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From the 9/17/2021 release of VAERS data:

Found 711,579 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 287 out of 7,116

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VAERS ID: 1628452 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site discharge, Injection site erythema, Injection site pain, Injection site reaction, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: The morning after vaccination, on moving arm, patient reached to touch his injection site because it was sore. He noted there was some milky gelatinous fluid at the site and on trying to remove it, some extruded ''in a string'' from the injection site. The site was surrounded by an area of redness about the size of a dime that layered peeled Patient was not I''ll and experienced no other problems.


VAERS ID: 1628611 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Cough, Dizziness, Erythema, Head discomfort, Headache, Oropharyngeal pain, Pain in extremity, Palpitations, Peripheral swelling, Pyrexia, Skin warm, Vertigo
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever for 9 days, throbbing headache for 18 days, joint pain still ongoing, heart palpitations still ongoing, Extreme dizziness and vertigo, sense of extreme pressure in head for several days, coughing and sore throat for 7 days, hot and red skin for 3 days, swelling and pain in right arm although this was mild compared to other symptoms. I?m doing my best to treat with Tylenol, but cannot find a doctor to help with the other symptoms.


VAERS ID: 1628772 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Nausea, Palpitations, Vomiting
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown- patient reported she had a physical prior to travel and was told she did not have a heart condition.
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: None completed - patient advised to see a provider.
CDC Split Type:

Write-up: A interpreter is used for this intake. Client reports she is scheduled for second Pfizer vaccine tomorrow. She reports nausea and vomiting for several days after her first vaccine. She reports fatigue and has experienced heart palpitations since her first vaccine twenty days ago. A MD call was made by the house supervisor and client was advised to have her fatigue and heart evaluated by a provider before moving forward with a second vaccine. Two providers were provided to the patient. Patient plans to travel back to her home by the end of the month and wishes to move forward with the second vaccine. She was advised to see a provider first, but she wishes to have the second vaccine tomorrow and take the risk of having worsening symptoms. Patient will return tomorrow with her uncle who is her driver and is staying at his home. Patient advised to eat a full meal and drink plenty of fluids before her appointment. She was also advised that she will need to stay in observation for 30 minutes.


VAERS ID: 1628847 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Motor dysfunction, Neuralgia
SMQs:, Peripheral neuropathy (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)

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

Write-up: Patient has nerve pain from elbow down to wrist, can''t hold a pot, started ever since she got the vaccine. She feels like a nerve got hit when she got the vaccine. She returned for her second dose 4 weeks later and reported that the symptoms hadn''t gotten any better and she was still having pain at that time.


VAERS ID: 1629079 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal
SMQs:, Dementia (broad)

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

Write-up: patient stated got a sensation in his right jaw soon after the immunization and they it went across to the left jaw and then disappeared after a 1/2 hour.


VAERS ID: 1631053 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Coagulation factor V level, Dental necrosis, Thrombosis, Toothache, Venous occlusion
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (1 glass daily); Non-smoker.
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Name: Coagulation factor V level; Result Unstructured Data: Negative.
CDC Split Type: USJNJFOC20210838162

Write-up: TOOTH WAS NOW DEAD; PAIN ON UPPER MOLAR RIGHT SIDE; ONE VEIN WAS COMPLETELY BLOCKED AND THREE OTHER VEINS PARTIALLY BLOCKED; BLOOD CLOT; This spontaneous report received from a patient concerned a 60 year old white male of unknown ethnicity. The patient''s weight was 193 pounds, and height was 73 inches. The patient''s concurrent conditions included drinks alcohol, and was non smoker. 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: 042A21A, and expiry: 21-JUN-2021) dose was not reported, 1 total administered at left deltoid around 12:00 in noon on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-AUG-2021, the patient noticed red marking and pain on the right leg. On 05-AUG-2021, diminished the use of right leg and walk was affected. On 06-AUG-2021, patient went to emergency room and diagnosed with blood clot and one vein was completely blocked and three other veins partially blocked. As of 06-AUG-2021, the patient was started on Eliquis 20 mg per day for 7 days. On 11-AUG-2021, the patient begins to feel pain on upper molar right side, so patient went to dentist on 18-AUG-2021. The patient was informed that the tooth was now dead, may had been micro clot blocking of circulating. At the time of this report the patient was on Eliquis 10 mg daily and regimen will last for six months. On an unspecified date, patient underwent factor 5 genetic marker test which was negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tooth was now dead, and the outcome of blood clot in vein and one vein was completely blocked and three other veins partially blocked was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210838162- covid-19 vaccine ad26.cov2.s-blood clot, one vein was completely blocked and three other veins partially blocked, tooth was now dead. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1632320 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Back pain, Constipation, Gastritis, Heart rate increased, Neck pain, Ophthalmic migraine, Swelling, Weight increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness:
Preexisting Conditions: Chronic Candidiasis.
Allergies: Topamax, Depakote, Amitriptyline, Esgic Plus, Protonix, Asacol, CT IV contrast, Grapes, Squash, Hops, Coffee, Mushroom, Papaya, Kiwi, Annatto, Black Pepper, Mold, Adhesive.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Painful swelling in the back of the neck occurred 20-30 mins after receiving vaccination, lasted about 6 hours, ocular migraine on 08/07, severe pain in the lower back left side by the hip, was seen by orthopedist, abdominal swelling, weight gain, gastritis, constipation, and elevated resting pulse rate normally close to 60,70 range, after vaccination is elevated to 90''s, 100''s.


VAERS ID: 1632589 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-26
Onset:2021-08-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes simplex test positive, Herpes virus infection
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A - only animals
Diagnostic Lab Data: HSV 2 IGG , Type Specific AB
CDC Split Type:

Write-up: I was diagnosed with herpes days after the vaccine


VAERS ID: 1632633 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-08
Onset:2021-08-03
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sudden onset of heavy bleeding, including large clots, approximately 2 weeks before usual start of menstruation; continuous bleeding for approximately 4 days; then no menstrual period for the month


VAERS ID: 1632977 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 4 LA / IM

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

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

Write-up: Patient presented to pharmacy stating they needed their 1st dose of Covid vaccine. Weeks after we gave the shot, we found out the patient had already received a J&J vaccine and 2 Pfizer vaccines at other facilities.


VAERS ID: 1633085 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Epistaxis, Joint swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: I have had a bad reaction to the flu shot twice in the past
Other Medications: levothyroxine montelukast metoprolol loratadine aspirin b12 d3
Current Illness: none at the time of the vaccination but had a sinus infection a month earlier in which I took a z-pack
Preexisting Conditions: hypothyroidism
Allergies: erythromycin bee stings shell fish
Diagnostic Lab Data: I currently started a new job in August and won''t have health insurance until September but will go see a doctor if it is still going on then
CDC Split Type:

Write-up: I have been having regular nose bleeds that are hard to stop and my right ankle has been swollen for the past week.


VAERS ID: 1633352 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-27
Onset:2021-08-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anger, Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hostility/aggression (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: N/A
Preexisting Conditions: DIABETES
Allergies: UNKOWN
Diagnostic Lab Data: ER DR. EXAIMED HIS HEART AND TOLD THE PATIENT * LOOKED A BIT ANGRY*.
CDC Split Type:

Write-up: ACCORDING TO PATIENT, A WEEK AFTER RECEVING MODERNA VACCINE, HE FELT A SUDDEN CHEST PAIN. HE IMMEDIATELY WENT TO ED. THE SYMPTOMS RESOLVED A FEW DAYS LATER.


VAERS ID: 1633979 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Eye disorder, Eye pruritus, Pruritus
SMQs:, Anaphylactic reaction (broad), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: After administrating vaccine PFIZER. We sat down to wait 15 minutes in the chairs located next to the place where the vaccine was administer. 10 minutes after, a red spot appeared on his neck, immediately I notified the nurses who were in charge, they took his temperature, pulse, oxygen, and checked his heart and everything came out with normal range. He was itchy on his face, and his eyes became small and itchy, they administered two tablets of BENADRYL in 15 to 20 minutes later the itching went away he had water and GATORADE we waited about 40.


VAERS ID: 1636681 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Feeling abnormal, Headache, Tinnitus
SMQs:, Dementia (broad), Hearing impairment (narrow), Arthritis (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: FLUTICASONE NASAL SPRAY, AUGMENTIN 875 MG, XANAX, B-12 SHOT RECENTLY, CLARITIN-D.
Current Illness: SINUS INFECTION, ALLERGIES, POSSIBLE AUTO-IMMUNE SYNDROME
Preexisting Conditions: ANXIETY, IBS
Allergies: AZITHROMYCIN, DICYCLOMINE, CODEINE, MORPHINE
Diagnostic Lab Data:
CDC Split Type:

Write-up: STARTED ON 08/03/21 - 1 DAY POST VACCINATION - EARS RINGING, HEADACHE FROM FRONT HAIRLINE TO BACK OF NECK, PAIN IN SHOULDER BLADE, FOGGY, ANXIOUS. TYLENOL NOT HELPING. 08/25/21 - CHRONIC EARS RINGING AND HEADACHE. PATIENT TOLD TO CALL COVID HOTLINE. I TOLD HER TO SEE A DR OR NP ON 8/25/2021. I CALLED AT 11:30 AM 8/26/21 - PATIENT DID NOT SEE NP/DR. SHE IS FEELING BETTER TODAY.


VAERS ID: 1636722 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-20
Onset:2021-08-03
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 LA / IM

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

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

Write-up: STARTED 2 WEEKS FROM 1ST VACCINATION - LUMP AND PUFFY ON UPPER BEND OF LEFT ARM REPORTED AT TIME OF 2ND VACCINATION 08/17/2021. SHE SAW A NP AND WAS TOLD TO SELF-MONITOR. CALLED 8/26/21 11:55 A.M. LEFT ARM IS JUST PUFFY, NOT HARD ANYMORE.


VAERS ID: 1636756 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Fatigue, Headache, Heart rate increased, Migraine, Pain in extremity, Paranasal sinus discomfort, Peripheral swelling, SARS-CoV-2 test negative, Skin reaction
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pnuemonia shot, I had a rash and swelling all down my arm 4 days after my shot. They gave me a steroid and it went away. I had s
Other Medications: Birth Control (Nortrell) - 1xday; Vitamin D - 1xweek/50,000 units
Current Illness: sinus infection (allergies)
Preexisting Conditions: Asthma; Heart Condition; Paracardial Infusion; Paracardial Cyst; PCV; Fibromyalgia
Allergies: Pomegranate; Amoxicillin; Penicillin; K-Tek; Doxycycline; strong antihistamines (heart stimulates); Imitrex
Diagnostic Lab Data: COVID test
CDC Split Type: vsafe

Write-up: The day after, I woke up with a sore arm. It was red and swollen. I was real fatigued. I had a slight small headache. I had some sinus pressure. I had diarrhea. A couple days later, I felt better. I was getting a headache every night. A week later, I had a 3-day migraine starting at the base of my skull. It was pounding. No matter what I took it didn''t help. My heart rate was elevated. I was super tired. I still had diarrhea. I was very uncomfortable. I went to urgent care. The COVID test came back negative and they told me it was just a virus. The next day, my headache finally went away. I still get headaches from time to time, but it''s not terrible. I am currently battling an upset stomach. I think it is from the pain medications. I have a doctor visit next week.


VAERS ID: 1636858 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood immunoglobulin A, Blood urea nitrogen/creatinine ratio, Flavivirus test negative, Henoch-Schonlein purpura, Joint swelling, Metabolic function test normal, Purpura, Rash, SARS-CoV-2 test negative, Scrotal swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vasculitis (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: COVID pcr 8/9/2021 neg 8/12/21 IgA 307 mg/dl * Chemistries normal Renal BUN Cr normal evaluation for Tick-borne illness negative
CDC Split Type:

Write-up: Henoch-Schonlein purpura with purpuric rash on upper and lower extremities from 8/3/2021. Joint swelling, scrotal swelling intermittently. Severe abdominal pain 8/19/2021 requiring hospitalization and steroids


VAERS ID: 1636929 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-27
Onset:2021-08-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Cough, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

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

Write-up: Cough.


VAERS ID: 1636945 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-19
Onset:2021-08-03
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007D21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, Cough, Diarrhoea, Pain, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chicken pox, HTN, mumps, mrsa.
Allergies: NKA
Diagnostic Lab Data: Covid test.
CDC Split Type:

Write-up: Cough, body aches, diarrhea, loss of smell.


VAERS ID: 1636957 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-02
Onset:2021-08-03
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Cough, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

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

Write-up: Cough, congestion, fever.


VAERS ID: 1636968 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-08-03
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Cough, Dyspnoea, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

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

Write-up: Cough, SOB, fever.


VAERS ID: 1636981 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-10
Onset:2021-08-03
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial tachycardia, Chest X-ray, Chills, Cough, Fall, Nasal congestion, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Accidents and injuries (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, hyperlipidemia
Allergies: Biaxin, clarithromycin, PCN
Diagnostic Lab Data: CXR, covid test
CDC Split Type:

Write-up: Shivering, nasal congestion, dry cough, fall, fevers, tachycardic.


VAERS ID: 1637002 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-07
Onset:2021-08-03
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Productive cough, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Anxiety, arthritis, asthma, CHF, COPD, OSA, Gastritis, hypercholesterolemia, kidney disease, osteoprosis, RA
Allergies: Bactrim, Compazine, Paxil, Tape
Diagnostic Lab Data: CXR, covid test
CDC Split Type:

Write-up: SOB, productive cough.


VAERS ID: 1637029 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-07
Onset:2021-08-03
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW981 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Suppressed lactation
SMQs:, Functional lactation disorders (narrow)

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

Write-up: Decreased breastmilk supply in left breast the side of the vaccine occurred 3 days after each vaccine and is still on going


VAERS ID: 1637033 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Chest X-ray, Cough, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

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

Write-up: Cough, rhinorrhea, sore throat, abd pain.


VAERS ID: 1637055 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 0172 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Inappropriate schedule of product administration, Insomnia, Myalgia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: flonase daily
Current Illness: none
Preexisting Conditions: mild asthma, well controlled
Allergies: none
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: I had COVID in October 2020. My repeat antibody testing for spike and nucleocapsid remained high q2months with testing. I had 1st Pfizer 7/15/21. Second dose 8/3/21. First dose I had fatigue, arm soreness, mild headache, mild total body myalgias. Second dose, around 12-13 hours after the injection I had severe myalgias, rigors, headache, insomnia. It lasted until around 8am then started to wane until 2pm the next day. I took 1000mg tylenol around midnight and then again at 8am. It was like mini early COVID again for me. I expected this type of reaction but just reporting since it was severe. I also developed a rash on my neck the AM after the injection. It resolved over 1 week and I used hydrocortisone cream sparingly on it after day 3 until day 7.


VAERS ID: 1637073 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-12
Onset:2021-08-03
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Muscle tightness, SARS-CoV-2 test, Urine output decreased
SMQs:, Acute renal failure (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Angioplasty, arthritis, gout, HF, HTN, kidney disease, PE, chicken pox.
Allergies: Lisinopril
Diagnostic Lab Data: CXR, covid test
CDC Split Type:

Write-up: Weakness, decreased urine output, tightness in upper back.


VAERS ID: 1637112 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LL / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1637116 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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

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

Write-up: Error: Improper Storage (temperature).


VAERS ID: 1637306 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-28
Onset:2021-08-03
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 2 - / IM

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

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

Write-up: Positive COVID-19 test and hospitalization


VAERS ID: 1637386 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No illnesses prior to vaccination. At the time of the vaccination I was feeling good and had no illnesses
Preexisting Conditions: None
Allergies: None that I?m aware of.
Diagnostic Lab Data:
CDC Split Type:

Write-up: At first I just felt tired but after I fell asleep I woke up in a cold sweat feeling extremely nauseated and dizzy. I vomited that morning and once more that afternoon. The entire day (August 3rd) I felt feverish and nauseous.


VAERS ID: 1637592 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 AR / IM

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

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

Write-up: starting on 8/3/21 she had numbness and tingling of her L arm and hand. It made her feel she had to shake her hand at times. Finally resolved on 8/23/21


VAERS ID: 1637835 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-27
Onset:2021-08-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: onset of Bells Palsey


VAERS ID: 1641114 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-31
Onset:2021-08-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Inflammation, Muscle spasms
SMQs:, Dystonia (broad)

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

Write-up: 2 days after shot kidney inflammation, worsened three weeks later, spasms


VAERS ID: 1641178 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-29
Onset:2021-08-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088021A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Condition aggravated, Neuropathy peripheral, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Coq10, red yeast rice, omega 3, rala, turmeric, Digestive enzymes, b12,
Current Illness: None
Preexisting Conditions: Arthritis
Allergies: Many meds, gluten
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Rashes on left arm, not on shot site, Rashes on right leg and arm Increase in neuropathy and arthritis pain


VAERS ID: 1641221 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood creatine phosphokinase, Chest X-ray, Chest discomfort, Chest pain, Differential white blood cell count, Electrocardiogram, Full blood count, Laboratory test, Metabolic function test, Painful respiration, Troponin I
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None. N/A. PT takes no medications, acutely or chronically. Patient had not been to any HCP nor sought any medical care at all, since her routine scheduled well-visit in October of 2020. PT takes no medications and had no underlying acute o
Current Illness: None. Perfectly healthy.
Preexisting Conditions: None, no acute or chronic health conditions. Has not been on any routine medications for over 10 years and has not had an acute infection or been on medications in past 2 years.
Allergies: NKDA and no known food or other allergies
Diagnostic Lab Data: PT was referred to ER by both Urgent Care MD and her pediatrician''s office. Patient saw Dr. for atypical chest pain. Lab Tests completed(8/3/2021): CBC and differential, CK Total, Comprehensive metabolic panel and Troponin I Imaging Tests (8/3/2021) included: ECG (12 lead); X-Ray chest (2 views).
CDC Split Type:

Write-up: PT woke up Tuesday morning about 48 hours after her first Covid-19 vaccination with persistent chest pain. She described it as pin-point, in the Sternum area and constant. When asked to describe her level of pain out of 10, she described it as a 7 or 8. It worsened upon forcing herself to take a deep breath, a forced cough (she was not coughing and had no other symptoms but upon a forced cough) and also when laughing. She had no other symptoms, no fever, no cough or Upper respiratory, and no known exposure to Covid-19. Her only complaint was persistent chest pain, and heaviness. I (her mother) called the pediatrician and we were advised to go to ER or urgent care. We have a specialty Urgent Care in local suburb of, so we went there first. Upon examination by the physician (Dr., MD) PT was diagnosed with Precordial Pain and recommended for referral to local ER for STAT bloodwork (urgent care in PA does not have that capability). Thus we then went to the ER at Hospital where pt. had the work up listed below. PT was discharged from the ER with instructions for her to make a follow up appointment with a pediatric cardiologist for an Echo Cardiogram and or MRI (hospital did not have capability) and to not get the second dose until the Cardiology appointment. She has follow up appointment at (Hospital) at the location but not until their soonest on 12 Oct 2021.


VAERS ID: 1641286 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-09
Onset:2021-08-03
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Headache, Illness, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allopurinol, Calcium, Zyrtec, Clonidine, Zetia, Gabapentin,
Current Illness: Immunocomprimised
Preexisting Conditions: Liver Transplant 1/9/2017, DVT, fibromyalgia, IBS, osteopenia, hypothyroidism, and obese
Allergies: Cipro, low dose ASA, Percodan, Probenecid, Pyridium, Ultram
Diagnostic Lab Data: SARS CoV 2 PCR COVID19 detected 8/8/2021.
CDC Split Type:

Write-up: On 8/8/2021 Admitted to Covid Unit. She started having illness last Thursday with body aches as well as headache. She is status post splenectomy. She thinks she had possible infection from her husband. Patient started having fever and chills on the weekend before admission. Tested positive for COVID-19 on 8/8/21. Patient previously vaccinated with Pfizer COVID-19 vaccine. First Dose: 02/16/2021 Lot Number EN6200 and Second Dose: 03/09/2021 Lot Number EN6206. On 8/10/2021: discharged. At the time of interview, she feels somewhat better, still has body aches. Did not have any further fever. Available records in Cerner have been reviewed. Patient denied any chest pain, shortness of breath, or diaphoresis. She denies any diarrheal illness. She did not have any nausea or vomiting. Lantus, nortriptyline, protonix, pravachol, and Coumadin.


VAERS ID: 1641613 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Axillary pain, Back pain, Blood calcium increased, Chills, Computerised tomogram abnormal, Flank pain, Hepatic steatosis, Injection site pain, Liver function test increased, Lymphadenopathy, Nausea, Pain in extremity, Positron emission tomogram abnormal, Ultrasound scan abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Calcium, Vitamin D, Flonase, Exemestane
Current Illness: Breast cancer
Preexisting Conditions: Breast cancer
Allergies: Augmentin - rash; oxycodone - rash
Diagnostic Lab Data: mild increase in LFTs, Calcium; PET/CT subsequently ordered and notable for mild R axillary adenopathy; RUQ US showing mild hepatic steatosis
CDC Split Type:

Write-up: symptoms noted after her 1st Pfizer COVID shot on 30 July 2020. On 3 Aug 2021, she developed R sided abdominal/flank/back pain in addition to pain of her R arm that involved not just the site of the injection but her whole R upper arm and R axilla. She also noted nausea and chills but no fevers and no rashes. Follow up with heme/onc had noted mild increase in LFTs, Calcium. PET/CT subsequently ordered and notable for mild R axillary adenopathy. Symptoms worsened and went to the ER at FBCH on 14 Aug 2021 with RUQ US showing mild hepatic steatosis. Has referral and appointment pending in October to the GI liver clinic.


VAERS ID: 1641705 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-08-03
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Aphonia, COVID-19, Cough, Fatigue, Headache, Nasopharyngitis, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinalgia, SARS-CoV-2 antibody test negative, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (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: Migraine PRN
Current Illness: None
Preexisting Conditions: Migraines controlled
Allergies: None
Diagnostic Lab Data: Covid-19 Positive 07/19/2021, PCR Test 07/30/2021 Negative, Antibody Test one month after shows the maximum amount of antibodies.
CDC Split Type: vsafe

Write-up: I tested positive for Covid-19. I had a very sore throat for three days straight. It was there all the time. It was unusual and I thought I was getting. I then started to feel like a normal cold with sneezing coughing and aches and pains. About three days later I developed a low grade fever and a headache. After that I got really congested and I lost my sense of taste and smell. I was also very fatigued the whole time. The most unusual symptom was that I felt like I was going to sneeze and my nose hurt for periods of time. I also lost my voice for a short period of time. In total I had symptoms for three weeks and I still had a little lingering fatigue.


VAERS ID: 1644477 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-13
Onset:2021-08-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Pain, Peripheral swelling, Pyrexia, Skin mass
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: A lump on her arm; Lump is sore; Patient now has a lump on her arm which has swelled to the size of a golf ball; Fever; Patient received her Covid-19 vaccine less than 26 days between doses; This spontaneous case was reported by a consumer and describes the occurrence of SKIN MASS (A lump on her arm), PAIN (Lump is sore), PERIPHERAL SWELLING (Patient now has a lump on her arm which has swelled to the size of a golf ball) and PYREXIA (Fever) in a 36-year-old female patient 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 13-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Patient received her Covid-19 vaccine less than 26 days between doses). On 05-Aug-2021, the patient experienced PYREXIA (Fever) (seriousness criterion medically significant). On an unknown date, the patient experienced SKIN MASS (A lump on her arm) (seriousness criterion medically significant), PAIN (Lump is sore) (seriousness criterion medically significant) and PERIPHERAL SWELLING (Patient now has a lump on her arm which has swelled to the size of a golf ball) (seriousness criterion medically significant). On 03-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Patient received her Covid-19 vaccine less than 26 days between doses) had resolved. On 05-Aug-2021, PYREXIA (Fever) had resolved. At the time of the report, SKIN MASS (A lump on her arm), PAIN (Lump is sore) and PERIPHERAL SWELLING (Patient now has a lump on her arm which has swelled to the size of a golf ball) outcome was unknown. No relevant concomitant medications were reported. No treatment information was provided. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, Lump on arm, Pain, Peripheral swelling and Pyrexia a causal relationship cannot be excluded. Causality for the event Inappropriate schedule of product administration is not applicable. Reporter did not allow further contact; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, Lump on arm, Pain, Peripheral swelling and Pyrexia a causal relationship cannot be excluded. Causality for the event Inappropriate schedule of product administration is not applicable


VAERS ID: 1644502 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dysstasia, Feeling abnormal, Head discomfort, Headache, Insomnia, Malaise, Neck pain, Panic attack, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety disorder (treatment with natural things)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: can''t be stand for too long because start feeling malaise, she only can be lying down; intense pressure on her back head; Intense pressure on her neck; Sometimes feels like pins sticking on head; Dizziness; Panic attack in the night; Isn''t able to sleep; Feeling malaise; still have strong headache/ did some exercise and on the afternoon she get up and felt a strong headache/ this headache doesn''t go away; felt like I was going to die; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (felt like I was going to die), DYSSTASIA (can''t be stand for too long because start feeling malaise, she only can be lying down), HEAD DISCOMFORT (intense pressure on her back head), NECK PAIN (Intense pressure on her neck) and PARAESTHESIA (Sometimes feels like pins sticking on head) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Anxiety disorder (treatment with natural things). On 30-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Aug-2021, the patient experienced FEELING ABNORMAL (felt like I was going to die) and HEADACHE (still have strong headache/ did some exercise and on the afternoon she get up and felt a strong headache/ this headache doesn''t go away). On an unknown date, the patient experienced DYSSTASIA (can''t be stand for too long because start feeling malaise, she only can be lying down), HEAD DISCOMFORT (intense pressure on her back head), NECK PAIN (Intense pressure on her neck), PARAESTHESIA (Sometimes feels like pins sticking on head), DIZZINESS (Dizziness), PANIC ATTACK (Panic attack in the night), INSOMNIA (Isn''t able to sleep) and MALAISE (Feeling malaise). The patient was treated with PARACETAMOL (TYLENOL) 03-Aug-2021 for Headache, at an unspecified dose and frequency. At the time of the report, FEELING ABNORMAL (felt like I was going to die), DYSSTASIA (can''t be stand for too long because start feeling malaise, she only can be lying down), HEAD DISCOMFORT (intense pressure on her back head), NECK PAIN (Intense pressure on her neck), PARAESTHESIA (Sometimes feels like pins sticking on head), DIZZINESS (Dizziness), PANIC ATTACK (Panic attack in the night), INSOMNIA (Isn''t able to sleep) and MALAISE (Feeling malaise) outcome was unknown and HEADACHE (still have strong headache/ did some exercise and on the afternoon she get up and felt a strong headache/ this headache doesn''t go away) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 09-Aug-2021: Follow up received included information about patient demographics, additional events, other relevant history, dose 1 details and treatment medication was added to the case.


VAERS ID: 1644504 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac flutter, Dyspnoea, Hyperhidrosis, Muscle tightness, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (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: USMODERNATX, INC.MOD20212

Write-up: Heart flutter; Tightness in neck; Hard time Breathing; Excessive sweating; Local swelling; Fever; This spontaneous case was reported by an other health care professional and describes the occurrence of CARDIAC FLUTTER (Heart flutter) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 03-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Aug-2021, the patient experienced CARDIAC FLUTTER (Heart flutter) (seriousness criterion medically significant), MUSCLE TIGHTNESS (Tightness in neck), DYSPNOEA (Hard time Breathing), HYPERHIDROSIS (Excessive sweating), SWELLING (Local swelling) and PYREXIA (Fever). At the time of the report, CARDIAC FLUTTER (Heart flutter), MUSCLE TIGHTNESS (Tightness in neck), DYSPNOEA (Hard time Breathing), HYPERHIDROSIS (Excessive sweating), SWELLING (Local swelling) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was provided. Treatment information was not provided. It was reported that symptoms were better during the day, some symptoms worsen again while relaxing 8/4. Company Comment: Based on the current available information and temporal association between the use of the product, and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product, and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1644555 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088021A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chills, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BUPROPION
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: felt out of breath; body pain was so severe; had a fever (didn''t take it); feeling very tired; tightness in the chest; diarrhea; chills; muscle pain; head ache; joint pain; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (diarrhea), CHEST DISCOMFORT (tightness in the chest), DYSPNOEA (felt out of breath), PAIN (body pain was so severe) and CHILLS (chills) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088021A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included BUPROPION for an unknown indication. On 02-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Aug-2021, the patient experienced DIARRHOEA (diarrhea), CHILLS (chills), MYALGIA (muscle pain), HEADACHE (head ache) and ARTHRALGIA (joint pain). On 04-Aug-2021, the patient experienced CHEST DISCOMFORT (tightness in the chest) and FATIGUE (feeling very tired). On an unknown date, the patient experienced DYSPNOEA (felt out of breath), PAIN (body pain was so severe) and PYREXIA (had a fever (didn''t take it)). At the time of the report, DIARRHOEA (diarrhea), DYSPNOEA (felt out of breath), PAIN (body pain was so severe), CHILLS (chills), MYALGIA (muscle pain), HEADACHE (head ache), ARTHRALGIA (joint pain), FATIGUE (feeling very tired) and PYREXIA (had a fever (didn''t take it)) had resolved and CHEST DISCOMFORT (tightness in the chest) had not resolved. NO Treatment drug reported. This case was linked to MOD-2021-281341 (Patient Link).


VAERS ID: 1645254 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Louisiana  
Vaccinated:2021-03-18
Onset:2021-08-03
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Drug ineffective
SMQs:, Lack of efficacy/effect (narrow), 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: VIREAD; CATAPRESS; PERCOCET [OXYCODONE HYDROCHLORIDE;OXYCODONE TEREPHTHALATE;PARACETAMOL]
Current Illness: Fracture; Hepatitis B
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: tested positive for COVID/ no symptoms; lack of efficacy; This spontaneous case was reported by a consumer and describes the occurrence of ASYMPTOMATIC COVID-19 (tested positive for COVID/ no symptoms) and DRUG INEFFECTIVE (lack of efficacy) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 045A21A and 023M20A) for COVID-19 vaccination. Concurrent medical conditions included Hepatitis B and Fracture. Concomitant products included TENOFOVIR DISOPROXIL FUMARATE (VIREAD), CLONIDINE (CATAPRESS) and OXYCODONE HYDROCHLORIDE, OXYCODONE TEREPHTHALATE, PARACETAMOL (PERCOCET [OXYCODONE HYDROCHLORIDE;OXYCODONE TEREPHTHALATE;PARACETAMOL]) for an unknown indication. On 18-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Aug-2021, the patient experienced ASYMPTOMATIC COVID-19 (tested positive for COVID/ no symptoms) and DRUG INEFFECTIVE (lack of efficacy). At the time of the report, ASYMPTOMATIC COVID-19 (tested positive for COVID/ no symptoms) and DRUG INEFFECTIVE (lack of efficacy) outcome was unknown. The patient was very pleased with the vaccine. Treatment information was not provided.


VAERS ID: 1645400 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-02
Onset:2021-08-03
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium carbonate (CALCIUM 600 ORAL) cholecalciferol, vitamin D3, (VITAMIN D3) 1,000 unit capsule cyanocobalamin, vitamin B-12, 1,000 mcg tablet extended release lovastatin (MEVACOR) 20 mg tablet metoprolol succinate XL (TOPROL-XL) 25 m
Current Illness:
Preexisting Conditions: Circulatory Varicose veins Venous insufficiency Multiple episodes of deep venous thrombosis (CMS/HCC) PAF (paroxysmal atrial fibrillation) (CMS/HCC) Digestive Diverticulosis Vitamin B 12 deficiency Malignant neoplasm of ascending colon (CMS/HCC) Musculoskeletal Osteopenia Endocrine/Metabolic Dyslipidemia IFG (impaired fasting glucose) Hematologic CLL (chronic lymphocytic leukemia) (CMS/HCC) Acute blood loss anemia Symptomatic anemia Iron deficiency anemia due to chronic blood loss Other Adjustment disorder with anxiety Overweight (BMI 25.0-29.9) On statin therapy Chronic anticoagulation
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Cough


VAERS ID: 1646218 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 INC202100991486

Write-up: swollen fingers and feet; This is a spontaneous report from a contactable consumer. A 13-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), dose 1 via an unspecified route of administration on 02Aug2021 as a single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient woke up with swollen fingers and feet next day after her first dose of vaccine. The outcome of the events was unknown . The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1646219 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Rash pruritic, Urticaria, Vaccination site rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100991517

Write-up: Itchy large bumpy (hives) rash on injection side (arm, side and back).; Itchy large bumpy (hives) rash on injection side (arm, side and back).; Itchy large bumpy (hives) rash on injection side (arm, side and back).; This is a spontaneous report from a non-contactable consumer, the patient. A 35-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3180) via an unspecified route of administration in the left arm on 02Aug2021 at 20:15 (at the age of 35-years-old) as a single dose for COVID-19 immunisation. Other medical history was reported as none. The patient had no known allergies to medications, food, or other products. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any medications within two weeks of vaccination. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 03Aug2021, the patient experienced itchy large bumpy (hives) rash on injection side (arm, side and back). The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events itchy large bumpy (hives) rash on injection side (arm, side and back) was not recovered at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1646285 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METOPROLOL TARTRATE; LEXAPRO
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100993391

Write-up: Blacked out within 5 minutes; This is a spontaneous report from a contactable consumer (patient). A 30-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration, administered in the left arm on 03Aug2021 at 15:45 (Lot Number: FC3180) as dose 1, single for COVID-19 immunization. Medical history included high blood pressure on an unknown date. The patient had no known allergies. The patient did not have COVID-19 prior to vaccination. The patient has not been tested post vaccination. Concomitant medications included metoprolol tartrate (manufacturer unknown) and escitalopram oxalate (LEXAPRO) taken for an unspecified indication, start and stop date were not reported and unspecified multivitamin. The patient previously received Tdap on 23Jul2021 on the right arm (at 30 years old) for immunization. The patient blacked out within 5 minutes at 15:45 (as reported) after the vaccination on 03Aug2021. The patient was relocated to a chair and blacked out again. The patient received an Epi pen injection as treatment for the event. The event resulted in a doctor or other healthcare professional office/clinic visit. The outcome of the event was recovering.


VAERS ID: 1646316 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood potassium, Blood potassium decreased, Blood pressure increased, Blood pressure measurement, Diaphragm muscle weakness, Fatigue, Hot flush, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Hypokalaemia (narrow)

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: Medical History/Concurrent Conditions: Allergic to cats; Allergy to chemicals; Food allergy; Hypokalemic periodic paralysis; Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: potassium; Result Unstructured Data: Test Result:drop; Test Date: 20210803; Test Name: potassium; Result Unstructured Data: Test Result:rebounded to 4.0; Test Name: blood pressure; Result Unstructured Data: Test Result:110/75; Test Date: 20210803; Test Name: blood pressure; Result Unstructured Data: Test Result:183/132; Test Date: 20210803; Test Name: blood pressure; Result Unstructured Data: Test Result:153/80
CDC Split Type: USPFIZER INC202100994288

Write-up: Difficulty expanding diaphragm muscles; blood pressure reached 183/132 within 10 minutes (normal is approx. 110/75).; Apparent serum potassium drop; felt muscles weakness begin with legs, then progress through arms and trunk.; flush with hot skin; exhaustion; This is a spontaneous report from a contactable consumer (patient). A 60-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not provided), via an unspecified route of administration in left arm on 03Aug2021 at 12:15 (at the age of 60-years-old) at dose 1, single for COVID-19 immunization. Medical history included hypokalemic periodic paralysis; and known allergies to penicillin, Fabreze, mango, and cats. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medications were reported as none. She did not receive any other medications within 2 weeks of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Facility where the most recent COVID-19 vaccine was administered was reported as pharmacy. Since the vaccination, the patient has not been tested for COVID-19. On 03Aug2021 at 12:30, the patient''s serum potassium apparently dropped. She was known to have a rare disorder, hypokalemic periodic paralysis. Within about 5 minutes (as reported), muscle weakness began on her legs, then progressed through her arms and trunk. She had difficulty expanding diaphragm muscles, had flush with hot skin, and her blood pressure (BP) reached 183/132 within 10 minutes (as reported) (normal was approximately 110/75). Primary care doctor on location administered a quick-acting BP lowering medicine. This brought her BP down to 153/80 within 45 minutes. She needed assistance to walk and went to the emergency room (ER) across the street from the vaccination site as per the primary care doctor. Weakness progressed to a moderate degree, mostly in the extremities and diaphragm. Throughout the episode, she continued ingesting electrolyte/potassium water with a total of approximately 2500 mg over 1 hour. This helped stopped the progression of weakness. After approximately 1 hour of observation in the ER, she was able to breathe properly and fully again. Potassium level rebounded to 4.0 within about 1/2. Therapeutic measures were taken as a result of the events. The events required doctor or other healthcare professional office/clinic and emergency room/department or urgent care visit. The patient was recovering at home with exhaustion (2021). The outcome of the event exhaustion was unknown and recovering for all other events. The events were reported as non-serious. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1646324 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Chills, Dizziness, Feeling abnormal, Heart rate, Malaise
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Hypertension (narrow), 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: Duloxetine; Pregabalin; Labetalol
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure abnormal; Fibromyalgia.
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Blood pressure; Result Unstructured Data: Test Result: 140 over a 100; Test Date: 20210803; Test Name: pulse; Result Unstructured Data: Test Result: very close to 80.
CDC Split Type: USPFIZER INC202100994384

Write-up: patient''s blood pressure and it was 140 over a 100; not feeling good; felt kind of weird; felt kind of chills; felt like she wanted to faint, she felt little dizzy; This is a spontaneous report from a contactable consumer (patient''s husband). A 27-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration in left arm on 03Aug2021 (Batch/Lot number was not reported; at the age of 27 years old) as dose 1, single for COVID-19 immunization. Medical history included fibromyalgia and blood pressure (abnormal). Concomitant medications included duloxetine; pregabalin; labetalol; and other unspecified medication, all for blood pressure. The patient received her first Pfizer vaccine today (on 03Aug2021, pending clarification). The patient told her husband that she was not feeling good and felt kind of weird. The patient also felt kind of chills. So, the patient''s husband came and checked the patient''s blood pressure and it was 140 over a 100 and pulse was very close to 80. The patient took blood pressure pills at nighttime and it helped some. The patient felt like she wanted to faint, she felt little dizzy earlier she was holding the baby. The patient''s husband is wondering whether it was side effects of the vaccine or if was because of her blood pressure condition. The reporter confirmed that the patient experienced the events probably about 05:30, about 2 hours after she received the shot. The patient is still experiencing the events. The patient had not yet recovered from the events. Information on the lot/batch number has been requested.


VAERS ID: 1646345 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Nausea, Pyrexia, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anemic
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100995639

Write-up: Itchy rash all over body; Dizziness; Nausea; Fever; Chills; Headache; This is a spontaneous report from a contactable consumer, the patient. A 34-year-old non-pregnant female patient received unknown dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 03Aug2021 at 09:30 (at the age of 34-years-old) as a single dose for COVID-19 immunisation. Medical history included anemic. The patient had no known allergies to medications, food or other products. Prior to vaccination, it was unknown whether the patient was diagnosed with COVID-19. The patient did not receive any medications within two weeks of vaccination. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 03Aug2021 at 11:00, the patient experienced itchy rash all over body, dizziness, nausea, fever, chills and headache. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of the events which included treatment with Benadryl. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events itchy rash all over body, dizziness, nausea, fever, chills and headache was recovering at the time of this report. The batch/lot numbers for, BNT162b2, were not provided and will be requested during follow up.


VAERS ID: 1646358 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Body temperature, Hallucination, Headache, Malaise, Pyrexia, Vital capacity, Vital functions abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: His temp; Result Unstructured Data: Test Result:102.4; Comments: His temp is 102.4; Test Date: 20210803; Test Name: Vitals; Result Unstructured Data: Test Result:97 over 133; Comments: 97 over 133 and it keeps going up
CDC Split Type: USPFIZER INC202100997156

Write-up: Hallucinating; He was not feeling good; His vitals, is 97 over 133 and it keeps going up; His temp was 102.4; Felt weak; Headache; This is a spontaneous report from a contactable consumer (patient is the grandson). A 14-year-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Batch/Lot Number: EW0153), via an unspecified route of administration, administered in left arm on 02Aug2021 in the afternoon (at the age of 14-years-old) as dose 2, single for COVID-19 immunisation. The patient preciously took first dose of bnt162b2 on 09Jul2021. The patient did not received any other vaccine within 4 weeks. Medical history included allergies. There were no concomitant medications. On 03Aug2021 at about 01:00 the patient experienced hallucinating, he was not feeling good, his vitals were 97 over 133 and it kept going up, his temp was 102.4, he felt weak and he had headache. It was reported that patient got his Pfizer shot on 02Aug2021 afternoon and the morning of 03Aug2021 he told to reporter that he was not feeling good. So, they gave him the Tylenol 500 mg (treatment). The reporter went to check his vitals, was 97 over 133 and it kept going up and his temp was 102.4 and he was hallucinating and he got terrible headache and he felt weak. The outcome of events was not recovered. No follow-up attempts are needed. No further information is expected


VAERS ID: 1646369 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Rapid test; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202100998022

Write-up: Tested positive for COVID; Tested positive for COVID; This is a spontaneous report from a contactable consumer or other non-HCP. A 34-year-old female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: UNKNOWN) via an unspecified route of administration on an unspecified date as dose 1, single and received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: UNKNOWN) via an unspecified route of administration on an unspecified date as dose 2, single (at the age of 34-years-old) for COVID-19 immunization. The patient was not pregnant at the time of vaccination. Patient medical history and concomitant was not reported. The patient did not receive any other vaccine within 4 weeks prior to the vaccine. The patient received no other medications within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. On 02Aug2021, the patient had signs of illness came on quickly. Started with a tickle in her throat in the afternoon, then woke up very ill in the middle of the night and tested positive the following morning. The patient informed tested positive for COVID on 03Aug2021 via rapid test (nasal swab). The adverse events resulted in doctor or other healthcare professional office/clinic visit. The treatment medication included cough syrup thus far, only 1.5 days into illness. The outcome of the event COVID-19 was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1646387 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-27
Onset:2021-08-03
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 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: 20210803; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: USPFIZER INC202100998818

Write-up: Tested COVID-19 positive after receiving her Pfizer-BioNTech COVID-19 vaccination; Tested COVID-19 positive after receiving her Pfizer-BioNTech COVID-19 vaccination; This is a spontaneous report from a contactable consumer (patient). A 57-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: EL0140; Expiration Date: 31Mar2021), via an unspecified route of administration, administered in arm on 27Jan2021 (Age at the vaccination: 56-year-old) as dose 2, single and also received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: EL0140; Expiration Date: 31Mar2021), via an unspecified route of administration on 06Jan2021 (Age at the vaccination: 56-year-old) as dose 1, single both for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient took her daily medications but declined to provide that information at the time of reporting. Patient stated she was advised by her husband who was a Pfizer employee, to report to Pfizer that she tested COVID-19 positive on 03Aug2021 after receiving her Pfizer BioNTech COVID-19 vaccination. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 03Aug2021. The investigation included reviewing the involved batch records, deviation investigation, evaluation of reference samples, an analysis of the complaint history for the reported lot and product type. The final scope was determined to be the associated lot(s) of the reported lot EL0140. A complaint sample was not returned. No related quality issues were identified during the investigation. There was no impact on product quality, regulatory, validation and stability. Regulatory authority concludes that the reported defect was not representative of the quality of the batch and the batch remains acceptable. The NTM process determined that a regulatory notification was required. The reported defect could not be confirmed on the reference samples. No root cause or CAPA were identified as the complaint was not confirmed. The outcome of events was unknown. Lot/ batch number is not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected.


VAERS ID: 1646428 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Headache, Hyperpyrexia, Pain, Pyrexia, SARS-CoV-2 test, Vaccination site pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Fever; Result Unstructured Data: Test Result:104 Fahrenheit; Test Date: 20210803; Test Name: Fever; Result Unstructured Data: Test Result:107 Fahrenheit; Test Date: 202103; Test Name: COVID-19; Test Result: Positive
CDC Split Type: USPFIZER INC202100999454

Write-up: have a fever/104/Now keeps 107 F; whole body is aching and warm; pain in her arm/My arm is still hurting where I got the shot; headache; Backache; This is a spontaneous report from a contactable consumer (patient). A 31-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration on 03Aug2021 (Lot Number: EW0180) as 0.3 mL single for COVID-19 immunization. Medical history included positive for COVID-19 from Mar2021 to an unknown date. The patient''s concomitant medications were not reported. On 03Aug2021, the patient has a fever. The first time she came to know it was 104, but now keeps 107 degree Fahrenheit. On 03Aug2021, she experienced headache, whole body is aching and warm, arm is still hurting where she got the shot. Took the vaccine at 9 or 10 and an hour after that she had a pain in her arm, headache and back ache around 10:15 or 11 yesterday. No treatment received for fever and body aches. Events did not require a visit to Emergency Room or Physician Office. Outcome of events was unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1646431 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 INC202100999478

Write-up: hives; This is a spontaneous report from a contactable nurse. A 16-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration on 03Aug2021 (Lot Number: EW0179) as dose 1, single for COVID-19 immunization. The patient''s medical and concomitant medications were not reported. The patient broke out in hives on 03Aug2021. The patient took Benadryl which resolved the hives and at the time of report, she was better and not having any symptoms. The pharmacist then asked recommendation for the second vaccine. Outcome of the event was recovered on 04Aug2021.


VAERS ID: 1646465 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-09
Onset:2021-08-03
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Body temperature, Chills, Cough, Dysphonia, Fatigue, Feeling abnormal, Lymphadenopathy, Nasal congestion, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: temperature; Result Unstructured Data: Test Result:100.3; Test Date: 20210804; Test Name: temperature; Result Unstructured Data: Test Result:100.3; Test Date: 20210804; Test Name: rapid Covid testing/QuickView at home OTC Covid-19 test; Test Result: Negative
CDC Split Type: USPFIZER INC202101000512

Write-up: tiredness; voice is scratchy; Chills; low grade temperature; slight cough; could feel lymph nodes swollen; stuffy nose off and on; felt like her body was fighting something, something was off; This is a spontaneous report from a contactable consumer (patient). A 38-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, lot number: EL3247, patient was 37-year-old at the time of vaccination), via an unspecified route of administration, administered in Arm Left on 09Feb2021 as DOSE 2, SINGLE for to protect her and family from Covid19 and elderly compromised family, children too young for vaccine. Medical history reported as no. There were no concomitant medications. Historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, lot number: EL3247, patient was 37-year-old at the time of vaccination), via intramuscular route of administration, administered in Arm Left on 21Jan2021 as DOSE 1, SINGLE for covid-19 immunisation. It was reported that patient got the Pfizer BioNTech Covid vaccine at mid-morning/late afternoon and then both her children (2 out of 3) both tested positive for Covid and she came down with symptoms. She did an over-the-counter rapid test, and it was negative, and it was suggested for her to retest in 24-36 hours. Patient weighs between 165-170 pounds. Reported that the oldest child was showing symptoms went to the withheld and took a test on Thursday evening, 29July2021 and got the positive results back on Monday, 02Aug2021. The middle child''s symptoms started a couple of days after the oldest on Friday, 30July2021 and because of the weekend they went to submit a test Monday, 02Aug2021 and got those results back late last night which was also positive. She ensured the control line showed and worked properly. It suggested for her to retest in 24-36 hours. No History of previous immunization with the Pfizer vaccine considered as suspect, no additional Vaccines Administered on Same Date of the Pfizer Suspect. On 03Aug2021, the patient experienced voice is scratchy, chills, low grade temperature, slight cough, could feel lymph nodes swollen, stuffy nose off and on, felt like her body was fighting something, something was off, on 04Aug2021, the patient experienced tiredness. The patient underwent lab tests and procedures which included temperature resulted as 100.3 on 03Aug2021, temperature resulted as 100.3 and rapid Covid testing/QuickView at home OTC Covid-19 test resulted as negative on 04Aug2021. Patient received treatment for low grade temperature with Advil. Reported that after taking advil at night before bed for the temperature/slight fever and it seemed to help and next day she woke up and she didn''t feel like she had a fever at all but had other events. No AE(s) require to visit emergency Room and physician office. The outcome of event (low grade temperature) was recovered on an unspecified date in 2021 and outcomes of all other events were not recovered. Follow-Up (09Aug2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1646468 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Unknown  
Location: Louisiana  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Pain
SMQs:, Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101000896

Write-up: Kind of achy all over; Feel achy; Feel of weak; Weak; This is a spontaneous report from a contactable consumer (patient). A 77-year-old (also the age at the time of vaccination) patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration, administered in arm Left on 02Aug2021 14:00 (Batch/Lot number was not reported) as DOSE 1, SINGLE for COVID-19 immunization. There were no medical history concomitant medications. On 03Aug2021, the patient felt weak and like kind of achy all over. No treatment was provided but the nurse who gave the patient the shot instructed that if the patient had any pain or anything, just to take Tylenol. Outcome of the events were unknown. Information regarding the batch/lot number has been requested.


VAERS ID: 1646469 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Lymphadenopathy, Nausea, Pruritus, Rash, Vaccination site pruritus, Vaccination site rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Food allergy; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101000904

Write-up: This is a spontaneous report from a contactable consumer (patient) received via COVID-19 VaccineReporting System. A 55-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in arm left on 03Aug2021 10:00 (Lot Number: EW0170; at the age of 55-years) as DOSE 1, SINGLE for COVID-19 immunization. Medical history included asthma, allergy to sesame seeds and penicillin. The patient''s concomitant medications were not reported. The patient previously took ibuprofen and experienced allergy. 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. The patient was not pregnant at the time of vaccination. On 03Aug2021 17:00, The patient experienced rash, itching at the injection site, and across the chest and up towards the neck, nausea, and swollen lymph nodes. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measure was taken as the result of the events which included Benadryl. Since the vaccination, the patient has not been tested for COVID-19. The outcome of the events was not recovered.


VAERS ID: 1646577 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Musculoskeletal chest pain
SMQs:, Other ischaemic heart disease (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: Medical History/Concurrent Conditions: Breast cancer; Hypertension; Lupus myocarditis; Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101008121

Write-up: Sharp pain in my heart; ribs on my left side became sore in front and back; This is a spontaneous report from a contactable consumer (patient). A 55-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number: FA7484), via an unspecified route of administration, administered in right arm on 02Aug2021 15:00 (at the age of 55-years-old) as dose 1, single for COVID-19 immunization. Medical history included lupus, breast cancer on left side from 2014, high blood pressure, and known allergies to sulfa titanium. Prior to vaccination, the patient was not pregnant, did not have COVID and did not receive any other vaccines within 4 weeks. The patient had unspecified concomitant medication within 2 weeks of vaccination. On 03Aug2021 13:00, the patient reported sharp pain in her heart. Her ribs on the left side became sore in the front and back. No treatment was received for the events. Post-vaccination, the patient has not been tested for COVID-19. Outcome of the events was recovered in Aug2021. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1646623 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-08-03
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: School       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
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: 20210803; Test Name: rapid test; Result Unstructured Data: Test Result:Covid-19
CDC Split Type: USPFIZER INC202101011748

Write-up: She got the vaccine but then she got covid.; She got the vaccine but then she got covid.; This is a spontaneous report from a contactable consumer or other non hcp. A 21-years-old female patient received bnt162b2 (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 May2021 as DOSE 2, SINGLE, dose 1 via an unspecified route of administration, administered in Arm on May2021 as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history was none. There were no concomitant medications. On an unspecified date in 2021 patient experienced breakthrough infection, she got the vaccine but then she got covid and sick on 03Aug2021. The patient underwent lab tests and procedures which included sars-cov-2 test: covid-19 on 03Aug2021. The outcome for all events was unknown. Information about lo/batch number has been requested.


VAERS ID: 1646637 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-08-03
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Polymerase chain reaction, Pyrexia, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210805; Test Name: PCR/Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101013066

Write-up: Patient got positive results of COVID-19 on 08-06-2021; Patient got positive results of COVID-19 on 08-06-2021; OTCs for fever; This is a spontaneous report from a contactable consumer or other non hcp. A 27-year-old non-pregnant female patient received bnt162b2 (BNT162B2, Lot Number: EP6955) via an intramuscular route of administration, administered in arm left on 23Mar2021 at 13:00 (age at the time of vaccination 27-years-old) as DOSE 1, SINGLE and dose 2 (Lot Number: EP6955) via an intramuscular route of administration, administered in arm left on 12Apr2021 at 13:00 (Age at the time of vaccination: 27-years-old) as DOSE 2, SINGLE for covid-19 immunisation. The patient had no known allergies. The patient medical history not reported. There were no concomitant medications reported. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had been tested for COVID-19. The patient didn''t receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not received any other medications within 2 weeks of vaccination. On 03Aug2021 at 08:00 AM, The patient got positive results of covid-19 on 08-06-2021 and OTCs for fever. The patient underwent lab tests and procedures which included polymerase chain reaction was positive on 05Aug2021. Therapeutic measures were taken as a result of OTCs for fever. Event occurred in a country different from that of the reporter. This may be a duplicate if the reporter also submitted directly to his/her local agency. The event OTCs for fever outcome was not recovered.


VAERS ID: 1646645 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101013200

Write-up: This is a spontaneous report from a contactable consumer, the patient. A 47-years-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA7485) via an unspecified route of administration in the left arm on 03Aug2021 at 12:00 (at the age of 47-years-old) as a single dose for COVID-19 immunisation. The patient had unspecified medical history. The patient had unspecified allergies to medications, food or other products. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient received unspecified concomitant medication within 2 weeks of vaccination. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 03Aug2021 at 16:00, after 4 hours of receiving the vaccine, the patient experienced shingles. The events result in emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were taken as a result of the reported event which included prescription medication. The clinical outcome of the event shingles was not recovered at the time of this report.


VAERS ID: 1646666 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Elephantiasis, Hypersensitivity, Oxygen saturation, Peripheral swelling, Pruritus, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Ocular infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: oxygen level; Result Unstructured Data: Test Result:95-97
CDC Split Type: USPFIZER INC202101013520

Write-up: feet swelled up a little bit; Elephantitis; Having trouble breathing/short of breath, she couldn''t take a deep breath; allergic reaction; legs were itching; weird-looking rash, very bumpy and red; bubbly and itching; weird-looking rash, very bumpy and red; bubbly and itching; weird-looking rash, very bumpy and red; bubbly and itching; This is a spontaneous report from a contactable nurse (patient). A 64-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), at same age, dose 2 intramuscular, administered in Deltoid Left on 03Aug2021 (Batch/Lot Number: EW0177) as DOSE 2, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0177), at age of 63 years old, on Left deltoid for covid-19 immunisation on 13Jul2021. Reported an "allergic reaction" after receiving the Pfizer-BioNTech COVID-19 Vaccine, patient developed a "bumpy and bubbly rash". Patient clarified she had an allergic reaction. As soon as she got the shot. She got the shot at 14:30-15:30, and within 2 hours, by 16:00, she was having trouble breathing. She was short of breath, she couldn''t take a deep breath. Her legs were itching. She had a weird looking rash- it''s very bumpy and red. It looks like Elephantitis. She explains further it''s a weird rash, it''s not hives, it''s a different kind of rash. She knew what hives was and it''s not hives. The rash was bumpy and looks bubbly, she still had the rash. The rash was very itch and she still had scars from it. She mentioned her feet swelled up a little bit. When probed for the seriousness criteria of her reaction, the patient stated it could be life-threatening if you can''t breathe. Her reaction began after her second dose. She received her second dose on 03Aug2021. The lot number is the same for both her first and second dose. She explains the amount of the dose was not on her vaccine record card. She felt the reaction was definitely caused from the vaccine. She stated there were no blood tests for this reaction. Her CO2, clarified as her oxygen level was between 95 and 97, which was okay. None of vaccines administered on same date of the Pfizer suspect. Patient went to emergency room urgent care because she couldn''t breathe. None of Vaccinations administered within four weeks prior to the first administration date of the suspect vaccine. Reporter seriousness for short of breath, she couldn''t take a deep breath was Life threatening Reporter considered that short of breath, she couldn''t take a deep breath and weird-looking rash, very bumpy and red; bubbly and itching were related. The outcomes of events having trouble breathing/short of breath, she couldn''t take a deep breath, Elephantitis and feet swelled up a little bit were unknown, while other events were not recovered.; Sender''s Comments: Based on the information available and close temporal association, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported events Elephantitis and Breathing difficult . The case will be reassessed once new information is available The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1646693 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis, Headache, Migraine, SARS-CoV-2 test, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hyperemesis gravidarum (I had a pregnancy complication 10 years ago)
Allergies:
Diagnostic Lab Data: Test Date: 20210804; Test Name: PCR; Result Unstructured Data: Test Result:Negative; Comments: Nasal Swab; Test Date: 20210805; Test Name: PCR; Result Unstructured Data: Test Result:Negative; Comments: Nasal Swab; Test Date: 20210806; Test Name: PCR; Result Unstructured Data: Test Result:Negative; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101014019

Write-up: Migraine; Vomit; Nose bleed; Headache; There was a faint but strange "dreamlike" feeling when I stood up & some faint distortions of light; This is a spontaneous report from a contactable consumer or other healthcare professional (patient). A 43-year-old non-pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: solution for injection, Lot number was unknown), via an unspecified route of administration, administered in Arm Left on 03Aug2021 (at the age of 43-years-old) as dose 1, single for covid-19 immunization at pharmacy or drug store. Medical history included hyperemesis gravidarum (she had a pregnancy complication 10 years ago) from an unknown date and unknown if ongoing. Patient had no known allergies. There were no concomitant medications. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. No list of any other medications the patient received within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination/post vaccination, the patient had been tested for COVID-19. Patient had excellent health and never needed any hospitalizations or long-term medications. Received Pfizer mRNA vaccine. Ok for about 15 minutes. 03Aug2021 5:18pm started to leave the pharmacy but there was a faint but strange dreamlike feeling when she stood up and some faint distortions of light so she stayed for a bit until she knew it was safe to drive. 7:15pm she experienced the first migraine of her life, it caused her to vomit, and the first nosebleed of her life approximately an hour after the shot. She had to lie down with a wet rage on her face due to the light, so it was hard to say the exact time. After she vomited, she felt well enough to drive to the ER. At 8:24pm arrived at the ER at the hospital so they could check her and analyze what was happening with the nosebleed. Now just headache which she had expected. They took her vitals and admitted her but unfortunately, due to the outbreak, there were over 100 people ahead of her and it was night so after several hours she needed to go home and go to bed so she did a follow up with her PCP the next morning. The adverse event resulted in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 04Aug2021 (nasal swab), sars-cov-2 test: negative on 05Aug2021 (nasal swab), sars-cov-2 test: negative on 06Aug2021 (nasal swab). No treatment was received. The outcome of events syncope, migraine, epistaxis, vomiting and headache was reported as recovered with lasting effects. No follow-up attempts are needed. No further information is expected.; Sender''s Comments: Based on the information in the case report and a plausible temporal relationship, a possible causal relationship between the events Syncope, migraine, headache, vomiting, epistaxis and suspect drug BNT162B2 cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1646702 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Tinnitus
SMQs:, Acute pancreatitis (broad), 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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101015198

Write-up: Ringing in Left ear; Low nausea; This is a spontaneous report from a contactable consumer, the patient. A 38-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3180) via an unspecified route of administration in the left arm on 03Aug2021 (at the age of 38-years-old) as a single dose for COVID-19 immunisation. Other medical history was reported as none. The patient had no known allergies to medications, food, or other products. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any medications within two weeks of vaccination. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 03Aug2021, the patient experienced ringing in left ear and low nausea. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events ringing in left ear and low nausea was not recovered at the time of this report.


VAERS ID: 1646706 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscular weakness, Pain, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None, Comment: No medical conditions
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101015231

Write-up: Heart palpitations for 3 days; Muscle weakness; Shooting pain along whole right side; This is a spontaneous report from a contactable consumer, the patient. A 42-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the right arm on 02Aug2021 at 17:30 (at the age of 42-years-old) as a single dose for COVID-19 immunisation. The patient did not have any relevant medical history. The patient had no known allergies. The patient did not receive any medication within 2 weeks of vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 03Aug2021 at 08:00, the patient experienced heart palpations for 3 days, muscle weakness and shooting pain along the whole right side which was ongoing at the time of this report. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. No therapeutic measures were taken as a result of the events. The clinical outcome of the event heart palpations was resolved on 06Aug2021 and muscle weakness and shooting pain along whole right side were not resolved at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow-up.


VAERS ID: 1646716 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Hypersensitivity, Nausea, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VIT D [COLECALCIFEROL]; PROPRANOLOL; SINGULAIR; PANTOPRAZOLE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy; Asthma; Breast cancer; Chronic bronchitis; Seizures; Sinus disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101015430

Write-up: This is a spontaneous report from a contactable consumer (patient) reported that a 50-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number was not reported), via an unspecified route of administration, administered in arm right on 02Aug2021 16:30 (at the age of 50-years-old) as dose 1, single for covid-19 immunisation. The vaccine was administered at the Pharmacy/drugstore. The patient medical history included breast cancer (TNBC), asthma, seizures, sinus, allergies, and chronic bronchitis. Concomitant medications included colecalciferol (VIT D [COLECALCIFEROL]); propranolol taken for an unspecified indication, start and stop date were not reported; montelukast sodium (SINGULAIR) taken for an unspecified indication, start and stop date were not reported; and pantoprazole; all were taken for an unspecified indication, start and stop date were not reported. The patient previously took Neosporin, and experienced allergy. On 03Aug2021, throat feels very swollen like allergic reaction, and chills, nausea. No treatment was received for the events. The outcome of the events was not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1646719 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Body temperature, Diarrhoea, Haematochezia, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: fever; Result Unstructured Data: Test Result:102; Comments: fever 102
CDC Split Type: USPFIZER INC202101015612

Write-up: Bloody stools; upset stomach; diarrhea; fever 102; This is a spontaneous report from a contactable consumer (patient). A 13-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot Number: Unknown), via an unspecified route of administration, in the left arm on 03Aug2021 at 11:30 (at the age of 13-years-old) as dose number unknown, single for covid-19 immunisation. Facility where the most recent COVID-19 vaccine was administered was pharmacy or drug Store. The patient medical history and concomitant medications were not reported. No known allergies. Prior to vaccination patient was not diagnosed with COVID-19. Since the vaccination the patient had not been tested for COVID-19. The patient did not receive any vaccines within four weeks prior to the vaccination. On 03Aug2021 at 17:00, the patient experienced bloody stools, upset stomach, diarrhea and fever 102. Seriousness criteria reported as no. The patient received any treatment for the event was unknown. The patient underwent lab tests and procedures which included body temperature: fever 102 on 03Aug2021. Adverse events resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Outcome of the events was recovered with sequelae on Aug2021.


VAERS ID: 1646750 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-26
Onset:2021-08-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 - / OT

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101017593

Write-up: Diarrhea; Nausea; Had episode of severe vomiting; This is a spontaneous report from a contactable consumer (parent). A 15-year-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: FA7484, Expiry Date: unknown) via an intramuscularly administered in arm on 26Jul2021 at 18:30 (at the age of 15-years-old) as DOSE 1, SINGLE for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient did not receive prior vaccination within 4 weeks. Reporter stated that patient received the first dose of the Pfizer vaccine about 2 weeks ago on wednesday and had an episode of severe vomiting on unspecified date in 2021. On 03Aug2021, he had diarrhea and nausea. On an unspecified date in 2021, he had another episode of vomiting. Later, there was an improvement compared to first vomiting episode. He took a Zofran. The reporter wanted to know if anyone else reported the same. For second dose due date, reporter did not know, it was most likely that he/she might not give it to the patient, but was not confirmed. Regarding causality, reporter thought a possibility but did not know for sure as reporter was not a vaccine professional. Reporter did not know about any laboratory test performed on patient or not. Therapeutic measures were taken for severe vomiting, diarrhea and nausea with zofran. The outcome of the event vomiting was recovering and other events outcome was unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1646754 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
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: 20210803; Test Name: Covid-19 PCR test; Test Result: Positive
CDC Split Type: USPFIZER INC202101021564

Write-up: Tested COVID-19 positive by PCR. Drawn Tues 03Aug and notified positive Thurs 05Aug/Cold-like URI symptoms so far and s; Tested COVID-19 positive by PCR. Drawn Tues 03Aug and notified positive Thurs 05Aug/Cold-like URI symptoms so far and some body aches; This is a spontaneous report from a contactable other healthcare professional (hcp). A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Lot number and expiry date were not reported) via an unspecified route of administration on an unspecified date as dose 1, single for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient was tested COVID-19 positive by PCR which was drawn Tuesday 03Aug2021 and notified positive on Thursday, 05Aug2021. Patient also had cold-like URI symptoms so far and some body aches. The outcome of the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender''s Comments: The efficacy of a drug varies from patient to patient and can be affected by different factors; however, a contributory role of the suspect product BNT162B2 to the reported drug ineffective / COVID-19 cannot be ruled out.


VAERS ID: 1646755 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-09
Onset:2021-08-03
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 - / OT

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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210801; Test Name: PCR/Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101021850

Write-up: Covid-19 positive test results; Covid-19 positive test results; This is a spontaneous report from a contactable consumer. A 51-years-old non-pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number: ER8729), via intramuscular route on 09Apr2021 as dose 2, single (at the age of 51 years) and first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number: EN6203), via intramuscular route on 16Mar2021 as dose 1, single (at the age of 51 years), for covid-19 immunization. Medical history and concomitant medications were not reported. It was unknown if the patient received any other vaccines within 4 weeks prior to the COVID vaccine. It was stated that, on 03Aug2021, the patient had Covid-19 positive test results. The adverse event resulted Doctor or other healthcare professional office/clinic visit. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had been tested for COVID-19 via PCR test via Nasal Swab sample taken on 01Aug2021, which came out to be positive. No treatment was received. The outcome for the event was recovering at the time of report. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1646759 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-08
Onset:2021-08-03
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Illness, SARS-CoV-2 test
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Rapid PCR test; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101021884

Write-up: got covid and got visibly sick from it.; got covid and got visibly sick from it.; got covid and got visibly sick from it.; This is a spontaneous report received from a Pfizer employee reported for a female patient. A 26-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: solution for injection, Lot Number: EW0173), via an unspecified route of administration on 08May2021 (at the age of 26-year-old), DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunisation. The patient was not pregnant at the time of vaccination. The patient medical history and concomitant medications were not reported. It was unknown Prior to vaccination the patient diagnosed with COVID-19. It was unknown if the patient received list of any other medications within 2 weeks of vaccination. It was unknown if the patient received any other vaccines within 4 weeks prior to the COVID vaccine. On 03Aug2021, the patient got covid and got visibly sick from it. Post vaccination, the patient underwent lab test which included sars-cov-2 test (nasal swab): positive on 03Aug2021. The event resulted into to doctor or other healthcare professional office/clinic visit. it was unknown if the patient received treatment for the event. The patient outcome of the events got covid and got visibly sick from it (covid-19 and sickness) was resolving at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1646760 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-08-03
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Rapid PCR; Result Unstructured Data: Test Result:If covid tested post vaccination: Yes; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101021885

Write-up: Contracted COVID; Contracted COVID; This is a spontaneous report from a contactable consumer via Pfizer Colleague. A male patient of an unspecified age received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- ER8736) via an unspecified route of administration on 17May2021 as dose number unknown, single for COVID-19 immunization. Medical history and concomitant medications were not reported. It was unknown If patient had covid prior to vaccination. It was unknown if patient received other vaccine in four weeks. On 03Aug2021, patient experienced contracted COVID. AE resulted in Doctor or other healthcare professional office/clinic visit. Patient had COVID tested Rapid PCR post vaccination via, nasal swab on 03Aug2021. It was unknown if patient received treatment. Seriousness was reported as no. The outcome of the events was unknown. No follow-up attempts are possible. No further information is expected. .


VAERS ID: 1646787 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-09
Onset:2021-08-03
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 - / OT

Administered by: Work       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DEXILANT; ZYRTEC; FLONASE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Acid reflux (oesophageal); Seasonal allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Covid-19 by PCR test; Test Result: Positive
CDC Split Type: USPFIZER INC202101022659

Write-up: I received the covid-19 vaccine and tested positive for Covid-19 by PCR test; I received the covid-19 vaccine and tested positive for Covid-19 by PCR test; This is a spontaneous report from a contactable consumer (patient). A 36-years-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) via intramuscular on 09Feb2021 (Batch/Lot Number: EL3247) (at the age of 36-years-old) as dose 2, single and received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) via an unspecified route of administration on 20Jan2021 (Batch/Lot Number: EL3247) (at the age of 36-years-old) as dose 1, single both for COVID-19 immunization. Medical history included acid reflux and seasonal allergies. Concomitant medications included dexlansoprazole (DEXILANT); cetirizine hydrochloride (ZYRTEC) and fluticasone propionate (FLONASE). 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. The patient reported that she received the covid-19 vaccine and tested positive for covid-19 by pcr test on 03Aug2021. The patient visited doctor or other healthcare professional office/clinic visit due to events. No treatment was received for the events. The patient underwent lab tests and procedures which included covid-19 by pcr test: positive on 03Aug2021. The outcome of event was recovering.


VAERS ID: 1646790 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-22
Onset:2021-08-03
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 RA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101022714

Write-up: Patient tested positive to COVID-19 on 03Aug2021.; Patient tested positive to COVID-19 on 03Aug2021.; This is a spontaneous report from a contactable Consumer. A Consumer reported for a 17-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number: EL3247 and expiry date was not reported), via Intramuscularly, in Arm Right, on 01Apr2021 at 09:00 AM (age at vaccination: 16 years), as a single dose for COVID-19 immunization and second dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number: EL3247 and expiry date was not reported), via Intramuscularly, in Arm Right, on 22Apr2021 at 09:00 AM (age at vaccination: 16 years), as a single dose for COVID-19 immunization at workplace clinic. The patient was not pregnant at the time of vaccination. The patient''s medical history and concomitant medications were not reported. The patient did not have known allergies. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient received other medication which included birth control within 2 weeks of vaccination. The patient was not diagnosed with COVID prior vaccination. The patient was tested for COVID post vaccination. The patient tested positive to COVID-19 on 03Aug2021. The patient did not receive any treatment for the events. The patient underwent lab test and producers which included SARS-CoV-2 test (Nasal Swab) on 03Aug2021: positive. Outcome of the events was recovered on an unspecified date in Aug2021.


VAERS ID: 1646824 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-08-03
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Fever; Result Unstructured Data: Test Result: 103 Fahrenheit; Test Name: More accurate Covid test; Result Unstructured Data: Test Result: Unknown results; Comments: covid test type post vaccination: Unknown, covid test result: Pending; Test Date: 20210804; Test Name: Nasal Swab; Test Result: Positive.
CDC Split Type: USPFIZER INC202101023422

Write-up: This is a spontaneous report from a contactable consumer. This consumer reporter for a 77-year-old female patient. A 77-year-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number unknown) via an unspecified route of administration on an unspecified date in 2021 as DOSE NUMBER UNKNOWN, SINGLE (age at vaccination: 77 years) for COVID-19 immunization. Medical history and concomitant medications were not reported. She was not pregnant at the time of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. Known allergies were unknown. It was reported that it had been vaccinated with the Pfizer Covid vaccine earlier this year. On 03Aug2021, she became sick with 103F fever. On 04Aug2021, patient underwent sars-cov-2 and tested positive for COVID using quick test. She was currently waiting for more accurate Covid test result. On an unspecified date in 2021 she had been short of breath and was very weak. No treatment was received. The patient underwent lab tests and procedures which included fever resulted as 103 Fahrenheit on 03Aug2021, more accurate Covid test result as unknown results on an unknown date covid test type post vaccination: unknown, covid test result pending, sars-cov-2 test resulted as positive on 04Aug2021. The clinical outcome of the event was unknown. The lot number for the vaccine [BNT162B2] was not provided and will be requested during follow up.


VAERS ID: 1646928 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Bedridden, Body temperature, Dizziness, Dry mouth, Dyspepsia, Gait inability, Genital burning sensation, Genital swelling, Influenza like illness, Lip swelling, Lyme disease, Pharyngeal hypoaesthesia, Taste disorder, Vertigo, Visual impairment
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ANTIVERT [DIHYDROERGOCRISTINE;LOMIFYLLINE]
Current Illness: Drug hypersensitivity; Hypertension (States she experiences this in the care because of motion, people, and noise.); Lyme disease (Diagnosed 10 years ago; states she was misdiagnosed 20 years prior to her diagnosis.)
Preexisting Conditions: Medical History/Concurrent Conditions: Anaphylaxis (States occurred when she was in her 40s. Says she had an epi-pen.); Body temperature abnormal (Caller mentions that her temperature hasn''t been normal since menopause); Brain injury (States this occurred when she was a small child); Heart attack (Caller states her doctor told her when he diagnosed her with Lyme Disease); Hypersensitivity NOS; Immunocompromised; Vertigo (Caller states this occurs due to her Lyme Disease)
Allergies:
Diagnostic Lab Data: Test Name: temperature; Result Unstructured Data: Test Result:96-97; Comments: around 96-97 degrees
CDC Split Type: USPFIZER INC202101029567

Write-up: like all the symptoms she got from Lyme disease got cranked up/ Lyme disease symptoms worsened; the room is spinning so fast I can''t even get out of bed to use the bathroom/ Vertigo intensified; been sick in bed/ In bed sick; burning and swelling in the genitalia; burning and swelling in the genitalia/ vaginal burning, or lower extremity burning; slight swelling of the lips; not able to ambulate; taste of plastic in the mouth,; throat was a little bit numb as well; dryness in the mouth; Weak; flu-like symptoms; digestion issues; Vision issues; Dizziness; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 79-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot Number: FA7485, Expiration date was not reported), (age at vaccination: 79-years) via an unspecified route of administration, administered in Arm Left on 03Aug2021 as dose 1, single for COVID-19 immunization. Medical history include ongoing Lyme disease from an unknown date (diagnosed 10 years ago; she was misdiagnosed 20 years prior to her diagnosis, causes her to dehydrate quickly, not sweat, and not to grow hair everywhere), heart attack from an unknown date to an unknown date (her doctor told her when he diagnosed her with Lyme Disease that the Lyme disease was a contributing factor to this heart attack), sensitivity to certain synthetic materials from an unknown date to an unknown date, anaphylaxis from an unknown date to an unknown date (years ago, to pesticides, occurred when she was in her 40s, she had an epi-pen). She stated that synthetic materials are what cause her to have the anaphylactic shock that closed off windpipe and everything. She was told after this to not eat any foods with pesticides, ongoing sensitivity to foods and drugs from an unknown date, brain injury from an unknown date to an unknown date (this occurred when she was a small child), ongoing high blood pressure from an unknown date (she experienced this in the care because of motion, people, and noise), vertigo from an unknown date (this occured due to her Lyme Disease), her temperature had not been normal since menopause and immunocompromised from an unknown date to an unknown date. She stated when she saw all the synthetic materials that were in this shot, she thought maybe it was one of those things. Who knew what was making her feel this way? Concomitant medication includes dihydroergocristine, lomifylline (ANTIVERT DIHYDROERGOCRISTINE; LOMIFYLLINE) was taken for Dizziness, Vertigo, start and stop date were not reported (she took over the counter Antivert as needed). Patient stated that she had Lyme Disease and was assured by her primary care provider. She stated she was off antibiotics for a month and then waited a week before she took her vaccine. It had done everything that she normally has with Lyme Disease and put it in stereo and felt Lyme disease symptoms worsened on 03Aug2021, like all the symptoms she got from Lyme disease got cranked up, she suffered with Lyme disease all the time and that the only treatment would be stem cell healing. Patient did not have any issues with her arm. Patient had small arms. She did not know if it was because she was fragile that she felt it so strong. Stated she had not had a care provider in a week and she was due for the second vaccine on 24Aug2021, but she was scared if it was much worse than this one she will not be able to take care of herself. On 03Aug2021, the patient experienced she had been sick in bed for a week. Patient stated that she was weak on 03Aug2021. She felt much worse she would have to go somewhere where someone can take care of her. She was only been eating because she kept enough broth and vegetables in the house. She also reported burning and swelling in the genitalia on 03Aug2021 and she did not know if it had to do with the urinary tract but everything down there was sort of swollen and red which continued up until yesterday morning; she stated that even care provider said yes she had experienced the same thing when she told her care provider (a woman in her 40s) about the genital symptoms. Her main concern was that she was not able to ambulate and it was like when you take niacin because of the Vertigo intensified on 03Aug 2021, and she could not ambulate because the room was spinning so fast she could not even get out of bed to use the bathroom. She states she was like that for the first 3 to 3.5 days. She also reported facial symptoms after her first dose, including her within 10 minutes had that taste of plastic in the mouth, and dryness in the mouth and slight swelling of the lips which lead to felt like when you have just got a fresh thing of novocaine in your lips and that her throat was a little bit numb as well but these symptoms resolved within 30 minutes. She said when the half hour was up it did not feel any harder. It did not feel like it was in tongue, throat was a little bit of numb but that dissipated and was fine. Patient stated that no one told her there would be vaginal burning, or lower extremity burning on 03Aug 2021. States it was the kind of flushed feeling on 03Aug2021 that you get after taking Niacin. She had to take a lot of Niacin in her life because of her Lyme disease and vertigo. She could barely stand up 03Aug2021. Stated she was trying to keep moving by walking with her walking stick. She stated her doctor did not know what to do and that he was not a Lyme doctor just a primary care doctor. He told her that maybe she should see a Lyme specialist. She did not think she would need to go see one just for a vaccine. She also mentioned that she ate all organic foods, she did not eat anything out of boxes and made everything from scratch. Stated that this made it harder for her to get by when she was not feeling well. Caller mentioned flu-like symptoms, digestion issues, vision issues, and dizziness on 03Aug2021 since the vaccine. The patient underwent lab test temperature with result around 96-97 degrees on an unknown date. The symptoms of her face/lips/ throat may be a sign of a severe allergic reaction, as follows: Difficulty breathing, Swelling of your face and throat. Directed back to HCP for guidance, as she may need to be monitored for a longer period of time, if they thought it suitable she received the second vaccine dose. The outcome of the events like all the symptoms she got from Lyme disease got cranked up/ Lyme disease symptoms worsened, the room is spinning so fast I can''t even get out of bed to use the bathroom/ Vertigo intensified, been sick in bed, burning and swelling in the genitalia, vaginal burning, or lower extremity burning, slight swelling of the lips, not able to ambulate, weak was not recovered. The outcome of the events taste of plastic in the mouth, throat was a little bit numb as well, dryness in the mouth, flu-like symptoms, digestion issues, vision issues, dizziness was unknown.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101031447 Same reporter/ drug, different patient/ AE;US-PFIZER INC-202101031448 Same reporter/ drug, different patient/ AE


VAERS ID: 1647129 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-30
Onset:2021-08-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Blood pressure measurement, Chest pain, Heart rate, Investigation, Malaise, Oxygen saturation
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Name: BP; Result Unstructured Data: Test Result:these have been normal; Test Name: pulse oximeter; Result Unstructured Data: Test Result:these have been normal; Test Name: cardiovascular system; Result Unstructured Data: Test Result:everything was fine; Test Name: tests for acid reflux; Result Unstructured Data: Test Result:unknown results; Test Name: pulse oximeter; Result Unstructured Data: Test Result:these have been normal
CDC Split Type: USPFIZER INC202101041813

Write-up: he was not feeling well; chest pain; anxiety; This is a spontaneous report from a contactable consumer (patient). A 40-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration, administered in the left arm on 30Jul2021 (batch/lot number: EW0181) at 40 years old as DOSE 1, SINGLE for COVID-19 immunization. The patient had no medical history, no concomitant medications, and had no prior vaccinations. The patient experienced chest pain and anxiety on 03Aug2021 and was not feeling well on an unspecified date. The patient reported that 4 days after his first dose, on 03Aug2021, he started having chest pain and anxiety. He went to the ER and they checked his cardiovascular system and said everything was fine. He continued having chest pain and went back to the ED and had another check-up and did tests for acid reflux, results were unknown. He had pulse oximeter and a BP cuff at home, these have been normal. The patient went to the ED for a 3rd visit and did not stay since it was too crowded. The ED has provided a F/U appt in 4 weeks. Patient asked if other people had these same symptoms after getting the Pfizer COVID vaccine. The patient further stated that he had been experiencing constant chest pain, which comes and goes from taking the Pfizer Vaccine. He tried to see if reports of chest pain from getting the vaccine have been received. Therapeutic measures were taken as a result of chest pain and anxiety which included administration of ibuprofen (MOTRIN) and alprazolam (XANAX) and these did not work. Patient does not have the lot numbers of these medications. He was about to talk to the representative about this thing to healthcare person from Pfizer because he was not feeling well since an unknown date. So, he needed to talk to them. The outcome of the events was unknown. It was reported that the patient was scheduled for the second shot on 20Aug2021. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1647286 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-08-03
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Feeling cold, Gait disturbance, Loss of consciousness, Myocardial infarction
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101056716

Write-up: heart attack; couldn''t take a breath/she couldn''t breathe; passed out a few times; couldn''t walk or make use of her legs; got so cold; This is a spontaneous report from a contactable consumer (patient). A 33-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 18Jun2021 08:00 (Batch/Lot number was not reported) at the age of 33-year-old as single dose for covid-19 immunization. The patient''s medical history was none, no known allergies. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient was not pregnant at the time of vaccination. The patient''s concomitant medications were none. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any other medications within 2 weeks of vaccination. Historical vaccine included first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) on 28May2021 08:00 AM at the age of 33-year-old, administered in Right arm for covid-19 immunization. On 10Aug2021, she woke up at 2 am and felt like she was having a heart attack; she couldn''t take a breath/she couldn''t breathe, and she passed out a few times. She also couldn''t walk or make use of her legs so her husband had to carry her around. Her breathing eventually returned but she was not breathing properly for the next few minutes that followed. After a while, she got so cold like she was stuck in a deep freezer and nothing was successful in warming her up. This episode lasted for about an hour before it passed. She asked her husband to hold off on calling the ambulance because she knew they could not afford the cost but she scheduled a full physical with her doctor the next day because she knew something was very wrong. The events resulted in [Doctor or other healthcare professional office/clinic visit, Life threatening illness (immediate risk of death from the event)]. No treatment received for the events. The outcome of the events was recovered on an unspecified date. No covid prior vaccination, no covid tested post vaccination. The lot number for bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 1651466 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Hypersensitivity, Vaccination site erythema, Vaccination site swelling
SMQs:, Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: * Fatigue and tiredness for two days from the night of vaccination, * Redness, swelling at the site of vaccine (left arm), * Allergy at different parts of the body--knee, wrist, thigh, foot, == Fatigue went away naturally after two days but allergy remained for a week. ==


VAERS ID: 1651516 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-02
Onset:2021-08-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Elquis, atenolpl-chlorthal, klor-con, iron, miltivitamin
Current Illness: None
Preexisting Conditions: Hypertension, DVT/PE
Allergies: Ace-inhibitor (ie zestorectic)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Adverse event: patient reported rapidly beating heart 6-12 hours after vaccine while sleeping. Extreme concern. Lasted about 20 minutes. Reported to PCP week of 23 Aug 2021. Doctor recommended proceed second dose.


VAERS ID: 1653563 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-01
Onset:2021-08-03
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abscess, Appendicitis perforated, Blood test, Computerised tomogram
SMQs:, Gastrointestinal perforation (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: vitamin C, Vitamin D, Levothyroxine,Atorvastatin, probiotics,
Current Illness: none
Preexisting Conditions: diverticulitis
Allergies: penicillin,sulfer
Diagnostic Lab Data: 2 CAT Scans, blood work
CDC Split Type:

Write-up: Ruptured Appendix. I was hospitalized and given IV antibiotics then sent home with 2 weeks of oral antibiotics, when the abscess clears up I will need surgery.


VAERS ID: 1653811 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiovascular evaluation, Chest X-ray, Chest pain, Echocardiogram normal, Electrocardiogram abnormal, Laboratory test, Pericarditis, Troponin I
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Erythromycin, penicillin: HIVES
Diagnostic Lab Data: 8/4/21 Hospital-ER: normal ecg, chest xr, labs including trop I 8/6/21 Abnormal ECG in my clinic 8/11/21 abnormal ecg at cardiology 8/17/21 Echocardiogram-normal
CDC Split Type:

Write-up: started to have chest pain around 2 days after 2nd dosage. Went to ER for work up-negative cardiac tests. Came to my office on 8/6/21-ECG shows some minor abnormalities. I gave patients Naproxen BID and referred to cardiology due to symptoms sounded like pericarditis. Saw Dr. diagnosed with pericarditis on 8/11/21. Started on Medrol dose pack. Went back to Dr. on 8/18 symptoms were not better so started on colchicine and prontonix. Patient an echo on 8/17/21 and report is normal.


VAERS ID: 1654323 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-10
Onset:2021-08-03
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Echocardiogram, Magnetic resonance imaging, Pericarditis, Positron emission tomogram, Thrombosis, Ultrasound Doppler
SMQs:, Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Echocardiogram 8/16 Trans esophageal Echocardiogram 8/17 CT Scan 8/17 PET Scan 8/17 2 MRIs 8/17 and 8/28 Countless chest X-rays Ultrasound of hands 8/18 Ultrasound of arms 8/27
CDC Split Type:

Write-up: Pericarditis and blood clots in arms. Symptoms started first week of august 2021


VAERS ID: 1655074 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-24
Onset:2021-08-03
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Nucleic acid 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: NAAT Covid test; Result Unstructured Data: Test Result:positive; Comments: Testing positive for Covid virus, after both vaccines.
CDC Split Type: USPFIZER INC202101076355

Write-up: Tested positive for Covid virus, after being fully vaccinated event; covid positive; This is a spontaneous report from Pfizer a contactable pharmacist, the patient. A 34-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number was not provided), via an unspecified route of administration, administered in the left arm on Friday 05Feb2021(at the age of 34 years) as dose 1, single, for COVID-19 immunization, by a technician. Reason for not providing lot number was mentioned as patient was unwilling to complete the report. The patient''s medical history and concomitant medications were not reported. On 05Feb2021, they injected the vaccine pretty low about 4.5-5 inches from the top of her shoulder (injected low in the arm and not in the muscle) and she believed that the vaccine was administered incorrectly, because it was not administered in the deltoid muscle (Vaccine administered at inappropriate site). She stated that, on unspecified date in 2021, her arm was pretty sore to lay on and the fatty tissue was sore, and she experienced pain at the injection site but did not experience any muscle soreness in her triceps or deltoid muscle. She states they are monitoring and tracking the vaccine breakthrough cases in their area and she had some concerns regarding one specific lot number that 15% of their breakthrough cases had received. The caller at the time, did not have the NDC or expiration date, however, was going to work on pulling patient information so that she would be able to have this information available to provide upon transfer. Agent states the Caller was an assistant director of health and works at a local health department. Agent states the Caller called because she had some concerns, and the health department is tracking breakthrough cases in her area. Agent reports that Caller states 15% of breakthrough cases are from one Pfizer Covid 19 Lot number: EN5318. Agent confirms Caller is calling about the Pfizer Covid 19 vaccine. Caller confirms she was calling about the Pfizer Covid 19 vaccine. Caller reclarifies later in report that 15% of the breakthrough cases in her county had the same lot number, EN5318, which was concerning. Caller states, reclarified later in report, she had 37 patients with partial identifiers. Caller states she cannot provide some identifying details and that she would need to check with her legal department first. Caller states that Covid positive was defined as having both vaccines and testing positive for Covid longer than two weeks after both doses. Testing positive for Covid virus, after both vaccines. Patient was hospitalized with Covid, but no other information can be provided by Caller. The outcome for the events was unknown at the time of report. Follow-up attempts completed. No further information expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101075254 Same reporter/ drug/ event for different patients


VAERS ID: 1655106 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Body temperature, Body temperature increased, Cardiac disorder, Chest discomfort, Chest pain, Cold sweat, Dyspnoea, Electrocardiogram, Feeling hot, Gastrointestinal disorder, Headache, Heart rate, Heart rate increased, Lymphocyte count, Lymphocyte count abnormal, Oxygen saturation, Renal pain, Swelling, Troponin
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19.
Allergies:
Diagnostic Lab Data: Test Name: BP; Result Unstructured Data: Test Result:160/147; Comments: it was 154/85; Test Name: temperature; Result Unstructured Data: Test Result:100.1; Test Name: EKG; Result Unstructured Data: Test Result: abnormal; Test Name: pulse; Result Unstructured Data: Test Result:124; Comments: pulse was still 130 at that time was 90/38 and his pulse dropped to 100 pulse of 82; his pulse was 156/95; Test Name: absolute lymphocytes; Result Unstructured Data: Test Result: out-of-whack; Test Name: o2; Result Unstructured Data: Test Result:92-98; Test Name: troponin; Result Unstructured Data: Test Result: normal.
CDC Split Type: USPFIZER INC202101091558

Write-up: pulse was 124; his BP was 160/147; intestinal discomfort; head got hot; his temperature was 100.1; chest felt real pressurized; neck was swollen; severe headache.; shortness of breath; kidney pain; felt clammy; only thing that was out-of-whack was is uric nitrogen, his absolute lymphocytes., and his ALT.; he is having chest pain; severe heart issues; This is a spontaneous report from a non-contactable consumer (patient himself). A male patient of an unspecified age received first dose of bnt162b2 (Solution injection; Batch/Lot number was not reported), via an unspecified route of administration on 01Aug2021 as dose 1, single for covid-19 immunisation. Medical history included COVID twice, he stated that he had COVID for two months, 6-8 weeks. He stated that he took like 4 antibiotics to help him get rid of it. He states he was one of those long haulers, they called them back in the day. He stated it happened in Apr2021 and was very chaotic. The patient''s concomitant medications were not reported. Caller stated he got his first injection on 01Aug2021. He stated that he started having symptoms, He states on Tuesday 03Aug2021 he was having some severe heart issues. He states his pulse was 124, his BP was 160/147, and he stated he wasn''t expecting to have a reaction to this because most of his coworkers have had Pfizer and they did fairly well on it. He stated that he wasn''t expecting to have any side effects and his concern was his heart. He stated he had to go get a cardiac work up on 05Aug2021. He stated he didn''t go on 04Aug2021 because he felt better but his pulse was still 130, he stated he has to look at his notes because he was fighting his case with his employer right now. He stated he was not against the vaccine he thinks it was a great product. He was not sure why he had a reaction to it. He stated he did not do well on it and his question was should he get the second shot and if so are the symptoms, because like he said he saw and what he read is he was suppose to get symptoms on the second shot, not the first shot. He stated he woke up with kidney pain because he took a nap when he got home, and he also had some intestinal discomfort. He said what''s weird on day two it moved closer to his belly button. He stated on 03Aug2021 he started drinking a little water trying to get that flushed out. He stated he was taking his temperature because his head got hot, not his whole body but his head, he said he felt his head because it was hot and he used his thermometer and his temperature was 100.1. His pulse was 124, his o2 was 92-98. He stated that he was just trying to treat it like when he has COVID, when his O2 stat was low he would get up and walk around, and he noticed with all this other stuff going on he couldn''t walk so he was like never mind he will go back and sit down and try to rest. He stated he made a call that night to the urgent care, he stated he works for (name), and they were on a two hour wait and he did tell the lady he had his vaccine and she said oh this was just a side effects. He said okay let me just get through the night and I will have my wife take care of me. The only thing she did was put cold compressions on my forehead to bring down the temperature of my head. He stated that helped but when he woke up he felt clammy and he emailed his doctor and the nurse called him and said go to urgent care. He states that he and his wife were on the way to urgent care but his pulse at that time was 90/38 and his pulse dropped to 100 and the only thing he felt that day was that his chest felt real pressurized, for most of the night into the evening. He stated his neck was swollen and he had a severe headache. He stated that he does give himself a timolol injection when he does have migraines/headaches. He did give himself a timolol injection because it helps his heart out but he wasn''t trying to treat his heart, he was only treating himself with what he was prescribed the medication for he states that he noticed the next morning because the nurse called him again asking him why he did go on 06Aug2021 to urgent care to get the cardiac work up, he stated he meant 05Aug2021. He stated because he had a headache and he gave himself a timolol injection and gave her the feedback that he recorded for the night, and the nurse told him that his doctor wants him to go and get a cardiac workup. He stated he went on Aug and his EKG did come back as abnormal, his troponin was within normal limits, He stated the only thing that was out-of-whack was was uric nitrogen, his absolute lymphocytes, and his ALT. He just wanted to see if it would be safe for him to get his second injection. If so would he be exempt. He stated he told his cardiologic that he was not his self, he stated he does notice his pulse elevating with normal walking He stated that he knows a cardiothoracic surgeon and they stated that when BP was that high it can put a lot of stress on the body. He stated on 13Aug2021 he was getting ready for work and he felt a severe burn pain in his chest and he had his wife bring the BP machine so he could check it and it was 154/85 with a pulse of 82. He states that he knew the nurse wanted him to get a workup and he called the urgent care and they had a two hour window so he went in that morning right away, his pulse was 156/95, they took him back right away and he states the EKG was abnormal. He states he is not sure why if he did anything to aggressive or if he was walking to fast by the time he gets to his car he was having chest pain and shortness of breath and his pulse is elevated again. Which was really weird because normally he would have to walk like a quarter mile to get his pulse above 107. He stated he wasn''t anticipating getting symptoms from the first vaccine because everyone got them from the second one. He stated he works in the medical field and he educates doctors left and right every day, and he states that the lady told him that USMI would give him resources for his doctor. He had a cardiac work up with his cardiologist on 09Aug2021 who he hasn''t seen for 10 years because he just needed to make sure that this is going to happen again. He stated his HR was back to normal and was back in the 70s like it used to be. He stated do people have these symptoms on the first dose because he couldn''t find anything. The outcome of events was unknown. No follow-up attempts are possible, information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1655738 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Culture urine negative, Nausea, Pain, Pollakiuria, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control, Allegra
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: 8/10 UA positive, urine culture negative 8/17 UA positive, urine culture negative 8/30 UA positive, urine culture pending
CDC Split Type:

Write-up: Started having urinary frequency and pain, nausea, and lower back pain 2 days later. Went to urgent care got antibiotics finished the course with no improvement. Went to urgent care again, got another antibiotic. Finished that course. No improvement, all symptoms worsening, terrible lower back pain. Went to emergency department, got another antibiotic finished that course and still no change in symptoms. Went to urgent care again per primary doctor since I couldn?t get in to see them for another 2 months.


VAERS ID: 1656584 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-06
Onset:2021-08-03
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Cough, Dyspnoea, Headache, Lung opacity, Myalgia, Pulmonary mass
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: 66 y/o male with PMHx of DM, gout, Hyperlipidemia, HTN, and kidney stone admitted for SOB due to Covid-19 on 8/7/21 Symptoms also include nonproductive cough, HA, and myalgias. Chest x-ray demonstrates multifocal patchy ground glass and airspace nodular opacities. Treated with supportive care. Pt discharged home on 8/9/21.


VAERS ID: 1658072 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-28
Onset:2021-08-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Heart rate, Heart rate abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Drug allergy (Penicillin , gabapentin)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Heart rate; Result Unstructured Data: Abnormal (Irregular Heart Rate fluctuations ranging from as low as 50 to as high as 100 BPM)
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Irregular Heart Rate fluctuations ranging from as low as 50 to as high as 100 BPM; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE ABNORMAL (Irregular Heart Rate fluctuations ranging from as low as 50 to as high as 100 BPM) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046B21A) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy (Penicillin , gabapentin). On 28-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Aug-2021, the patient experienced HEART RATE ABNORMAL (Irregular Heart Rate fluctuations ranging from as low as 50 to as high as 100 BPM). At the time of the report, HEART RATE ABNORMAL (Irregular Heart Rate fluctuations ranging from as low as 50 to as high as 100 BPM) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Aug-2021, Heart rate: abnormal (abnormal) Abnormal (Irregular Heart Rate fluctuations ranging from as low as 50 to as high as 100 BPM). mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant medication was reported. No treatment history was reported. Most recent FOLLOW-UP information incorporated above includes: On 24-Aug-2021: Follow-up received on 24 Aug 2021 included no new information.


VAERS ID: 1658454 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-15
Onset:2021-08-03
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization with COVID-19 Reported per vaccine EUA


VAERS ID: 1658788 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Paraesthesia
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: Lexapro, progesterone, statin and thyroid
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within minutes I had heat/tingling in my right foot. It comes and goes. It has been happening since I got the shot almost a month ago. It happens at least a few times every hour to sometimes many times in just 10 minutes.


VAERS ID: 1659031 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-03
Onset:2021-08-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient received an extraneous dose of Janssen COVID-19 vaccine. Pt denies all complaints or reactions.


VAERS ID: 1659146 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-07
Onset:2021-08-03
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (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: Belsomra PRN, paroxetine
Current Illness: None known
Preexisting Conditions: Depression, anxiety, insomnia
Allergies: None known
Diagnostic Lab Data: COVID-19 test
CDC Split Type:

Write-up: Client reported a breakthrough case of COVID-19 diagnosed by a medical provider after receiving 2 doses of Moderna on 03/07/21 and 04/07/21 from this ARNP.


VAERS ID: 1659215 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-01
Onset:2021-08-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Dysmenorrhoea, Echocardiogram abnormal, Electrocardiogram ambulatory abnormal, Electrocardiogram normal, Extrasystoles, Gastrooesophageal reflux disease, Impaired work ability, Insomnia, Palpitations, Red blood cell sedimentation rate increased, Ventricular extrasystoles
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 2 EKGs, Holter Monitor (Indicated PVCS), Echo (indicated PVCS), Chest Xrays, blood tests normal except for high sedimentation rate (42).
CDC Split Type:

Write-up: 2 days after my first shot I started to have left sided chest pain. The first few nights were so bad I couldn''t sleep on my left side. With chest pain also came palpitations where it felt like my heart was skipping a beat. Palpitations were on and off until 4 days after where they were constant, one per minute, the whole day. Visited urgent care the next day for that reason, got an EKG, chest xray, everything looked normal. Was advised to rest on Monday (take off work) and see cardiologist ASAP. Saw doctor that Tuesday, EKG looked normal. Scheduled for echo and blood tests later. In the meantime I took magnesium which didn''t seem to help, I did take 600MG of Advil one day for menstrual pain and my chest pain went away as did the palpitations. But following that I had horrible acid reflux where I felt food coming up in my mouth constantly for several days and gum inflammation. I have never had issues taking that much advil before. It is a month after my first dose and I still experience palpitations every day. At night they are the worst where I feel them once per minute, sometimes several following each other. With my ''attacks'' I still get chest pain, still left sided. Caffeine does not seem to affect my palpitations as I have cut back with no effects.


VAERS ID: 1661086 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-30
Onset:2021-08-03
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Brain natriuretic peptide, C-reactive protein, Echocardiogram, Myocarditis, Red blood cell sedimentation rate increased, SARS-CoV-2 test, Troponin, Upper respiratory tract infection
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Antinuclear antibody increased
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: BNP; Result Unstructured Data: HIGH; Test Date: 20210803; Test Name: C-reactive Protein; Result Unstructured Data: HIGH; Test Date: 20210803; Test Name: (On Echocardiogram) Myocardial stress; Result Unstructured Data: NORMAL; Test Date: 20210803; Test Name: Sedimentation Rate; Result Unstructured Data: HIGH; Test Date: 20210803; Test Name: COVID-19 test; Test Result: Negative ; Result Unstructured Data: Negative; Test Date: 20210803; Test Name: Troponin; Result Unstructured Data: HIGH
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Admitted to the hospital for presumed URI/myocarditis; (On Echocardiogram) Myocardial stress; This spontaneous case was reported by a physician and describes the occurrence of UPPER RESPIRATORY TRACT INFECTION (Admitted to the hospital for presumed URI/myocarditis) and MYOCARDITIS ((On Echocardiogram) Myocardial stress) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 014M20A and 012M20A) for COVID-19 vaccination. The patient''s past medical history included Antinuclear antibody increased. On 30-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Aug-2021, the patient experienced UPPER RESPIRATORY TRACT INFECTION (Admitted to the hospital for presumed URI/myocarditis) (seriousness criterion hospitalization) and MYOCARDITIS ((On Echocardiogram) Myocardial stress) (seriousness criteria hospitalization and medically significant). The patient was hospitalized from 03-Aug-2021 to 04-Aug-2021 due to MYOCARDITIS and UPPER RESPIRATORY TRACT INFECTION. The patient was treated with METOPROLOL for Adverse event, at an unspecified dose and frequency. On 04-Aug-2021, UPPER RESPIRATORY TRACT INFECTION (Admitted to the hospital for presumed URI/myocarditis) and MYOCARDITIS ((On Echocardiogram) Myocardial stress) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Aug-2021, Brain natriuretic peptide: high (High) HIGH. On 03-Aug-2021, C-reactive protein: high (High) HIGH. On 03-Aug-2021, Echocardiogram: normal (normal) NORMAL. On 03-Aug-2021, Red blood cell sedimentation rate increased: high (High) HIGH. On 03-Aug-2021, SARS-CoV-2 test: negative (Negative) Negative. On 03-Aug-2021, Troponin: high (High) HIGH. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was mentioned. The patient is currently undergoing a rheumatological work up. Prior to vaccination, the patient had an elevated ANA and is being assessed for fibromyalgia versus lupus. Laboratory data was mentioned on an unknown date patient took covid test which was negative as was the tests for respiratory pathogens. Treatment information was mentioned as patient treated with nasal oxygen. Company comment: Very limited information regarding this events has been provided at this time. Further information has been requested.; Sender''s Comments: Very limited information regarding this events has been provided at this time. Further information has been requested.


VAERS ID: 1661182 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-02
Onset:2021-08-03
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-01
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetes
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: delta variant; Test Result: Positive; Test Date: 20210802; Test Name: quick test; Test Result: Negative; Test Date: 20210803; Test Name: quick test; Test Result: Positive.
CDC Split Type: USPFIZER INC202101075459

Write-up: tested positive for COVID-19 after the COVID-19 vaccination; tested positive for COVID-19 after the COVID-19 vaccination; This is a spontaneous report from a contactable consumer (patient herself). This consumer reported different events for 4 patients. This is 1 of 4 reports. A 64-year-old female patient received bnt162b2 (formulation: solution for injection; NDC number: unknown; expiry date: unknown), dose 1 via an unspecified route of administration on 12Mar2021 (Lot number was not reported) as dose 1, single and dose 2 via an unspecified route of administration on 02Apr2021 (Lot number was not reported) as dose 2, single (at the age of 64 years) for covid-19 immunisation. Medical history included diabetes from 2014 and its ongoing. It has been about 7 years since she has had diabetes. She is not on insulin. She controls it with exercise and diet. There were no concomitant medications. The patient reported that she tested positive for covid-19 after the covid-19 vaccination on 03Aug2021. Patient confirms that she tested positive for the delta variant on 03Aug2021 and 16Aug2021 was the last day of her isolation. Her first dose was on 12Mar2021 and her 2nd dose was on 02Apr2021. Probed for NDC, lot number and expiry date and she say she has them in her phone, but she can''t really read them. She sees that it says Pfizer, but she can''t really see what it says beside that. Therapy start date populated as the date for the caller''s first COVID vaccine and the therapy stop date populated as the date for the caller''s second COVID vaccine. The reason that she got tested is because the caller''s husband tested positive on 02Aug2021 and so herself got the quick test and it was negative on 02Aug2021 but then had tested positive on 03Aug2021 and had sore throat and symptoms. The patient underwent lab tests which included delta variant which showed positive on 03Aug2021 and quick test showed negative on 02Aug2021 and positive on 03Aug2021. The outcome of the event COVID-19 was recovered on 16Aug2021. Caller reporting on herself mentioned that she had her Pfizer COVID vaccines and then tested positive for the delta variant of COVID on 03Aug2021 and 16Aug2021 was the last day of her isolation. The caller''s first dose was on 12Mar2021 and her 2nd dose was on 02Apr2021. Probed for NDC, lot number and expiry date and she says she has them in her phone but she can''t really read them. She sees that it says Pfizer but she can''t really see what it says beside that. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up. Linked Report(s): US-PFIZER INC-202101077101 Same reporter/ drug/ event for different patients; US-PFIZER INC-202101077103 Same reporter/ drug/ event for different patients.


VAERS ID: 1662130 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-24
Onset:2021-08-03
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), 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), Opportunistic infections (broad), COVID-19 (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: Aimovig
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data: August 4 - Positive Covid=19 Test
CDC Split Type:

Write-up: I developed a sore throat and headache on August 3. I tested positive for Covid-19 on August 4. I had a fever on August 4 for about 2 hours I was very tired for several days I developed a cough that is still lingering In general, symptoms remained mild


VAERS ID: 1662186 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-24
Onset:2021-08-03
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Cough, Loss of consciousness, Malaise, Mobility decreased, Oropharyngeal pain, Pain in extremity, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril; Gabapentin; Verapamil; Metformin; Atorvastatin; Omeprazole; Amlodipine; Topiramate; Trazadone
Current Illness: No
Preexisting Conditions: I have high blood pressure; diabetes; migraines
Allergies: I have an allergy to cinnamon; corn silk; allergy to antihistamine
Diagnostic Lab Data: COVID PCR test. And it was positive.
CDC Split Type: vsafe

Write-up: I had a sore arm. In August I tested COVID. I had a lot of symptoms and got really sick. Fevers for 4 days, sore throat, lingering cough, lost sense of taste. In bed for entire week. I had head congestion in my head.


VAERS ID: 1662361 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-01
Onset:2021-08-03
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Exposure to SARS-CoV-2, SARS-CoV-2 RNA increased
SMQs:, COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: sars-cov-2 rna, = positive 8/3/2021
CDC Split Type:

Write-up: Tested positive for covid-19 on 8/3/2021. He was an exposure and did not have any symptoms at the time.


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