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

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



Case Details (Reverse Sorted by Onset Date)

This is page 261 out of 8,010

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VAERS ID: 1759895 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SCKX7 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Blepharospasm, Cold sweat, Dizziness, Electroencephalogram, Investigation, Malaise, Seizure
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Convulsions (narrow), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Egg allergy (can trigger eczema flare-ups); Food allergy (can trigger eczema flare-ups)
Allergies:
Diagnostic Lab Data: Test Name: EEG; Result Unstructured Data: Test Result:unknown results; Comments: in the afternoon; Test Name: Various tests; Result Unstructured Data: Test Result:All examinations without result
CDC Split Type: DEPFIZER INC202101238904

Write-up: Seizure; flickering eyelids; soaked; pain in the abdomen; dizziness; malaise; This is a spontaneous report from a non-contactable consumer downloaded from the WEB, regulatory authority number DE-PEI-CADR2021176775. A 12-year-old male patient received the second dose of BNT162B2 (COMIRNATY, mRNA TOZINAMERAN) via an unspecified route of administration on 05Sep2021 at 15:30 (Batch/Lot Number: SCKX7) as 0.3 ml dose for COVID-19 immunization. Medical history included food allergy (Chicken and eggs), can trigger eczema flare-ups, and unknown if ongoing. Concomitant medication was not reported. On 06Sep201, the patient experienced seizure. On 06Sep2021, in the morning, the patient experienced dizziness and malaise. On 06Sep201 at 09:30, the patient experienced pain in the abdomen. Slumped backwards, flickering eyelids, squeaking noises made and soaked. Everything took maybe 1 to 2 minutes. The pain disappeared after a few minutes. The event of seizure was resulted in hospitalization. The patient underwent lab tests and procedures which included electroencephalogram: in the afternoon with unknown results on 06Sep2021, Various tests: all examinations without result on an unspecified date. Emergency room for children. Various tests carried out there, electroencephalogram (EEG) in the afternoon. Stayed in hospital overnight for observation. All examinations without result. Doctors assume a one-off event. The outcome of seizure was recovered on 06Sep2021. The outcome of pain in the abdomen was recovered. The outcome of other events was unknown. No follow-up attempts are possible. No further information expected.


VAERS ID: 1759945 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-06
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Vestibular neuronitis
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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: FIPFIZER INC202101239699

Write-up: Vestibular neuronitis; This is a spontaneous report from a contactable consumer (patient) downloaded from a Regulatory Authority. The regulatory authority report number is FI-FIMEA-20214733. A 44-year-old male patient received bnt162b2 (COMIRNATY, Batch/Lot Number: UNKNOWN), via an unspecified route of administration on an unspecified date as single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced vestibular neuronitis on 06Sep2021 with outcome of not resolved. The patient was hospitalized for vestibular neuronitis for 5 days. The event was serious per hospitalization. Started unexpectedly without warning, by ambulance to the hospital and 5 days in the ward, diagnosis was vestibular neuronitis. No previous symptoms, illnesses or medications. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1760059 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-08
Onset:2021-09-06
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, COVID-19, Cough, Drug ineffective, Dyspnoea, Oxygen saturation, Oxygen saturation decreased, Pyrexia, Rhinitis, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: RITUXIMAB
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Obesity; Pemphigus
Allergies:
Diagnostic Lab Data: Test Date: 20210912; Test Name: Body temperature; Result Unstructured Data: Test Result:38.9; Test Date: 20210912; Test Name: O2 saturation; Test Result: 84 %; Comments: under 6L of O2; Test Date: 2021; Test Name: Covid-19 PCR test; Test Result: Positive
CDC Split Type: FRPFIZER INC202101239788

Write-up: Vaccination failure; COVID-19 pneumonitis; Oxygen saturation decreased 84%; Dyspnea; Cough; rhinitis; fever; This is a spontaneous report from a contactable pharmacist downloaded from the regulatory authority number FR-AFSSAPS-ST20213453. A 45-year-old female patient received second dose of BNT162B2 (COMIRNATY, solution for injection, Batch/Lot Number: unknown, Expiry date: not reported) via an unspecified route of administration on 08Jul2021 as DOSE 2, 0.3 ML SINGLE and received first dose of BNT162B2 (COMIRNATY, solution for injection, Batch/Lot Number: unknown, Expiry date: not reported) via an unspecified route of administration on 09Jun2021 as DOSE 1, 0.3 ML SINGLE for covid-19 immunization. Medical history included pemphigus and obesity. Concomitant medication(s) included rituximab (RITUXIMAB) taken for pemphigus since Nov2020 (December 2020 and April 2021). SARS-Cov-2 pneumonia in a fully vaccinated patient. PCR + (positive) COVID-19 (variant unknown), 15 days before admission to hospital with initial symptoms: cough, rhinitis and fever in 2021. The patient experienced Alteration of general condition with onset of dyspnea on 06Sep2021. on 12Sep2021, The patient experienced covid-19 pneumonitis and was hospitalized. The patient sent to emergency department for 84% desaturation under 6L of O2 and fever at 38.9 on admission transfer to intensive care on 12Sep2021. The patient underwent lab tests and procedures which included body temperature: 38.9, oxygen saturation: 84 % and under 6L of O2 on 12Sep2021, Covid-19 PCR test: positive on an unknown date in 2021. The outcome of the events was not recovered. No follow-up attempts are possible. Information on batch lot number cannot be obtained. No further information is expected.


VAERS ID: 1760096 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-06
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: AUPFIZER INC202101243072

Write-up: Bell''s palsy; This is a spontaneous report received from the Regulatory Authority. The regulatory authority report number is 624072. A contactable healthcare professional reported that a 31-year-old male patient received BNT162B2 (COMIRNATY, Solution for injection), via an unspecified route of administration, on an unspecified date (Batch/Lot number was not reported) as dose number unknown, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced Bell''s palsy on 06Sep2021. The outcome of event Bell''s palsy was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1760100 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-06
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Transient ischaemic attack
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: AUPFIZER INC202101243750

Write-up: Transient ischaemic attack; This is a spontaneous report from a contactable other health professional via the Regulatory Authority. Regulatory authority report number is 625393. A 38-year-old male patient received BNT162B2 (COMIRNATY, Batch/Lot number was not reported) via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced transient ischaemic attack on 06Sep2021 with outcome of recovered in Sep2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1760522 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Acetonaemia, Alanine aminotransferase, Aspartate aminotransferase, Auscultation, Base excess, Basophil count, Blood bicarbonate, Blood calcium, Blood chloride, Blood creatine phosphokinase, Blood creatinine, Blood disorder, Blood fibrinogen, Blood glucose, Blood glucose increased, Blood lactate dehydrogenase, Blood magnesium, Blood potassium, Blood pressure diastolic, Blood pressure systolic, Blood sodium, Body temperature, C-reactive protein, Calcium ionised, Carbon dioxide, Cardiomyopathy, Cephalin flocculation, Coagulopathy, Disorientation, Electrocardiogram, Eosinophil count, Glomerular filtration rate, Haematocrit, Haemoglobin, Haemoglobin distribution width, Heart rate, Hypotonia, International normalised ratio, Investigation, Lymphocyte count, Lymphopenia, Mean cell haemoglobin, Mean cell haemoglobin concentration, Mean cell volume, Mean platelet volume, Monocyte count, Myositis, Neurological examination, Neutrophil count, Neutrophil count increased, Oxygen saturation, PCO2, PO2, Peripheral coldness, Petechiae, Platelet count, Platelet distribution width, Protein total, Prothrombin level, Prothrombin time, Red blood cell count, Red cell distribution width, Romberg test, Syncope, Tonic clonic movements, Troponin I, Vaccination site pain, Visual impairment, White blood cell count, pH body fluid
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Haematopoietic cytopenias affecting more than one type of blood cell (broad), Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (narrow), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Ecchymosis (Mother); Epistaxis (Mother)
Allergies:
Diagnostic Lab Data: Test Name: Ketonemia; Result Unstructured Data: Test Result:0.4 mmol/L; Test Name: ALT; Result Unstructured Data: Test Result:25 u/l; Test Name: AST; Result Unstructured Data: Test Result:23 u/l; Test Name: Cardiopulmonary auscultation; Result Unstructured Data: Test Result:rhythmic, not ploys.; Comments: Good bilateral air intake without overadded noises, no respiratory work; Test Name: Excess blood bases; Result Unstructured Data: Test Result:-1.2 mmol/L; Test Name: Excess extracellular liq. bases; Result Unstructured Data: Test Result:-0.8 mmol/L; Test Name: Basophils; Result Unstructured Data: Test Result:0.0 10E3 E3 /uL; Test Name: Basophils; Test Result: 0 %; Test Name: HCO3; Result Unstructured Data: Test Result:24.8 mmol/L; Test Name: Calcium; Test Result: 9 mg/dl; Test Name: Chloride; Result Unstructured Data: Test Result:103 mmol/L; Test Name: CPK; Result Unstructured Data: Test Result:59 u/L; Test Name: Creatinine; Test Result: 0.55 mg/dl; Test Name: Fibrinogen derivative; Test Result: 302.4 mg/dl; Test Name: Blood glucose; Test Result: 48 mg/dl; Test Name: Blood glucose; Test Result: 109 mg/dl; Test Name: Glucose; Test Result: 102 mg/dl; Test Name: LDH; Result Unstructured Data: Test Result:200 U/L; Test Name: Magnesium; Test Result: 1.8 mg/dl; Test Name: Potassium; Result Unstructured Data: Test Result:3.8 mmol/L; Test Name: Diastolic blood pressure; Result Unstructured Data: Test Result:63 mmHg; Test Name: Systolic blood pressure; Result Unstructured Data: Test Result:110; Test Name: Sodium; Result Unstructured Data: Test Result:139 mmol/L; Test Name: Temperature; Result Unstructured Data: Test Result:36.7; Test Name: Ionic calcium; Result Unstructured Data: Test Result:1.17 mmol/L; Test Name: TCO2; Result Unstructured Data: Test Result:26.2 mmol/L; Test Name: Cephalin time; Test Result: 28.9 s; Test Date: 20201221; Test Name: Cephalin time; Test Result: 28.7 s; Test Name: C-reactive Protein; Result Unstructured Data: Test Result:0.5 mg/l; Test Name: Electrocardiogram; Result Unstructured Data: Test Result:sinus rhythm, electric axis + 50?; Comments: Interval PR 0.14 seconds, QRS0.1 seconds complexes and normal morphology in all precordial leads, QT interval corrected 0.37 seconds, no signs of overgrowth of cavities or repolarization disorders. Conclusion: normal registration.; Test Name: Eosinophils; Result Unstructured Data: Test Result:0.1 10 E3 /uL; Test Name: Eosinophils; Test Result: 1.1 %; Test Name: Estimated Glomerular Filtration; Result Unstructured Data: Test Result:90.0 ml/min/1.73m2; Test Name: Hematocrit; Test Result: 45.2 %; Test Name: Hemoglobin; Result Unstructured Data: Test Result:15.9 g/dl; Test Name: Haemoglobin distribution width; Result Unstructured Data: Test Result:2.72 g/dl; Test Name: Heart rate; Result Unstructured Data: Test Result:96; Test Name: Heart rate; Result Unstructured Data: Test Result:90 bpm; Test Name: I.N.R; Result Unstructured Data: Test Result:1.26; Test Name: Large unstained cells (LUC); Result Unstructured Data: Test Result:0.08 10 E3 /uL; Test Name: measured oxygen saturation; Result Unstructured Data: Test Result:39.9; Test Name: Standard bicarbonate; Result Unstructured Data: Test Result:22 mmol/L; Test Name: Lymphocytes; Result Unstructured Data: Test Result:0.6 10 E3 /uL; Test Name: Lymphocytes; Test Result: 7.7 %; Test Date: 20111107; Test Name: Lymphocytes; Test Result: 3.6 %; Test Date: 20180612; Test Name: Lymphocytes; Test Result: 2.7 %; Test Date: 20201221; Test Name: Lymphocytes; Test Result: 2.2 %; Test Name: Mean corpuscular haemoglobin; Test Result: 29.8 pg; Test Name: Mean corpuscular haemoglobin concentration; Result Unstructured Data: Test Result:35.2 g/dl; Test Name: Mean corpuscular volume; Result Unstructured Data: Test Result:84.6 fl; Test Name: Mean Platelet Volume; Result Unstructured Data: Test Result:8.7 fL; Test Name: Monocytes; Result Unstructured Data: Test Result:0.5 10 E3 /uL; Test Name: Monocytes; Test Result: 6.3 %; Test Name: Neurological examination; Result Unstructured Data: Test Result:conscious, oriented, collaborative.; Comments: No meningeal or neck stiffness. Normorreactive isochoric pupils, normal cranial nerves, strength and tone suitable for their age, osteotendinous reflexes present and symmetrical, no dysmetries or dysdiadokinesias. Barany negative, Unterberger negative, no gait or balance disturbances, bilateral negative Babinski.; Test Name: Neutrophils; Result Unstructured Data: Test Result:6.4 10 E3 /uL; Test Name: Neutrophils; Test Result: 83.9 %; Test Name: Saturation; Test Result: 100 %; Test Name: pCO2; Result Unstructured Data: Test Result:46 mmHg; Test Name: pH; Result Unstructured Data: Test Result:7.35; Test Name: Platelet; Result Unstructured Data: Test Result:191 10E3/uL; Test Name: Platelet; Test Result: 0.17 %; Test Date: 20111107; Test Name: Platelets; Result Unstructured Data: Test Result:456; Test Date: 20180612; Test Name: Platelets; Result Unstructured Data: Test Result:231; Test Date: 20201221; Test Name: Platelets; Result Unstructured Data: Test Result:191; Test Name: Platelet distribution width; Test Result: 48.9 %; Test Name: pO2; Result Unstructured Data: Test Result:24 mmHg; Test Name: Total proteins; Result Unstructured Data: Test Result:7.4 g/dl; Test Name: Prothrombin Activity; Test Result: 65.1 %; Test Name: Prothrombin time; Test Result: 14.6 s; Test Date: 20201221; Test Name: Prothrombin time; Test Result: 13.6 s; Test Name: Red Blood Cells; Result Unstructured Data: Test Result:5.34 10*6/uL; Test Name: Red cell distribution width; Test Result: 13.2 %; Test Name: Romberg; Test Result: Negative ; Test Name: Troponin I; Result Unstructured Data: Test Result:3 pg/mL; Test Name: Leukocytes; Result Unstructured Data: Test Result:7.61 10 E3 /uL; Test Name: Leukocytes; Result Unstructured Data: Test Result:7.61 10 E3 /uL
CDC Split Type: ESPFIZER INC202101229190

Write-up: This is a spontaneous report from a contactable physician, regulatory authority number ES-AEMPS-995027. A 12-year-old male patient received BNT162B2 (Covid19 Pfizer), intramuscular, administered in left deltoid on 05Sep2021 (Lot number was not reported) as dose 2, single for COVID-19 immunization. Medical history was not reported; patient had no known allergies, no chronic diseases or surgeries. Family history included mother had repeated epistaxis and ecchymosis with minimal trauma that required laser coagulation of the nasal mucosa. The patient''s concomitant medications were not reported. The patient previously received BNT162B2 (Covid19 Pfizer) on 11Aug2021 (Lot number: FG4442) intramuscular as dose 1, single for COVID-19 immunization. The patient received second dose of COVID-19 vaccine on 05Sep2021 and patient was brought to the emergency room due to loss of consciousness on 06Sep2021. About two hours prior he reported subjective instability with pain in the inoculation area of the vaccine. He has slept an hour and a half prior to this incident. When he woke up he sat at the table and when he started eating he reported worsening instability, he got up, went to the living room and it was when his mother had to catch him for generalized hypotonia without response to stimuli. On the sofa, in supine position, the patient did not react and presented tonic movements of upper and lower extremities. The loss of consciousness has lasted one minute without lethargy but disorientation. The patient comments that prior to his loss of consciousness he saw everything in black. No emesis. No sphincter incontinence during this event. No recent infectious history. Physical examination: Weight: 43.4 kg, Saturation: 100%, Temperature:36.7, Heart rate: 96, Systolic Blood Pressure :110, Diastolic Blood pressure: 63 mmHg, Blood glucose: 48 mg/dl, Stable pediatric evaluation triangle. Good general condition. Good color, hydration. Cold extremities with 3-second capillary filling on both hands and feet. Skin showed numerous and flat micropetechia in the upper region of the anterior face of the chest. Inoculation zone of the vaccine at the level of the left deltoid without alteration of the surrounding skin and with mild painful muscle inflammation. Cardiopulmonary auscultation: rhythmic, not ploys. Good bilateral air intake without over added noises, no respiratory work. Neurological: conscious, oriented, collaborative. No meningeal or neck stiffness. Normorreactive isochoric pupils, normal cranial nerves, strength and tone suitable for their age, osteotendinous reflexes present and symmetrical, no dysmetries or dysdiadokinesias, Romberg negative, Barany negative, Unterberger negative, no gait or balance disturbances, bilateral negative Babinski. Patient''s treatment and evolution: at 17:40 capillary glycemia 109 mg/dl and ketonemia 0.4 mmol/L. They proceeded to electrocardiogram, peripheral venous channeling, blood tests and intravenous fluid therapy with 5% glucosalin serum at baseline needs. At 18:45, the patient reported feeling better. Cold extremities persisted although with capillary filling 3 seconds, has tolerated biscuits and juice without incident. The analysis showed lymphopenia and mild coagulopathy. Observation was decided until completing 4 hours of stay from the event. At 19:30, patient had good evolution. It was decided to be discharged home and summoned to the General Pediatrics consultation for lymphopenia (possible vaccine reaction) and coagulopathy (to rule out hereditary coagulopathy through the mother). Complementary tests: Electrocardiogram: frequency 90 bpm, sinus rhythm, electric axis + 50, Interval PR 0.14 seconds, QRS0.1 second complexes and normal morphology in all precordial leads, QT interval corrected 0.37 seconds, no signs of overgrowth of cavities or repolarization disorders. Conclusion: normal registration. Analytics: leukocytes 7.61 10 E3 /uL (4.5 - 11.4), neutrophils 6.4 10 E3 /uL (1.7 - 7.9), lymphocytes 0.6 10 E3 /uL (1.2 - 5.0), monocytes 0.5 10 E3 /uL (0.1 - 1.1), eosinophils 0.1 10 E3 /uL (0.0 - 0.7), basophils 0.0 10E3 E3 /uL (0.0 -0.2), large unstained cells (LUC) 0.08 10 E3 /uL (0.0 - 0.5), neutrophils % 83.9 % (36.0 - 77.0), lymphocytes % 7.7 % (20.0 - 47.0), monocytes % 6.3 % (0.0 - 9.0), eosinophils % 1.1 % (0.5 - 5.5), basophils % 0.0 % (0.0 - 1.8), % large unstained cells (LUC) 1.00 % (0.0 - 4.0). Blood count: red blood cells 5.34 10E6/uL (4.1 - 5.55), hemoglobin 15.9 g/dL (12.5 - 16.0), hematocrit 45.2 % (36.5 - 47.5), mean corpuscular volume: 84.6 fL (78.0 - 93.0), mean corpuscular hemoglobin: 29.8 pg (26.0- 32.5), mean cell haemoglobin concentration 35.2 g/dL (31.5 - 36.0), red cell distribution width 13.2 % (11.5 - 14.0), haemoglobin distribution width 2.72 g/dL (2.2 - 3.2). Hemogram: platelets 191 10E3/uL (170.0 - 400.0), platelet 0.17 % (0.12 - 0.36), platelet distribution width 48.9 % (25.0 - 65.0), mean platelet volume 8.7 fL (5.9 - 9.9). Coagulation Study Prothrombin Time 14.6 seconds (9.0 - 13.0), prothrombin activity 65.1 % (70.0 - 120.0), International normalised ratio 1.26 (0.0 - 1.15), Cephalin time 28.9 sec (23.0 - 34.5), fibrinogen derivative 302.40 mg/dL (150.0 - 400.0). Gasometry: venous blood sample, pH 7.35 (7.33 - 7.42), pCO2 46 mmHg (38.0 - 48.0), pO2 24 mmHg (20.0 - 45.0), HCO3 24.8 mmol/l (23.0 - 28.0), Total CO2 26.2 mmol/l, BEb (Excess blood bases) -1.2 mmol/l, BEecf (Excess extracellular liq. bases) -0.8 mmol/l, SBC (Standard bicarbonate) 22.0 mmol/l, sO2m (measured oxygen saturation) 39.9 %. Biochemical determinations in serum/plasma glucose 102 mg/dl (60.0 - 100.0), urea 27 mg/dl (20.0 - 50.0), creatinine 0.55 mg/dl (0.4 - 0.83), total proteins 7.4 g/dl (5.7 - 8.2), calcium 9.0 mg/dl (8.7 - 10.4), ionic calcium 1.17 mmol/L (1.15 -1.35), sodium 139 mmol/L (136.0 - 145.0), potassium 3.8 mmol/L (3.5 - 5.3), chloride 103 mmol/L (99.0 - 109.0), magnesium 1.8 mg/dl (1.3 - 2.7), creatine phosphokinase (CPK) 59 U/L (46.0 - 171.0), troponin I (us-TnIc) 3 pg/mL (0.0 - 60.0), high sensitivity troponin Interpretation Undetectable result. Acute myocardial damage, lactate deshydrogenase (LDH) 200 U/L (120.0 - 246.0), alanine aminotransferase (ALT) 25 U/L (10.0 -49.0), aspartate aminotransferase (AST) 23 U/L (0.0 - 37.0), glomerular filtration rate Estimate, estimated glomerular filtration [CKD-EPI] 90.0 ml/min/1.73m2, protein specific determinations C-reactive Protein 0.5 mg/L (0.0 - 5.0). Diagnoses were vasovagal syncope (possible vaccine reaction), mild blood dysrasias, lymphopenia (possible vaccine reaction, and coagulopathy (rule out possible hereditary coagulopathy). In his medical record there was consultation for vasovagal syncope in 2018 while standing. Platelets on 21Dec2020: 191, 12Jun2018: 231, 07Nov2011: 456. Lymphocytes on 21Dec2020: 2,20, 12Jun2018: 2,70, 07Nov2011: 3,60. Prothrombin time (quick) on 21Dec2020 13,60. Cephalin time on 21Dec2020 28, 70. Outcome of the events lymphopenia and petechiae was not recovered, syncope vasovagal recovered on 06Sep2021, and the remaining events was unknown. No follow-up attempts are possible. No further information expected.


VAERS ID: 1760573 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG4493 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Anaphylactic shock, Diarrhoea, Functional gastrointestinal disorder, Localised oedema, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRPFIZER INC202101273682

Write-up: generalized urticaria; fever; diarrhea; Anaphylactic reaction; anaphylactic shock; neck edema; digestive disorders; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority FR-AFSSAPS-NC20214383. A 45-year-old male patient received the first dose of BNT162B2 (COMIRNATY, Lot Number: FG4493), at the age of 45 years old, via intramuscular in left arm on 06Sep2021 at single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 06Sep2021, 2h after the injection, the patient experienced neck edema, then anaphylactic shock with digestive disorders then the next day generalized urticaria with fever and diarrhea. Seriousness criteria was reported as life-threatening. Therapeutic measures were taken as a result of events. In summary, patient experienced anaphylactic-like reaction after vaccine dose 1. The outcome of events was recovered. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1760879 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Hypoaesthesia, Inappropriate schedule of product administration, Limb discomfort, Pain, Photophobia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Medication errors (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: GBPFIZER INC202101265546

Write-up: INAPPROPRIATE SCHEDULE OF VACCINE ADMINISTERED; numbness/ this time on right arm; light temperature; fatigue/ Stayed in bed 3 days because of the fatigue; heavy right arm; real sore; heavy right arm; This is a spontaneous report from a contactable consumer received from the Regulatory Authority (RA). This is one of two reports. This is a split case for dose 2, different events. Regulatory authority report number is GB-MHRA-WEBCOVID-202109200745459260-AHLBI. Safety Report Unique Identifier is GB-MHRA-ADR 25966959 A 50-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 06Sep2021 (Batch/Lot number and expiry date not reported) as DOSE 2, SINGLE for COVID-19 immunization. It was unsure if patient has had symptoms associated with COVID-19, not had a COVID-19 test. Patient was not pregnant. Patient was not currently breastfeeding. Patient had not tested positive for COVID-19 since having the vaccine. Patient was not enrolled in clinical trial.Medical history and concomitant medications were not reported. Historical vaccine included BNT162B2 on 13Jun2021 date as dose 1, single for COVID-19 immunization and experienced hypoaesthesia, photophobia, fatigue, nausea, oropharyngeal pain and muscular weakness. The patient experienced numbness/this time on right arm on an unspecified date with outcome of recovered on an unspecified date, light temperature on an unspecified date with outcome of recovered on an unspecified date, fatigue/stayed in bed 3 days because of the fatigue on an unspecified date with outcome of recovered on an unspecified date, heavy right arm on an unspecified date with outcome of recovered on an unspecified date, real sore on an unspecified date with outcome of recovered on an unspecified date, heavy right arm on an unspecified date with outcome of unknown, and inappropriate schedule of vaccine administered 06Sep2021 with outcome of unknown. The event was reported as serious, medically significant and disabling by the health authority. Case narrative: I have my 1st dose on 13 June in my left arm. During my first dose I woke up the next morning with: half my head to my hip on my left side feeling numb; throat hurt and left hand side ear also hurt; left arm was numb and painful; I felt nausea; lots of fatigue. The half side numbness symptoms lasted approx 3 weeks and I stayed pretty much in bed for the entire 3 weeks. Thereafter, they got significantly better quite quickly. First week symptoms were most severe. Couldn''t order a COVID-19 test at the time as there wasn''t stock available on-line. It was impossible to get hold of GP at local surgery so just stayed in bed. I work from home but was unable to work for 3 weeks. 2nd Pfizer dose I took on 6 Sept - symptoms lasted 4 days, this time on right arm. Light temperature, real sore and heavy right arm. Stayed in bed 3 days because of the fatigue. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender''s Comments: Linked Report(s) : GB-PFIZER INC-202101242786 same patient, different dose number and different event.


VAERS ID: 1760955 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG9019 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram, Interchange of vaccine products, Magnetic resonance imaging, Off label use, X-ray
SMQs:, Hearing impairment (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202109; Test Name: Blood test; Result Unstructured Data: Test Result:overnight tests and scans confirmed it was bells p; Comments: overnight tests and scans confirmed it was bells palsy; Test Date: 202109; Test Name: CT scan; Result Unstructured Data: Test Result:overnight tests and scans confirmed it was bells p; Comments: overnight tests and scans confirmed it was bells palsy; Test Date: 202109; Test Name: MRI; Result Unstructured Data: Test Result:overnight tests and scans confirmed it was bells p; Comments: overnight tests and scans confirmed it was bells palsy; Test Date: 202109; Test Name: X-ray; Result Unstructured Data: Test Result:overnight tests and scans confirmed it was bells p; Comments: overnight tests and scans confirmed it was bells palsy
CDC Split Type: IEPFIZER INC202101279062

Write-up: Bells palsy; Off label use; Interchange of vaccine products; This is a spontaneous report from a contactable consumer downloaded from the Regulatory Authority-WEB, regulatory authority number IE-HPRA-2021-084173, Safety Report Unique Identifier IE-HPRA-2021-084173. A 60-years-old male patient received second dose (INITIAL PFIZER DOSE) of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: FG9019) via an unspecified route of administration on 06Sep2021 at the age of (60-years-old) as dose 2 (INITIAL PFIZER DOSE) single for covid-19 immunisation. The patient medical history was reported as historical vaccine (vaxzevria, Batch/Lot Number: ABX350) on 09May2021 as dose 1 single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. It was reported that on 06Sep2021 after 15 minutes administration of the vaccine the patient experienced bell''s palsy. The patient further reported that within minutes of the vaccine administration patient had a tingling effect on the left side of the face. The patient was treated with steroids and anti-inflammatory tablets for the event of bells palsy and patient was admitted in hospital due to the event and reported that he was discharged on the second day, and he was instructed to continue the treatment with steroids and anti-inflammatory tablet for one week. The patient further reported on an unspecified date he had a bad reaction after the administration of the first dose of Vaxzevria and he was recommended to be administered Comirnaty as a second dose of COVID-19 vaccine. On an unspecified date in Sep2021 the patient underwent tests and scans in the hospital (blood tests, X-Rays, CT and MRI scans), which confirmed the initial diagnosis of his GP of bells palsy. The patient was not recovered from the event of bells palsy at the time of report. No follow up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : IE-HPRA-2021-073820


VAERS ID: 1761162 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-06
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arrhythmia, Dizziness, Palpitations, Presyncope
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: AUPFIZER INC202101244501

Write-up: Arrhythmia; Dizziness; Palpitations; Presyncope; This is a spontaneous report from a contactable other health professional via the Regulatory Authority. Regulatory authority report number is 627442. A 35-year-old female patient received BNT162B2 (COMIRNATY, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date as DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced arrhythmia, dizziness, palpitations and presyncope all on 06Sep2021. The outcome of the events was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1762551 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Hemianopia, Ischaemic stroke
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Optic nerve 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: ESPFIZER INC202101250231

Write-up: Hemianopsia; Ischaemic stroke; This is a spontaneous report from a contactable physician downloaded from the Regulatory Agency (RA)-WEB, regulatory authority number ES-AEMPS-1005387. A 15-year-old male patient received BNT162B2 (COMIRNATY) at the age of 15-years-old, intramuscular on 06Sep2021 (Batch/Lot Number: Unknown) as dose 1, 0.3 ml single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On 06Sep2021, the patient experienced Right upper hemianopsia due to left occipital ischemic stroke after the first dose. The outcome of the events was recovering. No follow-up attempts are possible, information about lot/batch number cannot be obtained.


VAERS ID: 1763721 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD9309 / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PTPFIZER INC202101273951

Write-up: Edema reaction to COMIRNATY Vaccine 2nd dose; This is a Spontaneous report from a contactable Physician downloaded from the regulatory authority-WEB. This is a report received INFARMED Regulatory authority report number PT-INFARMED-B202109-892 with Safety Report Unique Identifier number PT-INFARMED-B202109-892. A 24-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number: FD9309) intramuscular, on 06Sep2021 (at the age of 24-years-old) as dose 2, 0.3 ML SINGLE for COVID-19 immunisation. The patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on an unspecified date as dose 1, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. No medication error occurred. On 06Sep2021, the patient experienced edema reaction to comirnaty vaccine 2nd dose, concentrate for injectable dispersion, 30 mcg/0.3 ml. According to the notifier, it caused incapacity. Therapeutic measures were taken as a result of edema reaction to comirnaty vaccine 2nd dose. Specific treatment of ADR was performed with ibuprofen, paracetamol and local application of ice. At the time of notification (2 days after the start of ADR), the reaction persisted without recovery. The reporter''s assessment of the causal relationship of the event with the suspect product was probable. The outcome of the event was unknown. No follow-up attempts are possible. No further information is expected.; Reporter''s Comments: Concomitant Drug: No. Does Medication Error Occurred: No.


VAERS ID: 1763730 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-06
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Diarrhoea, Fatigue, Headache, Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Concomitant elements very healthy
Allergies:
Diagnostic Lab Data:
CDC Split Type: PTJNJFOC20211002701

Write-up: SLEEPINESS; VOMITING; DIARRHOEA; HEADACHE; FATIGUE; LACK OF APPETITE, TOTAL; CHILLS; PYREXIA; ASTHENIA; This spontaneous report received from a consumer via a Regulatory Authority (EVHUMAN Vaccines, PT-INFARMED-J202109-1449) on 01-OCT-2021 and concerned a 19 year old male. The patient''s weight was 86 kilograms, and height was 180 centimeters. The patient''s pre-existing medical conditions included: Concomitant elements very healthy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 21C18-03 expiry: UKNOWN) 0.5 ml, 1 total, administered on 16-AUG-2021 for covid-19 immunisation. No concomitant medications were reported. On 06-SEP-2021, the patient experienced sleepiness, vomiting, diarrhoea, headache, fatigue, lack of appetite total, chills, pyrexia and asthenia. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sleepiness, diarrhoea, headache, chills, pyrexia, and asthenia on 11-SEP-2021, vomiting on 06-SEP-2021, and lack of appetite, total on 10-SEP-2021, and was recovering from fatigue. This report was serious (Disability Or Permanent Damage).; Reporter''s Comments: Concomitant Medication x, Did Medication Error Occur x, Other information Does not use any type of medication or supplementation.


VAERS ID: 1764157 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-06
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Headache, Myalgia, Pyrexia, Seizure
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: LTJNJFOC20211007601

Write-up: Headache; Joint ache; Convulsions; Fever chills; Muscle ache; This spontaneous report received from a consumer via a Regulatory Authority (EVHUMAN Vaccines, LT-SMCA-6085N) on 05-OCT-2021 and concerned a 34 year old male of unknown race and ethnicity. The patient''s weight was 70 kilograms, and height was 173 centimeters. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 7383516 expiry: UNKNOWN) 0.5 ml, 1 total administered on 06-SEP-2021 for covid-19 immunisation. Drug start was reported as 1 day and end period was reported as 4 days. No concomitant medications were reported. On 06-SEP-2021, the patient experienced headache, joint ache, convulsions, fever chills, muscle ache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache, joint ache, fever chills, and muscle ache on 09-SEP-2021, and convulsions on 06-SEP-2021. This report was serious (Other Medically Important Condition).


VAERS ID: 1766245 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Menstruation delayed, SARS-CoV-2 test
SMQs:, Fertility disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210921; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC202101259113

Write-up: Late period; This is a spontaneous report from a contactable consumer. This consumer reported for two reports. This is the first of two reports. This is a report received from the regulatory authority. Regulatory authority report number: GB-MHRA-WEBCOVID-202109221939519250-NB3B7, Safety Report Unique Identifier: GB-MHRA-ADR 25980155. A 17-year-old female patient received BNT162B2 (COVID-19 MRNA VACCINE BIONTECH), via an unspecified route of administration on 06Sep2021 (Batch/Lot Number: not reported) as DOSE 2, SINGLE for COVID-19 immunisation. The patient was 17-years-old at the time of reporting. The patient''s medical history and concomitant medications were not reported. Patient has not had symptoms associated with COVID-19. Patient is not pregnant, Patient is not currently breastfeeding. Patient is not enrolled in clinical trial. The patient previously took BNT162B2 (COVID-19 MRNA VACCINE BIONTECH), via an unspecified route of administration on an unspecified date (Batch/Lot Number: not reported) as DOSE 1, SINGLE for COVID-19 immunisation. After the first dose, her period was on time. However, was extremely painful and a noticeable increase in severity of pain from regular periods. After the second dose, the patient experienced late period wherein her period was extremely late on 06Sep2021, despite her periods being almost clockwork regular. The event was considered serious: medically significant. The patient underwent lab tests and procedures which included COVID-19 virus test: No - Negative COVID-19 test on 21Sep2021. The outcome of event was recovering. No follow-up attempts are possible. No further information is expected. Information about lot/batch number cannot be obtained


VAERS ID: 1769375 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1F038A / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain lower, Asthenia, Back pain, Blood pressure measurement, Body temperature, Decreased appetite, Dyspnoea, Fatigue, Feeling hot, Headache, Hyperthermia, Hypotension, Influenza like illness, Insomnia, Maternal exposure during pregnancy, Musculoskeletal stiffness, Nausea, Neck pain, Pain, Pain in extremity, Pelvic pain, SARS-CoV-2 test, Sleep disorder, Thirst
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cesarean section
Allergies:
Diagnostic Lab Data: Test Date: 20210907; Test Name: blood pressure; Result Unstructured Data: Test Result:9/5; Test Date: 20210909; Test Name: blood pressure; Result Unstructured Data: Test Result:Normal; Test Date: 20210910; Test Name: blood pressure; Result Unstructured Data: Test Result:11/7; Test Date: 20210907; Test Name: Body temperature; Result Unstructured Data: Test Result:38.5; Comments: hypertermia; Test Date: 20210909; Test Name: Body temperature; Result Unstructured Data: Test Result:no fever; Test Date: 20210910; Test Name: Body temperature; Result Unstructured Data: Test Result:no fever; Test Date: 20210904; Test Name: COVID-19 PCR test; Test Result: Negative
CDC Split Type: FRPFIZER INC202101256502

Write-up: waking up still tired/remain exhausted; pain in the lower back; hotness; beginning of neck pain which spread down the left arm then aches everywhere; loss of appetite; intense thirst; asthenia; Breath shortness; sleep disturbance; impossible to sleep; stiffness; nausea; lower abdomen pain; aches; Hypotension; hyperthermia at 38.5; headache; Influenza like illness; Pain pelvic; Maternal Exposure During Pregnancy, first trimester ; pain in the left arm; This is a spontaneous report from a contactable nurse (patient) downloaded from the Regulatory Agency (RA)-WEB, regulatory authority number FR-AFSSAPS-BR20213467. A 30-year-old female patient received BNT162B2 (COMIRNATY, solution for injection, lot number: 1F038A), intramuscularly on 06Sep2021 (at the age of 30 years old) as dose 2, single for COVID-19 immunization. Medical history included caesarean section from 2017 to an unknown date. Last menstrual period date was 01May2021. The patient''s concomitant medications were not reported. The patient experienced pain in the left arm on 06Sep2021, beginning of neck pain which spread down the left arm then aches everywhere, loss of appetite, intense thirst, asthenia, breath shortness, sleep disturbance, impossible to sleep, stiffness, nausea, lower abdomen pain, aches, hypotension, hyperthermia at 38.5, headache, influenza like illness, pain pelvic on 07Sep2021, waking up still tired/remain exhausted, pain in the lower back, hotness on 08Sep2021. The reporter assessed all events as serious (medically significant). It was also reported that the patient also experienced maternal exposure during pregnancy, first trimester on 06Sep2021. It was reported that on 06Sep2021, it was just pain in the left arm. 1 g paracetamol was taken every 6 hours until bedtime. On 07Sep2021 in the morning, beginning of neck pain which spread down the left arm then aches everywhere: taking paracetamol relieved her. At noon, loss of appetite, intense thirst. In the afternoon, asthenia and sleep disturbance: impossible to sleep, stiffness, nausea, lower abdomen pain, aches, despite taking paracetamol every 6 hours, intense thirst. In the evening, blood pressure at 9/5 and hyperthermia at 38.5 with headaches. On 08Sep2021, she woke up early but with appetite. During the day again, aches and pains, loss of strength, intense thirst, loss of appetite, shortness of breath, hotness. She finally slept well that night. On 09Sep2021, in bed all day no strength, appetite better, but with nausea, headaches, thirst. Afternoon nap of 2 hours 15 minutes, despite that, still without strength, normal blood pressure, and no fever. From Thursday to Friday, slept well all night, waking up still tired, pain in the lower back and head, appetite better, 2-hour nap in the morning, she remained exhausted. Normal blood pressure at 11/7 and no fever. Sick leave taken on 10Sep2021 with gynecologist. Overall, the patient experienced flu syndrome, pelvic pain, hypotension, and shortness of breath. The patient was 18 weeks pregnant at the onset of the events. The patient was due to deliver on 05Feb2022. The patient underwent lab tests and procedures which included COVID-19 PCR test: negative on 04sep2021, blood pressure: 9/5 on 07Sep2021, normal on 09Sep2021 and 11/7 on 10Sep2021, and body temperature: 38.5 (hyperthermia) on 07Sep2021, no fever on 09Sep2021 and no fever on 10Sep2021. The outcome of all events was recovering. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1770156 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-06
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic rhinitis
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210906; Test Name: SARS-CoV-2 test; Result Unstructured Data: Positive Iu international unit(s)
CDC Split Type: PTJNJFOC20211009902

Write-up: VACCINATION FAILURE; This spontaneous report received from a health care professional via Regulatory Authority (PT-INFARMED-T202109-1752) on 06-OCT-2021 concerned a 27 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: allergic rhinitis. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: XE393, expiry: unknown) 0.5 ml, 1 total, administered on 20-JUL-2021 for covid-19 immunisation. No concomitant medications were reported. On 06-SEP-2021, the patient underwent SARS-CoV-2 test (severe acute respiratory syndrome coronavirus 2) and result of it found to be positive Iu international unit (s) (vaccination failure). The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from vaccination failure. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint.; Reporter''s Comments: Did a Medication Error Occur?-No Other information-Symptoms started on 06-Sep-2021 - Fever, cough, myalgias, nasal congestion, anosmia, ageusia, diarrhea, abdominal pain, arthralgias, generalized weakness. Has a medical history of allergic rhinitis on 04-May-2021.


VAERS ID: 1777753 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-06
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), 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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Gastric cancer; Hypertension arterial; Type II diabetes mellitus
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210908; Test Name: SARS-CoV-2 test; Result Unstructured Data: Positive
CDC Split Type: FRJNJFOC20211016339

Write-up: VACCINATION FAILURE; This spontaneous report received from a physician via a Regulatory Authority (FR-AFSSAPS-PC20214488) on 08-OCT-2021 and concerned a 56 year old male. The patient''s weight was 93 kilograms and height was 182 centimeters. The patient''s concurrent conditions included: type 2 diabetes mellitus, gastric cancer, and hypertension arterial. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number was not reported) 1 dosage forms, 1 total, administered on 31-JUL-2021 for covid-19 vaccination. The duration of drug administration was 1 day. The drug start period and last period was 38 days. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 06-SEP-2021, the patient experienced vaccination failure. On an unspecified date, the patient was hospitalized. On 08-SEP-2021, Laboratory data included: SARS-CoV-2 test (NR: not provided) Positive. Treatment with covid-19 vaccine ad26.cov2.s was withdrawn on 31-JUL-2021. The patient recovered from vaccination failure on 25-SEP-2021. This report was serious (Hospitalization Caused / Prolonged). This report was associated with product quality complaint.


VAERS ID: 1783904 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG9019 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Amylase, Pancreatitis acute
SMQs:, Acute pancreatitis (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: AQUADEKS [BETACAROTENE;BIOTIN;CALCIUM PANTOTHENATE;COLECALCIFEROL;CYANOCOBALAMIN;DL-SELENOMETHIONINE; HYPERTONIC SALINE; KALYDECO
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cystic fibrosis; Malabsorption; Pancreatic insufficiency ((since starting CFTR modulator))
Allergies:
Diagnostic Lab Data: Test Date: 202109; Test Name: Amylase; Result Unstructured Data: Test Result:Results Unknown; Comments: Raised amylase 829.
CDC Split Type: IEPFIZER INC202101298458

Write-up: ACUTE PANCREATITIS; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB, regulatory authority number IE-HPRA-2021-084307, Safety Report Unique Identifier number is (IE-HPRA-2021-084307). This case (IE-HPRA-2021-084307) is linked to IE-HPRA-2021-084363. A 14-years-old male patient received first dose of bnt162b2 (COMIRNATY, Formulation; Solution for injection, Lot Number: FG9019), via an unspecified route of administration on 06Sep2021 (at the age of 14-year-old) as DOSE 1, SINGLE for covid-19 immunisation. Medical history included cystic fibrosis from an unknown date and unknown if ongoing, Pancreatic insufficiency from an unknown date and unknown if ongoing (since starting CFTR modulator), malabsorption from an unknown date and unknown if ongoing. Concomitant medication(s) included betacarotene, biotin, calcium pantothenate, colecalciferol, cyanocobalamin, dl-selenomethionine, folic acid, nicotinamide, phytomenadione, pyridoxine hydrochloride, riboflavin, sodium ascorbate, thiamine mononitrate, tocopherol, tocopherols mixed, ubidecarenone, zinc sulfate taken for malabsorption, start and stop date were not reported; hypertonic saline taken for cystic fibrosis, start and stop date were not reported; ivacaftor (KALYDECO) taken for cystic fibrosis, start and stop date were not reported. It was stated that on 06/Sep/2021, the patient was vaccinated with his first dose of Comirnaty (batch details FG9019). 7 hours later on 06/Sep/2021 the patient experienced abdominal pain/cramps, which settled that night. Symptoms recurred the following day with associated vomiting and onset of severe epigastric pain. Symptoms resolved over the following 6 days. The patient was treated with intravenous fluids, nothing by mouth (NPO). The patient was slowly reintroduced to food. The patient underwent laboratory investigations, results of which were as follows; Amylase: 829 (units unspecified). At the time of reporting the patient had recovered. On 06Sep2021 the patient experienced acute pancreatitis. The patient underwent lab tests and procedures which included amylase results unknown on Sep2021 Raised amylase 829. The clinical outcome of event was recovered on an unspecified date in Sep2021. No follow-up attempts are needed. No further information is expected.; Sender''s Comments: Linked Report(s) : IE-HPRA-2021-084363


VAERS ID: 1784329 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0348 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: CSF test, Cervical radiculopathy, Dyspnoea, Hypoaesthesia, Magnetic resonance imaging, Neck pain, Nerve conduction studies, Neuralgic amyotrophy, Neuropathy peripheral, Pain in extremity, Presyncope, Sensory disturbance, Swelling, Swelling face, Vaccination site pain
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210925; Test Name: cerebrospinal fluid test; Test Result: Negative ; Test Date: 20210929; Test Name: cerebrospinal fluid test; Result Unstructured Data: Test Result:without protein increase; Comments: the patient was observed with analgesic drugs without protein increase in CSF; Test Date: 20210924; Test Name: cervical spinal cord MRI; Result Unstructured Data: Test Result:no abnormality in spinal cord or radiculopathy; Comments: and there was an abnormal signal in the left dorsal soft tissue; Test Date: 20210928; Test Name: nerve transmission test; Result Unstructured Data: Test Result:there was a possibility of left neck Radiculitis
CDC Split Type: JPPFIZER INC202101295290

Write-up: suspicion of Neuralgic amyotrophy/Brachial plexus neuritis; Radiculitis/left neck Radiculitis; Dyspnoea; Neck pain; Swelling from the left neck to face; Swelling from the left neck to face; Numbness in the entire left palm; severe pain in the vaccination site of left upper arm; nerve disorder of left upper arm; Painful L arm; suspected vagal reflex/vasovagal reflex; abnormal sensation; This is a spontaneous report from a contactable pharmacist received from the regulatory authority. Regulatory authority report number is v21128908. A 14-year and 8-month-old female patient received first dose of bnt162b2 (COMIRNATY, Solution for injection), intramuscular in left upper arm on 06Sep2021 (at the age of 14-year and 8-month-old) (Batch/Lot Number: FD0348; Expiration Date: 31Oct2021) as single dose for covid-19 immunisation. Medical history was none. There were no points to be considered on the vaccine screening questionnaire (primary diseases, allergies, vaccinations and illnesses within the last one month, medications the patient was taking, past adverse effect history, growth status). The patient''s concomitant medications were not reported. The patient experienced abnormal sensation on 06Sep2021, nerve disorder of left upper arm on 06Sep2021, painful L arm on 06Sep2021, suspected vagal reflex/vasovagal reflex on 06Sep2021, severe pain in the vaccination site of left upper arm on 07Sep2021, numbness in the entire left palm on 11Sep2021, swelling from the left neck to face on 22Sep2021, dyspnoea on 23Sep2021, neck pain on 23Sep2021, suspicion of neuralgic amyotrophy/brachial plexus neuritis on 24Sep2021, radiculitis/left neck radiculitis on 24Sep2021. On 24Sep2021 (18 days after the vaccination), the patient was admitted to the hospital. The course of the event was as follows: On 06Sep2021 (the day of the vaccination), the patient received the COVID-19 vaccination manufactured by Pfizer via intramuscular in left upper arm. Immediately after the vaccination, the patient appeared Painful L arm and nerve disorder of left upper arm. After that, the patient appeared a symptom of suspected vagal reflex, and BOSMIN 0.3 mg was injected in the right upper arm by intramuscular injection. From 07Sep2021 to 08Sep2021 (from 1 day after the vaccination to 2 days after the vaccination), the patient appeared severe pain in the vaccination site of left upper arm. On 11Sep2021 (5 days after the vaccination), the pain remained but improved, but the patient appeared Numbness in the entire left palm. On 22Sep2021 (16 days after the vaccination), the patient had an emergency outpatient visit to another hospital because she appeared Swelling from the left neck to face. On 23Sep2021 (17 days after the vaccination), the patient had an outpatient visit to the reporting hospital due to Dyspnoea and Neck pain in the middle of the night, and the patient was diagnosed with no apparent Swelling in the neck and face. On 24Sep2021 (18 days after the vaccination), the patient was admitted to the reporting hospital on suspicion of Neuralgic amyotrophy. A cervical spinal cord MRI was performed. There was no abnormality in spinal cord or radiculopathy and there was an abnormal signal in the left dorsal soft tissue. On 25Sep2021 (19 days after the vaccination), in order to distinguish between Brachial plexus neuritis and Radiculitis, cerebrospinal fluid test, nerve transmission test, and Somatosensory evoked potentials were scheduled to be ranked and under the careful examination. IVMP and so on was a treatment candidate. On 25Sep2021 (19 days after the vaccination), the result of Cerebrospinal fluid test was reported as negative. On 28Sep2021 (22 days after the vaccination), nerve transmission test was performed. On 29Sep2021 (23 days after the vaccination), from the result of NCS, it was considered that there was a possibility of left neck Radiculitis, and the patient was observed with analgesic drugs without protein increase in CSF. Therapeutic measures were taken as a result of the events. On 29Sep2021 (23 days after the vaccination), the outcome of the events was not recovered. The reporter classified the event as serious (hospitalized) and assessed that the event was related to bnt162b2. There was no other possible cause of the event such as any other diseases. The reporter commented as follows: The Symptoms had appeared immediately after the intramuscular injection of the COVID-19 vaccine in the upper left arm, and the causal relationship could not be denied. There was an abnormal signal in the left dorsal soft tissue, and it was presumed that careful examination and treatment by the current hospitalization were appropriate. No follow-up attempts are possible. No further information is expected; Reporter''s Comments: The Symptoms had appeared immediately after the intramuscular injection of the COVID-19 vaccine in the upper left arm, and the causal relationship could not be denied. There was an abnormal signal in the left dorsal soft tissue, and it was presumed that careful examination and treatment by the current hospitalization were appropriate.


VAERS ID: 1787052 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-06
Submitted: 0000-00-00
Entered: 2021-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Cough, Pyrexia, SARS-CoV-2 test, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210829; Test Name: Body temperature; Result Unstructured Data: Greater than 38?C; Test Date: 20210906; Test Name: COVID-19 PCR test; Result Unstructured Data: POSITIVE
CDC Split Type: PHJNJFOC20211012528

Write-up: COVID 19 PNEUMONIA; COUGH; FEVER GREATER OR EQUAL TO 38 DEGREE CELSIUS; CONFIRMED CLINICAL VACCINATION FAILURE; This spontaneous report received from a health care professional via a Regulatory Authority [regulatory authority,PH-PHFDA-300109050] concerned a 77 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, intramuscular, batch number was not reported, expiry date: unknown) dose was not reported, frequency 1 total, administered on 27-JUL-2021 for an unspecified indication. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 29-AUG-2021, Laboratory data included: Body temperature (NR: not provided) Greater than 38?C. On 06-SEP-2021, the patient experienced confirmed clinical vaccination failure. Laboratory data included: COVID-19 PCR test (NR: not provided) POSITIVE. On 03-OCT-2021, the patient experienced covid 19 pneumonia, cough and fever greater or equal to 38 degree celsius. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from cough, and fever greater or equal to 38 degree celsius on 03-OCT-2021, was recovering from covid 19 pneumonia, and the outcome of confirmed clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000196514.; Sender''s Comments: V0: 20211012528-Covid-19 vaccine ad26.cov2.s- Confirmed clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS.


VAERS ID: 1787220 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-06
Submitted: 0000-00-00
Entered: 2021-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Heart rate increased, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ROSUVASTATIN; FIASP; TOUJEO
Current Illness: Type 1 diabetes mellitus
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: PTJNJFOC20211024882

Write-up: PALPITATIONS; ANXIETY; CHEST TIGHTNESS; INCREASED HEART RATE; This spontaneous report received from a consumer via Regulatory Authority (PT-INFARMED-T202109-2210) on 12-OCT-2021 concerned a 31 year old male of unknown race and ethnicity. The patient''s weight was 80 kilograms, and height was 177 centimeters. The patient''s concurrent conditions included: type 1 diabetes mellitus. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number was not reported) 0.5 ml, 1 total, administered on 30-AUG-2021 for covid-19 immunisation. The batch number was not reported. Per procedure, no follow-up will be requested for this case. Concomitant medications included insulin aspart for drug used for unknown indication, insulin glargine for drug used for unknown indication, and rosuvastatin for drug used for unknown indication. On 06-SEP-2021, the patient experienced palpitations, anxiety, chest tightness and increased heart rate. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from palpitations, anxiety, chest tightness, and increased heart rate. This report was serious (Disability Or Permanent Damage).; Reporter''s Comments: Concomitant medication Rosuvastatine, fiasp, toujeo. Did medication error occur? No - Other information - Diabetes type 1


VAERS ID: 1671147 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-04
Onset:2021-09-05
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac function test, Cellulitis, Depression, Erythema, Feeling hot, Hot flush, Hypersensitivity, Incomplete course of vaccination, Malaise, Oral discomfort, Oropharyngeal discomfort, Sepsis, Skin test, Swelling face, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bystolic 10mg, Ethacrynic Acid
Current Illness: N/A
Preexisting Conditions: Hypertension, Brain Aneurysm non ruptured; Psoriasis and Psoriatic Arthritis newly diagnosed
Allergies: Seasonal Allergies; Sulfa drugs; Keflex
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I was hospitalized in April of 2021 with cellulitis and Sepsis. I was under the care of a Cardiologist. I have been hospitalized from 08/12/2021 until 08/18/2021. since I received the first dose of the vaccine. I started to feel heat and swelling in my face about 36 hours after the vaccine. It was like hot flashes and I did not feel well. When I looked in the mirror my face was red and swollen and my throat, mouth and lips were uncomfortable. I was treated with Benadryl and Xanax and released. During the week after that I was skin tested by a doctor and that night my legs and arms started shake and I was feeling hot flashes all over my chest and my arms and legs. On 08/12/2021 I was taken by ambulance to the hospital, and they packed me with ice. I was treated with Benadryl,, Xanax and they did a lot of testing. I was supposed to go back for the follow up on my scratch testing for the skin test, but I was in the hospital. After I was released, I was very depressed and started to have another allergic attack and returned to the hospital on 08/21/2021 and they did cardiac testing. My blood pressure has been under control since this started. I have not received the second dose under advice of my doctor.


VAERS ID: 1674753 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Cough, Dizziness, Fatigue, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Armour thyroid 90mg qd
Current Illness: URI approx 30 days prior, with negative covid test.
Preexisting Conditions: Hashimoto''s thyroiditis
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe arthralgias and myalgia Headache, dizziness Fever $g101.4F Cough Fatigue


VAERS ID: 1674888 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Pain, 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: One A Day Multi Vitamin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, Body Aches, Chills


VAERS ID: 1674950 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051E21A / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Headache, Myalgia, Nausea, Pyrexia, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Alopecia Universalis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sudden onset tachycardia, headache, dizziness, nausea, diarrhea, muscle ache, fatigue, 101.6? fever with chills.


VAERS ID: 1674963 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Nausea, Pain, Retching
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Carbamazepine, synthroid, Prozac, Mobic as needed
Current Illness:
Preexisting Conditions: Trigeminal neuralgia, hypothyroid, obesity, s/p gastric bypass
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Horrible headache, body aches, dry heaves/nausea, fatigue


VAERS ID: 1674973 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 4 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product preparation 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: Medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted


VAERS ID: 1674975 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 5 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product preparation 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: Army medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted


VAERS ID: 1674979 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 6 LA / IM

Administered by: Public       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: Staff did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted


VAERS ID: 1674981 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 7+ LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product preparation 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: medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted


VAERS ID: 1674982 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 7+ LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation 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: medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted


VAERS ID: 1674983 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product preparation 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: Vial of Pfizer was not diluted and patient received a full vial of pfizer vaccine undiluted


VAERS ID: 1674984 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / UNK LA / IM

Administered by: Public       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: Army medic did not dilute the vial of pfizer and patient received a full vial of pfizer vaccine undiluted


VAERS ID: 1675013 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dizziness, Nervousness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: PT WAS FINE IMMEDIATELY FOLLOWING VACCINE. ABOUT 5 MINUTES LATER, STATED HE WAS FEELING A BIT LIGHT HEADED. WE HAD HIM LIE DOWN FOR A FEW MINUTES. HE STATED THAT HE DOES GET NERVOUS/ ANXIOUS WITH SHOTS AND THIS HAS HAPPENED TO HIM BEFORE FOLLOWING HIS FLU SHOTS. HE REPORTED NO TACHYCARDIA, SWEATING, SWELLING OF THROAT/MOUTH, ETC. HE ALSO STATED HE DID NOT EAT YET TODAY. HE DRANK SOME WATER AND HAD A PIECE OF CANDY. WE CHECKED HIS BLOOD PRESSURE WHICH WAS NORMAL AT 121/79. HEART RATE WAS ALSO NORMAL AT 68. HE SAT IN VIEW OF THE PHARMACY FOR ABOUT 10 MORE MINUTES AND STATED HE FELT FINE AT THAT POINT. I DID CALL HIM ABOUT 45 MINUTES LATER. HIS MOTHER SAID HE WAS GETTING SOMETHING TO EAT AND THAT HE FELT FINE. NO FURTHER FOLLOW UP NEEDED.


VAERS ID: 1675014 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Pain in extremity, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: woke up with heart palpitations. felt chest pain and pain in right arm from shoulder to wrist


VAERS ID: 1675020 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Crying
SMQs:, Depression (excl suicide and self injury) (broad)

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

Write-up: Uncontrollable sobbing for no apparent reason. Started morning after shot and there are no triggers whatsoever. Crying and sobbing at anything.


VAERS ID: 1675022 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-09-01
Onset:2021-09-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: Itchy rash on side and down on lower portion of left arm. No treatment because he just woke up with it today.


VAERS ID: 1675044 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR UJ702AC / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetnus Vaccine from a long time about over 40 years prior, pt had a migraine and low grade fever
Other Medications: none that we are aware of
Current Illness: nothing
Preexisting Conditions: Lots of issues including long term colon issues and history of heart surgery
Allergies: Allergy to Tetnus toxin caused to feel unwell almost 40 years ago. Eggs caused pt to get upset stomach, but she also has colon issues that she thought were probably the cause
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: After asking for and confirming they wanted the flu shot, receiving receipt of flu vaccine, and receiving the flu shot, the patient was upset about receiving a flu shot instead of the covid vaccine. We discussed the request and confirmation of flu shot, the receipt the patient received for the flu shot and the patient''s discussion with the patient asking about previous flu shots. She then requested the covid vaccine and it was administered to her.


VAERS ID: 1675062 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-08
Onset:2021-09-05
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Acoustic stimulation tests, Balance test, Blood test, Computerised tomogram head, Dizziness, Ear discomfort, Gait disturbance, Head discomfort, Magnetic resonance imaging head, Nausea, Tremor, Vertigo
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Details in previous VAERs report filed 9/5/21
Other Medications: claritin, rhinocort aqua, singulair, arnuity inhaler, synthroid, vit b-6, vit c, calcium, vit d, biotin, glucosamine chondroitin, vit e, topomax
Current Illness:
Preexisting Conditions: breast cancer, hypothyroidism, asthma, migraine
Allergies: sulfa, percoset, codeine, tramadol
Diagnostic Lab Data: Brain Ct scan - 4/3/21, Brain MRI 5/21, Balance Test 5/21, Blood work 4/3/21, Hearing Test 5/21, VT - therapy for vertigo 6/21-7/21
CDC Split Type:

Write-up: Vertigo - 1st time ever had happened. Came on all of a sudden, no accident occurred, without any warning, didn''t hit my head...was just sitting in a car that wasn''t moving. The weirdest feeling started in my head, felt dizzy, lightheaded, when tried to walk couldn''t walk in a straight line, felt all this pressure in my left ear and my head almost like I was getting a headache, but didn''t....within a couple hours it progressed and ended up in the ER because every time I tried to walk my whole body would start shaking and felt nausea as well, that the room was spinning. Have battled vertigo, dizziness, pressure in my left ear, and head since that day.


VAERS ID: 1675065 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Sensation of foreign body
SMQs:, Anaphylactic reaction (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: unkown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: Augmentin, Rocephin, Omnicef, Zantac
Diagnostic Lab Data: mom gave benadryl and emergency services called
CDC Split Type:

Write-up: pt said throat felt like had a lump


VAERS ID: 1675085 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: I have been having a lot of numbness throughout the area where I received the Pfizer shot. Today, Sunday 9/5/21 by entire left side was numb starting from the left side of my face, down to my left arm all the way through my left leg.


VAERS ID: 1675103 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: Patient claims he blacked out for a second or so. he did not fall off of chair. Regained blood pressure quickly and steadily felt better. Stayed in the rx area for 30 minutes and felt good.


VAERS ID: 1675113 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-19
Onset:2021-09-05
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9263 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Fatigue, Infection, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 MG Tablet Take by mouth daily. Information, Historical fenofibrate (TRIGLIDE) 160 MG Tablet Take by mouth daily. Information, Historical finasteride (PROSCAR) 5 MG Tablet Take by mouth daily. Information, Histor
Current Illness:
Preexisting Conditions: BPH (benign prostatic hyperplasia) Diabetes mellitus High cholesterol Hypertension Kidney calculi
Allergies: Sulfa antibiotics
Diagnostic Lab Data: SARS-COV-2, NAA, Detected: 08/30/21
CDC Split Type:

Write-up: Patient required hospitalization due to breakthrough infection. Patient received the Pfizer vaccine (2nd dose in series) on 02/19/21. Patient was hospitalized from 08/30/21 - 09/03/21. Below is copied from discharge summary: Patient is a 69 y.o. male with PMHx of diabetes, hyperlipidemia, hypertension, BPH who presented to the hospital for shortness or breath. Patient stated that he tested positive for COVID-19 on 08/24. Since then he has been experiencing cough, fatigue, and shortness of breath. He stated that today he woke up and could not catch his breath and hence he called rescue. On arrival, patient saturations were 80s, and he was placed on 4 liters nasal cannula. Patient stated that he has been on steroids and antibiotics outpatient basis. Admitted to Hospital Medicine.


VAERS ID: 1675115 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad)

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

Write-up: Muscle weakness all over. Joint pain


VAERS ID: 1675116 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

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

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

Write-up: syncopal reaction directly after administering vaccine. patient was seated, did not hit his head, and came to within 30 seconds


VAERS ID: 1675117 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / UNK LA / IM

Administered by: Pharmacy       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: OZEMPIC, PIOGLITAZONE, LISINOPRIL/HCTZ, SIMVASTATIN, JARDIANCE , METFORMIN
Current Illness: NONE
Preexisting Conditions: DIABETES, HYPERNTENSION, HYPERCHOLESTEROLEMIA
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: NO ADVERSE EVENTS- PT PRESENTED FOR 2ND COVID SHOT. HE SCHEDULED HIS APPT ONLINE AND FILLED OUT HIS PAPERWORK ONLINE. HE FILLED EVERYTHING OUT FOR MODERNA. HE PRESENTED AND STATED HE WAS HERE FOR HIS SECOND MODERNA VACCINE. WE BILLED THE INSURANCE AS HIS SECOND DOSE AND IT WAS ACCEPTED. AFTER I GAVE HIM THE VACCINE, I ASKED FOR VACCINATION RECORD CARD. WHEN HE GAVE IT TO ME- IT WAS MARKED AS PFIZER FOR HIS FIRST DOSE. I QUESTIONED HIM AND SAID HE BELIEVED HE RECEIVED MODERNA INITIALLY. I RESEARCHED THIS AND WAS ABLE TO VERIFY THAT HE DID GET PFIZER AS HIS FIRST DOSE. HE WAS GIVEN MODERNA AS HIS SECOND DOSE TODAY. HE REPORTED NO ISSUES AND STATED HE WOULD CALL US IF ANY OCCURRED. I DOCUMENTED THE CORRECT VACCINE INFORMATION ON HIS VACCINATION RECORD CARD.


VAERS ID: 1675118 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-02
Onset:2021-09-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

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

Write-up: Pt presented to ED 3 days later with acute PE


VAERS ID: 1675122 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: HR: 66 , Oz: 96% , BP: 110/60
CDC Split Type:

Write-up: Left arm feeling tingly, lightheaded. Patient received a cold bottle of water and arm movement. Pt stated of feeling better able to drive.


VAERS ID: 1675137 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Blood glucose normal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: BP 121/83 Blood sugar 78
CDC Split Type:

Write-up: Patient fainted approximately 3 minutes after receiving dose, she regained consciousness shortly after. Patient noted abdominal pain when she became conscious. EMS was called to ensure patient was ok.


VAERS ID: 1675141 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: No to the best of my knowledge
Preexisting Conditions: No to the best of my knowledge
Allergies: No, per immunization form
Diagnostic Lab Data: Initial blood pressure after rxn: 85/60 Initial heart rate after rxn: 71 Secondary blood pressure after rxn: 91/63 Secondary heart rate after rxn: 62
CDC Split Type:

Write-up: Patient was nausea, sweating, dizzy and light headed.


VAERS ID: 1675153 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Dyspnoea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: The patient fainted within a few minutes after receiving the vaccination. She was with her significant other who was sitting with her. It appeared that she was having difficulty breathing at one point while she was out. She came to within a minute or so and was disoriented. I had my technician call EMS who did a thorough screening. She was cleared and left the store on her own about 20 minutes later. She was provided with a bottle of water and a cold compress from store management.


VAERS ID: 1675161 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-02
Onset:2021-09-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 LA / IM

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

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

Write-up: Significant erythema and swelling at the injection site location. Patient reports pain and hot to touch. Approximately 2-3 inches in diameter. Advised patient to report to urgent care for evaluation.


VAERS ID: 1675170 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-01
Onset:2021-09-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram normal, Fall, Pallor
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: Montelukast
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies: NA
Diagnostic Lab Data: Assessed vitals, ekg, BS in vehicle. All WNL
CDC Split Type:

Write-up: Pt was pale and dizzy. Fell over in chair. Never lost pulse or resp. This occurred about 12 min Post-inj.


VAERS ID: 1675195 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose normal, Deafness, Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad)

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

Write-up: Patient refers lack of hearing, dizziness and nausea. Patient is pale and sweaty. Vitals are taken 110/60 BP, 99% oxygen, 65 pulse, and Dextrose 52. Glucose tablet is administered and Dextrose is taken with a results of 57. 20ml of syrup and after 5 minutes his Dextrose had a result of 77.


VAERS ID: 1675196 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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 seeing spots then passed out for a short time then woke back up.


VAERS ID: 1675197 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: 17 year old had sob and nauseated shortly after vaccine adminstration . pt having mask over his nose may have contributed to it since he never wore mask over nose and also did not eat breakfast


VAERS ID: 1675203 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Cough, Dyspnoea, Nasal congestion, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: He woke up with shortness of breath, Fever, sore throat, nasal congestion, cough, body aches, and sore throat.


VAERS ID: 1675208 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Patient was fine initially after vaccination at 430 PM, 15 minutes later as I was giving him his card he described suddenly feeling lightheaded and nauseous. I gave him some water and a Benadryl tab, within a minute he asked to go to my bathroom. He than began to vomit for a few minutes. By 5 PM he came to me, saying he felt better. I had him take a second Benadryl tablet, and he felt well enough to walk home.


VAERS ID: 1675209 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 1 LA / IM

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

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

Write-up: patient felt lightheaded and very hot. she was given water and a banana after she stated she had not eaten all day. 15 minutes after finishing banana and drinking water patient felt much better and headed home.


VAERS ID: 1675214 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Haemorrhage, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Upon receiving Pfizer vaccine, patient was instructed to remain in store for any reactions. Patient began walking in the aisle of the store, then quickly approached pharmacy lobby area while holding back of head with dripping blood. He reported feeling dizzy and fainted. Pharmacy staff came to quickly aid with ice packs and water. Emergency personnel was contacted as well as patient''s family members. Patient was closely monitored for consciousness and activity. Patient''s father and girlfriend had arrive and was also monitoring patient. Emergency response was contacted a 2nd time for ETA arrival. Paramedics arrived on scene within 15 minutes and carefully assessed patient. After thorough assessment, patient decided to have his father transport him to urgent care. Paramedics and pharmacy staff safely escorted patient and family members off pharmacy premises. Patient was transported to urgent care with father.


VAERS ID: 1675217 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fall
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: also with blood drawn or needlesticks
Other Medications: birth control, Zyrtec
Current Illness: none
Preexisting Conditions: prior fainting with other vaccines
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient experienced being dizzy after getting a vaccine . and fell.


VAERS ID: 1675218 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-09-05
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

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

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

Write-up: Left arm started to tingle shortly after receiving shot then after a few hours, my arm went completely numb and feeling didn''t return for 2 days.


VAERS ID: 1675226 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Blood pressure increased, Feeling abnormal, Headache, Nervousness, Paraesthesia, Pruritus, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: Gentamicin and Penicillin
Diagnostic Lab Data: Basic vitals, quick assessment by EMT.
CDC Split Type:

Write-up: The patient got the shot at 1300. At 1330 patient states she has an itchy arm, her tongue felt weird, and there was tingling down her legs. She said she also had a headache. I called an ambulance as tongue swelling could lead to airway obstruction. She stated that she has bouts with anxiety. The EMTs came and stated that there was not a rash and anaphylaxis usually occurs within 10 to 15 minutes. Around this time was 1400. Patient purchased some benadryl. Patient refused EMTs offering to take her to the hospital. Her BP/pulse was elevated and she said she had a headache and was shaky. The EMTs left and I advised her to have someone drive her home. I called the patient at approximately 1500 and she said she was feeling better and her daughter picked her up..


VAERS ID: 1675228 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PROMETRIUM 100MG, DICLOFENAC 1% GEL, OLMESARTAN HCTZ 20-12.5MG TAB
Current Illness: NONE REPORTED
Preexisting Conditions: ASTHEMA, HIGH BLOOD PRESSURE
Allergies: NONE
Diagnostic Lab Data: BLOOD PRESSURE TAKEN 152/82 PULSE 93
CDC Split Type:

Write-up: SHORTLY AFTER THE INJECTION SHE STATED THAT HER HEART FELT LIKE IT WAS RACING, FELT HOT, DIZZY, HAD HER REMAIN SEATED, GOT A FAN TO HELP COOL HER OFF. SHE SIPPED ON WATER THAT SHE HAD. TOOK HER BLOOD PRESSURE/HEART RATE WAS ELEVATED SOME. SHE DID NOT WANT AN AMBULANCE. AS SHE SAT THERE SHE STARTED FEELING BETTER. SHE LEFT WITH HER FAMILY SAYING SHE FELT BETTER.


VAERS ID: 1675244 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 - / IM

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

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

Write-up: Pt''s husband called and said after their walk today patient was presenting with shortness of breath and tiredness and fatique.


VAERS ID: 1675250 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Gait disturbance, Lethargy, Loss of personal independence in daily activities, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient reports fever, lethargy, and light-headedness that effects her ability to walk and perform normal daily activities. These started the morning of 9/5/21. We spoke in the mid afternoon. Several hours later I called her to follow-up and her light-headedness had decreased somewhat.


VAERS ID: 1675252 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: no known drugs, otc, dietary supplements
Current Illness: no know illnesses
Preexisting Conditions: no chronic health conditions
Allergies: Amoxicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient came in for her second Covid vaccine approximately at 4:15 pm today. She was told to stay in the store for 15 minutes. After her and her finance left the store, her throat started to close up and she could not breathe. She told him to take her back to our store ASAP. When she got into the building she was struggling to breathe. I gave her a dose of epinephrine in her left thigh and had my tech call 911. EMTs arrived, gave her oxygen, got to to sit up, put her on a gurney to take her to the ambulance for observation. They let her go home. Her finance is watching her.


VAERS ID: 1675253 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: REPORTED BY PATIENT ON VAR: MS, ASTHMA, LUPUS, RA, SJOGRENS, NEUROPATHY
Allergies: NONE REPORTED BY PATIENT
Diagnostic Lab Data:
CDC Split Type:

Write-up: APPROXIMATELY 18 MINUTES AFTER RECEIVING COVID VACCINATION, PATIENT REPORTED SHORTNESS OF BREATH AND SENSATION OF THROAT CLOSING. PHARMACIST ADMINISTERED 50MG DIPHENHYDRAMINE PO AND 0.3MG EPINEPHRINE IM TO RIGHT DELTOID @ APPROXIMATELY 5:15PM. PHARMACIST MONITORED PATIENT UNTIL EMS ARRIVED AT APPROXIMATELY 5:22PM. PATIENT REMAINED CONSCIOUS THROUGHOUT EVENT, BUT DID EXPERIENCE MILD TACHYCARDIA (HR<120) AFTER EPINEPHRINE.


VAERS ID: 1675254 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Presyncope
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: about 5 minutes after getting the vaccine the patient started having vasovagal syncope and started to pass out. I came to know through my technician and I had to jump to the patient and make him lie down in supine position with EMS activation steps alerted to the technician. Patient was responding and had a pulse of 70 / minute and did not completely pass out. Laying him down in supine position helped with enhancing the circulation and he quickly started feeling better within 20 to 30 seconds. and therefore EMS was called off and I kept observing the patient to ensure that he was responding and starting to feel better. We kept the patient with us for about 30 minutes and he was feeling fine. I called him back at 3:45 pm to see how he was doing and he was doing fine .


VAERS ID: 1675256 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Normal blood work on 9/5/21
CDC Split Type:

Write-up: Woke up after getting my second vaccine the day before and I was covered head to toe in hives that were extremely itchy and painful. Upon going to the urgent care they gave my fluids, diphenhydramine, methylprednisolone and famotidine.


VAERS ID: 1675257 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Malaise, Pallor
SMQs:, Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Attendee received first dose Pfizer vaccine at 11:15 am in the Left arm. Lot# EW0217. Attendee was directed to observation area. At 11:20 voiced complaints of feeling unwell. Attendee''s skin was cold, clammy, and pale. Attendee''s respirations were not tachypneic or dyspneic. Denied dizziness. Reported anxiety with injections in the past. Continuous Pulse oximetry applied. HR: 48 BP: 116/80 RR: Unable to assess O2Sat%: 100 11:22 - Attendee assisted to the cot to lie down. Had him take some deep breaths and he was given some cool water to sip on. 11:25 - Attendee stated he felt much better, no longer clammy or pale. HR: 60 BP: 118/78 RR: 16 O2Sat%: 100 11:48 -Denied complaints and joking with staff. HR: 58 BP: Not taken RR: 16 O2Sat%: 100 Temp: 11:50 - Care Practitioner educated on home discharge/adverse reaction instructions and attendee was discharged to home with his wife. Attendee did not have any reported escalation of symptoms and was able to walk out of clinic independently. Attendee was retained for a longer observation time to make sure that it was safe for them to leave.


VAERS ID: 1675258 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Nausea, Pallor, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Attendee received first dose Pfizer vaccine at 12:45 in the right arm. Lot# EW0217. Attendee was directed to observation area. At 13:00 voiced complaints of dizziness and nausea. 911 was called. Attendee''s skin was cool, clammy and pale. Attendee''s respirations were not tachypneic or dyspneic. Attendee assisted to the cot to lie down. Continuous pulse oximetry applied. 13:03 ? Sitting in the chair HR: 58 BP: 115/65 RR: 16 O2Sat%: 100 13:08 ? While moving to the cot, the attendee did vomit x 3-4 times HR: 48 BP: N/A RR: N/A O2Sat%: 100 13:15 - Attendee stated he felt better, no longer cool or clammy. Paleness decreasing. HR: 71 BP: 100/60 RR: 14 O2Sat%: 100


VAERS ID: 1675275 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH IDK / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site swelling, Injection site warmth, Pain, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Ibuprofen
Current Illness: HSV
Preexisting Conditions: HSV
Allergies: Codeine, Prednisone
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Bruising around injection, pain in entire left arm, body aches, and the injection spot is hot and a little swollen


VAERS ID: 1675277 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: none reported
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient received her 1st dose of Moderna vaccine and had facial swelling and trouble breathing around 2 hours later. She was advised to go to the ER and was sent home and told to take benadryl. I advised on her on the correct dosing of benadryl and told her to go back to the ER if her symptoms worsened.


VAERS ID: 1675280 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Dizziness, Slow response to stimuli, Urinary incontinence, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: The patient came in today for her first COVID vaccine today. I reviewed her forms with her, and she confirmed she did not have any allergies to her knowledge. Her vaccine was administered somewhere around 12:30pm, and I advised her of the 15 minute waiting period. She requested to stay in the immunization room instead of moving to the waiting area because she said she felt light-headed. I asked if she had eaten anything, and she said no, except for some crackers she just ate. I asked if she had any gum or a piece of candy in her purse, and she said she didn''t have anything. I said it would be okay to stay in the immunization room for the observation period, but that I would return to check on her. (I removed the SHARPS container and Moderna vial prior to leaving). Within a few minutes, someone we believed to be her boyfriend came around to get in the door to the immunization room to see her. My tech, went around to let him in, and then let me know I needed to check on the patient now. I went in the immunization room, and she was sitting in the chair with her eyes closed. She still was responsive, but somewhat slow to answer questions. I asked her boyfriend to go get her some orange juice, thinking she may be hypoglycemic. Before he came back, she started to vomit, and also urinated on herself. He returned, and I watched her closely and picked up an epinephrine injection box. I then advised against her having anything by mouth anymore. She didn''t have any swelling of lips, could still breath, and there wasn''t any redness/swelling at the injection site, but I went ahead and called emergency services on my cell phone. They couldn''t make out what I was saying due to bad reception, so I had to call from the pharmacy, and stretch the phone back to the room. One of the questions they asked was if she was having any abdominal pain, but she said it was just her back. (Whether she realized it or not, I''m thinking she had something else going on before she even received the vaccine, even though she indicated on her consent form that she didn''t have an illness going on). The paramedics came, and I let them know I didn''t administer any epinephrine. Before they left, they told me she was fine. I notified the customer service manager about the paramedics and emergency services call, and she was aware. Then I asked for a biohazard clean up of the immunization room.


VAERS ID: 1675295 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Pen, sulfa drugs,
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy vomiting tightness in my chest feel like I got an instant cold


VAERS ID: 1675297 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-12
Onset:2021-09-05
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9808 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood sodium decreased, COVID-19, Confusional state, Hyponatraemia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lasix, alvesco, omeprazole, insulin, singulair, metoprolol, atorvastatin, asa, nitrostat
Current Illness:
Preexisting Conditions: CAD, DM2, HTN, HLD
Allergies: T3, norco, januvia, dilaudid, moxifloxacin, tramadol, victoza, lisinopril
Diagnostic Lab Data: covid PCR+ 8/24
CDC Split Type:

Write-up: diagnosed with covid, hospitalized. confused, hyponatremic Na 129


VAERS ID: 1675299 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
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: none
CDC Split Type:

Write-up: patient had syncope like less than a minute after the injection. she passed out for 2 to 3 seconds and then she woke up all alert. she passed out again few times (4 to 5 times) for like 2 to 3 seconds. no sweating or cold extremities reported. all vitals are good. asked to move to supine and to elevate legs, mom said it is better for her to stay sitting on chair. she did not fall or hurt herself. she vomited a little after her 5th episode, and after that she felt so well. i observed her carefully for 30 minutes aside with her mom. after 45 minutes she left with her mother.


VAERS ID: 1675307 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

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

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

Write-up: Patient''s father filled out the patient information for son with a birthdate of which would make him 12 today. Upon reviewing ,I handed the consent form back to them to answer some screening questions. I did not notice that the son had corrected the father''s dating of . The patient received the Pfizer vaccine 8 days before his 12 year birthday.


VAERS ID: 1675311 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, Incorrect dose administered, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: unknown
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received 3 doses of vaccine due to overdraw from vial. Patient monitored for 30 min after injection. Experienced some aching at site of injection comparable to expected side effects. No other adverse effect of overdose noted in the 30 minute observation period.


VAERS ID: 1675317 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NO ALLERGIES THAT PATIENT IS AWARE OF
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called the pharmacy at around 5:10 pm reporting that after she reached home 1 hour after receiving the vaccine at 11:44 am at the pharmacy she noticed she was bleeding at injection site and she applied couple of bandages and the bleeding stopped and then she was tired so she went to sleep. After she woke up she noticed that it is swollen at the site of injection and has a little bump and looks bruised. Other then that she feels tired.


VAERS ID: 1675335 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088921A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Lip swelling, Pharyngeal swelling, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I woke up this morning at 9 am, about 38 hours after my second dose, with huge, swollen lips. I took a Benadryl which didn''t have any effect. By 2 pm my lips were even bigger and my tongue and throat were starting to swell. I took 2 more Benadryl and some of the swelling went gone down in my throat but I''m unable to take a full breath. My lips are still extremely swollen. I called an RN through my insurance who said I should get to the emergency room right away but I''m not spending $5000+ unless my throat starts to close again.


VAERS ID: 1675336 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Migraine
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, Amerge, multi vitamin, calcium carbonate
Current Illness: None
Preexisting Conditions: Migraines
Allergies: Aspirin and morphine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe migraine NOT relieved by migraine medication. My migraines are controlled and will dissipate with medication-this headache would not respond to medication


VAERS ID: 1675341 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-02
Onset:2021-09-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lower urinary tract symptoms
SMQs:

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

Write-up: UTI symptoms


VAERS ID: 1675349 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-31
Onset:2021-09-05
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Birth control, zoloft, women''s multivitamin, vitamin D3, Zinc
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breakthrough bleeding, 3 weeks out from placebo pills on birth control. No cramping before the bleeding.


VAERS ID: 1675351 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Condition aggravated, Ear pain, Headache
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: N/A
Current Illness: Headache
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache now I have sharp ear pain on my left ear


VAERS ID: 1675359 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Influenza like illness, Malaise, Myalgia, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Desvenlafaxine Bariatric supplement Iron tablets Tylenol PM Cyclobenzaprine Prazosin Probiotic Omeprazole
Current Illness: None
Preexisting Conditions: Herniated discs, depression, knee arthritis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Flu like symptoms- fever, headache, muscle aches, fatigue, general malaise


VAERS ID: 1675390 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30138A / 3 LA / IM

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

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

Write-up: Error: Booster Given Too Early-


VAERS ID: 1675394 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: Patient fainted about 5 minutes post vaccination


VAERS ID: 1675395 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient fainted outside in parking lot, hitting her head. Attended to by EMS, vitals within normal limits and went home.


VAERS ID: 1675398 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Muscle rigidity, Seizure, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), 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-Mild, Systemic: Seizure-Medium, Additional Details: immediately follwing administration patient appeared to be incoherent ( could not support head)/ fainted and became rigid and had a seizure. Patient fell out of chair and then became responsive. Patient was not in pain, was breathing okay and coherent. Paramedics were called and all vital signs were okay.


VAERS ID: 1675399 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too High-


VAERS ID: 1675400 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Weakness-Severe


VAERS ID: 1675401 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (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: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium


VAERS ID: 1675402 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild


VAERS ID: 1675403 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Face injury, Fall, 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), Accidents and injuries (narrow), 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? Yes
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, Additional Details: Pt fainted from seated position and hit the floor face first. He was responsive and able to roll onto back and rest for several minutes before sitting up. Emergency services arrived and took vitals. He almost fainted again and so was taken to hospital but not admitted. He has since recovered. Pt states he was most likely dehydrated before the vaccination.


VAERS ID: 1675404 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

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

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

Write-up: Systemic: Dizziness/Lightheadedness-Mild, Systemic: Fainting/Unresponsive-Medium, Additional Details: Approximately 5 min after vaccine administration, patient fell over in the chair he was sitting in. He was unresponsive for approximately 10 sec. He stayed on the floor while alert until the ambulance arrived. The EMT''s took over care and proceeded to check patient. The patient was removed from the pharmacy area via gurney and taken to a nearby hospital.


VAERS ID: 1675406 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Flushing, Hyperhidrosis, Nausea, Pallor, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Systemic: Weakness-Mild, Additional Details: skin looks pale


VAERS ID: 1675407 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Epistaxis, Fall, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Additional Details: Patient came for 2nd dose, Patient was in good shape. After receiving the 2nd dose after maybe 5 to 7 mins patient fainted. i was standing at the door with my back and then i heard patient fell to the floor and bleeding from the nose. i asked him with happended, and patient responsed that he felt light headed and fainted. Patient then was able to get up and sit on the chair, i called 911 and 10 to 15 minutes later Police arrive and few mins later the Paramatics arrived.


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