel tired she is stating to feel better. she didn''t have a sore arm or anything and that the Covid-19 vaccine didn''t seem to bother her. She stated she did notice having chills but realized it was because she had her air conditioning too high and was cold from the air temperature, does not think she had a fever. The patient experienced mild chills on 04Jun2021, but she was no longer having. Relevant tests was none. The outcome of the events feel tired was reported as recovering and mild chills was reported as recovered on 04Jun2021. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1387835 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Connecticut  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lymph node palpable
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:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021655232

Write-up: palpable node on her left collar bone; This is a spontaneous report from a contactable consumer (patient) via medical information team. A female patient of an unspecified age (age: 61, unit: unknown) received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection) via an unspecified route of administration administered in left arm on 02Jun2021 as single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. It was reported that the patient received her second dose of the Pfizer Covid 19 Vaccine on Wednesday 02June2021. On Thursday 03June2021, she experienced a palpable node on her left collar bone. The patient was asking if the symptom has been reported. The outcome of the event was unknown.


VAERS ID: 1387837 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Epistaxis
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021655351

Write-up: severe nose bleed; This is a spontaneous report received from a contactable consumer (patient''s fiance). A male patient of an unspecified age received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection), via an unspecified route of administration on 03Jun2021 as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) for COVID-19 immunisation. She stated patient got the second dose of Pfizer on 03Jun2021. It was almost 2 hours ago. Now he was having a severe nosebleed. It was not stopping. She states this never happened before. It didn''t happen the first time he got a dose and he has never had a problem with bleeding through the nose. The outcome of the event was unknown. Follow-up needed. Information about batch/lot number has been requested.


VAERS ID: 1387989 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Chills, Migraine, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Migraine, fever, chills, muscle pain, joint pain


VAERS ID: 1388015 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysphonia
SMQs:, Parkinson-like events (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: Lisinopril 5mg, Pravastatin 80 mg, Potassium Chloride ER 10 MEG, Trulicity .75/0.5 interjector pen, Albuterol Sulfate HFA 108 (90) base, Colestipol HCI-1 GM, Trintellix 20 MG, Breo 200-25 MCG, Omeprazole 20 MG, Torsemide 20 mg , Fluticasone
Current Illness:
Preexisting Conditions: COPD, Diabetic
Allergies: Ampicillin, Cipro, Clindamycin, Atorvastatin Calcium
Diagnostic Lab Data:
CDC Split Type:

Write-up: rasp voice and hoarseness


VAERS ID: 1388043 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Adenovirus test, Aortic valve incompetence, Aspartate aminotransferase normal, Blood bicarbonate normal, Blood chloride normal, Blood creatinine normal, Blood immunoglobulin G, Blood immunoglobulin M, Blood lactic acid normal, Blood potassium normal, Blood sodium normal, Chest X-ray, Chest pain, Cough, Diarrhoea, Echocardiogram, Echocardiogram abnormal, Electrocardiogram abnormal, Electrocardiogram normal, Fibrin D dimer normal, Glycosylated haemoglobin increased, Haematocrit decreased, Haemoglobin decreased, Headache, Human metapneumovirus test, Influenza A virus test negative, Influenza B virus test, Intensive care, International normalised ratio normal, Mitral valve incompetence, Monocyte count increased, Painful respiration, Platelet count normal, Protein total normal, Prothrombin time normal, SARS-CoV-2 antibody test, SARS-CoV-2 test, SARS-CoV-2 test negative, Sinus bradycardia, Toxicologic test normal, Tricuspid valve incompetence, Troponin I increased, Troponin increased, Urine analysis normal, Vitamin D deficiency, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Pseudomembranous colitis (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Concerta
Current Illness: He had temperature of 38 ?C on Saturday after the second dose of SARS-CoV-2 vaccine (on Thursday, 6/3/2021). Pt said that he had a loose bowel movement, intermittent cough, and headache.
Preexisting Conditions: obesity, insulin resistance, mixed dyslipidemia, vitamin D deficiency, elevated hemoglobin A1c, anxiety disorder, and ADHD
Allergies: NKA
Diagnostic Lab Data: 6/8/21 - His lab investigation including troponin I of 5.1 ng/mL (upper limit is 0.034 ng/mL), CBC: WBCs 5.9, hemoglobin 13.7, hematocrit 41.1, platelet 230, monocyte 9.6 % (upper normal is 4%), sodium 142, potassium 3.8, chloride 104, bicarb 28, BUN 10, creatinine 0.79. ALT 31, AST 64, alkaline phosphatase 80, total protein 7.4, albumin 4.3, PT 11, INR 1, PTT 32.7, D-dimer less than 200, urine toxicology screen is negative, urine analysis is negative, rapid Covid antigen was negative. He had twelve-lead ECG with sinus rhythm, normal axis, intervals, and voltages. Labs Lab results 06/08/2021 14:56 SARS CoV 2 IgG Negative 06/08/2021 14:54 Troponin iSTAT 1.30 ng/mL HI 06/08/2021 07:15 Troponin iSTAT 2.85 ng/mL HI 06/08/2021 03:02 SARS CoV 2 (ID Now) Negative 06/08/2021 01:54 Sed Rate 19 mm/hr D-Dimer 0.53 ug/mL FEU HI Fibrinogen 429 mg/dL HI Magnesium Lvl 2.2 mg/dL Procalcitonin <0.050 ng/mL CRP 1.8 mg/dL HI TSH 1.77 uIU/mL SARS CoV 2 IgG Negative SARS CoV 2 by PCR Not Detected RSV by PCR Not Detected Adenovirus Not Detected Coronavirus 229E by PCR Not Detected Coronavirus HKU1 by PCR Not Detected Coronavirus NL63 by PCR Not Detected Coronavirus OC43 by PCR Not Detected Metapneumovirus Not Detected Rhino/Entero by PCR Not Detected Influenza A Not Detected H1N1 (Swine) Not Detected Influenza A H1 by PCR Not Detected Influenza A H3 by PCR Not Detected Influenza B Not Detected Parainflu 1 Not Detected Parainflu 2 Not Detected Parainflu 3 Not Detected Parainfluenza 4 by PCR Not Detected Bordetella pertussis by PCR Not Detected Bordetella Parapertussis PCR Not Detected Chlamydia pneumoniae by PCR Not Detected Mycoplasma pneumoniae by PCR Not Detected RPP Commment * 06/08/2021 01:46 Troponin iSTAT 2.70 ng/mL HI 06/08/2021 01:44 Lactic Acid iSTAT 1.03 mmol/L Sample Ven VENOUS Site Ven . FiO2 Ven 0 % NA RR/IVM Ven . bpm PEEP Ven 0.00 NA PIP Ven 0.00 NA BP Ven 0.0 mmHg NA Temp Ven 37.0 DegC NA pH Ven 7.37 pCO2 Ven 44.6 mmHg pO2 Ven 37.0 mmHg NA BE Ven 0.0 mmol/L HCO3 Ven 25.7 mmol/L CO2 Totl Ven 27.0 mmol/L O2 Sat Ven 69.0 % LOW 06/08/2021 01:43 CKMB i STAT 19.9 ng/mL HI 6/8/21 - Chest x-ray IMPRESSION: No acute cardiopulmonary process. 6/8/21 - Transthoracic Echocardiogram - No structural abnormalities seen in the setting of poor echocardiographic windows. Trivial to mild tricuspid regurgitation and mitral regurgitation. Trivial aortic regurgitation. Qualitatively normal left ventricular systolic function. No significant pericardial effusion.
CDC Split Type:

Write-up: Pt is a 15-year-old man with history of obesity, insulin resistance, mixed dyslipidemia, vitamin D deficiency, elevated hemoglobin A1c, anxiety disorder, and ADHD. He presented today to the ER with history of chest pain in the past 3 days. This chest pain is intermittent, sharp in nature, mainly in the retrosternal area, precipitated by deep breath, partially relieved by Tylenol, ibuprofen, or laying down. He denied any history of trauma, or recent viral illnesses. The severity of this chest pain ranging between 4?5/10 with no radiation. He had temperature of 38 ?C on Saturday after the second dose of SARS-CoV-2 vaccine (on Thursday, 6/3/2021). He said that he had a loose bowel movement, intermittent cough, and headache. He denied any nausea, vomiting, nasal congestion, skin rashes, change in urine, muscle pain, or joint pain. At the ER, he was in stable condition, afebrile, with stable vital signs. He received 1 dose of Motrin 600 mg for the chest pain. ER dr. was consulted and he recommended admission to the CICU for further investigation and management. 6/9/21 - Troponin levels downtrending (last 1.30). ID consulted and recommended obtaining adenovirus PCR, enterovirus PCR, GI panel, Mycoplasma IgM, COVID IgG, COVID NP, and COVID spike protein. Will follow as an outpatient. CXR normal. EKG with sinus bradycardia, while calm. Echocardiogram results normal. RPP and COVID negative. Behavioral medicine followed. Discharged on 6/9/21. Hospital course CV Troponin level on admission was 2.7 and have been closely monitored. Last level obtained on 06/08 was 1.3. ECG 06/08 - sinus bradycardia. Echocardiogram 06/08 - essentially normal with trivial to mild tricuspid regurgitation and mitral regurgitation and trivial aortic regurgitation. Chest pain has now resolved and patient has good hemodynamics with good pulses, good blood pressures, and cap refill less than 2 secs. He will follow with Dr. in 1 week. No rigorous exercise for one week.


VAERS ID: 1388086 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Injection site pain, Injection site swelling, Nausea, Neck pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Abilify, Clonazepam
Current Illness: On the Pharmacy COVID-19 Vaccine Informed Consent form, patient had checked yes as too whether she had a positive test for COVID-19 or has a doctor ever told you that had COVID-19.
Preexisting Conditions:
Allergies: none known
Diagnostic Lab Data: none at this time
CDC Split Type:

Write-up: Patient came in 7 days after receiving 2nd Moderna COVID-19 complaining of excruciating neck pain. She received this dose at 11:15 am 6/3/2021 and by that evening was experiencing chills, fever, nausea, swelling and pain in right arm in injection site. The fever and chills subsided in a few days but the pain travelled up to her neck. I called her primary care provider, and his office will reach out to her as she wants to be seen on 6/10/2021 by her primary care doctor.


VAERS ID: 1388157 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-14
Onset:2021-06-03
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram thorax, Culture urine, Dyspnoea, Electrocardiogram, Fibrin D dimer increased, Full blood count, HIV test, Human chorionic gonadotropin, Metabolic function test, SARS-CoV-2 test, Scan with contrast, Troponin, Urine analysis
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Phentermine, Prozac, Albuterol, Melatonin, Vitamin D,CBD, Zyrtec, Tylenol
Current Illness: Chronic Asthma
Preexisting Conditions: Chronic Asthma; COVID in January 2021 and received passive antibody therapy. COVID in April 2021 "mild case". Managed at home .
Allergies: No Known Allergies
Diagnostic Lab Data: CBC,CMP,HIV, HCG, Resp PCR with Covid, Troponin, Urinalysis, Urinalysis with reflex to culture, and Urine culture. CT chest pulmonary embolism With IV contrast, 12 lead EKG x2, Chest XR one view,
CDC Split Type:

Write-up: 31 year old female asthmatic who upon several episodes of SOB went to ER , where she was told that Dimers were elevated and she considered a possible pulmonary embolism patient. She was placed on low dose aspirin, prednisone and Tessalon.


VAERS ID: 1388199 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-29
Onset:2021-06-03
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Bell's palsy, Ear pain, Facial paresis, Ophthalmoplegia, SARS-CoV-2 test negative
SMQs:, Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Ocular motility disorders (narrow), Immune-mediated/autoimmune disorders (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: Kelnor 1/35
Current Illness: None
Preexisting Conditions: Obesity
Allergies: None
Diagnostic Lab Data: 6/3/21: Urgent care visit thinking I had an ear infection. Also conducted COVID19 rapid test (negative). Prescribed ?Neomycin and Polymyxin B sulfates and Hydrocortisone Otic Suspension, USP? ear drops. 6/4/21: Started ear drops. Urgent care visit for COVID19 PCR and rapid test. Both tests negative/no trace. 6/7/21: Video visit with Primary Care Physician for Palsy. Prescribed Valacyclovir and Prednisone. Stopped taking ear drops.
CDC Split Type:

Write-up: Developed Bell?s Palsy. 6/3/21: Ear ache (right side) 6/4/21: Lost sense of taste in 3/4 of mouth (front and right side) 6/5/21: Right eye paralysis (not blinking) 6/6/21: Right side facial and weakness (little to no movement)


VAERS ID: 1388283 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       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: Diltizem
Current Illness: na
Preexisting Conditions: na
Allergies: Penicillin, sulfur,seafood , nuts
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Swelling of face


VAERS ID: 1388465 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-30
Onset:2021-06-03
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Unusual spotting in between periods while on the pill and heavier cycle.


VAERS ID: 1388488 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-06-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Intermenstrual bleeding, Menstrual disorder
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: Both and her twin sister got their first period in the same week (2 weeks after vaccination). Although pediatrician said they might not have period in 1-2 years during their heath check in March 2021.
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: and her twin sister all got their first period two weeks after vaccination. They both have brown spots for a day or two only, no heavy flow. Their pediatrician said they won''t have period for another year during their health check on March 2021.


VAERS ID: 1388628 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan/HCT Metformin Simvastatin Pantoprazole
Current Illness: None
Preexisting Conditions: Hypertension Type 2 DM
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Macular -Papular rash on posterior aspect of neck, just inferior to hair line.


VAERS ID: 1388885 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Paraesthesia, Rash, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: patient had tingling on face starting on 6/3/21, on 6/4/21 broke out in rash, on 6/5/21 rash broke open to open sores/ 6/10/2021 diagnosed with shingles


VAERS ID: 1388890 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-14
Onset:2021-06-03
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 2 - / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054A21A / 1 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Pulmonary embolism, X-ray
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril 20 mg
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: Ibuprofen
Diagnostic Lab Data: CT Scan, xrays and admittance to hospital on 6/3/2021.
CDC Split Type:

Write-up: On June 3rd, 2021 I was admitted to the hospital with multiple pulmonary embolisms in both lungs in multiple spots. No family history or any other medical history that would cause this.


VAERS ID: 1388931 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-20
Onset:2021-06-03
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / SYR

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

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

Write-up: Exactly 2 weeks after second vaccine dose I got shingles


VAERS ID: 1389007 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-23
Onset:2021-06-03
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL 9261 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 9581 / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Cough, Decreased appetite, Fatigue, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Rituxan for Multiple Sclerosis
Current Illness: Spinal stenosis surgery 5/16/2021 at Hospital then went to rehab institute . She was admitted to Hospital 6/4 through 6/9 due complications from spine surgery. She did develop symptoms on 6/3/2021 of cough, sore throat, decreased appetite , fatigue and chills.
Preexisting Conditions: Multiple Sclerosis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had spinal surgery 5/16 and was at an inpatient rehab facility until 6/3 where discharged and then readmitted back to Hospital on 6/4 due to spinal complications. She was then discharged on 6/9/2021 to home. Thus case was readmitted due to spinal surgery complications, not due to to COVID.


VAERS ID: 1389054 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 1 LA / IM

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

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

Write-up: 17 yo-vaccine licensed for 18 yo and older. No adverse effects.


VAERS ID: 1389344 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-01
Onset:2021-06-03
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site 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: Open heart bypass surgery scheduled
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Infection at puncture site and radiating outward


VAERS ID: 1389772 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / 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? 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: This is the 2nd dose of moderna covid vaccine for this patient. The patient is 16 years old and received moderna vaccine which is not indicated for her age. she is not experiencing any adverse events.


VAERS ID: 1389816 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2005-05-25
Onset:2021-06-03
   Days after vaccination:5853
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Myocarditis
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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Myocarditis


VAERS ID: 1390046 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-05
Onset:2021-06-03
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN N/A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Biopsy, Breast mass, Breast neoplasm, Mammogram, Metastases to lymph nodes, Ultrasound scan
SMQs:, Breast tumours of unspecified malignancy (narrow), Haematological malignant tumours (narrow), Non-haematological tumours of unspecified malignancy (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: Multivitamin Calcium supplement
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 6/4/2021: Mammograms and ultrasounds 6/8/2021: Biopsies of two locations on the breast and one lymph node
CDC Split Type:

Write-up: I don''t know if it''s related, but a friend reminded me I should report it on my V-safe, and then they called me and told me to fill this out. On 6/3/2021 I found a lump in my left breast (same side as the vaccine) and it has been confirmed today (6/10/2021) to be Intraductal Carcinoma. It has already spread to a lymph node.


VAERS ID: 1390690 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Iowa  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Headache, Injection site pain, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Generalised aching; Osteoarthritis
Preexisting Conditions: Medical History/Concurrent Conditions: Motor vehicle accident
Allergies:
Diagnostic Lab Data:
CDC Split Type: JNJFOC20210612046

Write-up: JOINT PAIN; SORE ARM; MUSCLE ACHES; HEADACHES; INJECTION SITE PAIN; This spontaneous report received from a patient concerned a 62 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included hit by a drunk driver when was 20, and concurrent conditions included osteoarthritis, and body aches. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUN-2021, the subject experienced joint pain. On 03-JUN-2021, the subject experienced sore arm. On 03-JUN-2021, the subject experienced muscle aches. On 03-JUN-2021, the subject experienced headaches. On 03-JUN-2021, the subject experienced injection site pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from muscle aches, headaches, joint pain, and sore arm, and the outcome of injection site pain was not reported. This report was non-serious.


VAERS ID: 1391017 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Accidental overdose
SMQs:, Drug abuse and dependence (broad), 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: USPFIZER INC2021650429

Write-up: she received 6 times more than the recommended dose; This is a spontaneous report from a contactable nurse. A 21-years-old female patient (reporters'' niece) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number: not reported), via an unspecified route of administration on 03Jun2021 as 1st dose, single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. On 03Jun2021, the patient had overdose accidental. The reporter stated that her niece received the first dose of the Pfizer BioNTech Covid-19 Vaccine, but the vaccination site informed them that she received 6 times more than the recommended dose. They did not specify if the vaccine was undiluted. The reporter wanted to know if there is a need to proceed with the 2nd dose of the Pfizer BioNTech Covid-19 vaccine, after getting a higher than recommended (6x) dose of the first one. The outcome of the event was unknown. Follow-up actions are needed. Further information is requested.; Sender''s Comments: Based on known drug safety profile, there is reasonable possibility of causal association between the event Overdose accidental and the suspect drug BNT162B2.


VAERS ID: 1391019 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Overdose, Product preparation issue
SMQs:, Drug abuse and dependence (broad), 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: USPFIZER INC2021651197

Write-up: 3 patients that received the Pfizer Covid 19 vaccine that was diluted with less than the recommended 1.8ml/three patients were administered a more concentrated dose of the COVID-19 Vaccine; 3 patients that received the Pfizer Covid 19 vaccine that was diluted with less than the recommended 1.8ml/Received first dose of COVID-19 vaccine that was more concentrated; diluted with only half the amount of diluent; This is a follow-up spontaneous report from a sponsored Program, from a contactable pharmacist reported for a 15-year-old male consumer (patient). This is a spontaneous report from a contactable pharmacist. A patient of 15-year-old male consumer received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number: EW0180, Expiration Date:20 Aug 2021), via intramuscular, administered in left arm on 03Jun2021 as 0.3 ml First dose, single dose for covid-19 immunisation. Time the Vaccination Was Given is Between 11:30 - 12:00 and NDC number of COVID-19 Vaccine is 59267100001. The patient medical history was none and concomitant medications were not reported. On 03Jun2021 the patient experienced 3 patients that received the Pfizer covid 19 vaccine that was diluted with less than the recommended 1.8ml on an unspecified. Consumer stated that asking for guidance on how to treat 3 patients that received the Pfizer Covid 19 vaccine that was diluted with less than the recommended 1.8ml as per EUA. Incorrect diluent volume (i.e., the vial contents were diluted with a diluent volume other than 1.8 ml, but a 0.3 ml dose was still administered). For doses administered with diluent volume less than 1.8 ml, Inform the recipient of the potential for local and systemic adverse events. patient came to get vaccinated since they are eligible. Verbatim event relatedness: COVID-19 Vaccine: Received first dose of COVID-19 vaccine that was more concentrated; diluted with only half the amount of diluent is unrelated. Pfizer COVID-19 Vaccine was diluted with half the amount of diluent. Three patients were administered a more concentrated dose of the COVID-19 Vaccine. Clarified Consumer wants to know what information Pfizer has. Wants to know what to expect, if patients are going to experience more serious side effects. Is the arm going to be more sore than usual? Wants to make sure the patients aren''t going to be harmed. Print on label is new and tiny. Clarified it was the first dose of the COVID-19 Vaccine for all three patients. Same NDC/LOT/EXP for all three patients. All three patients received 0.3ml injected intramuscularly into the left arm. Consumer clarifies the age of this patient as 15years old. Initially provided age of 12 years. Clarified and documented as provided. Patient Age at Time of Vaccination in Months: or Years was reported as 13 years old. Patient did not visit emergency Room or physician Office. Patient did not receive any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. Seriousness is reported as wouldn''t say Medically significant but would describe as Serious. The outcome for events was unknown. Information about batch/lot number has been requested. Follow-up: (03Jun2021) This is a follow-up spontaneous report from a sponsored Program, from a contactable pharmacist reported for a 15-year-old male consumer (patient). Additional information received was as follows: Product (Start date: 03Jun2021, Expiry date: 20 Aug 2021, Lot number: EW0180, Dose: First dose, Dosage: 0.3ml, Route of administration: intramuscularly, anatomical location: left arm), Event (Received first dose of COVID-19 vaccine that was more concentrated; diluted with only half the amount of diluent merged with 3 patients that received the Pfizer Covid 19 vaccine that was diluted with less than the recommended 1.8ml and Three patients were administered a more concentrated dose of the COVID-19 Vaccine merged with 3 patients that received the Pfizer Covid 19 vaccine that was diluted with less than the recommended 1.8ml) No follow-up attempts are needed. No further information is expected ; Sender''s Comments: Based on known drug safety profile, there is reasonable possibility of causal association between the event overdose, Inappropriate dilution of medication and the suspect drug BNT162B2.,Linked Report(s) : US-PFIZER INC-2021650089 same reporter/product/event, different patient;US-PFIZER INC-2021651198 same reporter/product/event, different patient


VAERS ID: 1391045 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Fever; Result Unstructured Data: Test Result:102
CDC Split Type: USPFIZER INC2021657822

Write-up: He began having a fever on Thursday night up to 102/he woke up again with a fever this morning; This is a spontaneous report from a contactable consumer. A 13-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported), dose 2 via an unspecified route of administration on 03Jun2021 as 2nd dose single dose for COVID-19 immunisation. The patient medical history and concomitant medication were not reported. The patient historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection) on 13May2021 as single dose for COVID-19 immunisation. On 03Jun2021 the reporter reported that the patient began having a fever on Thursday night up to 102 but she has been able to keep it under control with Ibuprofen. She reports concern that he woke up again with a fever this morning and didn''t know if she should be worried, asking, how long should the fevers last? Reporter stated that she already gave all of the adverse event information to someone else to file a report, no reference number for that encounter. Treatment was received for fever with ibuprofen. The patient underwent lab tests and procedures which included body temperature: 102 on an unspecified date. Outcome of the event was unknown. Information about the lot/batch number has been requested.


VAERS ID: 1391048 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021658372

Write-up: she experienced her arm was itching all up and down, not on the side where she took the shot, the other arm the other arm It''s really bad, it''s like under your skin it''s itching; I was rubbing my arm and I broke out in little welt, I broke out with the welt on each arm.; Sick of the discomfort I am having because I am itching; Sick of the discomfort I am having because I am itching; I don''t know what''s happening with me and I didn''t like feeling I feel with this side effects. So, that''s what I am trying to figure out; This is a spontaneous report from a contactable consumer (patient). A 72-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EW0185) via an unspecified route of administration on 03Jun2021 at 09:00 (at the age of 72 years) as 1st dose, single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On 03Jun2021, patient took the COVID shot morning about 9 O''clock and just a minute ago right after the vaccination, her arm was itching all up and down, not on the side where she took the shot, the other arm. Well at both of them at the bottom, she was rubbing her arm and broke out in little welt on each arm. And it''s real bad, it''s like under the skin its itching. Patient was really trying to find out about her arm as she was sick of the discomfort she was having because of itching. Patient enquired that she does not know what''s happening with her and she didn''t like feeling she felt with this side effects. Patient just wanted to know what was wrong, why she was having side effects, why does she have to go through all of that. The outcome of the events was unknown. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1391069 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Aphasia, Dysstasia, Hypokinesia
SMQs:, Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021659123

Write-up: She couldn''t move or stand.; And she couldn''t talk for 8-9 hrs; She couldn''t move or stand.; This is a spontaneous report from a contactable consumer or other non hcp. A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; formulation: Solution for injection (Lot number was not reported expiry date was not reported) via an unspecified route of administration on an unspecified dose, as a single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. On 03Jun2021 patient experienced she couldn''t move or stand, she couldn''t talk for 8-9 hrs and she couldn''t move or stand. The outcome of the events was unknown. Product Complaint: There is no product complaint associated with this case Information on the batch/lot number has been requested.


VAERS ID: 1391087 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 Date: 202106; Test Name: Fever; Result Unstructured Data: Test Result:101.44
CDC Split Type: USPFIZER INC2021660189

Write-up: Fever like 101.44; This is a spontaneous report from a contactable consumer or other non hcp. This consumer reported for a 13-year-old male patient received bnt162b2 (BNT162B2 PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot Number: EW0178, Expiration date: unknown), via an unspecified route of administration, administered in left arm on 03Jun2021 as 2nd dose, single dose for covid-19 immunization. The patient medical history was not reported. The patient''s concomitant medications were not reported. He was a healthy kid before vaccination. Patient received dose 1 of bnt162b2 on 13May2021 for Covid-19 immunization and experienced mild side effects. On 03Jun2021 the patient experienced fever like 101.44. He started running fever after second dose of vaccine. The patient underwent lab tests which included body temperature 101.44 on Jun2021. Therapeutic measures were taken as a result of fever like 101.44 includes Its going down with Ibuprofen and Acetaminophen that seemed to get under control, but it kept coming back and the reporter just didn''t know that was something normal that she should expect. Reporter was just curious that her 13-year-old got his second dose of Pfizer on 03Jun2021, so its 06Jun2021 and he was still running a fever like 101.4. The outcome of fever was not recovered.


VAERS ID: 1391103 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021663356

Write-up: Slight headache; Sore arm; Tired; This is a spontaneous report from a contactable consumer (parent). A male patient of unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number: UNKNOWN), via an unspecified route of administration on 02Jun2021 at 2nd dose, single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 03Jun2021, patient woke up around 11am and had slight headache, which lasted all day, sore arm and tired. Outcome of the events was unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained.


VAERS ID: 1391137 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Axillary pain, Fatigue, Insomnia, Malaise, Myalgia, Restlessness
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), 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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (multiple allergies (including drug allergies)); Chest pain
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021665150

Write-up: He developed achiness on both sides under his arm pit extending primarily to pectoral muscles and deltoid; He developed achiness on both sides under his arm pit extending primarily to pectoral muscles and deltoid; He couldnt sleep because of the pain; Also reports stomach discomfort; Experienced fatigue; Feeling under the weather and restless; Restlessness; This is a spontaneous report from a contactable consumer (patient''s mother).Follow-up (06Jun2021) and Follow up (07Jun2021) received from previously reported consumer were processed together along with initial information. A 23-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EW0187; Expiration Date: 31Aug2021), via an unspecified route of administration on 03Jun2021 (at an age of 23-year-old during vaccination) as a 2nd dose, single dose for COVID-19 immunisation. The patient''s medical history included multiple allergic reactions (including drug allergies) after having his wisdom teeth out and had chest muscle pain. The patient''s concomitant medications were not reported. The reporter stated that, the patient was not related to any study or programme. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot Number: Not reported), via an unspecified route of administration on unspecified date as a 1st dose, single dose for COVID-19 immunisation. On 03Jun2021, the reporter stated that the patient experienced fatigue, feeling under the weather and restlessness. On Sunday early morning, the patient developed achiness on both sides under his arm pit extending primarily to pectoral muscles and deltoid, he could not sleep because of the pain and stomach discomfort. The reporter stated that as of last evening that it was kind of the same. No investigational assessment was reported. The reported wanted to know if her son chest muscles pain was normal or not. The reporter worried if her son needed medical care right away. The reporter concerned about lot number whether there was any issue involved with lot number. The reported stated that, the pharmacist did not follow proper procedure while with the administration of the vaccine however she was unable to identify a specific concern. The reporter was informed to provide information about side effects and to refer to doctor about side effects if there continue. The outcome of the events was unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1391257 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Hunger, Hypoaesthesia, Injection site bruising, Injection site pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Tendinopathies and ligament 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: USJNJFOC20210612797

Write-up: STARVING IN MORNING; HEAD OR BRAIN FUZZY, FEEL DRUGGED, FEEL WEIRD; DIZZINESS; A PALE YELLOW BRUISE WHERE THE INJECTION WENT IN; DIDN''T FEEL A THING IN THE ARM; MINIMAL ARM SORENESS; SHOT DID HURT A LITTLE WHEN IT WENT IN; This spontaneous report received from a patient concerned an adult of unspecified sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 205A21A and expiry: UNKNOWN) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUN-2021, the subject experienced shot did hurt a little when it went in. On 04-JUN-2021, the subject experienced starving in morning. On 04-JUN-2021, the subject experienced head or brain fuzzy, feel drugged, feel weird. On 04-JUN-2021, the subject experienced dizziness. On 04-JUN-2021, the subject experienced a pale yellow bruise where the injection went in. On 04-JUN-2021, the subject experienced didn''t feel a thing in the arm. On 04-JUN-2021, the subject experienced minimal arm soreness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from shot did hurt a little when it went in on 03-JUN-2021, and the outcome of starving in morning, dizziness, head or brain fuzzy, feel drugged, feel weird, minimal arm soreness, a pale yellow bruise where the injection went in and didn''t feel a thing in the arm was not reported. This report was non-serious.; Sender''s Comments: V0:Medical assessment comment not required as per standard procedure as case assessed as Non-serious.


Result pages: prev   147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=246&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166