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

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



Case Details (Reverse Sorted by Onset Date)

This is page 267 out of 5,069

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VAERS ID: 1376794 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Systemic: Swelling of hand on side of injection-Medium


VAERS ID: 1376863 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (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: Prilosec 40mg Ibuprofen 2 tablets
Current Illness: None
Preexisting Conditions: GERD Iron deficiency anemia Irregular heartbeat Anxiety Migraine
Allergies: Azithromycin Imitrex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Heart palpitations, began an hour after vaccine. Heart palpitations still occur sporadically along with some pain. No treatment.


VAERS ID: 1376892 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-18
Onset:2021-06-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Fibrin D dimer normal, Full blood count normal, Metabolic function test, Pericarditis, Troponin normal
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 06/02/21; normal CBC, normal BMP, normal (negative) d-dimer, normal (negative) troponin
CDC Split Type:

Write-up: Patient presented to Urgent Care and then was sent to the ED for evaluation. Found to have pericarditis on EKG. Labs including troponin reassuring. Patient discharged home with referral to Cardiology for outpatient follow up.


VAERS ID: 1376916 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-26
Onset:2021-06-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Injection site rash, 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? 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: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA Covid Arm: Approx 4" circular painful and itchy rash around injection site. See https://www.health.com/condition/infectious-diseases/coronavirus/covid-arm-rash-moderna


VAERS ID: 1377015 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 AR / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient briefly fainted post Covid vaccination. Spoke to her mother later that evening, feeling much better.


VAERS ID: 1377016 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Syncope, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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, Systemic: Vomiting-Mild, Additional Details: Patient briefly fainted post Covid vaccination, then vommited, stated that his head felt hot. Spoke to mother later in the evening. Patient felt much better.


VAERS ID: 1377028 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, 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? 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, Systemic: Weakness-Mild


VAERS ID: 1377343 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-13
Onset:2021-06-01
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Induration, Injection site mass, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (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: Xarelto, Oxycontin, Oxycodone, aspirin 81, azathioprine, calcium, colace, estroven, folic acid, Gabapentin, Marinol, magnesium citrate, probiotics, Ocrevus infusion, Synthroid, Triliptal, volteran, vitamin C & D3, Zanaflex, Depakote, mecli
Current Illness: MS, trigeminal neuralgia, Factor V Leiden, Hypothyroidism, fibromyalgia, degenerative disc disorder, TMJ, vasovagal syncope, asthma, migraines, rheumatoid arthritis, prosthetic left eye
Preexisting Conditions: MS, Trigeminal Neuralgia, Rheumatoid Arthritis, Hypothyroidism, Fibromyalgia, Factor V,
Allergies: Codeine, Wellbutrin, Topamax, NSAIDS, sulfa antibiotics, morphine, methotrexate, hydroxychloroquine, Leflumonide, mycophenolate, Food - pumpkin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore hard lump at the site of the injection lasting for 12 days after the injection. Extreme/severe full body tremors -30 minutes, 3 times during that day, two and a half weeks after the injection.


VAERS ID: 1377719 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA 003C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dry mouth, Dysphagia, Immediate post-injection reaction, Injection site pain, Myalgia, Nodule, Oropharyngeal discomfort, Sensory disturbance, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament 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: First dose was 5/4/21. No side effects until the next day. Side effects include intense fatigue and soreness on entire left si
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa, Iodine
Diagnostic Lab Data: Paramedics took my vitals and they were normal.
CDC Split Type:

Write-up: Immediate pain in injection site, felt the vaccine travel through left side of body, when it reach my neck, I felt a tightening around my throat and I could not swallow. The length of time it took to reach this point was within 5 minutes or so of the shot. Paramedics came and checked my vitals, which were normal. Eventually, tightness loosened and I felt better. The next day, there was a knot in my throat/neck that subsided by afternoon. It felt like I was punched in the throat. I also had dry mouth for about 24 hours. In addition, I felt muscle and joint aches for six days.


VAERS ID: 1377802 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-15
Onset:2021-06-01
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Inflammation, Injection site erythema, Injection site warmth, Joint range of motion decreased, Magnetic resonance imaging, X-ray
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol 50mg, Zolpidem 5mg, Alprazolam 0.25mg
Current Illness: acute otitis media treated with antibiotics on 4/10/21
Preexisting Conditions: Hypertension
Allergies: penicillin, sulfa antibiotics
Diagnostic Lab Data: Patient to have MRI this week - pending results X-ray done the week of 5/31-6/6 showed signs of inflammation in the shoulder joint area
CDC Split Type:

Write-up: Patient initially had redness and warmth at the injection site, this went away after a week. Recently the patient has noticed some loss of mobility with the left shoulder accompanied with pain in the shoulder joint.


VAERS ID: 1377809 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chills, Cold sweat, Fatigue, Headache, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I am in the process of trying to get a doctors appointment, as I have been in denial for the past six days that I should be concerned over these continuing symptoms.
CDC Split Type:

Write-up: Immediate adverse effects were consistent with what is considered to be normal. I am not here to complain about the immediate adverse effects. The EXTREME fever, chills, fatigue, and extreme headache went away after a day. I can continue to experience a mild form of all of these symptoms since day one. I am now on day six. I am also on day six of experiencing swelling in my feet and my legs. As of day two or three, I am experiencing increasing chest discomfort and my fevers and clamminess are beginning to increase. After gaslighting myself and telling myself everything from I am experiencing allergies too maybe I have a tight bra on... I am now trying to make an appointment with my doctor because I believe I might have a heart infection. Myocarditis. Fingers crossed cause a heart issue would... kill me.


VAERS ID: 1377863 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral, Pharyngeal hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 88mcg
Current Illness: None
Preexisting Conditions: Hashimoto?s. I may have NF-1. I have had several schwannomas removed from my body, the most invasive of which was from my spinal cod (c4-6 area).
Allergies: None
Diagnostic Lab Data: I did not visit a medical facility post reaction.
CDC Split Type:

Write-up: 5 minutes following the shot in my left arm, the left side of my throat, tongue and face (from underneath eye, down to mandible, across from ear to nose) went numb. Feeling was similar to that of being frozen for a dental procedure. It lasted 48 hours. My left hand and foot also went numb and remain mildly numb. Similar to feeling I had when my spinal court tumor was discovered 15 years ago. Post resection, it subsided as pressure on nerves was alleviated. Very scary. I won?t return for a second shot.


VAERS ID: 1377902 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / IM

Administered by: Pharmacy       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: fluoxetine 10mg
Current Illness: none known
Preexisting Conditions: depression
Allergies: none known
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Itchy patches of rash on forearms, chest, legs, and abdomen. Rash resolving on 6/5/21


VAERS ID: 1378027 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Fatigue, Myalgia, Nasal congestion, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Apri Multivitamin
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: None
Diagnostic Lab Data: ID NOW SARS-CoV-2 Molecular PCOT Covid19 Negative 06/07/2021
CDC Split Type:

Write-up: Reports myalgia, fatigue, fever, nasal congestion. sore throat, fatigue, cough


VAERS ID: 1378034 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal dreams, Chills, Crying, Daydreaming, Distractibility, Disturbance in attention, Dizziness, Feeling abnormal, Hallucination, Headache, Hyperhidrosis, Hyperventilation, Initial insomnia, Nausea, Nightmare, Soliloquy
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: 1) sweating, chills, some difficult to describe feelings, dizziness, light headache, light nausea 2) difficulty in going to sleep, abnormal dreams, nightmares, hallucinations, unusual/bizarre images, preoccupied, day dreaming 3) Occasional hyperventilation 4) Unable to focus. I am slow to understand/comprehend/react. 5) Sometimes when I wake up, I find myself crying. 6) During the day, sometimes I find myself talking to myself when there is nobody else in the room but me.


VAERS ID: 1378058 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Peripheral swelling, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tramadol, Irbesartan, Lipitor, omeprazole, Celexa
Current Illness: low back pain/hip pain
Preexisting Conditions: htn, chronic low back pain, hyperlipidemia, depression, GERD
Allergies: nkda
Diagnostic Lab Data: dopplers
CDC Split Type:

Write-up: DVT- developed leg pain and swelling for several days. Presented to ED for evaluation. Found to have RLE DVT


VAERS ID: 1378169 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-26
Onset:2021-06-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Hemiplegia, Magnetic resonance imaging, SARS-CoV-2 test negative
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI - 6-2-21 to rule out other cause, SARS-CoV2 by PCR - negative
CDC Split Type:

Write-up: Seen in ED for Bells Palsy 1 week after 2nd Covid-Moderna dose. Follow up with provider on 6/7 and still has right side paralysis


VAERS ID: 1378190 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036LZ1A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Vaccination complication
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl 3/day
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Covid Arm


VAERS ID: 1378235 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

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

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

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


VAERS ID: 1378238 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

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

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

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


VAERS ID: 1378255 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

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


VAERS ID: 1378297 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: FEVER OVER 102 DEGREES FOR APPROXIMATELY 72 HOURS. NAUSEA AND VOMITTING FOR OVER 72 HOURS. UNABLE TO KEEP DOWN ANY LIQUIDS OR TYLENOL. VOMITTING EVERY 15 MINUTES OVER A 5 HOUR PERIOD BETWEEN HOURS 48 AND 53. FINALLY ABLE TO GET ACCESS TO ONDANSETRON TO ALLEVIATE VOMITTING AND KEEP FROM GOING TO URGENT CARE FOR DEHYDRATION.


VAERS ID: 1378392 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-05-13
Onset:2021-06-01
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: Tested for COVID and Strep test - last two (June 1st) - negative
CDC Split Type: vsafe

Write-up: Runny nose - four - five days; sore throat for two days. Treatment - increased water intake and rest. Went to doctor on June 1st


VAERS ID: 1378467 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Inappropriate schedule of product administration, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient got 2nd shot 12 days after the 1st dose. 1st dose was given 05/20/2021, 2nd dose was given 06/01/2021. He had typical second dose adverse effects such as fever, chills, fatigue that lasted 24-48 hours.


VAERS ID: 1378513 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-05-15
Onset:2021-06-01
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 2 RA / SYR

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

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

Write-up: Patient experienced hives all over body about 2 weeks after second vaccine dose. Patient received steroids but hives have not yet resolved.


VAERS ID: 1378515 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-24
Onset:2021-06-01
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, Pain in jaw, Tinnitus
SMQs:, Hearing impairment (narrow), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: metformin, lisinopril, Effexor, Lipitor,
Current Illness:
Preexisting Conditions: type 2 diabetes, arthritis, depression. low thyroid, high blood pressure, high cholesterol
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: migraine, thought stroke was had, jawline pain, tinnitus


VAERS ID: 1378746 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Erythema, Feeling abnormal, Feeling hot, Headache, Myalgia, Nausea, Pain, Pyrexia, Restlessness, Sensitive skin, Sleep disorder, Spider vein
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Akathisia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (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: Flu Vaccine - CVS fall of 2020 (severe headache and nausea - could not stop throwing up for a day/two due to headache)
Other Medications: Gummi vitamins Anti-histamine (Zytec) because I have to take it daily
Current Illness:
Preexisting Conditions: Autoimmune disease (ulcerative colitis) Unknown allergy/illness - skin rash/dermagraphia (noted sensitivity to nightshade products) Previous lab testing showed antiphospholipid antibodies, but more recently, these have been better
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6/7 hours after vaccine- chills, fever (100.8), very weak *Felt miserable and restless, radiating heat in body *Trouble sleeping *Small pinpricks of pain in different parts of body *Muscle soreness *Blood seemed to be throbbing *Nausea in morning, but ate crackers (so did not throw up like after flu vaccine) *Skin more sensitive than normal (when shaving and when bumped foot into wall accidentally) Next day (6/2)- no energy, easily overexerted; had to sit down after standing, like in shower 6/3- light-headedness after eating chocolate products 6/4- light-headedness, blood appeared to be pooling in legs some when standing (legs would turn red) *Blood still feels weird 6/5- Pinprick feeling in parts of body, still feeling weak during the day 6/6- Weak feeling/headache (stamina is bad still), veins look more red than usual (existing spider veins) 6/7- Feel much better, still feeling rough in the morning when I wake up (Monitored own symptoms, but need not need to go to Dr. or hospital)


VAERS ID: 1378753 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Miralax PRN
Current Illness: 1st dose 4/29/21 Pfizer 2nd dose 5/28/21 Pfizer
Preexisting Conditions: Patient Active Problem List Diagnosis ? CARPAL TUNNEL SYNDROME ? ANGIOEDEMA ? HEADACHE ? Abnormal glucose tolerance test in pregnancy, antepartum
Allergies: NKA
Diagnostic Lab Data: 1. Dizziness -COVID: 4/29 and 5/28 and since her 2nd vaccination + dizziness -she was fine after vaccination/later that day had eye exam with no issues as she uses contacts/glasses/they did not dilate eyes and then that afternoon noted dizziness -notes with turning head abruptly like when driving having to turn side to side/last seconds -denies any head trauma, no change in vision from baseline-she does have slight left eye inward turn and her baselinen from youth/pt well aware with minimal impact on vision per pt -she says week prior just routine/not taking any otc meds/no allergy meds/no current dizziness -no gait changes/no neurological changes BP Readings from Last 3 Encounters: 06/02/21 126/82 12/03/20 132/78 08/21/20 130/81 1. Intermittent dizziness -sounds more Like BPPV with nl neurological exam, no red flags -suspect no related to recent vaccination but will still have team report to VAERS -given so mild rec obsv next 1-2 weeks as suspect will resolve/see Chart details -she does not really drink alcohol/rec stay hydrated 1. Your dizziness seems more like BPPV. Less likely related to yoru vaccine but none the list we will report
CDC Split Type:

Write-up: Pt received vaccine doses at pharmacy came in for OV having dizziness after second dose for more than 3 days


VAERS ID: 1379029 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Discomfort, Dyspnoea, Electrocardiogram, Laboratory test, SARS-CoV-2 test, Urine analysis, X-ray
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: Childhood asthma. Has not exacerbated in over 10 years.
Allergies: Hydrocodone
Diagnostic Lab Data: Labs - 2 ER visits EKG - all 3 ER visits COVID Test - 1 ER visit Urine sample - 1 ER Visit X-Ray - 2 ER visits
CDC Split Type:

Write-up: Extreme chest burning/pain/tightness, shortness of breath, pressure in my neck around my throat. Persistent nearly 7 days after 2nd vaccine.


VAERS ID: 1379039 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-24
Onset:2021-06-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (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: Fluoxetine
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Disseminated herpes zoster/ shingles , valacyclovir


VAERS ID: 1379061 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

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

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

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


VAERS ID: 1379528 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-27
Onset:2021-06-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram, Sensory disturbance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Sharp pain in chest especially when inhaling; clicking at left of sternum with heart beat; unable to get deep breath. Given IV anti-inflammatory.


VAERS ID: 1379754 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye pain, Headache
SMQs:, Glaucoma (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: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Acute headache on right side of head and eye. Today after one week I still have severe headaches daily.


VAERS ID: 1380637 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Wrong product 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: USJNJFOC20210604872

Write-up: WRONG VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient was previously treated with mrna 1273 for prophylactic vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, and expiry: UNKNOWN) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUN-2021, the subject experienced wrong vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of wrong vaccine administered was not reported. This report was non-serious. This case, from the same reporter is linked to 20210603388.


VAERS ID: 1380654 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Ear pain, Fatigue, Headache, Pain in jaw, Paraesthesia oral, Pruritus, Rash, Rash macular, Skin discolouration, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALBUTEROL [SALBUTAMOL]
Current Illness: Abstains from alcohol; Asthma; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Comments: The patient had no history of drug abuse or illicit drug use and also had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210607495

Write-up: PAIN IN EAR; PAIN IN JAW; STRANGE FEELING IN BACK OF THROAT AS IF SOMETHING WAS STUCK BOTTOM OF THROAT; ITCHING; TINGLING IN LIPS; BLOTCHING FLANK (UPPER BACK, NECK AND FACE); DISCOLORATION; RASH ALL OVER ARM (ARM OF VACCINE); TIREDNESS; HEADACHE; This spontaneous report received from a patient concerned a 51 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included covid, and concurrent conditions included asthma, non-alcoholic, and non-smoker, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug use and also had no known allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: UNKNOWN) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. Concomitant medications included salbutamol for asthma. On 01-JUN-2021, the subject experienced strange feeling in back of throat as if something was stuck bottom of throat. On 01-JUN-2021, the subject experienced itching. On 01-JUN-2021, the subject experienced tingling in lips. On 01-JUN-2021, the subject experienced blotching flank (upper back, neck and face). On 01-JUN-2021, the subject experienced discoloration. On 01-JUN-2021, the subject experienced rash all over arm (arm of vaccine). On 01-JUN-2021, the subject experienced tiredness. On 01-JUN-2021, the subject experienced headache. On 02-JUN-2021, the subject experienced pain in ear. On 02-JUN-2021, the subject experienced pain in jaw. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from strange feeling in back of throat as if something was stuck bottom of throat on 02-JUN-2021, and itching, and blotching flank (upper back, neck and face) on 01-JUN-2021, was recovering from rash all over arm (arm of vaccine), tiredness, and headache, had not recovered from pain in ear, and pain in jaw, and the outcome of tingling in lips and discoloration was not reported. This report was non-serious.


VAERS ID: 1380669 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210608105

Write-up: This spontaneous report received from a pharmacist concerned a 67 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 207A21A expiry: 23-JUN-2021) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced incorrect product storage. On 03-JUN-2021, the subject experienced vaccine administered past the 6 hours frame inside the fridge. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered past the 6 hours frame inside the fridge and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1380671 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (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: Alcohol use (He drinks a glass of wine occasionally.); Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies and no drug abuse or illicit drug use. The patient had no health conditions and exercises regularly.
Allergies:
Diagnostic Lab Data: Test Date: 20210601; Test Name: Antibody test; Result Unstructured Data: No antibodies; Comments: Healthcare
CDC Split Type: USJNJFOC20210608194

Write-up: SUSPECTED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report was received from a 62-year-old American Indian or Alaskan native, not Hispanic/Latino male patient. The patient''s height, and weight were not reported. The patient drinks a glass of wine occasionally, and does not smoke. He had no known drug allergies and no drug abuse or illicit drug use. The patient had no health conditions and exercises regularly. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration was not reported, batch number: 043A21A, and expiry: 21-JUN-2021) dose was not reported, 1 total, administered on left arm on 05-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUN-2021, the patient got an antibody test done which showed no antibodies (suspected immunological vaccine failure). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of suspected immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0- 20210608194-Covid 19 vaccine-Suspected immunological vaccine 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: 1380685 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210611752

Write-up: EXPIRED VACCINE ADMINISTERED; PUNCTURED VIAL WAS STORED IN THE REFRIGERATOR FOR 6 HOURS AND 36 MINUTES; This spontaneous report received from a pharmacist concerned a 56 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 02-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced punctured vial was stored in the refrigerator for 6 hours and 36 minutes. On 02-JUN-2021, the subject experienced expired vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the expired vaccine administered and punctured vial was stored in the refrigerator for 6 hours and 36 minutes was not reported. This report was non-serious.


VAERS ID: 1380696 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Piloerection
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: USJNJFOC20210612255

Write-up: GOOSEBUMPS THROUGHOUT THE NIGHT AND THE FOLLOWING DAY; CHILLS THROUGHOUT THE NIGHT AND THE FOLLOWING DAY; STRONG HEADACHE THROUGHOUT THE NIGHT AND THE FOLLOWING DAY; This spontaneous report received from a consumer concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 01-JUN-2021, the subject experienced goosebumps throughout the night and the following day. On 01-JUN-2021, the subject experienced chills throughout the night and the following day. On 01-JUN-2021, the subject experienced strong headache throughout the night and the following day. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the strong headache throughout the night and the following day, chills throughout the night and the following day and goosebumps throughout the night and the following day was not reported. This report was non-serious. This case, from the same reporter is linked to 20210611877.


VAERS ID: 1381296 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Skin discolouration
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021634762

Write-up: Caller developed a tiny little area which is grayish somehow like a bruise on her left arm, on the same arm where she got the vaccine; Caller developed a tiny little area which is grayish somehow like a bruise on her left arm, on the same arm where she got the vaccine; This is a spontaneous report from a contactable consumer (patient) or other non hcp. A 75-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number and Expiry date: not provided), dose 2 via an unspecified route of administration, on 01Jun2021 at 07:30 (age at the time 75-year-old), as single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number and Expiry date: not provided), dose 1 via an unspecified route of administration, on an unspecified route (age at the time 75-year-old), as single dose for COVID-19 immunization. On 01Jun2021, the patient experienced a tiny little area which was grayish somehow like a bruise on her left arm, on the same arm. It was reported that, she was just alarmed as what she had read on the vaccination sheet was just injection site redness and not that one like patient. The patient would like to know if there were reports like the side-effect she had experienced. The outcome of the events was unknown. Information on lot/Batch number has been requested.


VAERS ID: 1381306 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2016-04-01
Onset:2021-06-01
   Days after vaccination:1887
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain lower, Abdominal pain upper, Memory impairment
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021636178

Write-up: Stomach cramps increased; Upset stomach; Memory is not good/sometimes she remember things that amazes her and sometimes she cannot remember what happened yesterday; Pain in lower abdomen; This is a spontaneous report from a contactable consumer (patient) and physician. A female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: EW0167), dose 2 via an unspecified route of administration, administered in Arm Left on 29Apr2021 12:00 as 2nd dose, single dose for COVID-19 immunization; palbociclib (IBRANCE), via an unspecified route of administration from Apr2016 (Batch/Lot number was not reported) to 27May2021, at 125mg caplets oral with water for 21 days on and seven days off once a day for stage IV metastatic breast cancer. The patient''s medical history and concomitant medications were not reported. No patient history. Family Medical History Relevant to AE(s): None. No other products. History of all previous immunization with the Pfizer vaccine considered as suspect: None. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient previously took BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: EW0153), dose 1 via an unspecified route of administration, administered in Arm Left on an unspecified date 12:05 as 1st dose, single dose for COVID-19 immunization and had stomach cramps. The patient stated that she was on Ibrance. The patient stated that she had second shot on 29Apr2021. Since the second vaccine, she had so much trouble with her stomach. The patient stated that this had been an ongoing thing. Her stomach cramps increased, and she had pain in her lower abdomen. The patient stated that she had the first shot three weeks before the second shot and had stomach cramps. The patient stated that stomach would not settle down. The patient stated that she would get some good days. The patient stated that last week on Thursday that she was in downward spiral and could not get out of it. The patient stated that she was being careful with what she ate. The patient stated that she stopped the Ibrance. The patient stated that this week was her seven days off and she would call today to ask for next month but wanted to take a reduced amount. The patient stated that when she saw her oncologist that she asked if people ever stop taking Ibrance and was told no that if one has a reoccurrence that it may not work as well. The patient stated that she did not ask for a reduction at that time but intends to. It was a temporary stop. The patient stated that this was more about Ibrance than the vaccine. The patient stated that she had pain in lower abdomen that started 10 days ago. The patient stated that she gets upset stomach from time to time but that it had been pretty constant since the first week in May. The patient stated that sometimes she remembers things that amazes her and sometimes she cannot remember what happened yesterday. The patient stated that other factors were involved (memory) at that time that her husband was ill. The patient stated that the stomach cramps started again 6 days after second vaccination and resolved last week. Recovered with lasting effects of upset stomach. The patient stated that she changed from capsules to caplets in 2020. The patient was treated with Mylanta. The patient stated that she had a video call scheduled with her nurse practitioner. Is eating soft foods and keeps drinking water. Relevant Tests: None. The event did not result in Emergency Room/Physician Office. The outcome of the events stomach cramps increased was recovered with sequelae, pain in lower abdomen, upset stomach was recovered, memory is not good/sometimes she remember things that amazes her and sometimes she cannot remember what happened yesterday was unknown. Follow-up attempts are possible. Further information is expected.


VAERS ID: 1381311 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-10
Onset:2021-06-01
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Migraine
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: USPFIZER INC2021638474

Write-up: Severe migraine; This is a spontaneous report from a non-contactable consumer (patient herself). A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number: not reported), via an unspecified route of administration on 10May2021 as 1ST DOSE, SINGLE DOSE for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 01Jun2021 (reported as today), the patient experienced severe migraine. She wanted to know if she can take Advil but fully aware as well that they should not take medicines in between doses so should she wait 1 more week after taking the 2nd dose. The outcome of the event was unknown. No follow-up attempts are Possible; information about lot/batch number cannot be obtained.


VAERS ID: 1381348 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anosmia, Body temperature, Chills, Fatigue, Headache, Injection site pain, Pain, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Osteoarthritis
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (in march (year unspecified))
Allergies:
Diagnostic Lab Data: Test Date: 20210602; Test Name: Body temperature; Result Unstructured Data: 99; Test Date: 20210602; Test Name: Body temperature; Result Unstructured Data: 100.9; Test Name: COVID-19 virus test; Result Unstructured Data: positive; Comments: covid-19 positive in march (year unspecified)
CDC Split Type: USJNJFOC20210604721

Write-up: BODY ACHES; CHILLS; FEVER; HEADACHE; FATIGUE; SORENESS AT INJECTION SITE; NO SENSE OF SMELL; This spontaneous report received from a patient concerned a male. The patient''s height, and weight were not reported. The patient''s past medical history included covid-19, and concurrent conditions included osteoarthritis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced no sense of smell. On 02-JUN-2021, the subject experienced body aches. On 02-JUN-2021, the subject experienced chills. On 02-JUN-2021, the subject experienced fever. On 02-JUN-2021, the subject experienced headache. On 02-JUN-2021, the subject experienced fatigue. On 02-JUN-2021, the subject experienced soreness at injection site. Laboratory data included: Body temperature (NR: not provided) 99, 100.9. Treatment medications included: naproxen sodium. Laboratory data (dates unspecified) included: COVID-19 virus test (NR: not provided) positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from soreness at injection site, fever, body aches, headache, and chills, and the outcome of fatigue and no sense of smell was not reported. This report was non-serious. This case, from the same reporter is linked to 20210604773.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as case is assessed as non serious.


VAERS ID: 1381406 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-05-27
Onset:2021-06-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DOXYCYCLINE MONOHYDRATE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021649907

Write-up: severe dizziness; vertigo; This is a spontaneous report received from a contactable female consumer (patient). A 31-year-old (non-pregnant) female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot number was not reported), via an unspecified route of ad-ministration, administered in arm right on 27May2021 15:00 (at the age of 31-year-old) as a 2nd dose, single dose for COVID-19 immunization. The patient ''s medical history was not reported. The patient had no known allergies. The patient''s concomitant medication included doxycycline monohydrate 100 mg. The patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in arm right on 06May2021 (at the age of 31-year-old) for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient experienced severe dizziness and vertigo on 01Jun2021 10:00 PM. Patient was not diagnosed for COVID-19 prior to vaccination. The patient had not tested COVID-19 post vaccination. The patient did not receive any treatment medication for the events. Outcome of the events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1381414 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Eye disorder, Fatigue, Feeling cold, Feeling hot, Head discomfort, Headache, Hypertension, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021650356

Write-up: dizziness; did not allow me to have my eyes open; blood pressure was high; felt my body very cold; arm was very swollen; pain, a sharp pain, especially on the right side of the brain and the part of my head; tiredness; heaviness in the head; anxious; felt a lot of heat in my body; One hour later in her right arm she had a lot of pain; This is a spontaneous report received from a contactable consumer or other non hcp. A female patient of an unspecified age received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/lot number was not reported), via an unspecified route of administration on 01Jun2021 as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient had first dose of the Pfizer COVID 19 vaccine on 01Jun2021 and ten minutes after that she started feeling dizzy and could not keep her eyes open and since she was still at the vaccination facility, they took her blood pressure, and it was high. One hour later in her right arm she had a lot of pain and it was swollen she felt the pain was a sharp pain that was on her right arm which was the arm she had the injection. Caller also felt pain in her brain and part of the head. Caller also reported being tired and had dizziness. Caller stated the headache and dizziness was constant, but she felt it mostly on the right side of her body which was the side she received the injection. Caller had to close her eyes so the dizziness would stop. Caller stated this happened on 01Jun2021 and 02Jun2021 and it was making her feel very anxious and she felt really really hot and when she had her blood pressure high, she felt her body cold. The clinical outcome of the events were unknown. Follow-up 2 (PRD 03Jun2021): This is a spontaneous report from a contactable consumer. This consumer (patient) reported that: dizziness, did not allow me to have my eyes open, blood pressure was high, felt my body very cold, arm was very swollen, pain, a sharp pain, especially on the right side of the brain and the part of my head, tiredness, heaviness in the head, anxious, felt a lot of heat in my body, one hour later in her right arm she had a lot of pain. Information on the lot/batch number has been requested. further information has been request-ed.


VAERS ID: 1381719 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-08
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

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

Write-up: No adverse event that we are yet aware of. Patient was inadvertently given 1 dose of Pfizer 4 weeks after having received 1 dose of Moderna Covid-19 vaccinations.


VAERS ID: 1381730 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-02-02
Onset:2021-06-01
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test negative
SMQs:, 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: celebrex, plaque nil, Lipitor, warfarin
Current Illness: fibrillation
Preexisting Conditions: RA, HimCholesterol, sleep apnea
Allergies: None
Diagnostic Lab Data: No other test was performed beyond the antibody presence tests. QUESTIONS TO CDC: what should be the next steps, alternative vaccines or medications to ensure immunity against Covid 10?
CDC Split Type:

Write-up: Three months after completion of vaccination 2 doses of Moderna, a blood test for CoviD 19 antibodies showed a totally negative result. Both types of antibodies (IgG and IgM) were tested and found negative.


VAERS ID: 1381733 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Disorientation, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PATIENT ORIENTED, VISIT YOUR PHYSICIAN FOR FOLLOW-UP
Current Illness: PATIENT REFERS THAT PREVIOUSLY, HE SUFFERED DIZZINESS CAUSING HIM LOSS OF CONSCIOUSNESS AND FRACTURES IN THE RIGHT ARM FOR APPROXIMATELY 1 MONTH.
Preexisting Conditions: PATIENT VERBALIZES THAT HE DOES NOT SUFFER FROM ANY CHRONIC CONDITION AT THE MOMENT OF EVALUATION. THEREFORE INDICATING HE HAS NOT VISITED ANY DOCTOR.
Allergies: Penicillin
Diagnostic Lab Data: NO LABORATORY DONE
CDC Split Type:

Write-up: PATIENT PRESENTED WITH NAUSEA, VOMITING AND DISORIENTATION.


VAERS ID: 1381886 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-19
Onset:2021-06-01
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Menstruation delayed
SMQs:, Fertility disorders (broad)

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

Write-up: After my second dose my next period did not start. I took pregnancy test every day for 10 days starting 2 days prior to period as my husband and I are trying. I am not pregnant and have yet to start a period. It is now 9 days late. I spoke to my OBGYN and after a series of questions she concluded its probably a side effect from vaccine.


VAERS ID: 1381909 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-06-01
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (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: Amlodipine (5 mg) Carvedilol (3.125 mg) Rosvustatin (5 mg) Baby Aspirin
Current Illness: Heart disease, sleep apnea, hypertension
Preexisting Conditions: N/A
Allergies: None
Diagnostic Lab Data: Visual inspection
CDC Split Type:

Write-up: Shingles developed on my left lower back and torso approximately three month after receiving the Covid-19 vaccine.


VAERS ID: 1381946 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1381958 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial flutter, Body temperature increased, Dizziness, Electrocardiogram abnormal, Heart rate increased, Hyperventilation, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Escitalopram 10mg once daily.
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Penicillin & pethidine
Diagnostic Lab Data: ECG performed found an arterial flutter.
CDC Split Type:

Write-up: I had my injection 5 minutes after, I fainted and began hyperventilating. Heart spiked to 160bpm, blood pressure 180/90, Temperature spiked to 38.9. Heart rate kept spiking on and off for hours I was transferred to hospital for monitoring and after and I was dizzy for 4 days still after vaccine.


VAERS ID: 1381982 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 3 RA / IM

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

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

Write-up: Error: Booster Given Too Early


VAERS ID: 1381996 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Mouth ulceration, Muscle swelling, Musculoskeletal discomfort, Myalgia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: as a child unknown which no records
Other Medications: vitamin C, Verapamil 160 mg , Bumex 2 mg , Potassium chloride 20 mu, on these since I was 35 yrs old, Metopolol 25 mg (on it since Feb 2020), allopurinol ( on it since I was 14)
Current Illness: NONE
Preexisting Conditions: hypertension, SI joint dysfuntion
Allergies: statins, losartan
Diagnostic Lab Data:
CDC Split Type:

Write-up: mouth ulcers going on 7 weeks, worsened after snd shot, myalgia, selling of righht shoulder back muscles


VAERS ID: 1382007 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: senna
Current Illness:
Preexisting Conditions: vitamin D deficiency, dyuria
Allergies: cashews, avocado, pollen, watermelon
Diagnostic Lab Data: PO diphenhydramine
CDC Split Type:

Write-up: patient felt numbness and tingling in Left arm


VAERS ID: 1382015 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

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

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

Write-up: 1140 Medical Technologist from HCF calling to report that a patient who received the J&J covid vaccine in March now tests positive for Covid 19. Patient started having a cough and shortness of breath on June 1st. Arrived at the hospital June 4th. Diagnosis : Covid pneumonia. Patient is improving on 3 liters of oxygen via nasal cannula. Meds: albuteral, decadron, apap , zofran, Remdesivir . Patient has history of being overweight , diabetic , and hypertensive.


VAERS ID: 1382058 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

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

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

Write-up: Patient has had a rash show up on both arms. The rash is primarily on the inside of the arm. It has been red, very itchy, and painful. The rash has improved as of today 6/8/21 but is still present.


VAERS ID: 1382077 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Gait disturbance, Guillain-Barre syndrome, Immunoglobulin therapy, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: Patient received covid vaccine (Pfizer) on 5/18/21. About 2 weeks prior to admission to hospital patient began having leg weakness and unsteady gait which has progressively gotten worse. Patient is beginning IVIG treatment for Guilian Barre syndrome.


VAERS ID: 1382088 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Hyperhidrosis, Injection site discolouration, Injection site erythema
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Pt c/o of severe abdominal cramping on day 5 post covid vaccination. Pt also had a c/o sweating. Pt feeling better now but still not 100%. Had red and purple at the injection site that was the size of a "playing card".


VAERS ID: 1382234 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-24
Onset:2021-06-01
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anti-thyroid antibody, Blood thyroid stimulating hormone increased, Hypothyroidism, Thyroxine normal
SMQs:, Hypothyroidism (narrow), Hyperthyroidism (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: June 1, 2021; LabCorp THYROID CASCADE PROFILE THYROID PEROXIDASE(TPO)AB THYROXINE(T4)FREE,DIRECT,SERUM
CDC Split Type:

Write-up: ELEVATED - TSH 10.300 uIU/mL ELEVATED - Thyroid Peroxidase Ab 198 IU/mL NORMAL - T4, Free (Direct) 0.94 ng/dL * An elevation of TSH with a normal FT4 in the presence of antithyroid peroxidase antibody is suggestive of Subclinical Hypothyroidism. ** NO SYMPTOMS *** NO PREVIOUS ISSUES; NO FAMILY HISTORY


VAERS ID: 1382351 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: headache, body aches, fever, chills, loss of appetite, loss of energy


VAERS ID: 1382361 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

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

Write-up: Patient reported having nerve pain and tingling the same day as she received the vaccine


VAERS ID: 1382382 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Eye pain, Facial asymmetry, Nightmare, Taste disorder
SMQs:, Taste and smell disorders (narrow), Glaucoma (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Urgent Care and ER visual evaluation.
CDC Split Type:

Write-up: The night after the shot, I have extremely vivid and lucid dreams. The following week on June first, I notice that the texture of food felt different. I was still able to taste, but my tongue felt numb, almost. On June 3, my eye began to hurt...like I had something in it. I added a couple eye drops and took some Advil, and that seemed to work. On June 4th, my eye became worse, and eye drops were not helping. On the morning of June 5th, I noticed my smile was off and I could not drink out of a straw properly. Food textures were still off and my eye was much worse. I went to the Urgent Care, and they advised me to go to the ER to rule out anything neurological. The symptoms I was and still am experiencing, and was diagnosed with was Bell''s Palsy. I have never had this happen before and rarely get sick. During this time I have had not other illness.


VAERS ID: 1382484 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-04-30
Onset:2021-06-01
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Amenorrhoea, Angina pectoris
SMQs:, Other ischaemic heart disease (narrow), Fertility disorders (broad)

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

Write-up: Heart pain Missing period/menstruation


VAERS ID: 1382514 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Menstrual disorder
SMQs:

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

Write-up: I have yet to get my period and I?ve always been on time since it began. Other women have also told me they experienced pain or no period after as well


VAERS ID: 1382648 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Dizziness, Dysstasia, Gait inability, Nausea, Pain, Pyrexia, Respiratory tract congestion
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: (Moderna COVID-19 Vaccine EUA). EVENT: Fever. SYMPTOMS: chills, overall weakness, body aches and pain (stomach, head, muscles, leg soreness/aches), mild to moderate congestion, little to no appetite nausea, dizziness. SIGNS: gradual development of mild to severe chills and overall body ache, nausea and dizziness at moving or walking. TIME COURSE: 4-5 Days. TREATMENT (Personal-no health insurance): Bed rest and sleep, at-home remedies, elderberry, otc medications (robitussin and alka seltzer), more rest. OUTCOME: weakness and no appetite, constant inability to get up or walk even for simple tasks, little to no energy, slow movements; faster recovery began on the 4th day with over-the counter medications.


VAERS ID: 1382664 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PE, migraines, allergies, hypotension, Asthma
Allergies: Albuterol, ASA, augmentin, cipro, compazine, levsin, Phenergan, Reglan, ketorlac, vicodin, cephalosporins, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anaphylactic reaction, sent to ED. Received Epi pen, dexamethasone, benadryl, pepcid, methylprednisolne. Sx resolve after observation and pt sent home


VAERS ID: 1382924 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Influenza like illness, Pain, 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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: This is a 16 year old patient that received Moderna for her first dose of Covid vaccine instead of receiving Pfizer. Per patients mother patient experienced body aches and flu like symptoms for 1 day after vaccine was administered and patient has been doing well since then.


VAERS ID: 1384322 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Joint swelling, Pain
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210612364

Write-up: ANKLES SWELLING; ANKLES REDNESS; IN PAIN AND HURTS TO WALK; This spontaneous report received from a consumer concerned a 28 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 05-JUN-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced in pain and hurts to walk. On 05-JUN-2021, the subject experienced ankles swelling. On 05-JUN-2021, the subject experienced ankles redness. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from ankles swelling, and ankles redness, and the outcome of in pain and hurts to walk was not reported. This report was non-serious.


VAERS ID: 1384323 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Headache, Injection site rash, Nausea, Pain in extremity, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210612395

Write-up: SORE ARM; RASH ON LEFT ARM AT ADMINISTRATION SITE (LEFT DELTOID)/3 OR 4 RASHES UNDER OR CLOSER TO THE ARMPIT (ABOUT 1-2 CENTIMETERS)/THE OTHER ONE BY INNER ELBOW/LIKE A MOSQUITO BITE THAT WELTS; HEADACHE; NAUSEA; BURNING; ITCHING; This spontaneous report received from a patient concerned a female of unspecified age. 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: 203a21a, expiry: UNKNOWN) dose was not reported, administered on 05-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced burning. On JUN-2021, the subject experienced itching. On 05-JUN-2021, the subject experienced sore arm. On 05-JUN-2021, the subject experienced rash on left arm at administration site (left deltoid) /3 or 4 rashes under or closer to the armpit (about 1-2 centimeters) /the other one by inner elbow/like a mosquito bite that welts. On 05-JUN-2021, the subject experienced headache. On 05-JUN-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the rash on left arm at administration site (left deltoid)/3 or 4 rashes under or closer to the armpit (about 1-2 centimeters)/the other one by inner elbow/like a mosquito bite that welts, itching, burning, headache, sore arm and nausea was not reported. This report was non-serious.


VAERS ID: 1384329 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Missouri  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE
Current Illness: Abstains from alcohol; Arthritis; Asthmatic; Highly allergic; Hypometabolism; Hypothyroidism; Impaired driving ability; Incontinent; Non-smoker; Senility
Preexisting Conditions: Medical History/Concurrent Conditions: Hospitalisation; Insomnia (when her Incontinent was bad, she could not sleep. She would take Advil or something made of herbs to sleep called "Midnight")
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210612878

Write-up: DIDN''T SLEEP MUCH LAST NIGHT; LITTLE RED DOTS ALL OVER BODY; SWOLLEN FACE; This spontaneous report received from a patient concerned an 84 year old female. The patient''s weight was 201 pounds, and height was 68 inches. The patient''s past medical history included could not sleep, and hospitalized, and concurrent conditions included asthma (asthmatic), hypothyroidism, senile, slow metabolism, arthritis, non-smoker, non alcoholic, heavily incontinent, unable to drive, and highly allergic. The patient experienced drug allergy when treated with oxycodone hydrochloride/paracetamol, and acetylsalicylic acid/caffeine/homatropine terephthalate/oxycodone hydrochloride/oxycodone terephthalate/phenacetin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included levothyroxine for hypothyroidism. On JUN-2021, the subject experienced swollen face. On JUN-2021, the subject experienced little red dots all over body. On 04-JUN-2021, the subject experienced didn''t sleep much last night. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from swollen face, and little red dots all over body on JUN-2021, and the outcome of didn''t sleep much last night was not reported. This report was non-serious.


VAERS ID: 1384665 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Electrocardiogram ST-T segment abnormal, N-terminal prohormone brain natriuretic peptide increased, Pulmonary embolism, Troponin increased
SMQs:, Cardiac failure (broad), Myocardial infarction (narrow), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Other ischaemic heart disease (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Clonazepam, Quetiapine, Prazosin
Current Illness: None known
Preexisting Conditions: Alcohol use, ischemic stroke, PTSD, HTN
Allergies: None
Diagnostic Lab Data: CT angiogram showing PEs and associated elevations in Troponin and NT-proBNP
CDC Split Type:

Write-up: Bilateral pulmonary embolism with evidence of R Heart Strain


VAERS ID: 1384682 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Rash, Skin disorder, Skin warm
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: AMOXICILLIN; KEFLEX [CEFALEXIN MONOHYDRATE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hives (so they were just wanting to watch her closely with this)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021634551

Write-up: Almost a leopard look, not like a regular rash.; There is a strange pattern on the upper half of her right thigh, very warm.; There is a strange pattern on the upper half of her right thigh, very warm.; This is a spontaneous report from female consumer (patient''s mother). This old female consumer (patient''s mother) reported patient (daughter). A 23-year-old female patient (age at vaccination: 23 year) received first dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number was not reported and expiry date: 31Aug2021), via an unspecified route of administration, in Arm Left, on 01Jun2021 at 09:30, as a single dose for COVID-19 immunization. The patient was taking Pfizer Covid Vaccine because just for health protection and for work. Vaccine administered was not at facility. There was no history of previous immunization with the Pfizer vaccine. There were no additional vaccines administered on same date of the Pfizer Suspect. The patient''s medical history included patient breaks out in hives (so they were just wanting to watch her closely with this), allergic to amoxicillin, and Keflex family of medicines (patient was 3 years old). There was no family medical history relevant to adverse events and no other relevant tests. Concomitant medications included amoxicillin and keflex (CEFALEXIN MONOHYDRATE). The reporter was calling on behalf of her daughter who received the first dose of the Pfizer Covid 19 vaccine about an hour ago. About an hour and a half ago, there was a strange pattern on the upper half of her right thigh, whole area feels very warm on 01Jun2021. Almost a leopard look, not like a regular rash on an unknown date. She just wanted to get Pfizer''s input and see about the side effects seen and stated they noticed it like 5 minutes ago, it''s staying steady right now. The reporter asked has this been reported as a side effect and did she need to get her in to see someone or did we need to get ready for an allergic reaction. The reporter got response as I would not be able to say if she was having a severe allergic reaction or not and suggested they reach out to her HCP to ask if she needs to come in to be seen or if they should go to the emergency room. There was a product complaint. Outcome of the events was unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1384687 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood cholesterol, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (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: CLOPIDOGREL; EZETIMIBE; ELIQUIS; DICYCLOMINE; LIPITOR [ATORVASTATIN]; MONTELUKAST SODIUM; PANTOPRAZOLE SODIUM; METOPROLOL SUCCINATE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Abdominal pain (so she took dicyclomine); Allergy to molds; Asthma (developed asthma from when she worked with cleaning materials); Heart attack; High cholesterol; House dust mite allergy; Ruptured intervertebral disc; Shortness of breath (prior to receiving the vaccine)
Allergies:
Diagnostic Lab Data: Test Name: lab work with the Lipitor; Result Unstructured Data: Test Result:cholesterol was high
CDC Split Type: USPFIZER INC2021634857

Write-up: heart started pounding and racing; This is a spontaneous report from a contactable consumer (patient). A 65-years-old female patient received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection, Batch/Lot Number: ER8727; Expiration Date: Aug2021, NDC number: 592671000-1) via an unspecified route of administration administered Arm Right on 01Jun2021, as single dose for covid-19 immunization (at the age of 65-years-old). Medical history included heart attack from Oct2020, asthma and she developed asthma from when she worked with cleaning materials and can''t be around industrial cleaning products because it sets off her asthma, ruptured back disc from Jan2017, having shortness of breath dyspnoea prior to receiving the vaccine, allergic to mold and dust mites, abdominal pain came back so she took some Pantoprazole sodium 40 mg, cholesterol was high on her lab work with the Lipitor. Concomitant medication(s) included clopidogrel (CLOPIDOGREL 75 mg once a day); ezetimibe (EZETIMIBE 10 mg, once a day); apixaban (ELIQUIS) 5 mg 2 times a day; and dicyclomine (DICYCLOMINE) 20 mg tablet taken for abdominal pain; atorvastatin (LIPITOR [ATORVASTATIN]) 80 mg NDC and lot unknown, expiration date 13May2022 taken for blood cholesterol; montelukast sodium (MONTELUKAST SODIUM) 10 mg taken for allergies; pantoprazole sodium (PANTOPRAZOLE SODIUM 40 mg) lot and NDC unknown, expiration date 05May2022 taken for abdominal pain; metoprolol succinate (METOPROLOL SUCCINATE) 25 mg once per day orally taken for heart. The patient previously took rosuvastatin calcium 40 mg tablet for cholesterol but when she started taking that it caused a lot of back pain and stomach pain and chest pain. Patient reported that she received first dose of vaccine on 01Jun2021 in afternoon and within 3 minutes after receiving the vaccine she was sitting down, and her heart started pounding and racing and she thought her heart was going to jump out of her chest and the symptom lasted for about 5-6 minutes and as she was currently in a research study and has a heart monitor in place until 06Jun2021. She did not know this could be from the vaccine. The patient didn''t know if she got the Pfizer covid vaccine because she didn''t feel anything, and she doesn''t have a sore arm. She also stated that she had abdominal pain this morning, so she took dicyclomine and was on Lipitor up until this week, but they had to swap her because her cholesterol was high on her lab work with the Lipitor and the patient was back on Lipitor as of today (date not specified). This morning the patient abdominal pain came back so she took some Pantoprazole sodium 40 mg and as the Pantoprazole did not work so she took the dicyclomine. The patient has been having shortness of breath prior to receiving the vaccine and no one can figure out why, so she did not think that happened from the vaccine, her stents were not clogged. The heartbeat was totally new for her and she never had that before. She further stated that she was scheduled to receive the second Pfizer Covid 19 Vaccine on 22Jun2021 and was asking if she should receive the second dose. She mentioned that she was high risk, and her doctors were hounding her to get the vaccine. Her symptoms were still ongoing. On an unknown date the patient underwent lab tests and procedures which included blood cholesterol which result showed cholesterol was high. The outcome of the event was not recovered.


VAERS ID: 1384693 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Overdose, Product preparation error
SMQs:, Drug abuse and dependence (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021636045

Write-up: received a vaccine that wasn''t diluted; received a vaccine that wasn''t diluted; This is a spontaneous report from a contactable other health care professional (on behalf of Pharmacist) via a Pfizer sponsored program. A 58-years-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE: Solution for injection, Batch/Lot Number: EW0167; Expiration Date: Aug2021, NDC: 59267100001), via an unspecified route of administration, administered in Arm Left on 01Jun2021 (at the age of 58-years-old) as a single dose for covid-19 immunisation. Patient had no medical history and concomitant medications were not reported was not reported. The patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE: Solution for injection, Batch/Lot Number: EW0171, Expiration Date: Aug2021, NDC: 59267100001) via an unspecified route of administration, administered in Arm Left on 11May2021 at 0.3 ml as a single dose for covid-19 immunisation. On 01Jun2021, (reported as happened an hour ago) the patient received a vaccine that wasn''t diluted. Reporter wanted to know the side effects that would happen to the customer who received the vaccine that wasn''t diluted. The seriousness of the events was reported as medically significant. The outcome of the events was unknown. Follow-up attempts needed. Additional information has been requested. ; Sender''s Comments: Based on known drug safety profile there is reasonable possibility of causal association between the reported events and the suspect drug.


VAERS ID: 1384701 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-26
Onset:2021-06-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, 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: ALEVE ARTHRITIS
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021641218

Write-up: Muscle ache; Tiredness; Chills; Fever; Headache; This is a spontaneous report from a contactable consumer (patient) via medical information team. A 34-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EW0172), via an unspecified route of administration in left arm on 26May2021 at 09:00 as a single dose for COVID-19 immunization at pharmacy. The patient''s medical history was not reported. Concomitant medication included ongoing naproxen sodium (ALEVE ARTHRITIS) at 220 mg, twice a day for minor headaches. The patient did not receive any additional vaccines administered on same day. The patient did not receive any vaccinations with 4 weeks prior to the fist dose administration. The patient did not experience any adverse events prior vaccination. It was reported that she experienced chills, fever, headache, muscle aches, tiredness. patient stated she woke up last night at 10:30 with chills, literally shivering until she realized possibly what was going on, says she then knew it was a fever on 01Jun2021. patient stated she took Tylenol to help see if it would subside some. She started to develop a headache on 01Jun2021, slept on and off throughout the night on. patient says this morning when she woke up and felt ok, her head hurt kind of hurt a little bit, and she was really tired on 02Jun2021. patient stated she began developing chills and was just kind of sleeping off and on all day, says she has a slight headache and has not taken any medicine since 5am, says she wanted to see what''s going to happen. The chills have gotten a little better. Today, she just started to develop muscle aches also on 02Jun2021 08:00. Fever began around 10:30 and she doesn''t feel she has a fever anymore. Headache began around midnight and it''s better, it''s tolerable. Last night, her headache was to the point, she had to force herself to sleep just because she knew she needed the sleep. Muscle aches began around 8am when she got up this morning. She confirms the aches are better, it feels fine to get up and walk, but they are still noticeably there. Tiredness was kind of off and on, says she wakes up from sleeping, then dozes back off. patient states she slept from 5am until 8am really good, and then by 9am she was ready to doze. She took a nap between 10 to 11am and has been up since. The tiredness comes in waves. The patient was not hospitalized. The patient did not underwent any laboratory test. The outcome of the event fever was unknown, fatigue was not resolved and all other events was resolving. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1384737 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-27
Onset:2021-06-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Body temperature, COVID-19, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: Body temperature; Result Unstructured Data: Test Result:102; Test Date: 202105; Test Name: Body temperature; Result Unstructured Data: Test Result:103; Test Date: 202105; Test Name: Body temperature; Result Unstructured Data: Test Result:104; Test Date: 20210601; Test Name: covid-19 test; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC2021650085

Write-up: his stomach is hurting bad; received the Pfizer Covid vaccine on 29May2021 and subsequently tested positive for Covid 19; This is a spontaneous report from a contactable consumer (patient''s wife). A 45 year old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Lot number: Unknown), via an unspecified route of administration on 27May2021, as first dose, single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On 29May2021, the patient experienced fever and it kept going up to 102, 103, 104 and that went on for two days. Treatment medications included Tylenol and Motrin, but nothing could lower the temperature. Patient was taken to Emergency room, where he was tested positive for COVID on 01Jun2021, therefore he returned home and stayed isolated for 14 days. In the Emergency room, patient was treated with an IV. On 03Jun2021, 7 days after the first shot of vaccine, the patient''s stomach was hurting badly. Reporter enquired whether this was the effect of the vaccine shot. The patient underwent lab tests and procedures which included body temperature: going up to 102, 103, 104 on unknown dates in May2021, and SARS-CoV-2 test: positive on 01Jun2021. The clinical outcome of the events was unknown. Information on the lot/batch number has been requested. Further information has been requested.


VAERS ID: 1384740 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Migraine, Vaccination site pain
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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021650193

Write-up: Her head is killing her/ Headache; Headache and woke up with migraine; Arm was very sore; This is a spontaneous report received from a contactable consumer (patient) via medical information team. A 56-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection, Lot number: EW0178), via an unspecified route of administration, administered in left arm on 01Jun2021 17:15 (at the age of 56-year-old) single dose for COVID-19 immunisation at Pharmacy. The patient medical history was none. Concomitant medications were not reported. Prior Vaccinations (within 4 weeks) were none. It was reported that her head was killing her. Asked what can she take for it. Headache at 18:45 and woke up with migraine on 01Jun2021. Arm was very sore on . Got it two days ago and immediately got a headache within an hour and a half or so. That night headache lasted all night and she went to bed Woke up in morning and still had nagging headache. Headache came and went all day. Would get worse and then go away. Last night headache started getting really bad. Went to bed early. Woke up this morning with a migraine. Arm very sore confirmed in the injection arm, upper left arm. Had a little soreness on 01Jun2021. On 02Jun2021 was more sore. 03Jun2021 it''s the same. The patient did not visit emergency room or physician office. The outcome of the events was not resolved. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1384771 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Diarrhoea, Dizziness, Feeling abnormal, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 202106; Test Name: Fever; Result Unstructured Data: Test Result:101.9 Fahrenheit
CDC Split Type: USPFIZER INC2021655137

Write-up: vomiting; fever; chills; diarrhea; dizzy and shaky; dizzy and shaky; she "felt [her] gut and pieces of tissues from [her] gut were coming out; This is a spontaneous report from a contactable consumer (patient). A 60-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection; Lot number: unknown) via an unspecified route of administration on 01Jun2021 (at the age of 60-year-old) as single dose for COVID-19 immunization. Patient medical history included COVID-19 in Nov2020 and long haulers before getting the vaccine. Concomitant medications were not reported. On an unspecified date in Jun2021, after receiving first dose of vaccine, patient experienced violent vomiting, fever at 101.9F, chills, diarrhea, felt dizzy and shaky. Patient explained she was sitting on the bowl, had diarrhea, and had her "head in a bucket" but the force at which she was vomiting was unbelievable. Patient described she felt [her] gut and pieces of tissues from [her] gut were coming out; and the content sprayed on her walls, even 6 feet away reaching the shower. Patient specified she didn''t vomit when she was infected with COVID-19. Patient explained that she feels better this morning but would like to know if she was contagious. Patient asked if she should quarantine for 14 days after experiencing side effects from the Pfizer-BIoNTech COVID-19 vaccine. Outcome of the events was unknown. Information about lot/batch no has been requested.


VAERS ID: 1384773 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021655890

Write-up: Fever; Chills; This is a spontaneous report from a contactable consumer (patient). A 52-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number and Expiration Date was not reported) via an unspecified route of administration on 02Jun2021 as unknown dose single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On Jun2021, the patient experienced fever and chills. The patient wanted to know what to do with the side effects. The patient received information that, these side effects usually start within a day or two of getting the vaccine. Side effects might affect ability to do daily activities, but they should go away in a few days and get tips on what to after getting vaccinated. The outcome of events was unknown. Information about batch/lot number has been requested.


VAERS ID: 1384929 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-05
Onset:2021-06-01
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Full blood count abnormal, Platelet count decreased, Rash, Rash erythematous, Red blood cell count decreased, Thrombocytopenia, Vasculitis
SMQs:, Anaphylactic reaction (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Vasculitis (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness:
Preexisting Conditions: Interstitial cystitis
Allergies: Amoxicillin, iodine, latex, sulfa
Diagnostic Lab Data: 06/01/2021 CBC low platelets 70 Low red blood cell count
CDC Split Type:

Write-up: Red rash on both legs with purple pin point rash all over body with bruising. Low platelet count, low red blood cell count Diagnosed with Vasculitis, Thrombocytopenia


VAERS ID: 1384948 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-26
Onset:2021-06-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO177 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cough, Dyspnoea, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (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: WEAK, COUGH... DIFFICULTY BREATHING AND TONS OF MUCUS. Patient states she is feeling better after taking abx - ciproflaxin 500 mg, Motrin 600mg every 8 hrs, Benzonatato 100 mg every 8 hours. She also states she is a Dentist, so she prescribed all of the above medications for herself. Lastly, she states she has been resting and her breathing has not been laborous any longer, overall she is improving.


VAERS ID: 1385097 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-17
Onset:2021-06-01
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization due to COVID-19


VAERS ID: 1385160 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19 immunisation, Product storage error
SMQs:, Medication errors (narrow), COVID-19 (narrow)

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

Write-up: Pharmacy did not take Pfizer vaccine out of freezer after 14 days of being between -25 and -15 degrees C. Was instructed by corporate office to administer another dose to be sure of effectiveness of vaccine.


VAERS ID: 1385207 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-02
Onset:2021-06-01
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Shingles around mid section


VAERS ID: 1385253 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-25
Onset:2021-06-01
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / UNK - / -

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

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

Write-up: COVID-19


VAERS ID: 1385328 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Numbness in fingers/hand


VAERS ID: 1385548 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood sodium decreased, Blood test, Chills, Headache, Injection site pain, Myalgia, Nausea, Pain, Pyrexia, Restlessness, Sleep disorder, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NP-Thyroid Vitamin D3 B-Complex
Current Illness: Mild headache from weather changes, allergies, mild cold
Preexisting Conditions: Hypo thyroid, muscle tension headaches, depression, ADHD, IBS on occasion Genital Herpes
Allergies: Armor thyroid, onion, garlic Sensitive to medications especially those causing drowsiness
Diagnostic Lab Data: Blood work fine, low sodium.
CDC Split Type:

Write-up: Headache worsening after about 6 hours and pain at injection site. Headache continued during the night, with restlessness, muscle soreness preventing sleep. Headache continued after getting up around 7 am, with nausea. Started drinking water, vomited around 10 am. Ate 2 pretzels, drank ginger ale. Fever of 99 degrees, chills. Took tylenol. Vomited around 2 pm. Tool Emetrol. Headache worse. Vomited at 4pm. and again at 6 and 8. Went to ER at 9. Vomited 2 more times while waiting. Given meds for vomiting, pain and IV fluids around 11:30 pm.


VAERS ID: 1385822 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-16
Onset:2021-06-01
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site reaction
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: Synthroid, 0.15mcg, 1xday Metformin, 500mg, 2xday Losartan-HCTZ,50/12.5mg, 1xday Potassium 20mg, 1xday Crestor, 20mg, 1xday metoprolol tartrate,12.5mg, 2xday Baby aspirin 18mg, 1xday Vitamin D3, 400IU, 1xday Multivitamin, (No dose)1xday Vit
Current Illness: None.
Preexisting Conditions: HTN (Well controlled) Cholesterol (Well controlled) Diabetes (Well controlled)
Allergies: Clindamycin Possible penicillin allergy Lactose Intolerance
Diagnostic Lab Data: None.
CDC Split Type: vsafe

Write-up: There was no real treatment. The outcome faded shortly after covering a large area of my arm about 3/4. It wasn''t hard to the touch or itched but I didn''t use anything on it after seeing my dermatologist/physician. He was the one to suggest to get the second dose on the opposite arm. This one lasted about 18 days instead of 2 weeks.


VAERS ID: 1385887 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site rash, Pruritus, Rash, Rash erythematous, Skin warm, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ritusimab every 6 months Oracea multi vitamins, vitamin D
Current Illness: MS
Preexisting Conditions: MS
Allergies: fluoroquinolones
Diagnostic Lab Data: none
CDC Split Type:

Write-up: On day 3 post dose, I noticed that I had a large cutaneous eruption around the injection site (left deltoid). It was erythematous with a well-defined raised border, not indurated. It was warm to the touch and tender. It was somewhat pruritic. It was about 13 cm down my upper extremity and about 8cm around the circumference. Now, at day 7, it is no longer tender at all, no longer pruritic, and only mildly erythematous. I never did administer any treatment at all (I saw no need).


VAERS ID: 1385918 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-21
Onset:2021-06-01
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lymphadenopathy, X-ray limb normal
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: clavicle x-ray 6/01/2021: normal
CDC Split Type:

Write-up: Cervical lymphadenopathy; onset 11 days after vaccine, not currently resolved.


VAERS ID: 1385927 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-03
Onset:2021-06-01
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19 pneumonia, Immunosuppression, White blood cell count decreased
SMQs:, Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA prn, amlodipine 5 mg po daily, aspirin 325 mg po daily, atorvastatin 40 mg po daily, benzonatate prn, levothyroxine 100 mcg daily, losartan-HCTZ 100-25 mg po daily, metformin XR 750 mg daily, omeprazole, topiramate 100 mg po B
Current Illness: Regularly scheduled Ocrelizumab infusion 5/24/2021
Preexisting Conditions: MS, T2DM, HTN, hypothyroid, CKD, MGUS, obesity
Allergies: NKDA
Diagnostic Lab Data: WBC : 5/29 1.9, 6/1 3.6
CDC Split Type:

Write-up: Patient received Pfizer covid vaccine in March 2021, developed COVID-19 pneumonia and hospitalized end of May 2021. Immunosuppressed on ocrelizumab for multiple sclerosis. Treated with 2 doses of remdesivir prior to discharge (no steroids).


VAERS ID: 1386133 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000-1 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Central nervous system lesion, Dysarthria, Gait disturbance, Hemiparesis, Hemiplegia, Magnetic resonance imaging head abnormal
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), 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? Yes
Hospitalized? Yes, 16 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: multiple sclerosis diagnosed December 2020, not on disease modifying therapy
Allergies: none
Diagnostic Lab Data: MRI brain showed at least 3 new lesions compared to December 2020, none enhancing. No spine lesions.
CDC Split Type:

Write-up: Patient received Pfizer vaccines on 5/7/21 and 5/28/21. On June 1, 2021, she started to notice LEFT arm weakness while texting. She presented to the emergency room June 2 2021 with LEFT arm and leg weakness, difficulty walking, and slurred speech. Over the next few days, sx progressed to dense hemiplegia of the LEFT arm $g leg.


VAERS ID: 1386180 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050 C21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Balance disorder, Dizziness, Hypoaesthesia, Joint noise, Lymphadenopathy, Muscle twitching, Nervousness, Pain, Sensory loss, Tinnitus, Tremor
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: dizziness starting after administration of vaccine . within a day progressing to tinnitus, joint pain, cracking joints, lymph swelling, shooting pains all over my body, twitching-shakiness , unsteadiness, lightheaded when standing , numbness in my whole body and inability to feel my hands & feet well, nervous system feels over activated.


VAERS ID: 1386228 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
SMQs:, Medication errors (broad)

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

Write-up: after vaccination noticed small amount of vaccine on arm at injection site possilble due to malfunction of intregra syringe, needle detached from syringe while deploying retraction of needle before placing sharps container. amount of vaccine present on outside of arm was deemed to be less than 1/2 dose of vaccine. and no re-vaccination necessary as per cdc guidelines. patient has been notified of incident.


VAERS ID: 1386247 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Fatigue, Gait disturbance, Musculoskeletal stiffness, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylonol. Took 2 before vaccine
Current Illness: no
Preexisting Conditions:
Allergies: yes, need allergy testing
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe reaction lasted 8 days. This is day 9 and still in pain, but not as bad. Wrote doctor msg twice, on day 3 and 8. Symptoms started when I laid down that night. Extreme pain in arm and entire abdominal wall. Lasted into next day and could not get out of bed. Day 3 muscles were still like rigor mortis. No stretching, magnesium, or Epsom salts helped. Upper back went out. Day 4-now, lower back went out. Can not sit, stand, lay down, get up with out extreme pain. Trouble walking/ stiff. Exhausted.


VAERS ID: 1386280 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: Pharmacy left Pfizer vaccine vials in the freezer for longer than 2 weeks at temperature (-25 and -15 degrees C). We gave doses out of these vials, rendering them possibly less effective.


VAERS ID: 1386403 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-19
Onset:2021-06-01
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood culture negative, Bundle branch block right, Chills, Computerised tomogram head, Computerised tomogram neck, Computerised tomogram normal, Echocardiogram normal, Electrocardiogram abnormal, Headache, Musculoskeletal stiffness, Myalgia, Myocardial necrosis marker increased, Pyrexia, Respiratory viral panel, SARS-CoV-2 test negative, Troponin I increased, Urine analysis normal, Vaccination complication, Viral myocarditis, Viral test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data: Troponin-I 0.053---0.073--- 1.060 ng/ml (Reference range <0.035 ng/ml) Echocardiogram normal EKG: NSR, incomplete RBBB COVID-19 PCR negative Respiratory viral panel PCR negative Blood cultures x 2 negative CT of head and soft tissues of neck normal urinalysis unremarkable
CDC Split Type:

Write-up: Approximately 13 days after vaccination, the patient developed headache, fever, chills, myalgias, arthralgias, and neck stiffness. There was no chest pain or shortness of breath. He required hospitalization 6/6/21-6/7/21. He was found to have elevated cardiac enzymes (Troponin). Viral myocarditis vs vaccine associated myocarditis were considered in the differential diagnosis.


VAERS ID: 1386616 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Ten minutes after covid vaccination, patient stood up to get the attention of pharmacy workers at the pharmacy drop off area. He did not make it to the counter. He turned pale and went unconscious. He collapsed and struck his head on the floor. Pharmacist got to him seconds later and he woke up. 911 was called and attended to him. He declined being taken to the hospital.


VAERS ID: 1386839 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Chest discomfort, Dizziness, Electrocardiogram normal, Fibrin D dimer normal, Full blood count normal, Headache, Heart rate increased, Metabolic function test, Troponin normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topical Fluorouracil
Current Illness:
Preexisting Conditions: Migraine
Allergies: Adhesive, Nickle
Diagnostic Lab Data: EKG normal 6/9/21 D-dimer, CBC, CMP, TSH, Troponin normal 6/9/21
CDC Split Type:

Write-up: Headache, intermittent chest tightness, "feeling faint" since vaccination (6/1 to current) Neuro exam normal. Mild increase in heart rate with orthostatic testing; advised hydration and rest. History of migraines but previously well controlled without medication; recommend follow up with patient''s neurologist.


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