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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 272 out of 5,069

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VAERS ID: 1427212 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-10
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram, Headache, Lumbar puncture, Pyrexia, Vomiting, X-ray
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210617; Test Name: CT scan; Result Unstructured Data: Test Result:Unknown result; Test Date: 20210617; Test Name: Lumbar punch; Result Unstructured Data: Test Result:Unknown result; Test Date: 20210617; Test Name: X-ray; Result Unstructured Data: Test Result:Unknown result
CDC Split Type: USPFIZER INC2021725837

Write-up: Severe headache which developed into uncontrollable throwing up.; Fever; Severe headache which developed into uncontrollable throwing up.; This is a spontaneous report from a contactable consumer (parent). A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, lot Number: not reported), via an unspecified route of administration on 10Jun2021 as unknown, sin-gle for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The reported stated that all their three children were vaccinated and two of them just had fever (in Jun2021) which was normal. One daughter (Patient) had severe headache (in Jun2021) which developed into uncontrollable throwing up. Patient has fever on an unknown date in jun2021. Since then, they were at hospital. She had been tested and had a lumbar punch, CT scan and X-ray were performed, and she was schedule for MRI. She never had migraine or anything before. On 17Jun2021, the patient underwent lab tests and procedures which included CT scan: unknown result, lumbar punch: unknown result and x-ray: unknown result. The outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1427227 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-11
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN HCL; AMLODIPINE; LOSARTAN; HYDROCHLOROTHIAZIDE; LORAZEPAM; VITAMIN D [VITAMIN D NOS]
Current Illness: Anxiety (had this condition for about 15 years); Blood pressure high (had this condition for about 15 years.); Diabetes (called it diabetes and pre-diabetes, for about 4 years); Pacemaker insertion (cardiac) (inserted 2 years ago); Pre-diabetes (called it diabetes and pre-diabetes, for about 4 years); Sinusitis (having this problem for 5-6 years)
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic headaches; Dizziness
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021726919

Write-up: headaches and dizziness have gotten worse; headaches and dizziness have gotten worse; This is a spontaneous report from a contactable consumer (patient herself). A 74-years-old female patient received first dose of BNT162B2 (BNT162B2, PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: EW0182, Expiration date and NDC number was unknown), via an unspecified route of administration, administered in right arm on 11Jun2021 as 1st dose, single dose for COVID-19 immunisation. Medical history included ongoing high blood pressure (for about 15 years), diabetes (called it diabetes and pre-diabetes, for about 4 years) and pre-diabetes (about 4 years), anxiety (for about 15 years), pacemaker (inserted 2 years ago) and sinus problems (for 5-6 years). Patient had chronic headache dizziness. Patient had no family medical history relevant to adverse event. Concomitant medications included metformin hydrochloride for diabetes; amlodipine for high blood pressure (been on medication for years); losartan for high blood pressure (been on medication for years); hydrochlorothiazide, as water pill for an unspecified indication (been on medication for years); lorazepam (been on and off this medication for 15 years); vitamin D. Patient received no other vaccinations within four weeks prior vaccinations (within 4 weeks). On 11Jun2021, patient had taken the dose. On an unspecified date Jun2021, patient stated that it seems like she had been a little dizzy and had headaches all week and stated that since receiving the vaccine, her headaches and dizziness had gotten worse. Patient stated she had a sinus problem, so she was not concerned. Patient normally takes one paracetamol (Tylenol), and it will go away. Patient noticed it more this morning (17Jun2021) when she took her walk and stated that she gets like that sometimes because she takes other medications; this time though it feels like it was lingering longer. Patient stated she had been getting them every day. On 17Jun20201, around 05:30 she took a lorazepam, and it went away, and she went back to sleep until around 12:30 when it started again. When it started again, she took a paracetamol (Tylenol). Patient was concerned about headache today (17Jun2021). No relevant tests were performed. Patient had no emergency room and physician office. Patient stated that she had had this problem with headaches and dizziness before the vaccine and now that she was looking at the side effects, she thought it might be something she needed to report. Patient asked if this was something to be concerned about and should she go to the doctor or emergency room for her symptoms. Patient was notified to consult with healthcare professional or seek emergent medical attention if needed. Patient has an appointment on 21Jun2021 (Monday) with her neurologist. The outcome of both the events was unknown. Follow-up (17Jun2021): This is a follow-up spontaneous report from a contactable consumer (patient).


VAERS ID: 1427233 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-05
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Gait disturbance, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021727030

Write-up: Numbness on the left side of her body; Its hard for her to walk; I don''t have balance; This is a spontaneous report received from Pfizer sponsored program. A contactable female consumer (patient) reported for herself. A female patient of an unspecified age received bnt162b2 (BNT162B2, Batch/Lot number was not reported), via an unspecified route of administration on 05Jun2021 as 1st dose, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On Jun2021, the patient experienced numbness on the left side of her body, its hard for her to walk and don''t have balance. Response received as Offered to give caller a website address to access the Fact Sheet for Recipients however she never stated if she wanted it or not. Stated the PI for the vaccine does not contain any information about numbness going down the side of the body as a side effect. Outcome for the case was unknown. Information on the lot/ batch number has been requested.


VAERS ID: 1427237 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-16
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021727144

Write-up: headache; This is a spontaneous report from a contactable consumer (patient) from a Pfizer sponsored program. A male patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number was not reported), dose 2 via an unspecified route of administration on 16Jun2021 as 2nd dose, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced headache on Jun2021. Patient mentioned that not a huge reaction; just looking for something to take the edge off. The outcome of the event was unknown. Information regarding the Lot/Batch number has been requested.


VAERS ID: 1427253 (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: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 INC2021728121

Write-up: Itching; Rash; This is a spontaneous report from a contactable consumer (reporter''s daughter). A 12-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number: Unknown), via an unspecified route of administration on an unspecified date in Jun2021 as a 1st single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. It was reported that patient went for Pfizer vaccine, last, two weeks back and she got the first dose of Pfizer and after 3 or 4 days, she was getting itching and rash on an unspecified date in Jun2021. So, still it was coming out going away even though the vaccine took like a three weeks back. Patient second dose was next Tuesday which was like 22Jun2021, reporter questioned that as still patient was getting rashes, reporter wants to know that if patient could get second dose or hold it on. Reporter seriousness for itching and rash was unspecified. The outcome of all events was not recovered. Information about batch/lot number has been requested.


VAERS ID: 1427265 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-16
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021732483

Write-up: headache; This is a spontaneous report from a Pfizer sponsored program. A contactable consumer (father) reported that a female patient (daughter) of an unspecified age received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number, Expiry date: Unknown), dose 1 via an unspecified route of administration on 16Jun2021 as 1st dose, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Historical vaccine includes first dose of bnt162b2 for covid-19 immunisation. It was reported that the patient is currently experiencing headache, and asked what over-the counter medication can he give for this? Outcome of the event was unknown. Follow up attempts completed. No further information expected.


VAERS ID: 1427266 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-16
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021732808

Write-up: a little fever; This is a spontaneous report from a contactable consumer (patient). This is the first case out of 2 cases. A male patient of an unspecified age received BNT162B2 (Pfizer Covid 19 vaccine, Solution for injection, number: Unknown, Expiry date: Unknown) via an unspecified route of administration on 16Jun2021 as single dose for Covid-19 immunization. The patient''s medical history and concomitant medications were not reported. On an unspecified date in Jun2021, the patient experienced fever. Consumer stated, "both had vaccine yesterday, he was feeling okay, a little fever but was good. He wanted to know whether should wait and drink some water or should go to emergency room and was that normal". Limited information was available over the call. Reporter seriousness was unspecified. Outcome of the event was recovered on an unspecified date in Jun2021. Information about batch/lot number has been requested.


VAERS ID: 1427268 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021732958

Write-up: Severe pain in her leg and now she has swelling in that leg; Severe pain in her leg and now she has swelling in that leg; This is a spontaneous report from a contactable consumer. A female patient (reporter''s mother-in-law) of an unspecified age received BNT162B2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number, Expiration date, NDC and UPC number was unknown), via an unspecified route of administration on an unspecified date (Sunday) as UNKNOWN, SINGLE for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On 16Jun2021, patient had a severe pain in her leg and in Jun2021, now patient had swelling in that leg. The outcome of both the events was unknown.


VAERS ID: 1427272 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-16
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, 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: FLONASE ALLERGY RELIEF; HYDROCHLOROTHIAZIDE; LOSARTAN; CARVEDILOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Latex allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021733455

Write-up: I have numbness in my leg; I started feeling the numbness even more; I have been tired; This is a spontaneous report from a contactable consumer(patient). A 49-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: EW0217; NDC number, UPC number and expiry date were reported as unknown) via intramuscularly on 16Jun2021 at 18:45 in left arm as a single dose for Covid-19 immunization. Medical history included latex allergy from an unknown date and unknown if ongoing. Concomitant medications included fluticasone propionate (FLONASE ALLERGY RELIEF); hydrochlorothiazide (HYDROCHLOROTHIAZIDE); losartan (LOSARTAN) and carvedilol (CARVEDILOL) all taken for an unspecified indication, start and stop date were not reported. The patient historical vaccine included first dose of BNT162B2 (COVID Pfizer vaccine, Formulation: Solution for injection lot number: EW0187) via intramuscularly on 26May2021 at 13:00 in left arm for COVID-19 immunization. The patient did not receive any prior vaccination within 4 weeks. After the second dose the patient she started feeling numbness (today) 17Jun2021 (at 04:00) at work and even more and started feeling the numbness even more its just kind of in her way. The patient was tired after she received the vaccine. She wanted to know where she can report the side effects as she had read about the symptoms of the vaccine which she didn''t came across. The patient reported her brother received both the doses of vaccine and he was fine. He did not experience anything. Investigation assessment was not reported. The outcome of the events was unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1427275 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-08
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pain, Vaccination site erythema, Vaccination site mass, 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: CONCERTA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: ADHD (Verbatim: ADHD)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021733977

Write-up: She got a knot where she got her injection and it was red and burning; it has got a hard knot and it is painful; She got a knot where she got her injection and it was red and burning; it has got a hard knot and it is painful; She got a knot where she got her injection and it was red and burning; it has got a hard knot and it is painful; She got a knot where she got her injection and it was red and burning; it has got a hard knot and it is painful/ got a knot her knot there; This is a spontaneous report received from a contactable consumer (Parent) or other non-non health care professional A 16-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number and Expiration date was not reported), via an unspecified route of administration on 08Jun2021 as 2nd dose, single for covid-19 immunisation. Medical history included attention deficit hyperactivity disorder (ADHD. Concomitant medications included methylphenidate hydrochloride (CONCERTA) taken for attention deficit hyperactivity disorder (ADHD), start and stop date were not reported. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported) via a unspecified route of administration (at the age of 16-yesr-old) on 18May2020 as first dose single for COVID-19 immunisation and experienced no reaction on previous exposure to vaccine. it was reported that patient got second dose of vaccine last week on Tuesday, On Jun2021 she got a knot where she got her injection, it was red and burning yesterday on 16Jun2021 and now it has got a hard knot and it is painful on 17Jun2021. reporter wanted to site where the vaccine was injected it has got a knot like a hard knot there and it was burning and red. No treatment was received for the events. The outcome of the events was reported as unknown. Information on the lot/batch number has been requested.


VAERS ID: 1427288 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-10
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lethargy, Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021737319

Write-up: vomited; She developed a fever that night through morning of 12Jun2021; She was lethargic; slept for 2 days; This is a spontaneous report received from a contactable consumer. A 14-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation; solution for injection, Lot number: unknown), via an unspecified route of administration on 10Jun2021 at 12:00 (at the age of 14-years old) as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previously received first dose of bnt162b2 (lot number: unknown) via an unspecified route of administration on an unspecified date (at the age of 14-years) as single dose for covid-19 immunisation and had no reaction on previous exposure to vaccine. On 10Jun2021 at 12:00, the patient received second shot and developed a fever that night through morning of 12Jun2021. On an unspecified date in Jun2021, the patient was lethargic and slept for 2 days. On 11Jun2021, the patient vomited. Event took place after use of product. The outcome of the events was unknown. Information about lot/batch number has been requested.


VAERS ID: 1427298 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-02
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain upper, Asthenia, Back pain, Muscle spasms, Pain, Pain in extremity, Sleep disorder
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IMITREX; KLONOPIN; CALCIUM + D3 [CALCIUM;COLECALCIFEROL]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety (Verbatim: Anxiety); Migraine
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021739320

Write-up: Lower down bad ache; Muscle cramp one on my leg; Weakness; Arm ache not at the shot but right the down lower/both of my arm aches real bad; Muscle cramp one on my leg and one on my stomach; I do have a ''dental sleep'' issue; This is a spontaneous report from a contactable consumer. This 67-year-old female consumer (patient) A 67-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: unknown, Expiration date: unknown), via unspecified route, administered in left arm on 02Jun2021 1:30 pm (at the age of 67-year-old) as 1st dose, single for COVID-19 immunization. The patient medical history includes migraine and anxiety. Patient family history reported as nothing or weakness. Concomitant medications include sumatriptan succinate (IMITREX) for migraine headache, clonazepam (KLONOPIN) for anxiety, calcium, colecalciferol (CALCIUM + D3) for normal things. Patient historical vaccine includes flu short for influenza immunization on an unspecified date, shingles shot and pneumonia shot for immunization on unspecified dates. Patient did not received other vaccine 4 weeks prior to Covid-19 vaccination. On an unspecified date in Jun2021 after the vaccination, the patient experienced lower down bad ache, muscle cramp one leg and stomach, weakness for two and half weeks, arm ache not at the shot but right the down lower and dental sleep. It was stated patient did not do any exercise but lower down her ache was very bad and 3 days later she had a muscle cramp one on my leg and one on her stomach, she had weakness and she was going on two and a half weeks now, there was a muscles cramp in her stomach area and in her leg and I had arm ache not at the shot but right the down lower at her arms and she had general weakness right now and she had this for two and a half weeks getting ready for my second shot on 26Jun2021." She had a ''dental sleep'' issue. Treatment options patient took include aspirin or NSAID just diclofenac sodium topical get lidocaine (2%) and "bupivacaine" (further not clarified) (1%), the lotion I had for muscle pain. Consumer stated, she had weakness, lying on bed and trying to get best immune system that would really help better, she doesn''t have any shortness of breath, just curious if someone experienced weakness or any felt like in the arm. The events assessed as non-serious. The outcome of the events pain, muscle spasm, abdominal pain and sleep disorder was unknown. The outcome of event asthenia was not recovered, pain in extremity was recovered on Jun2021 and unknown for all other events. No follow-up attempts possible. No further information expected.


VAERS ID: 1427302 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Mononucleosis (He heard that mono virus remains in a body dormant. not had fatigue like this since 1996.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021740353

Write-up: Fatigue; He feels drowsy whenever he wakes up; This is a spontaneous report from a contactable consumer (patient). A 52-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EW0187, Expiration date: Unknown), via an unspecified route, administered in Left Arm on 01Jun2021 at 11:00 (52-year-old of age at vaccination) as a 2nd dose, single for COVID-19 immunization. The patient''s medical history included mononucleosis from 1996 (he had heard that mono virus remains in a body dormant). He was not fatigue like this since 1996.The patient''s family history was reported as none. The patient''s concomitant medication was reported as none. The patient was not related to a study or program. Vaccination facility was reported as pharmacy. The patient was not administered with any additional vaccine on same date of the Covid-19 vaccine. The patient was not administered with any other vaccine within 4 weeks prior to Covid-19 vaccine. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EW0168, Expiration date: Unknown), via an unspecified route, administered in Left Arm on 11May2021 at 11:30 (52-year-old of age at vaccination) as a 1st dose, single for COVID-19 immunization. On unknown date in Jun2021, the patient experienced fatigue. He stated that, he still had fatigue. He was not depressed and was eating well. He had a fair amount of daily activity. Two times a day (time not specified by reporter) was whenever it suddenly comes over him, and he takes a nap. He felt drowsy whenever he wakes up, like he was coming off a sleeping pill: Began two or three days after the second dose of the Covid-19 vaccine. It was about the same, but not as strong as two weeks ago. Two hours ago, he fell asleep and took a nap. He took vaccine as he thought it was smart thing to do on a society level. The patient had neither visited physician office nor emergency room. The patient had neither undergone any relevant test and procedure not any investigation assessment. The outcome of the events was not recovered. Information on Lot/Batch number was available. Additional information had been requested.


VAERS ID: 1427420 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA C23C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Antibody test, Dysmenorrhoea, Fatigue, Hypomenorrhoea, 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: I was taking Limital, Zoloft, and Wellbutrin.
Current Illness: None
Preexisting Conditions: I have an auto immune disease and mental health.
Allergies: I''m allergic to Keflex and Gabapentin.
Diagnostic Lab Data: I''ve taken an antibody test 3 times in between vaccination.
CDC Split Type: vsafe

Write-up: My period was 2 weeks late which is uncommon and when it did start the worse cramps, the period was lighter than normal, and I was extra fatigued.


VAERS ID: 1427434 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-26
Onset:2021-06-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Febrile neutropenia, Full blood count, Pneumonia, X-ray
SMQs:, Agranulocytosis (narrow), Haematopoietic leukopenia (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: High Blood Pressure
Allergies: none
Diagnostic Lab Data: CT, CBC, X-ray
CDC Split Type:

Write-up: Neutropenic fever and pneumonia


VAERS ID: 1427653 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-27
Onset:2021-06-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BUSPIRONE , OLMESARTAN,BUPROPION
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: DOCTOR APPT JULY 21, 2021
CDC Split Type:

Write-up: A RASH AFTER MY SECOND SHOT - MOSTLY IN LEG ARE - SPREA D TO OTHERS IF TOUCHED - I HAVE NEVER HAD ANY SKIN ISSUES IN MY LIFE UNTIL I TOOK THIS SHOT - THEY ARE SMALL , VERY ITCHY , BUMPS. IF SCRATED LEAD TO ALMOST A WELT . THIS HAS BEEN ONGOING 3 WEEKS NOW , IT IS MISERABLE AND i CANNOT WEAR SHORTS - IT IS ALMOST LIKE CHICKEN POX AND IT IS ALSO VERY UNCOMFORTABLE


VAERS ID: 1427708 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 1 RA / IM

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

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

Write-up: None


VAERS ID: 1427717 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-14
Onset:2021-06-01
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site hypoaesthesia, X-ray
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: XRAYS
CDC Split Type: vsafe

Write-up: Started feeling numbness in left arm from injection site to fingers.


VAERS ID: 1427882 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A 6/1/21 / 3 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA RECEIVED 5/3/2 / 2 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA RECEIVED 3/31 / 1 - / -

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

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

Write-up: Received 3 Moderna Vaccines. 1st received on 3/31/21. Then she received her second and third vaccine on 5/3/21 and 6/1/21. I spoke to find out if this was an error or if she did receive 3 vaccines. She expressed she did receive 3 doses. She stated she did not return on the proper date after getting her first vaccine so she thought she had to start the series again. She denied telling that she received her first dose. I asked her If I could have a nurse call her back to fill out the VEARS with her and she agreed. Multiple attempts were made to contact this patient to get additional information to fill out forms. She has not called back after several voice messages were left. I am completing this form with only the information from my initial contact with her.


VAERS ID: 1427903 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-05-22
Onset:2021-06-01
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no known medications
Current Illness: No known illnesses
Preexisting Conditions: No known medical history
Allergies: No known medication or food allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt received a first dose of Moderna vaccine on 05/22/21 at 1:00pm while being in an unauthorized age group per the CDC. The pt was scheduled on 06/25/21 to receive their 2nd dose of Moderna vaccine at 2:30pm. The clinic manager called the parent to notify them of the situation. The pt visit was cancelled until further information was given from the CDC. The CDC was called at 1430 on 06/25/21 by clinic manager. According to the CDC, ?If the patient is age 12 to 17 years and Moderna vaccine was inadvertently administered as the first dose instead of Pfizer-BioNTech vaccine, administer Moderna vaccine as the second dose (as off-label use, because Moderna vaccine is not authorized in this age group). Report this to VAERS as a vaccine administration error.? This information was relayed to the parent, and sent via email with the CDC information. The parent stated they would let us know if they decide to get the 2nd dose of the Moderna vaccine. Patient currently does not have any known adverse events or outcomes.


VAERS ID: 1428074 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-07
Onset:2021-06-01
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Balance disorder, Blood test, Dizziness, Gait disturbance, Magnetic resonance imaging, Musculoskeletal chest pain, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: On the first day after taking the shot: couldn''t walk well; very dizzy; loss of balance; blurry vision; couldn''t focus; difficulty riding my bike. I went to the doctor and I was recommended to see a neurologist. I gradually got better over time. I still have soreness in my ribs and I can walk somewhat normally. I feel like I have 90% recovered.


VAERS ID: 1428891 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-04
Onset:2021-06-01
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (broad)

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

Write-up: My 2nd vaccine dose reaction in the first week included strong joint pain (every single joint in both hands and wrists, along with knees, hips, and other joints), which was completely new to me. That had seemed to resolve, however now 7.5 weeks after that 2nd dose, I''ve realized that I''ve had most of the day and night joint pain in one, the other, or both my hips for at least 2 weeks now (so from weeks ~5-7.5 after my 2nd vaccine dose), and this has not yet resolved.


VAERS ID: 1429276 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Injection site pain, Injection site swelling, Insomnia, Musculoskeletal pain, Pain, Pain assessment
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin C; calcium citrate; tegretol; vitamin D3; cymbalta; iron; lamictal; synthroid; lithium; melatonin; nortriptyline; sinergin; acarbose; cholestyramine; vitamin b12; Breo inhaler prn; creon pancreatic lipase; tylenol; MULTIVITAMINS [V
Current Illness: Abstains from alcohol; Bipolar affective disorder, manic; Fibromyalgia; Hand pain (Went to pain management program); Hypothyroidism; Non-smoker; Reactive hypoglycemia
Preexisting Conditions: Comments: The patient had known allergies antidepressant drug had agitation allergy and narcotics drug had itching allergy. The patient did not have any drug abuse/illicit drug use. The patient is taking eye drops for unknown indication.
Allergies:
Diagnostic Lab Data: Test Date: 20210610; Test Name: Pain scale; Result Unstructured Data: 7-8/10
CDC Split Type: USJNJFOC20210632769

Write-up: EXTREME FATIGUE; EXTREME MUSCLE PAIN; JOINT PAIN; PAIN IN SHOULDER; SWELLING IS WORSE IN RIGHT ARM; PAIN ALL OVER BODY MORE IN HANDS AND ELBOWS; NOT BEEN ABLE TO SLEEP; PAIN IS WORSE IN RIGHT ARM; This spontaneous report received from a patient concerned a 64 year old female. The patient''s weight was 220 pounds, and height was 62 inches. The patient''s concurrent conditions included fibromyalgia, bipolar polar i, hypothyroidism, reactive hypoglycemia, abstains from alcohol, non smoker, and preexisting hand pain, and other pre-existing medical conditions included the patient had known allergies antidepressant drug had agitation allergy and narcotics drug had itching allergy. the patient did not have any drug abuse/illicit drug use. the patient is taking eye drops for unknown indication. The patient was previously treated with risperidone for bipolar disorder; and experienced vomiting when treated with dexamethasone for drug used for unknown indication, and drug allergy when treated with erythromycin for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 26-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included acarbose non-company for drug used for unknown indication, calcium citrate for drug used for unknown indication, colecalciferol for drug used for unknown indication, colestyramine for drug used for unknown indication, duloxetine hydrochloride for drug used for unknown indication, fluticasone furoate/vilanterol trifenatate for drug used for unknown indication, iron for drug used for unknown indication, lamotrigine for drug used for unknown indication, levothyroxine sodium for drug used for unknown indication, lithium non-company for drug used for unknown indication, melatonin for drug used for unknown indication, nortriptyline for drug used for unknown indication, pancreatin for drug used for unknown indication, phenytoin for drug used for unknown indication, tegretol non-company for drug used for unknown indication, vitamin b12 nos for drug used for unknown indication, vitamin c for drug used for unknown indication, oxycodone/paracetamol for pain, and vitamins nos. On JUN-2021, the subject experienced pain all over body more in hands and elbows. On JUN-2021, the subject experienced not been able to sleep. On JUN-2021, the subject experienced pain in shoulder. On JUN-2021, the subject experienced swelling is worse in right arm. On JUN-2021, the subject experienced pain is worse in right arm. On 10-JUN-2021, the subject experienced joint pain. On 10-JUN-2021, the subject experienced extreme muscle pain. Laboratory data included: Pain scale (NR: not provided) 7-8/10. On an unspecified date, the subject experienced extreme fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from extreme fatigue, had not recovered from extreme muscle pain, swelling is worse in right arm, pain is worse in right arm, pain all over body more in hands and elbows, and joint pain, and the outcome of pain in shoulder and not been able to sleep was not reported. This report was non-serious.


VAERS ID: 1429295 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Eye pain, Headache, Pain in extremity, Pyrexia, Sinus pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Glaucoma (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: USJNJFOC20210646609

Write-up: BACK PAIN; FEVER; LITTLE HEADACHE; EYES HURTING; SINUS PAIN FOREHEAD AND EYES; LITTLE PAIN IN HER RIGHT LEG; This spontaneous report received from a consumer 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, route of admin not reported, batch number: Unk) dose was not reported, administered on 16-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On JUN-2021, the subject experienced sinus pain forehead and eyes. On JUN-2021, the subject experienced little pain in her right leg. Treatment medications included: ibuprofen, and paracetamol. On 17-JUN-2021, the subject experienced eyes hurting. On 17-JUN-2021, the subject experienced fever. On 17-JUN-2021, the subject experienced little headache. On 18-JUN-2021, the subject experienced back pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sinus pain forehead and eyes, and little pain in her right leg, and the outcome of fever, eyes hurting, little headache and back pain was not reported. This report was non-serious.


VAERS ID: 1429302 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Eye movement disorder, Feeling cold, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210648451

Write-up: slight blurriness in the center of vision; NEED TO BLINK MORE OFTEN; TEETH CLATTERING; CHILLS; HEADACHE/LOW GRADE HEADACHE IN FOREHEAD, TOP OF HEAD AND EACH TEMPLE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and expiry: UNKNOWN) dose was not reported, administered on 04-JUN-2021 15:39 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced slight blurriness in the center of vision. On JUN-2021, the subject experienced need to blink more often. On JUN-2021, the subject experienced teeth clattering. On JUN-2021, the subject experienced chills. On JUN-2021, the subject experienced headache/low grade headache in forehead, top of head and each temple. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from teeth clattering, and chills on JUN-2021, and had not recovered from headache/low grade headache in forehead, top of head and each temple, slight blurriness in the center of vision, and need to blink more often. This report was non-serious.


VAERS ID: 1429308 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Body temperature decreased, Chills, Condition aggravated, Feeling abnormal, Headache, Lethargy, Pain
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210615; Test Name: Body temperature; Result Unstructured Data: 95.5 F
CDC Split Type: USJNJFOC20210651147

Write-up: BODY ACHES; BODY TEMPERATURE 95.5 F; LETHARGY; NOT FEELING LIKE HIMSELF; CHILLS; HEADACHE; FEELING WORSE; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286, expiry: 23-JUL-2021) dose was not reported, administered on 14-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced feeling worse. On 15-JUN-2021, the subject experienced body aches. On 15-JUN-2021, the subject experienced body temperature 95.5 f. On 15-JUN-2021, the subject experienced lethargy. On 15-JUN-2021, the subject experienced not feeling like himself. On 15-JUN-2021, the subject experienced chills. On 15-JUN-2021, the subject experienced headache. Laboratory data included: Body temperature (NR: not provided) 95.5 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body temperature 95.5 f on 17-JUN-2021, and had not recovered from headache, body aches, chills, lethargy, not feeling like himself, and feeling worse. This report was non-serious. This case, from the same reporter is linked to 20210651363.


VAERS ID: 1429371 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-06-01
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202106; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021686131

Write-up: she receive both of the doses of the Pfizer back in April and returned home in the beginning of June and developed symptoms when at home and infected her family member; she receive both of the doses of the Pfizer back in April and returned home in the beginning of June and developed symptoms when at home and infected her family member; This is a spontaneous report from a contactable consumer. A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via an unspecified route of administration on Apr2021 (Batch/Lot number was not reported) as dose 2, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On Jun2021, the patient experienced she receive both of the doses of the Pfizer back in April and returned home in the beginning of June and developed symptoms when at home and infected her family member. It was reported that there was a Pfizer vaccination infection breakthrough in a patient who was hospitalized and also infected her family member while she was doing the required mandatory quarantine at home upon arrival. It was stated that "this is the Public announcement, she receive both of the doses of the Pfizer back in April and returned in the beginning of June and developed symptoms when at home and infected her family member, so they were not exactly in the announcement". Reported asked on where to link the announcement to Pfizer to look at or where the reporter could relate the information to and further stated that in the announcement it didn''t say Diarrhea to what kind of Diarrhea or whatsoever it didn''t really go into detail, except telling the public that it has to do with the Pfizer vaccination. The patient underwent lab tests and procedures which included COVID-19 test: positive on Jun2021. The outcome of the events was unknown. Information on Lot/Batch number has been requested.


VAERS ID: 1429378 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthma, Dyspnoea, Fibrin D dimer, Fibrin D dimer increased
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Haemorrhage laboratory terms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy; Asthma (She has had this condition her whole life)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202106; Test Name: D-dimer; Result Unstructured Data: Test Result:Elevated
CDC Split Type: USPFIZER INC2021688499

Write-up: Bad Shortness of Breath; Severe asthma exacerbation; Elevated D-Dimer; This is a spontaneous report from a contactable consumer (patient). A 26-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot Number: EW0185) at the age of 26 years old, as DOSE 2, SINGLE for COVID-19 immunisation. Medical history included ongoing asthma (she has had this condition her whole life) and ongoing allergy to polysorbate. There were no concomitant medications. Historical vaccination included bnt162b2 for COVID-19 immunization received on unspecified date (Dose number: 1 and Lot Number: EW0183). The patient wanted to make sure that Pfizer is aware about her reaction that she was in the hospital for. The patient had severe asthma. After her second dose of the vaccine she developed bad shortness of breath. She used her regular asthma treatments. She ended up in the hospital for severe asthma exacerbation due to the inflammatory response of the vaccine. Stated that maybe Pfizer needs to look into more studies with asthmatics. The patient stated that her symptoms started the same day as her second dose of the vaccine. She was admitted to the hospital this past Tuesday, 08Jun2021 and was discharged last night (09Jun2021). She stated that she was pretty sure that it is the vaccine that caused these events. She states she had an elevated D-Dimer on Jun2021; she believes this was related to the vaccine also. The event bad shortness of breath required emergency room visit. The patient was hospitalized due to bad shortness of breath and severe asthma exacerbation from 08Jun2021 to 09Jun2021. Outcome of the events was unknown. No other vaccines received 4 weeks prior to first COVID vaccination. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1429610 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-20
Onset:2021-06-01
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Differential white blood cell count, Electrocardiogram, Full blood count, Metabolic function test, Palpitations, Troponin I, Ventricular extrasystoles
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Larissa Oral contraceptive Levothyroxine 25 mg NP Thyroid 32 mg Spironolactone 50 mg
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies: Sulfa
Diagnostic Lab Data: Basic lab panel CBC and differential POCT Troponin I performed 2 times Troponin I, POC ECG 12 Lead
CDC Split Type:

Write-up: I started experiencing heart palpitations that lasted for days at a time at the end of May 2021/beginning of June 2021. After several weeks where the palpitations continued, I sought treatment where they diagnosed this and saw that my heart is prematurely beating and then pausing to reset itself. On 6/24/2021 I went to the ER on advice from my doctor. From what they say, there is not really a treatment for these symptoms and I will just have to wait and see if they go away. At this reporting time, they are still ongoing. I''m to follow up with my family medicine doctor.


VAERS ID: 1429789 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-06-06
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Loss of personal independence in daily activities
SMQs:, Dementia (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: Phentermine 30mg daily
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: Percocet/morphine Pork Tree nuts/peanuts
Diagnostic Lab Data: Patient to see doctor on Tuesday 6/29
CDC Split Type:

Write-up: Patient complains of frequent headaches since getting the vaccine almost 3 weeks ago. Headaches interfere with activities of daily life.


VAERS ID: 1429813 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-17
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site discolouration, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (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: Armor Thyroid, Lasix, Lipitor, Adderall XR, Bayer Low Dose, Trelegy, Ipratropium Bromide and Albuterol Sulfate, Pro Air, Green tea, ginger, Basil, Honey
Current Illness: N/A
Preexisting Conditions: Stage 4 COPD, Thyroid, high blood pressure
Allergies: Wheat, Soy, Bactrum, Avolox, Flexerell, Keflex, Ibuprophine, Penicciline
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: injection site turned black and is hardened


VAERS ID: 1429857 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-01
Onset:2021-06-01
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Deep vein thrombosis, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin
Current Illness:
Preexisting Conditions: Paroxysmal Afib
Allergies: NKDA
Diagnostic Lab Data: CT Pulmonary Embolism scan
CDC Split Type:

Write-up: DVT/Pulmonary Embolism


VAERS ID: 1429959 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-29
Onset:2021-06-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Electrocardiogram, Fibrin D dimer, Full blood count, Metabolic function test, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: June 4, 2021 Emergency Room, : Lab Tests: CBC auto differential; basic metabolic panel; D-dimer, quantitative Toponin; Xray Chest; EKG Blood Pressure: 136/84; Pulse 76; Respiration 16; Oxygen Saturation 99%; Temperature 98.4 Diagnosis: Chest Pain, unspecified type Since June 4, 2021 has been taking 325mg aspirin three times per day.
CDC Split Type:

Write-up: Chest pains since day 4 of receiving second dose of Moderna COVID-19 vaccine. On June 4, 2021 went to Health Clinic for physical; conducted EKG and was slightly abnormal. Within twenty minutes of leaving the Clinic, RN from Clinic called and advised the cardiologist reviewed the EKG and recommended going to emergency room for a blood draw and heart enzyme test.


VAERS ID: 1430132 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-24
Onset:2021-06-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: The next period following my second vaccine was unusually heavy. Within hours of starting, I had extremely heaving bleeding for 2 days.


VAERS ID: 1430293 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-31
Onset:2021-06-01
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH GR8732 / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins, fish oil, aspirin, vitamin d, zinc
Current Illness: None
Preexisting Conditions: MILD COPD, SEASONAL, ALLERGIES-THAT IS WHAT I BELIEVE I HAD,USUALLY GET UPPER RESPIRATORY ISSUES ONCE A YEAR, COUGH WAS MUCH WORSE THIS TIME BUT SUDAFED DAILY EVENTUALLY CLEARED ME UP
Allergies: No e
Diagnostic Lab Data: Zero
CDC Split Type:

Write-up: Sore arm for 1 day


VAERS ID: 1430309 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: Dose given two days after expiration date


VAERS ID: 1430316 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given past expiration


VAERS ID: 1430322 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given past expiration


VAERS ID: 1430326 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given past expiration


VAERS ID: 1430328 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given past expiration


VAERS ID: 1430332 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given per expiration


VAERS ID: 1430338 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given past exipration


VAERS ID: 1430340 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given past expiration


VAERS ID: 1430345 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given past expiration


VAERS ID: 1430353 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-21
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given past expiration


VAERS ID: 1430355 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-21
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given past expiration


VAERS ID: 1430359 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given past expiration


VAERS ID: 1430370 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-21
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

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

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

Write-up: vaccine given after expiration


VAERS ID: 1430371 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-21
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

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

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

Write-up: vaccine given after expiration


VAERS ID: 1430478 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-12
Onset:2021-06-01
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Heavy menstrual bleeding, Menstrual disorder, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility 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: Multivitamin, Levothyrozine, Synjardy, Vitamin C and Iron
Current Illness: None
Preexisting Conditions: Type 2 Diabetes and Hashimoto''s Thyroiditis
Allergies: Cephalosporins, Mushrooms and Dust mites
Diagnostic Lab Data: Hormones and thyroid levels were tested on June 22 and results came back normal.
CDC Split Type:

Write-up: Two months after completing the second Moderna vaccine, my menstrual cycle has changed. In May, my cycle was extremely lighter than normal. In June, I experienced passing of 1 large blood clot daily with no menstrual flow from June 1 to June 16. From June 17 to June 24, I''ve experienced a heavier than normal flow with the passing of multiple large clots throughout the day. From June 25 to current, I have no more clots but still have a menstrual flow. The gynecologist commented that it could be a side effect of the vaccine or my fibroids. I have had my fibroids for over 15 years and my fibroid symptoms took place while in my twenties. No treatment was suggested. Simply wait and see.


VAERS ID: 1430535 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

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

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

Write-up: 12-hour migraine, weakness and dizziness


VAERS ID: 1430621 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: About two days after the vaccine, started to feel shortness of breath, heart palpitations and elevated pulse.


VAERS ID: 1430988 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-06-01
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Laboratory test, Mobility decreased, Musculoskeletal stiffness, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Zyrtec, Effexor, multi-vitamins, probiotics
Current Illness: None
Preexisting Conditions: Spasmodic Dysphonia, IBS
Allergies: Gabapentin, Phenergan, Ultram
Diagnostic Lab Data: mobility test by Dr. on June 28th, 2021.
CDC Split Type:

Write-up: The swelling in the upper left arm eventually came down (after 2 weeks), but resulted in a symptom similar to frozen shoulder (from the back of the shoulder down to the elbow.) Cannot raise the left arm and has not healed after 5+ weeks post vaccination.


VAERS ID: 1431022 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Oropharyngeal pain, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: not known
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: tested with RT-PCR on 6/18 and test came back positive for covid-19
CDC Split Type:

Write-up: Developed sore throat and cough. became positive for Covid - 19 after Johnson and Johnson Vaccine was received-


VAERS ID: 1431073 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear discomfort, Eructation, Hyperacusis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow)

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

Write-up: My hearing in my right ear is not as good asbefore. Burping clears it then shortly after the same. Kinda like when your on a plane then your eardrum eventually clears


VAERS ID: 1431164 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

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

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

Write-up: Vaccine given past expiration


VAERS ID: 1431171 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-06-28
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

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

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

Write-up: Vaccine given past expiration


VAERS ID: 1431207 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

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

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

Write-up: Vaccine given past expiration


VAERS ID: 1431221 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

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

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

Write-up: Vaccine given past expiration


VAERS ID: 1431228 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-06
Onset:2021-06-01
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW/W0173 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Blood test, Fibrin D dimer increased, Mobility decreased, Pain in extremity, Thrombosis, Ultrasound Doppler, Vaccination site pain
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Thrombophlebitis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin Lexapro Sulfasalazine Birth Control
Current Illness: none
Preexisting Conditions: Celiac Disease Psoriatic Arthrits
Allergies: none
Diagnostic Lab Data: D-dimer blood test Doppler scan of my left arm
CDC Split Type:

Write-up: The pain in my arm post vaccination on 5.6.21 never fully went away. It got better for a couple weeks but still noticed it. Around the beginning of June, the pain in my arm, at the vaccination site, started to intensify. I kept an eye on it for a couple weeks, thinking it''d get better but it didn''t, it just got worse. On Tuesday, June 15th the pain really intensified. To the point that by Thursday, June 17th I was unable to move my arm. Because the pain was so bad I went to Urgent Care where they thought I was having muscle spasms. I knew something wasn''t right so I contacted my doctor that afternoon who then sent me for blood work. He ran a D-dimer test which came back elevated on Friday June 18th. From there I went to the ER so they could run a doppler scan on my left arm. The pain was so bad they were only able to do half the test but quickly saw that I have a blood clot in one of the veins. The ER doctor put me on Eliquis and now here I am.


VAERS ID: 1431247 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

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

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

Write-up: Vaccine given past expiration


VAERS ID: 1431282 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-21
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

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

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

Write-up: Vaccine given past expiration


VAERS ID: 1431305 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-21
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

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

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

Write-up: Vaccine given past expiration


VAERS ID: 1431310 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-21
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

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

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

Write-up: Vaccine given past expiration


VAERS ID: 1431450 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO172 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Urine analysis
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Strong stomach pains and aches


VAERS ID: 1431593 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Inflammation, Product administered at inappropriate site
SMQs:, Drug abuse and dependence (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210648739

Write-up: JANSSEN COVID 19 VACCINE INJECTED INTO TENDON VERSUS MUSCLE; INFLAMMATORY RESPONSE TO UNKNOWN SIDE OF ARM INJECTED THAT WAS LIKE AN ORANGE ON HER SHOULDER; CHILLS FOR THE FIRST FEW HOURS AFTER INJECTION; This spontaneous report received from a consumer concerned a 63 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 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 janssen covid 19 vaccine injected into tendon versus muscle. On 01-JUN-2021, the subject experienced inflammatory response to unknown side of arm injected that was like an orange on her shoulder. On 01-JUN-2021, the subject experienced chills for the first few hours after injection. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills for the first few hours after injection on 01-JUN-2021, and had not recovered from janssen covid 19 vaccine injected into tendon versus muscle, and inflammatory response to unknown side of arm injected that was like an orange on her shoulder. This report was non-serious.


VAERS ID: 1431765 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-13
Onset:2021-06-01
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Oropharyngeal pain, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prescriptions: Ozempic, Metformin, Rosuvastatin, Fenofibrate, Propranolol. Supplements: Multi-vitamin, Vitamin D
Current Illness: n/a
Preexisting Conditions: High cholesterol
Allergies: Erythromyacin
Diagnostic Lab Data: COVID-19 test
CDC Split Type:

Write-up: Low grade fever, sore throat


VAERS ID: 1432218 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-28
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: 15yo pt was administered a Janssen COVID-19 vaccine dose today, 6/28/2021. It is unknown if pt is experiencing adverse events but I still wanted to report this incident.


VAERS ID: 1432768 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Decreased activity, Diarrhoea, Fatigue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: STELARA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210638463

Write-up: DIARRHEA(GASSY, UPSET STOMACH, RUNNING TO BATHROOM); FEELING WORST, FEELING DOWN MORE THAN UP, NOT TO MOTIVATED TO GO OUTSIDE; NO PHYSICAL ACTIVITY; FEELING FEVERISH; TIRED; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 04-JUN-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. Concomitant medications included ustekinumab for drug used for unknown indication. On JUN-2021, the subject experienced diarrhea (gassy, upset stomach, running to bathroom). On JUN-2021, the subject experienced feeling worst, feeling down more than up, not to motivated to go outside. On JUN-2021, the subject experienced no physical activity. On JUN-2021, the subject experienced feeling feverish. On JUN-2021, the subject experienced tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tired, diarrhea(gassy, upset stomach, running to bathroom), no physical activity, and feeling worst, feeling down more than up, not to motivated to go outside, and the outcome of feeling feverish was not reported. This report was non-serious.


VAERS ID: 1432780 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Fatigue, Headache, Hypersomnia, Injection site pain, Myalgia, Ocular hyperaemia, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (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: Alcohol use (Rarely on special occasion.); Non-smoker
Preexisting Conditions: Comments: Patient had no prior medical history and no known allergies. The patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210648295

Write-up: The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 203A21A expiry: UNKNOWN) dose was not reported, administered on 09-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced tiredness. On JUN-2021, the subject experienced fatigue. On JUN-2021, the subject experienced lack of energy. On 12-JUN-2021, the subject experienced headache. On 12-JUN-2021, the subject experienced soreness in right arm at injection site. On 12-JUN-2021, the subject experienced pain in the muscle in upper arm. On 16-JUN-2021, the subject experienced dark red blood in left eye. On 20-JUN-2021, the subject experienced slight blurred vision in left eye. On 20-JUN-2021, the subject experienced sleeping more than usual. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, dark red blood in left eye, tiredness, slight blurred vision in left eye, fatigue, lack of energy, sleeping more than usual, soreness in right arm at injection site and pain in the muscle in upper arm was not reported. This report was non-serious.


VAERS ID: 1432783 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Electroencephalogram, Feeling abnormal
SMQs:, Dementia (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: Alcoholic (occasionally); Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Comments: No Health Issue
Allergies:
Diagnostic Lab Data: Test Date: 20210621; Test Name: EEG; Result Unstructured Data: UNKNOWN; Test Date: 20210621; Test Name: CT scan; Result Unstructured Data: UNKNOWN; Comments: have another one next week
CDC Split Type: USJNJFOC20210648458

Write-up: BRAIN FOG; This spontaneous report received from a patient concerned a 47 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included got covid-19, and concurrent conditions included alcoholic, and non smoker. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029, expiry: UNKNOWN) dose was not reported, administered on 21-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced brain fog. On 21-JUN-2021, Laboratory data included: Computerized tomography scan (NR: not provided) UNKNOWN, and Electroencephalogram (NR: not provided) UNKNOWN. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of brain fog was not reported. This report was non-serious. This case, from the same reporter is linked to 20210648429.


VAERS ID: 1432814 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Oropharyngeal pain, Productive cough, Pyrexia, Rhinorrhoea, Secretion discharge
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: USJNJFOC20210654329

Write-up: SORE THROAT; RUNNY NOSE; HEADACHE; LOW GRADE FEVER; WET COUGH THAT''S INTERMITTENT AND THE COUGH IS PRODUCTIVE; THICK YELLOWISH GREEN DRAINAGE; This spontaneous report received from a patient via a company representative concerned a 62 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and expiry: UNKNOWN) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced wet cough that''s intermittent and the cough is productive. On JUN-2021, the subject experienced thick yellowish-green drainage. On 12-JUN-2021, the subject experienced sore throat. On 12-JUN-2021, the subject experienced runny nose. On 12-JUN-2021, the subject experienced headache. On 12-JUN-2021, the subject experienced low-grade fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sore throat, runny nose, headache, and low-grade fever. on JUN-2021, and had not recovered from wet cough that''s intermittent and the cough is productive, and thick yellowish-green drainage. This report was non-serious.


VAERS ID: 1432817 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Impaired work ability, Nausea
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210654645

Write-up: FEELING AWFUL; CAN''T WORK; EXTREME HEADACHE; NAUSEA; This spontaneous report received from a patient via a company representative 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 22-JUN-2021 for prophylactic vaccination. The batch number was not reported. Per procedure no follow-up will be requested for this case. No concomitant medications were reported. On JUN-2021, the subject experienced feeling awful. On JUN-2021, the subject experienced can''t work. On JUN-2021, the subject experienced extreme headache. On JUN-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feeling awful, extreme headache, nausea, and can''t work. This report was non-serious. .


VAERS ID: 1432819 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dry mouth, Headache, Limb discomfort, Muscle strain, Musculoskeletal chest pain, Nausea, Pain in extremity, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VERAPAMIL
Current Illness: Cluster headache; Narcolepsy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210655376

Write-up: DISCOMFORT IN UNDERSIDE OF RIB; DISCOMFORT IN LEFT ARM; NAUSEA; HEADACHE; TINGLING DOWN TO FINGERNAILS; PULLED A MUSCLE IN BACK; DIZZINESS, LIGHTHEADEDNESS UPON STANDING; DRY MOUTH; ARM HURTS WHEN STRETCHED; This spontaneous report received from a patient concerned a 65 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included narcolepsy, and cluster headache. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820095, expiry: UNKNOWN) dose was not reported, administered on 21-JUN-2021 for prophylactic vaccination. Concomitant medications included verapamil for cluster headache. On JUN-2021, the subject experienced tingling down to fingernails. On JUN-2021, the subject experienced pulled a muscle in back. On JUN-2021, the subject experienced dizziness, lightheadedness upon standing. On JUN-2021, the subject experienced dry mouth. On JUN-2021, the subject experienced arm hurts when stretched. On 21-JUN-2021, the subject experienced discomfort in underside of rib. On 21-JUN-2021, the subject experienced discomfort in left arm. On 21-JUN-2021, the subject experienced nausea. On 21-JUN-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the discomfort in left arm, dizziness, lightheadedness upon standing, dry mouth, nausea, headache, pulled a muscle in back, arm hurts when stretched, discomfort in underside of rib and tingling down to fingernails was not reported. This report was non-serious.


VAERS ID: 1432836 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Injection site pain, Insomnia, Pain
SMQs:, Extravasation events (injections, infusions and implants) (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: USJNJFOC20210655640

Write-up: BODY ACHES; COULDN''T SLEEP FOR 4 HOURS; CHILLS; INJECTION SITE PAIN; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on JUN-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On JUN-2021, the subject experienced injection site pain. On 24-JUN-2021, the subject experienced body aches. On 24-JUN-2021, the subject experienced couldn''t sleep for 4 hours. On 24-JUN-2021, the subject experienced chills. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from chills, body aches, and couldn''t sleep for 4 hours, and had not recovered from injection site pain. This report was non-serious.


VAERS ID: 1432870 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blindness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal 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: USMODERNATX, INC.MOD20212

Write-up: Vision was blurred all week long; Blind; This spontaneous case was reported by a consumer and describes the occurrence of BLINDNESS (Blind) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In June 2021, the patient experienced BLINDNESS (Blind) (seriousness criterion medically significant). On an unknown date, the patient experienced VISION BLURRED (Vision was blurred all week long). At the time of the report, BLINDNESS (Blind) and VISION BLURRED (Vision was blurred all week long) outcome was unknown. Concomitant medications were not reported . Treatment information was not provided.; Sender''s Comments: Very limited information regarding these events have been provided. Further information has been requested.


VAERS ID: 1432884 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO158 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Orchitis
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ACETAMINOPHEN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Ankle sprain (Ankle sprain (1 year ago)); Skull fracture (Skull Fracture (30 years ago))
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021695247

Write-up: Diagnosis of Orchitis of right testicle; This is a spontaneous report from a contactable consumer (patient). A 32-year-old male patient received the second dose of bnt162b2 (BNT162B2, Solution for injection, Lot Number: EWO158), via an unspecified route of administration, administered in Arm Left, on 01Jun2021 08:15 (received at the age of 32-years-old) as DOSE 2, SINGLE for COVID-19 immunisation. The most recent COVID-19 vaccine was administered at the hospital. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to vaccination, and has not been tested for COVID-19 post vaccination. Medical history included ankle sprain in 2020 (1 year ago) and skull fracture in 1991 (30 years ago). Concomitant medication included acetaminophen (ACETAMINOPHEN) taken for an unspecified indication, start and stop date were not reported. The patient previously received the first dose of bnt162b2 (BNT162B2, Lot Number: EWO158), administered in Arm Left, on an 11May2021 08:15 (received at the age of 32-years-old) for COVID-19 immunisation and had no reaction. The patient previously took ibuprofen and experienced drug allergy. The patient experienced diagnosis of orchitis of right testicle on Jun2021. The adverse event resulted into a doctor or other healthcare professional office/clinic visit, emergency room visit, and hospitalization. Therapeutic measures were taken as a result of the adverse event. Treatment included ROCEPHIN, VIBRAMYCIN, ULTRAM. Outcome of the event was not recovered.


VAERS ID: 1432886 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-10
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Eye pain, Eye swelling, Hypersensitivity, Nausea, Pain, Pruritus, Rash, Swelling face
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021695580

Write-up: woke up with allergy all over the body; rash all over my body; minor pain; pain and swollen eyes; pain and swollen eyes; Swelling all over my face; my neck and my body is very red and Itchy; my neck and my body is very red and Itchy/body very red like sunburn; Nausea; This is a spontaneous report from a contactable consumers (one of them is the patient). A 33-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Batch/Lot Number: EW0168) via an unspecified route of administration into left arm on 10Jun2021 (at the age of 33-year-old) as dose 1, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On Jun2021 patient woke up with allergy all over the body, rash all over the body, minor pain, pain and swollen eyes, swelling all over the face, neck and body is very red; further reported as body was very red like sunburn and itchy and nausea. Patient went to the emergency room and was given a shot of steroid and a shot of Benadryl. Outcome of event "nausea" was unknown while the outcome of all other events was not recovered.


VAERS ID: 1433250 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-26
Onset:2021-06-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pneumonia
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

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

Write-up: - Multifocal pneumonia


VAERS ID: 1433321 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-23
Onset:2021-06-01
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 74099652171 / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Neuralgia
SMQs:, Peripheral neuropathy (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: I do not know who to talk to about this. I?m trying to get an appointment with my doctor when I want to see someone who specializes in the problem that my arm is experiencing due to the shot
CDC Split Type:

Write-up: After my second shot a week later my arm is in serious nerve pain


VAERS ID: 1433322 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Cardiac failure congestive, Cardiac flutter
SMQs:, Cardiac failure (narrow), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow)

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

Write-up: Patient called and stated he felt heart fluttering that was diagnosed as a fib that progressed to acute congestive heart failure.


VAERS ID: 1433506 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-28
Onset:2021-06-01
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Injection site pain, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Nadalol Sertraline
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: None
Diagnostic Lab Data: No adverse event. No tests
CDC Split Type:

Write-up: I do not think this is an adverse reaction at all. My lower back started swelling and having pain. My chiro is caring for me. I reported this on my form because it asked for new symptoms. The only reaction I have had is my left arm has remained and still is very painful and the pain is deep into my arm at the exam site. I have not told my PCP.


VAERS ID: 1433681 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Autoscopy, Dysstasia, Movement disorder, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Eliquis (5 mg twice daily); Sotalol - 80 mg twice daily, Losartan Potassium 100 mg once daily; Lorazepam 0.5 mg (as needed - usually twice daily); Calcium + d3,; COq10 (100 MG) , b12, D3, Vitamin C, Repatha every two weeks (by injection
Current Illness: Nothing
Preexisting Conditions: Heart Issues, AFib - has happened about 3 times in the last 5 years,
Allergies: Penicillin, all statins, Arimidex
Diagnostic Lab Data: I contacted my doctor through portal June 2 - ; he did not recommend any medical tests or lab tests.
CDC Split Type:

Write-up: It started with a "tingling" feeling starting at the top of my head and going down to my feet. For a period of time, I was unable to move - my legs week; could not stand. I could not move my fingers and hands. I felt like I was "out of my body" It was very frightening.. After about an hour, all my feeling came back to my body; I was able to walk (not very confidently yet)). I was weak for several hours.


VAERS ID: 1433684 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433696 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433710 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433725 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433733 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433767 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433771 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433781 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433787 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

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

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

Write-up: vaccine given after expiration


VAERS ID: 1433805 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433820 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433838 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: vaccine given after expiration


VAERS ID: 1433856 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-05
Onset:2021-06-01
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Type 1 diabetes mellitus
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: I was diagnosed with Type 1 diabetes on June 20, 2021


VAERS ID: 1433874 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Exposure during pregnancy, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: *prenatal vitamins with 0.8 mg folic acid
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 38 year old G3 P2 22 week *pregnant no complications. At approximately 11:33 the patient reported hives to upper arms and axilla, Denies SOB, swelling to lips, eyes, tongue and throat, diaphoresis, N/V chest pain or abdominal pain. Medicated with 25 mg of Benadryl. by mouth


VAERS ID: 1433919 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-24
Onset:2021-06-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adnexa uteri 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: daily thyroid medication
Current Illness: non, seasonal allergies
Preexisting Conditions: Hashimoto''s disesase
Allergies: penicillin, sulfa-based drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Since the vaccine, I have had chronic pain in my ovaries. This pain feels similar to that of the pain you might experience during a heavy menstrual cycle. This pain has been constant for the past 6 weeks.


VAERS ID: 1433949 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-01
Onset:2021-06-01
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood iron, Fatigue, Full blood count, Iron binding capacity total, Iron deficiency anaemia, Serum ferritin, Temperature intolerance
SMQs:, Guillain-Barre 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: Prilosec, Prozac, Botox, Ajovy, Allegra, Singulair, Topamax, Multivitamin, Voltaren, Cambia, Nurtec, B6, D3, Klonopin, Lomaira
Current Illness:
Preexisting Conditions: Fibromyalgia, seasonal allergies, migraine headaches, Raynauds, depression, anxiety, ADHD
Allergies: Tessalon Perles, triptans
Diagnostic Lab Data: CBC - 6/12/2021 Ferritin - 6/15/2021 Iron & Tibc - 6/16/2021
CDC Split Type:

Write-up: Iron deficiency anemia ? fatigue, cold intolerance, general weakness. Noticeable ~2 months after second dose (around 5/23/2021). Diagnosed early June.


VAERS ID: 1433973 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Paranasal sinus discomfort
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: None
Current Illness: None
Preexisting Conditions: Back pain, hand eczema
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ive been having severe headaches and sinus pressure since i took the second vaccine on 6/1. The headaches won?t go away and consistent every day


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