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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 320 out of 7,116

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VAERS ID: 1632619 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-05-05
Onset:2021-07-31
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation, Back pain, Biopsy, Cardiomyopathy, Echocardiogram, Ejection fraction decreased, Electrocardiogram, Mediastinal mass
SMQs:, Cardiac failure (narrow), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Cardiomyopathy (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: D3, lisinopril, pravastatin, tamulosin, trulicity
Current Illness:
Preexisting Conditions: HTN, DM, HLD, BPH,
Allergies: none
Diagnostic Lab Data: EKG, ECHO, biopsy
CDC Split Type:

Write-up: Patient presented with back pain. Was found to be in A fib RVR, new onset, also found to have cardiomyopathy with EF 20%. Patient was having DOE for 1 month prior off and on. Further imaging showed Mediastinal mass. Patient presented to me to receive anesthesia. I asked patient if he had been vaccinated and he said he received moderna shot a few months ago and did not remember the exact date. These finding are new since receiving the vaccine. Unknown if related


VAERS ID: 1632690 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-19
Onset:2021-07-31
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 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? 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: Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized due to COVID-19. Patient is fully vaccinated.


VAERS ID: 1632736 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-31
Onset:2021-07-31
   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 FA7465 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Nausea, Vaccine positive rechallenge, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none all med are as needed
Current Illness: no
Preexisting Conditions: knee pain
Allergies: penicillin sulfa morphine septra prednisone
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5 hours after receiving the vaccination severe headaches ,nausea vomiting no appetite extreme fatigue. Also had all the same effects after receiving the 2nd vaccination on 8/21 .


VAERS ID: 1632777 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-13
Onset:2021-07-31
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Computerised tomogram, X-ray
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: Chronic Lung Disease, Cardiovascular Disease, Hypertension
Allergies:
Diagnostic Lab Data: Patient had a CT scan and an X-ray.
CDC Split Type:

Write-up: Patient is currently in hospital. Patient was unaware he had COVID and thought he was experiencing symptoms from his lung cancer. Patient is not sure how he may have been exposed to COVID. Patient is fully vaccinated.


VAERS ID: 1632855 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-07-26
Onset:2021-07-31
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue
SMQs:, Arthritis (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: calcium, Vitamin d, Vitamin C, HLA joint support
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin, Levaquin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: about 5 days after 2nd dose, 7-26-21 (first dose was 6-28-21, same lot number) she noticed every joint hurting. Hands were the worst. She felt fatigued and chilly. No noted fevers. She felt this way for about 3 weeks. On 8-22-21 she said she started feeling better with the joint pain, easier to get out of bed and to use her curling iron. Used Ibuprofen for the joint pain.


VAERS ID: 1633034 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-31
Onset:2021-07-31
   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 - / 1 LA / SYR

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

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

Write-up: Fever, body aches, chills, myalgia, headache


VAERS ID: 1633048 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Electrocardiogram normal, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol inhaler, Flovent
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Penicillin, Sulfa
Diagnostic Lab Data: ER visit, EKG normal
CDC Split Type:

Write-up: Episodes of palpitations that started the day after vaccine, have lasted $g3 weeks


VAERS ID: 1633367 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-17
Onset:2021-07-31
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Laboratory test, Magnetic resonance imaging head, Magnetic resonance imaging neck
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: Flu Shot
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 08-02-2021 Neurologist Wellness panel with Laboratory 8-3-2021 ENT MRI of neck/brain
CDC Split Type:

Write-up: Bell''s Palsy


VAERS ID: 1633599 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-14
Onset:2021-07-31
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Seasonique Amitriptyline Omeprazole Magnesium B12
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Venous ultrasound
CDC Split Type:

Write-up: On August 6 I was diagnosed with a DVT to my right leg. The clot went from my calf to my mid thigh.


VAERS ID: 1636586 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-15
Onset:2021-07-31
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Nasal congestion, Pyrexia, SARS-CoV-2 test
SMQs:, 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: Anemia, angina, CAD, CVA, DVT, DM, MI, Hypercholesterolemia, HTN, Kidney disease, PVD, Spinal stenosis.
Allergies: ACE inhibitors
Diagnostic Lab Data: CXR, covid test.
CDC Split Type:

Write-up: Nasal congestion, fever.


VAERS ID: 1636954 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-31
Onset:2021-07-31
   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 RA / 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: 1637132 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-24
Onset:2021-07-31
   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 EW70186 / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Pain, Paraesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Vitamins, Iron 65 Mg, Aspirin 81 mg daily, stool softener Colace 100 mg as needed.
Current Illness: None.
Preexisting Conditions: None.
Allergies: Sulfa (rash)
Diagnostic Lab Data: None. Virtual visit with Doctor and that''s it.
CDC Split Type: vsafe

Write-up: About a week or two after vaccine I started feeling pain in my joints in my hands. I thought it would just away so I continued to work and do whatever. A couple of weeks later, I started noticing my fingers and feet starting to swell but it could be part of pregnancy. It does feel like carpal tunnel but my Doctor said it could be part of pregnancy or the vaccine. She recommended I wear a wrist brace. I''ve been elevating my hand so the swelling could go down but I still feel pain when I bend it and sometimes I get numbness and tingling in the fingers and the whole hand and arm. This is still ongoing. I''ve had carpal tunnel before but never had pain in my joints, so I do know this is a little different. Third Pregnancy. 38 Weeks Pregnant.


VAERS ID: 1637148 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-06
Onset:2021-07-31
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Fatigue, Headache, 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? 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: PCR + COVID-19
CDC Split Type:

Write-up: Fatigue, Headache, positive COVID-19 test


VAERS ID: 1637336 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Malaise, Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: notified primary doctors office on 8/26/2021 at 1645
CDC Split Type:

Write-up: Patient states that she was sickly days after and her arm two days after had limited mobility and is still sore and a bit painful 28 days post.


VAERS ID: 1637345 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site reaction, Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad)

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

Write-up: Muscle twitching every 3-5 minutes. Started in the deltoid (injection site) then moved into my bicep, where it is predominantly. However, within the last week it has moved to my entire body.


VAERS ID: 1641267 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-23
Onset:2021-07-31
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site discomfort, Injection site erythema, Injection site induration, Injection site nodule, Injection site pruritus, Injection site swelling, Injection site warmth
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: First DPT vaccine received as baby in 1987 resulted in passing out and being admitted to hospital. Pediatrician followed up with
Other Medications: Loratadine 10mg, Omeprazole 40mg, Triamterene-HCTZ 37.5-25mg, Dicyclomine 10mg 3x per day as needed, Bupropion HCL SR 150mg 2x per day, Zofran ODT 8mg 3x per day as needed, Nuva Ring
Current Illness: NA
Preexisting Conditions: IBS
Allergies: adhesives
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Developed knot on arm near injection site. Was red, firm, swollen, sore, itchy and warm to touch. Very uncomfortable. Grew for 3 days, treated with cold compress. After 3 days knot went down and area was no longer firm or swollen but was still red, sore, itchy, and warm to touch. Treated with Tylenol, Ibuprofen, Benadryl, and cold compress. Remaining symptoms subsided 08/08/2021


VAERS ID: 1641401 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Feeling abnormal, Gait disturbance, Headache, Lethargy, Menstrual disorder, Pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: DAILY VITAMINS, DEPO-PROVERA
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: DAY AFTER VACCINE- PATIENT WOKE UP FEELING EXTREMELY LETHARGIC, MASSIVE HEADACHE, AND WHOLE BODY WAS IN PAIN (ESPECIALLY LOWER BACK AREA). PATIENT HAS BEEN ON DEPO-PROVERA FOR 16 YEARS, AND NEVER EXPERIENCED BLEEDING. UPON ADMINISTRATION OF THE SHOT, PATIENT EXPERIENCED MENSTRUATION ONE WEEK AFTER BEING VACCINATED. 5 DAYS AFTER VACCINE- PATIENT WAS ADMITTED TO THE HOSPITAL DUE TO SEVERE LOWER BACK PAIN, HEADACHE THAT WOULD NOT SUBSIDE, AND FEVER OVER 101. PATIENT WAS HAVING TROUBLE WALKING. PATIENT REPORTS NOT FEELING COMPLETELY BACK TO NORMAL UNTIL APPROXIMATELY 3 WEEKS AFTER BEING VACCINATED.


VAERS ID: 1641802 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blepharospasm, Contusion, Epistaxis, Muscle spasms
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Accidents and injuries (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

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

Write-up: Starting the next day, 07/31/2021, patient experienced leg cramps, twitching in left eye, and bruise in left arm. A week later, Nose bleeds started to occur. Patient still experienced intermittent leg cramps, eye twitch and nose bleed for an additional 2-3 weeks. Although improved she is still experiencing some of the effects. She called her doctor and was observed by her son''s eye doctor. Both did not believe cause for concern.


VAERS ID: 1642873 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site bruising, Injection site erythema, Injection site pruritus, Injection site rash, Injection site swelling, Injection site warmth, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: Regular flu shot, got sick with flu symptoms , 1998, age 19, never received annual flu shot again due to that.. not sure of br
Other Medications: Xanax, Wellbutrin, Subutex, Lo Ovral Birth Control pills, Sumatriptan 1 or 2 a month(when OTC ibuprofen doesn?t work for migraine)
Current Illness: None
Preexisting Conditions: Anxiety/ Depression, overweight, Migraines
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Started hurting in mid of night after day of shot. Woke up to itchy, oval, red, warm to touch, and raised/swollen. Felt fatigued evening after shot and following day, not sick, just tired. The shot location stayed bothersome, red, swollen, warm all weekend and went away by Monday morning. Following Friday, week to the day of original shot, woke up and arm was itchy, lifted shirt and realized the red, hot circle on my arm was back but took up larger area. Much bigger than first weekend. So odd that it came back exactly a week later for the entire weekend again. All same symptoms but shot location was much bigger, itchy and hot to touch, swollen and raised. Noticed faint yellowish bruise under skin for up to two weeks after second weekend of swelling. Kind of afraid to see what happens with the second shot, if the first did this.


VAERS ID: 1644347 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Patient vaccinated with expired Moderna Covid-19 vaccine; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient vaccinated with expired Moderna Covid-19 vaccine) in a 13-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002C21A) for COVID-19 vaccination. No Medical History information was reported. On 31-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jul-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient vaccinated with expired Moderna Covid-19 vaccine). On 31-Jul-2021, EXPIRED PRODUCT ADMINISTERED (Patient vaccinated with expired Moderna Covid-19 vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomittant medications and treatment was reported by the patient. Most recent FOLLOW-UP information incorporated above includes: On 12-Aug-2021: Follow up received contains new information included updated demographic information of patient.


VAERS ID: 1644429 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   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: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: Patient received a dose of the vaccine from a vial that was punctured and stored for greater than 12 hours; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received a dose of the vaccine from a vial that was punctured and stored for greater than 12 hours) in a 57-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. No Medical History information was reported. On 31-Jul-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jul-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received a dose of the vaccine from a vial that was punctured and stored for greater than 12 hours). On 31-Jul-2021, EXPIRED PRODUCT ADMINISTERED (Patient received a dose of the vaccine from a vial that was punctured and stored for greater than 12 hours) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use not reported. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 05-Aug-2021: Follow-up: Event term updated. On 11-Aug-2021: Follow up received on 11-AUG-2021 contains non-significant information.


VAERS ID: 1644430 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-03
Onset:2021-07-31
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: Patient received a dose of the vaccine from a vial that was punctured and stored for greater than 12 hours; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received a dose of the vaccine from a vial that was punctured and stored for greater than 12 hours) in a 36-year-old male adult exposed to mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) , while the parent received the product for COVID-19 vaccination. No medical history was provided. On 03-Jul-2021, the parent received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 31-Jul-2021 at 4:45 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On 31-Jul-2021, after exposure to mRNA-1273 (Moderna COVID-19 Vaccine), the adult was diagnosed with EXPIRED PRODUCT ADMINISTERED (Patient received a dose of the vaccine from a vial that was punctured and stored for greater than 12 hours). On 31-Jul-2021, EXPIRED PRODUCT ADMINISTERED (Patient received a dose of the vaccine from a vial that was punctured and stored for greater than 12 hours) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The vial was punctured on 30-JUL-21 at 4.45pm, it was used and then put back into the refrigerator on that day. Then on 31-JUL-2021, it was used again at 10:45AM and it was left out of the refrigerator, the last dose was given at 3:45PM was noted. No concomitant medications are provided by reporter. No treatment medications are provided by reporter. Most recent FOLLOW-UP information incorporated above includes: On 11-Aug-2021: Updated reporter contact information. Ethnicity and race info are updated from unknown to Not Hispanic or Latino and other respectively.


VAERS ID: 1644757 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-07-14
Onset:2021-07-31
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 RA / OT

Administered by: Unknown       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? 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: 20210713; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: The patient tested positive for COVID-19; This spontaneous case was reported by a pharmacist and describes the occurrence of COVID-19 (The patient tested positive for COVID-19) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 043B21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jul-2021, the patient experienced COVID-19 (The patient tested positive for COVID-19). At the time of the report, COVID-19 (The patient tested positive for COVID-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 13-Jul-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.


VAERS ID: 1644801 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007D21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site urticaria
SMQs:, Hypersensitivity (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: USMODERNATX, INC.MOD20212

Write-up: arms broke out in hives initially on the right where the injection was done then spread to the left arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE URTICARIA (arms broke out in hives initially on the right where the injection was done then spread to the left arm) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007D21A) for COVID-19 vaccination. No Medical History information was reported. On 31-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 31-Jul-2021, the patient experienced VACCINATION SITE URTICARIA (arms broke out in hives initially on the right where the injection was done then spread to the left arm). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Hives, at a dose of 1 dosage form. On 31-Jul-2021, VACCINATION SITE URTICARIA (arms broke out in hives initially on the right where the injection was done then spread to the left arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were given by the reporter.


VAERS ID: 1644803 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-16
Onset:2021-07-31
   Days after vaccination:15
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: Confusional state, Dyspnoea, Insomnia, Nausea, Nervousness, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Confusion; Nausea; Nervous attacks; Shortness of breath; Couldn''t sleep at night; Tremors; This spontaneous case was reported by a consumer and describes the occurrence of NERVOUSNESS (Nervous attacks), DYSPNOEA (Shortness of breath), INSOMNIA (Couldn''t sleep at night), TREMOR (Tremors) and CONFUSIONAL STATE (Confusion) in a 65-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 16-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 31-Jul-2021, the patient experienced NERVOUSNESS (Nervous attacks), DYSPNOEA (Shortness of breath), INSOMNIA (Couldn''t sleep at night), TREMOR (Tremors) and NAUSEA (Nausea). On 11-Aug-2021, the patient experienced CONFUSIONAL STATE (Confusion). At the time of the report, NERVOUSNESS (Nervous attacks), DYSPNOEA (Shortness of breath), INSOMNIA (Couldn''t sleep at night), TREMOR (Tremors), CONFUSIONAL STATE (Confusion) and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. The patient was told to take Benadryl by the pharmacist.


VAERS ID: 1644841 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04021A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Heart rate, Heart rate increased, Hypersensitivity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210731; Test Name: Heart rate; Result Unstructured Data: Increased.
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Allergic reaction; Increased Heart Rate; Fever; Shortness of Breath; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HEART RATE INCREASED (Increased Heart Rate), PYREXIA (Fever), DYSPNOEA (Shortness of Breath) and HYPERSENSITIVITY (Allergic reaction) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 04021A) for COVID-19 vaccination. No Medical History information was reported. On 31-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jul-2021, the patient experienced HEART RATE INCREASED (Increased Heart Rate) (seriousness criterion hospitalization), PYREXIA (Fever) (seriousness criterion hospitalization) and DYSPNOEA (Shortness of Breath) (seriousness criterion hospitalization). On an unknown date, the patient experienced HYPERSENSITIVITY (Allergic reaction) (seriousness criterion hospitalization). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL A) for Adverse event, at an unspecified dose and frequency. On 31-Jul-2021, HEART RATE INCREASED (Increased Heart Rate) and DYSPNOEA (Shortness of Breath) had resolved. On 01-Aug-2021, PYREXIA (Fever) had resolved. At the time of the report, HYPERSENSITIVITY (Allergic reaction) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 31-Jul-2021, Heart rate: increased (High) Increased. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not reported. 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: 1645050 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Epistaxis, Gait disturbance, Loss of personal independence in daily activities, Muscle spasms, Pain, Traumatic haemorrhage
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: XANAX; CYMBALTA; LEXAPRO; LIVALO; LYRICA
Current Illness:
Preexisting Conditions: Comments: No medical history was reported
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: couldn''t walk around the house; really painful; horrible back pain; Lower back spasm; couldn''t go to work; while she was trimming toe nail, she cut one a little bit short, and it started bleeding profusely; the worst nose bleed ever in her life / Blood was gushing out of her nose, or pouring out of blood from her nose; This spontaneous case was reported by a consumer and describes the occurrence of TRAUMATIC HAEMORRHAGE (while she was trimming toe nail, she cut one a little bit short, and it started bleeding profusely), EPISTAXIS (the worst nose bleed ever in her life / Blood was gushing out of her nose, or pouring out of blood from her nose), BACK PAIN (horrible back pain), MUSCLE SPASMS (Lower back spasm) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (couldn''t go to work) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. No medical history was reported. Concomitant products included ALPRAZOLAM (XANAX) from 2013 to an unknown date, DULOXETINE HYDROCHLORIDE (CYMBALTA) from 2013 to an unknown date, ESCITALOPRAM OXALATE (LEXAPRO) from 2013 to an unknown date, PITAVASTATIN CALCIUM (LIVALO) and PREGABALIN (LYRICA) for an unknown indication. On 30-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 31-Jul-2021, the patient experienced EPISTAXIS (the worst nose bleed ever in her life / Blood was gushing out of her nose, or pouring out of blood from her nose). On 01-Aug-2021, the patient experienced TRAUMATIC HAEMORRHAGE (while she was trimming toe nail, she cut one a little bit short, and it started bleeding profusely). On 03-Aug-2021, the patient experienced BACK PAIN (horrible back pain), MUSCLE SPASMS (Lower back spasm) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (couldn''t go to work). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) for Back pain, at an unspecified dose and frequency. In August 2021, LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (couldn''t go to work) had resolved. At the time of the report, TRAUMATIC HAEMORRHAGE (while she was trimming toe nail, she cut one a little bit short, and it started bleeding profusely), EPISTAXIS (the worst nose bleed ever in her life / Blood was gushing out of her nose, or pouring out of blood from her nose) and MUSCLE SPASMS (Lower back spasm) outcome was unknown and BACK PAIN (horrible back pain) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. It was stated that the pain has subsided but she still has residual pain as of today. She took some advil for her back pain, but it did not really work and help. She ended up taking soma. Patient felt like her clotting factor was unfunctional. 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: 1645239 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-07-22
Onset:2021-07-31
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       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? 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: 20210731; Test Name: COVID-19 Molecular test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: got Covid; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (got Covid) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 22-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 31-Jul-2021, the patient experienced COVID-19 (got Covid). At the time of the report, COVID-19 (got Covid) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 31-Jul-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications details were provided. No treatment Medications details were provided.


VAERS ID: 1646030 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-30
Onset:2021-07-31
   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 FA6780 / 2 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Pain in extremity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOLOFT
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 INC202100976422

Write-up: Fatigue; Sore Arm; Low-Grade Fever; Throwing Up; This is a spontaneous report from a contactable consumer, the patient. A 12-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA6780) via an unspecified route of administration in the right arm on 30Jul2021 at 10:30 (at the age of 12-years-old) as a single dose for COVID-19 immunisation. The patient did not have any medical history. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Concomitant medications included sertraline hydrochloride (ZOLOFT) taken from an unknown date for an unspecified indication. The patient received some unspecified vaccine on the 30Jul2021. The patient did not have any known allergies to food, medication or other products. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA6780) via an unspecified route of administration in the right arm on 07Jul2021 at 15:30 (at the age of 12-years-old) as a single dose for COVID-19 immunisation. On 31Jul2021 at 08:30, the patient experienced fatigue, sore arm, low-grade fever, and throwing up. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. No therapeutic measures were 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 fatigue, sore arm, low-grade fever, and throwing up were unknown at the time of this report.


VAERS ID: 1646033 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-23
Onset:2021-07-31
   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 EW0198 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscular weakness, Systemic lupus erythematosus
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DYAZIDE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Antiphospholipid syndrome; Congestive heart failure; COPD; Fibromyalgia; Kidney cancer stage III; Lupus erythematosus systemic; Mitral valve disease; Pulmonary embolism; Sjogren''s disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100976533

Write-up: I have lupus of the connective tissues and had just come out of my flare 4 weeks ago. 2 days ago I''m waiting till another flare; terrible terrible muscle weakness and it''s really bad; This is a spontaneous report from a contactable consumer (patient). A 65-years-old female patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration in Arm Right on 23Jul2021 10:00 (Batch/Lot Number: Ew0198) (at the age of 65-years-old) as single dose for covid-19 immunisation. Medical history included chronic obstructive pulmonary disease, mitral valve disease, cardiac failure congestive, renal cancer stage III, pulmonary embolism from 06May2021, antiphospholipid syndrome from 2003, fibromyalgia from 2007, Sjogren''s syndrome from 2007 , Lupus connective tissues 2007 from 2007 and drug allergy to Morphine. 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. Patient was not pregnant. Concomitant medications included hydrochlorothiazide, triamterene (DYAZIDE) taken for an unspecified indication. The patient reported she had lupus of the connective tissues and had just come out of her flare 4 weeks before reporting. On 31Jul2021 02:00 she was waiting till another flare and she was having terrible terrible muscle weakness and it was really bad. The patient was treated with Muscle relaxant. Since the vaccination, the patient has been tested for COVID-19. The outcome of the events was not recovered.


VAERS ID: 1646040 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-31
   Days after vaccination:3
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: Deafness unilateral, SARS-CoV-2 test
SMQs:, Hearing impairment (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? 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: 20210731; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202100976569

Write-up: right ear being completely deaf; This is a spontaneous report from a contactable nurse (patient). A non-pregnant 25-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration, administered in left arm on 28Jul2021 at 19:45 (Batch/Lot number was not reported) (at the age of 25-years-old) as dose 1, single for COVID-19 immunisation. The patient was not pregnant at time of vaccination. The vaccination facility type was pharmacy or drug store. The patient had no relevant medical history, past drug history and concurrent conditions. The patient had no concomitant medications. 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. On 31Jul2021 at 06:15, Saturday, the 3rd day after receiving the vaccine, the patient woke up with her right ear being completely deaf. This has never happened, and she was a regular at cleaning her ears. The adverse event resulted in a doctor or other healthcare professional office/clinic visit. The patient was not diagnosed with COVID-19 prior to vaccination. The patient has been tested for COVID-19 since the vaccination which included nasal swab SARS-CoV-2 test: negative on 31Jul2021. The patient did not receive any treatment. The outcome of the event was not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.; Sender''s Comments: Based on the current available information and the close drug-event temporal association, a possible contributory role of the suspect product BNT162B2 to the development of event deafness unilateral cannot be totally excluded/assessed. 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: 1646042 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-31
Onset:2021-07-31
   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 EW0198 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: VITAMIN C [ASCORBIC ACID]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100976576

Write-up: Hands begin to shake; This is a spontaneous report from a contactable consumer, the patient. A 49-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0198) via an unspecified route of administration in the left arm on 31Jul2021 at 14:00 (at the age of 49-years-old) as a single dose for COVID-19 immunisation. Medical history included blood pressure. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included ascorbic acid (VITAMIN C) from on an unknown date, for unknown indication and unknown if ongoing. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 31Jul2021 at 14:45, the patient took the vaccine in left arm, sat for 15 minutes, monitoring and then the patient left. The patient went to gas station to get gas and his hands began to shake. The event did not result in doctor or other healthcare professional office or clinic visit, and emergency room or department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. No therapeutic measures were taken as a result of the reported event. The clinical outcome of the event hands began to shake was recovering at the time of this report.


VAERS ID: 1646043 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Lymphadenopathy, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: QVAR; DEPAKOTE; SINGULAIR; REQUIP; VRAYLAR; ALB
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; Bipolar I disorder (Bipolar 1); Depression (Severe depression); Obsessive-compulsive disorder (OCD)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100976580

Write-up: Headache; Nausea; Tired; Swollen lymph node in armpit; This is a spontaneous report from a contactable consumer, the patient. A 45-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Lot Number: EW0185) via an unspecified route of administration in the left arm on 29Jul2021 at 10:00 (at the age of 45-year-old) as a single dose for COVID-19 immunisation. The medical history included bipolar 1, obsessive-compulsive disorder (OCD), sever depression and anxiety. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The concomitant medications included beclometasone dipropionate (QVAR), valproate semisodium (DEPAKOTE), montelukast sodium (SINGULAIR), ropinirole hydrochloride (REQUIP), cariprazine hydrochloride (VRAYLAR) and albendazole (ALB), all from unknown dates and for unspecified indications. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Lot Number: EW0164) via an unspecified route of administration in the left arm on 08Jul2021 at 10:15 (at the age of 45-year-old) as a single dose for COVID-19 immunisation. On 31Jul2021 at 16:00, the patient experienced headache, nausea, tired and swollen lymph node in armpit. The adverse events did not result in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. The patient did not receive any treatment for the reported events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events headache, nausea, tired and swollen lymph node in armpit were not recovered at the time of this report.


VAERS ID: 1646085 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-07-28
Onset:2021-07-31
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Blood oestrogen, Pruritus, Urticaria, Vitamin D
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Estrogen low; Shellfish allergy; Vitamin D low
Allergies:
Diagnostic Lab Data: Test Name: estrogene level; Result Unstructured Data: Test Result: Low; Test Name: vitamin D level; Result Unstructured Data: Test Result: Low.
CDC Split Type: USPFIZER INC202100980177

Write-up: Blisters; Hives extreme itchiness on left arm and toes , ankles and bottom of feet/ hives; Hives extreme itchiness on left arm and toes, ankles and bottom of feet./ Itchiness; This is a spontaneous report from a contactable consumer (patient). An adult female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm left on 28Jul2021 at 18:00 (Lot Number: FA7484) as single dose for COVID-19 immunisation. Medical history included low vitamin D and estrogen levels. The patient reported known allergies to FLAGYL and as a child to raw shrimp shells. There were no concomitant medications. The patient reported hives, extreme itchiness on left arm and toes, ankles and bottom of feet. The shot was Wednesday evening. Hives, blisters, itchiness Saturday (on 31Jul2021 at 8:00). Saturday night took BENADRYL because itchiness was so bad. Since the vaccination the patient has not been tested for COVID-19. The patient outcome of the events was not recovered. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1646090 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   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 EW0196 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Syringe issue, Underdose, Vaccination site extravasation
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100980683

Write-up: While I was administering the vaccine, some of it leaked from the syringe. So, I had the needle into the muscle the same time the syringe leaked from the site; While I was injecting it to the patient it leaked at the same time from the site.; While I was administering the vaccine, some of it leaked from the syringe; It was not fully administered.; This is a spontaneous report from a contactable consumer. A patient of unspecified age and gender received unknown dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection; Batch/Lot Number: EW0196 (not clarified appropriately), NDC number, UPC number, expiry date was reported as unknown) via an unspecified route of administration on 31Jul2021 as a single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The reporter stated that while injecting the vaccine with the needle into the muscle, some of it leaked from the syringe at the same time from the site. The vaccine was not fully administered to the patient. The reporter wanted to know what to be done in the situation. The outcome of all the events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1646105 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-30
Onset:2021-07-31
   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: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 INC202100984261

Write-up: Severe chest pain; This is a spontaneous report from a non-contactable consumer or other non hcp. A 33-years-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: not reported), dose 1 via an unspecified route of administration, administered in Arm Left on 30Jul2021 at 13:00 (at the age of 33-years-old) as dose 1, single for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced severe chest pain on 31Jul2021 at 14:00. Patient received no other vaccine in four weeks. The event resulted in Emergency room/department or urgent care visit. No treatment was given for the event. Prior to vaccination, the patient was not diagnosed with COVID. Since the vaccination, the patient has not been tested for COVID-19. Outcome of the event was recovering. No follow-up attempts are possible; information about lot/batch number cannot been obtained.


VAERS ID: 1646114 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-27
Onset:2021-07-31
   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 FA7484 / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, the patient was diagnosed with COVID-19)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100985100

Write-up: Rash on my abdomen; Scalp and palm were very itchy; This is a spontaneous report from a contactable consumer, the patient. A 52-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA7484) via an unspecified route of administration in the arm right on 27Jul2021 at 19:45 (at the age of 52-years-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19 as prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not have any allergies to medications, food, or other products. The patient did not receive any medication within two weeks of vaccination. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 31Jul2021 at 01:30, the patient woke up with a rash on abdomen and her scalp and palms were very itchy. The events resulted 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 events and included treatment with diphenhydramine hydrochloride (BENADRYL) and famotidine (PEPCID) from an unknown date. The clinical outcome of the events rash on abdomen and scalp and palm were very itchy was not resolved at the time of this report.


VAERS ID: 1646123 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-24
Onset:2021-07-31
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary mass
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma chronic (Chronic Asthma); Seafood allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100985451

Write-up: Lump under armpit; This is a spontaneous report from a 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: EW0183) via an unspecified route of administration in the left arm on 24Jul2021 at 11:00 (at the age of 35-years-old) as a single dose for COVID-19 immunisation. The patients'' medical history included chronic asthma and a known allergy to seafood. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccination. On 31Jul2021, the patient experienced lump under armpit. The event did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event lump under armpit was not resolved at the time of this report.


VAERS ID: 1646157 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-30
Onset:2021-07-31
   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 FA7485 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthropod bite, Peripheral swelling, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: CLARITIN; VITAMIN C
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Seasonal allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100986026

Write-up: This is a spontaneous report from a contactable consumer (patient). A 15-year-old female patient received bnt162b2 (BNT162B2), via an unspecified route of administration, administered in left arm at the age of 15 years old on 30Jul2021 11:00 (Batch/Lot Number: FA7485) as dose 1, single for covid-19 immunisation. Medical history included seasonal allergies. Concomitant medications included CLARITIN taken for an seasonal allergies start and stop date were not reported; VITAMIN C taken for an unspecified indication, start and stop date were not reported. On 31Jul2021, the patient experienced hives that spread to her entire body. The hives spread on her thigh to left calf, to entire body except her bottom but stated they may have been there too. The patient stated she felt like she had been bit by bugs however she had not gone outside. On Sunday, she had one episode and today, she had one episode. It also started around 11:00. The patient also reported that the palms of her hands were getting very swollen and tight to the touch started on Sunday (01Aug2021) and it was also around 11:00. Since the hives were so itchy, burning, and painful, she called the doctor, the office was so overwhelmed that they called a nurse, that told her to give her Benadryl, Pepcid, and Calamine Lotion. It seemed to work, she gave Benadryl 15 ml the second time, the 3rd time, and her hives started to dissipate but other places pop up, she woke up and 10 minutes after again with the hives, she started takin Benadryl. The last time she took Benadryl was until yesterday, but today she had an occurrence, at 11 o'' clock an hour ago, the Clorox wipes swelled up her hands. The patient recovered from the event the palm of her hand swollen and became tight to the tough. The outcome of the event urticaria was not recovered, while the outcome of the event swelling of hands was unknown.


VAERS ID: 1646161 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-10
Onset:2021-07-31
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: DEPOPROVERA
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 INC202100986148

Write-up: Tingling in left leg and toes; This is a spontaneous report from a contactable consumer, the patient. A 25-year-old, non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0167) via an unspecified route of administration in the arm left on 10Jul2021 (at the age of 25-year-old) as a single dose for COVID-19 immunisation. The patient had no medical history and 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 other medications in two weeks prior to the vaccination. The patient received DEPOPROVERA medication (reported as other vaccine received with in four weeks prior to COVID vaccine) for an unknown indication from 26Jul2021 and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0191) via an unspecified route of administration in the arm left on an unknown date in 2021 as a single dose for COVID-19 immunisation. Since the vaccination, the patient had not been tested for COVID-19. On 31Jul2021 at 22:00, the patient experienced tingling in left leg and toes. No therapeutic measures were taken as a result of the event. The clinical outcome of the event tingling in left leg and toes was not recovered at the time of this report.


VAERS ID: 1646240 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-28
Onset:2021-07-31
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysstasia, Fatigue, Nausea, Pruritus, SARS-CoV-2 test, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? 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: 20210801; Test Name: PCR; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20210801; Test Name: Rapid Test; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202100992805

Write-up: Full body itchy painful hives/welts; Full body itchy painful hives/welts; fatigue; light-headedness/dizziness; nausea; unable to stand for more than a few minutes at a time continuing on Day 6 after second dose; This is a spontaneous report from a contactable consumer (patient) via Pfizer sponsored program Pfizer RXPathways. A 31-years-old male patient received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration, administered in Arm Left on 28Jul2021 at age of 31 years old (Batch/Lot Number: EW0198) as DOSE 2, SINGLE for covid-19 immunisation. Facility where the most recent COVID-19 vaccine was administered was Pharmacy or Drug Store. None Medical history. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine and did not receive any other medications the patient received within 2 weeks of vaccination. The patient''s concomitant medications were not reported. Historical vaccine included bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Left on 07Jul2021 at age of 31 years old (Batch/Lot Number: EW0217) as DOSE 1, SINGLE for covid-19 immunisation. The patient experienced Full body itchy painful hives/welts, fatigue, light-headedness, dizziness, nausea, unable to stand for more than a few minutes at a time continuing Day 6 after second dose (this report is written on Day 6 and these symptoms are still ongoing even with prescription steroids (a steroid shot). Started date of events was on 31Jul2021. The events resulting Doctor or other healthcare professional office/clinic visit and Emergency room/department or urgent care. Patient claimed a severe adverse reaction to COVID vaccine. The patient underwent lab tests and procedures which included sars-cov-2 test (Rapid Test, Nasal Swab): negative on 01Aug2021, sars-cov-2 test (Nasal Swab, PCR): negative on 01Aug2021. Therapeutic measures were taken as a result of all events. The outcome of all events was not recovered.


VAERS ID: 1646351 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-30
Onset:2021-07-31
   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 - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphonia, Balance disorder, Blood pressure measurement, Confusional state, Cough, Decreased appetite, Heart rate, Heart rate increased, Hypertension, Lymphadenopathy, Migraine, Nausea, Oropharyngeal pain, Pharyngitis, Pyrexia, Renal pain, Swelling
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Agranulocytosis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), 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: INSULIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergic reaction to analgesics; Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: Type 1 juvenile diabetes
Allergies:
Diagnostic Lab Data: Test Date: 20210731; Test Name: Blood pressure; Result Unstructured Data: Test Result:212/147 mmHg; Comments: normally 108/60; Test Date: 20210731; Test Name: Heart beat; Result Unstructured Data: Test Result:Rapid
CDC Split Type: USPFIZER INC202100995842

Write-up: blood pressure reaching 212/147 normally 108/60; Fever; migraine headache; rapid heartbeat; nausea; not hungry; coughing; sore throat; swollen neck and lymph nodes; looks like strep in the back of my throat; loss of voice; pain in kidneys; confusion; loss of balance when standing; swollen neck and lymph nodes; This is a spontaneous report from a non-contactable consumer (patient). A 32-year-old female patient (not pregnant) received the second dose of BNT162B2 via an unspecified route of administration on the left arm on 30Jul2021 at 19:00 at the age of 32-year-old as single dose for COVID-19 immunization. Medical history included Type 1 juvenile diabetes and morphine allergy. 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 did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Concomitant medication included insulin taken for type 1 juvenile diabetes. The patient previously received the first dose of BNT162B2 via an unspecified route of administration on the left arm on 08Jul2021 at 05:00 PM at the age of 32-year-old as single dose for COVID-19 immunization. The patient previously taken morphine on an unspecified date and experienced known allergies. On 31Jul2021 at 07:00 am, the patient experienced fever, migraine headache, rapid heartbeat and blood pressure reaching 212/147 (normally 108/60), nausea, not hungry, coughing, sore throat, swollen neck and lymph nodes, looks like strep in the back of my throat, loss of voice, pain in kidneys, confusion and loss of balance when standing. No treatment was received. The outcome of events was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1646367 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-07-31
   Days after vaccination:91
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, Fatigue, Headache, Illness, 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: 20210802; Test Name: COVID test; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC202100997985

Write-up: sick at home; COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; headache; Fatigue; This is a spontaneous report from a contactable consumer reported for a patient. A 52-years-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number: unknown, Expiration date: unknown) via an unspecified route of administration, administered at an unspecified anatomical location on an unspecified date in Apr2021 (age at vaccination was unknown) as dose 1, single and second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number: unknown, Expiration date: unknown) via an unspecified route of administration, administered at an unspecified anatomical location on an unspecified date in May2021 (age at vaccination was unknown) as dose 2, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On 31Jul2021, the patient experienced headache, fatigue, fever, sore throat, cough. It was reported that on 31Jul2021-01Aug2021, the patient stated experiencing headache, fatigue, fever, sore throat, cough. On 02Aug2021, the patient tested positive for COVID. The patient underwent lab test which included Sars-cov-2 test: positive on 02Aug2021. As of 03Aug2021, he was sick at home, no hospitalization. The event took place after use of product. 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: 1646379 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-16
Onset:2021-07-31
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH KW0162 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Herpes zoster, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D3; FLONASE [FLUTICASONE PROPIONATE]; ZYRTEC [CETIRIZINE HYDROCHLORIDE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Multiple myeloma (Has been in remission for almost 5 years)
Allergies:
Diagnostic Lab Data: Test Name: Blood test; Result Unstructured Data: Test Result:Results unknown; Comments: For liver
CDC Split Type: USPFIZER INC202100998395

Write-up: This is a spontaneous report from a contactable consumer or other non hcp (Patient). A 59-year-old female patient received first dose of bnt162b2 (BNT162B2, PFIZER-BIOTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: KW0162), via an unspecified route of administration, administered in Arm Left on 16Jul2021 11:30 (age at vaccination 59-year-old) as single dose for COVID-19 immunization. The patient medical history included Multiple myeloma from an unknown date and unknown if ongoing Has been in remission for almost 5 years. Concomitant medication included vitamin d3 (VITAMIN D3) taken for hypovitaminosis start and stop date were not reported, fluticasone propionate (FLONASE [FLUTICASONE PROPIONATE]) taken for sinusitis, start and stop date were not reported, cetirizine hydrochloride (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) taken for hypersensitivity, start and stop date were not reported. Prior vaccinations within 4 weeks were reported as no. It was reported that she had her first dose of the Pfizer COVID-19 vaccine on 16Jul2021, and this past weekend had itching all over her body on stomach, upper pelvic area, around and under breast, underarms and thighs. She wanted to call to see if this was possible side effects from the vaccine. She saw her doctor and was told to take her Hydroxyzine and was given a steroid cream to use, and they did talk about getting the second dose, which she was scheduled to get on 06Aug2021. They were weighing her options about receiving the second dose and her doctor told her to get it, but her doctor also did some blood work to check her liver, the caller was thinking she might be getting Shingles. Caller states she has an appointment with an allergist to check her sinus but thinks she will bring this up as well to see if that doctor could help. Upon date 04Aug2021 it was reported that she scheduled for the second dose 5Aug2021. She took some blood tests to see if it could possibly be her liver but, caller states it was not her liver. She just made an appointment for an allergy test that was not until 24Aug2021. Her doctor did say to go ahead and take the second dose and to not miss it. She was not the one who administered the shot. Itching on her stomach, pelvic area, around her breast, under her breast, underarms and thighs: They were telling her that side effects would start probably the same day or maybe 2 or 3 days later and they you don''t know when side effects will happen. It started this weekend on Saturday 31Jul2021. It was probably in the morning because she woke up scratching. Clarified that she noticed the itching in all of the mentioned areas at the same time. She took the pills she was told to take for the itching, the Hydroxyzine. The medication, cream was a steroid, the brand name was Elocon, she has the generic one but does not know the name, just that it starts with the letter M. She saw another physician in the same place but can''t think of the name. She is the one who gave her the cream and told her to take hydroxyzine. She just wanted to let us know about this. Needs to know if this could be one of the symptoms. Wants us to let them know she already spoke to a nurse. patient did not receive additional Vaccines on Same Date of the Pfizer Suspect. The patient underwent lab tests and procedures which included blood test results unknown. Therapeutic measures were taken as a result of itching on her stomach, pelvic area, around her breast, under her breast, underarms and thighs. The outcome for the events was reported as unknown at the time of this report. Follow up information has been requested.


VAERS ID: 1646400 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-02-09
Onset:2021-07-31
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 1 LA / 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: 20210802; Test Name: Rapid Antigen Test; Result Unstructured Data: Test Result: Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202100999128

Write-up: COVID-19 Positive Test Results; COVID-19 Positive Test Results; This is a spontaneous report from a contactable consumer. A 58-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection, Lot Number: EL9269, Expiry date: Unknown) via intramuscularly administered in Arm Left on 02Mar2021 (at the age of 58-years-old) as dose 2, single and patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection, Lot Number: EM9809, Expiry date: Unknown) intramuscularly administered in Arm Left arm on 09Feb2021 as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 31Jul2021 the patient experienced COVID-19 positive test results. On 02Aug2021 the patient underwent lab tests and procedures which included sars-cov-2 test (Rapid Antigen Test) as positive for nasal Swab. Patient did not receive other vaccine in four weeks. Patient has no covid prior vaccination, He tested for covid post vaccination. The events resulted in doctor or other healthcare professional office or clinic visit. No treatment received for the events. The outcome of the events was not recovered. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1646628 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
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: Dyspnoea, Headache
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101012208

Write-up: My breathing pattern has change where I have moments that I can''t breathe well; Headaches; This is a spontaneous report from a contactable consumer (patient). A 29-year-old female patient (not pregnant) received the first dose of BNT162B2 via an unspecified route of administration on the left arm on 29Jul2021 at 14:00 at the age of 29-year-old as single dose for COVID-19 immunization. Medical history was not reported. No COVID prior vaccination. No COVID tested post vaccination. No known allergy. No other vaccine in four weeks. No other medications in two weeks. On 31Jul2021 at 12:00 PM, the patient experienced breathing pattern had change where he had moments that he can''t breathe well and headaches occur. No treatment was received. The outcome of events was not recovered. Information about the Lot/batch number has been requested.


VAERS ID: 1646640 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-10
Onset:2021-07-31
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / -

Administered by: Pharmacy       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: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210801; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC202101013096

Write-up: COVID test result Positive / throat, cough, nasal congestion; COVID test result Positive / throat, cough, nasal congestion; This is a spontaneous report from a contactable consumer (patient). A 15-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in Arm Right on 10Jun2021 (Lot Number: EW0191) and dose 1 via an unspecified route of administration, administered in Arm Right on 20May2021 (Lot Number: EW0187), both at single dose (at the age of 15 years old) for COVID-19 immunisation. Medical history included known allergies: Penicillin. There were no concomitant medications. The vaccines were administered at Pharmacy or Drug Store. Prior to vaccination, the patient was not diagnosed with COVID-19. On 31Jul2021, the patient experienced sore throat, cough, nasal congestion. COVID test result was positive on 01Aug2021. Post vaccination patient was diagnosed with COVID-19. Patient did not receive any treatment for the reported events. The outcome of the events was recovering.


VAERS ID: 1646659 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-30
Onset:2021-07-31
   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 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disease recurrence, Myalgia, Polymyalgia rheumatica
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Vasculitis (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to antibiotic; Polymyalgia rheumatica
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101013429

Write-up: Seemed to reactivate my polymyalgia rheumatica autoimmune; Seemed to reactivate my polymyalgia rheumatica autoimmune; Muscle pain; This is a spontaneous report from a contactable consumer (patient). A 65-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: FC3180), via an unspecified route of administration, administered in right arm on 30Jul2021 18:30 (at 65 years old) as dose 1, single for COVID-19 immunization. Medical history included polymyalgia rheumatica, and allergies to fluorquinolone family of antibiotics. 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 has not been tested for COVID-19. There were no concomitant medications. The patient previously took erythromycin, sulfamethoxazole, and levofloxacin and experienced drug allergy. On 31Jul2021, the patient reported muscle pain and reported that the vaccine seemed to reactivate her polymyalgia rheumatica autoimmune. There were no treatments received for the events. The outcome of the events was not recovered. Follow-up attempts are completed, No further information is expected.


VAERS ID: 1646662 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-30
Onset:2021-07-31
   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: Angina pectoris
SMQs:, Other ischaemic heart disease (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: Medical History/Concurrent Conditions: Anxiety attack
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101013457

Write-up: she felt her heart was squeezed really tight and had a similar feeling with anxiety attack; This is a spontaneous report from a contactable consumer. This 48-year-old female consumer reported for herself that. A 48-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), dose 1 via an unspecified route of administration on 30Jul2021 as (At the age of 48-years) DOSE 1, SINGLE for covid-19 immunisation. Medical history included anxiety from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The patient experienced she felt her heart was squeezed really tight and had a similar feeling with anxiety attack. It was reported that Caller had the 1st dose of the Pfizer COVID 19 vaccine on 30Jul2021 the day after, she felt her heart was squeezed really tight and had a similar feeling with anxiety attack Asking if this is a reported side effects of the vaccine - She has been experiencing the symptoms until now. The outcome of evets was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1646727 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-07-30
Onset:2021-07-31
   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: Chest discomfort, Chest pain, Dyspnoea, Fatigue, Headache, Pain, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101015892

Write-up: Chest pains; short of breath; pounding heart beat (even if sitting or laying still); headache; body aches; tightness in chest; extreme fatigue; This is a spontaneous report from a non-contactable consumer (patient). A 43-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the right arm on 30Jul2021 at 14:00 (batch/lot number was not reported) as dose 1, single for COVID-19 immunization. The patient''s medical history was not reported. There were no concomitant medications. The patient previously took codeine and experienced allergies. Facility where the most recent COVID-19 vaccine was administered was pharmacy or drug store. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine and the patient has no other medications received within 2 weeks of vaccination. The patient experienced chest pains, short of breath, pounding heart beat (even if sitting or laying still), headache, body aches, tightness in chest, extreme fatigue on 31Jul2021 at 07:00 with outcome of not recovered. The case was assessed as serious. No treatment was received for the adverse events. The adverse events resulted in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1646842 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-17
Onset:2021-07-31
   Days after vaccination:164
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, Respiratory symptom, 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: 20210731; Test Name: COVID test; Test Result: Positive
CDC Split Type: USPFIZER INC202101024235

Write-up: symptomatic w upper respiratory symptoms; break through COVID diagnosis per urgent care/positive COVID test; break through COVID diagnosis per urgent care/positive COVID test; This is a spontaneous report from a contactable consumer (patient). A 72-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 17Feb2021 as Dose number unknown, Single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On 31Jul2021, patient experienced break through COVID diagnosis per urgent care/positive covid test, symptomatic w upper respiratory symptoms on an unspecified date. Reported that event took place after use of product. Patient did not wish to be contacted for follow-up. The patient underwent lab tests and procedures which included COVID test: positive on 31Jul2021. The clinical outcome of events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1646867 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   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 - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Gait disturbance, Limb discomfort
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101027627

Write-up: Pain on the left side of the hip; it is preventing her from walking; she said felt heavy; This is a spontaneous report from a contactable pharmacist. A 12-years-old patient of an unspecified gender received second dose bnt162b2 (BNT162B2, Solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on 31Jul2021 as DOSE 2, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 31Jul2021 the patient experienced pain on the left side of the hip, it is preventing her from walking, she said felt heavy lot number and expiration date of the suspected medication were not provided limited information was available from the reporter. The outcome of the events arthralgia, gait disturbance, limb discomfort was unknown. Information on lot/batch number has been requested.


VAERS ID: 1647003 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-11
Onset:2021-07-31
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 RA / OT

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? 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: Asthma
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: PCR; Test Result: Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202101034721

Write-up: This is a spontaneous report from contactable consumers. A 22-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), intramuscular, administered in Arm Right on 11Mar2021 at 21-years-old (Batch/Lot Number: EN6207) as dose 1, single for COVID-19 immunization. Medical history included Asthma. Facility where the most recent COVID-19 vaccine was administered. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient''s concomitant medications were not reported. The patient experienced break-through covid infection on 31Jul2021 (as reported) with outcome of recovered in 2021. No treatment was given. Prior to vaccination, was the patient was not diagnosed with COVID-19. Since the vaccination, has the patient been tested for COVID-19. Results of tests and procedures for investigation of the patient: PCR (03Aug2021): Positive (Lab Notes: Nasal Swab). Follow-up attempts are completed. No further information is expected.


VAERS ID: 1653727 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash, Injection site swelling, Nausea, Pain, Paraesthesia, Peripheral swelling, Pruritus, Rash, Taste disorder, Vaccination complication
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms 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: Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Itch Generalized-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Body Aches Generalized-Medium, Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Nausea-Mild, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: Pt complaint of self diagnosed "COVID arm" after recieving 1st dose of Moderna. Severe pain and some rash at injection site. Mild changes to taste also present. At time of 2nd vaccine, swelling gone out of arm, no taste aversion. Pt report "felt better" after 2nd shot that after 1st. Pt to call RPh on duty to report any futher complications.


VAERS ID: 1653848 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Abnormal faeces, Asthenia, Chest X-ray, Chest discomfort, Chills, Condition aggravated, Coordination abnormal, Decreased appetite, Differential white blood cell count, Dizziness, Dyspnoea, Dyspnoea exertional, Electrocardiogram, Emotional distress, Fatigue, Feeling hot, Fibrin D dimer, Flatulence, Full blood count, Gastrointestinal pain, Head discomfort, Headache, Heart rate irregular, Hyperhidrosis, Hypoaesthesia, Hypoaesthesia oral, Influenza A virus test, Influenza B virus test, Injection site pain, Injection site swelling, Injection site warmth, Lymphadenopathy, Malaise, Metabolic function test, Mobility decreased, Muscle fatigue, Muscle tightness, Panic attack, Paraesthesia, Parosmia, Photophobia, Platelet count, Red blood cell morphology, Retching, Rheumatoid arthritis, SARS-CoV-2 test, Skin warm, Taste disorder, Thyroid disorder, Time perception altered, Tinnitus, Troponin T, Vibratory sense increased, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Cardiac arrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (narrow), Noninfectious diarrhoea (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 100mg Acetaminophen, 162mg Aspirin, 25mg Diphenhydramine HCL, 600mg Calcium, Multivitamin (Women''s), 125mg Levothyroxine
Current Illness: Grave''s disease.
Preexisting Conditions: Grave''s disease.
Allergies: Sulfa, Epinephrine, Naproxen, Antibiotics, Latex, Wood, Nitrous oxide, Curry, Peanuts/nuts, Bee''s wax, Chlorine, Gold, Wool, Aloe, Shea butter, Mints, Salt, Hormones, Soy, Fish, Crabs, Onions, Peppers, Seeds, Avocados, Strawberries, Peaches, Apricots, Papaya, Banana, Kiwi fruit, Mangoes, Grapes, Hibiscus, Artificial/low calorie sweeteners, Helium
Diagnostic Lab Data: 8/2/21 - XR Chest 1 VW, Frontal ECG 12-Lead Platelet Estimate D-dimer, quantitative Basic Metabolic Panel CBC & differential, automated Troponin T Gen 5 Stat RBC Morphology SARS COV-2 & Influenza A/B
CDC Split Type:

Write-up: 7/30- 1st jab! 7/31- RA flare-ups in both hands (all digits) & @ the site of previous injuries: R torn rotator cuff, hips, knees, wrists, ribs, neck; Site of injection is warm & swollen; Overall warmth; No concept of time; Malaise; Strange taste in mouth/smell; Face/tongue numbness; Eyes are sensitive to light; Heart feels floppy. 8/1- *new symptoms only* Glands swollen in neck affecting tinnitus & breathing; Thyroid bit feels attacked; Chest feels heavier; Pressure at the base of skull; Chills/sweating. +Soreness & overall warmth at site reduced. 8/2- ER for tests.


VAERS ID: 1654029 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Covid Arm. Infection at site of injection. Red, itchy swollen rash.


VAERS ID: 1654031 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-12
Onset:2021-07-31
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anti-thyroid antibody, Anxiety, Autoimmune thyroiditis, Depression, Fatigue, Irritability, Polydipsia, Polyuria, Psychomotor hyperactivity, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Depression (excl suicide and self injury) (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood test on 8/12/21. high thyroglobulin antibodies and high thyroid peroxidase antibodies
CDC Split Type:

Write-up: A few weeks after getting the vaccine had symptoms of hashimotos thyroiditis (hashitoxicosis). Found high thyroglobulin antibodies and high thyroid peroxidase antibodies from bloodtest. Symptoms include weight loss, anxiety, fatigue, hyperactivity, irritability, polyura, polydipsia, depression.


VAERS ID: 1654085 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none listed
Preexisting Conditions: none listed
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient came in on 8/29/2021 for his second dose of Moderna. Pateint is required to fill out a questionaire before the immunization. On the questionaire the patient mentioned that he experienced his heart racing/chest pain. I asked further questions. Patient said he experienced this with the first shot of Moderna for a day or 2 after the first dose. I explained to him that these symptoms can match Myocarditis associated with the vaccine. I told the patient about the side effects of Myocarditis and said to be on the safe side to call his PCP on Monday 9/29/21 and get checked out on a precautionary basis due to the similar side effects even though it happened a month ago. 2nd dose is on hold for now, waiting to see if he is cleared by his doctor. Patient agreed.


VAERS ID: 1655072 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:2021-01-31
Onset:2021-07-31
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body mass index, 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: Atrial fibrillation; Blood pressure high; Diabetes
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: BMI; Result Unstructured Data: Test Result:34.9; Test Date: 20210731; Test Name: NAAT Covid test; Test Result: Positive
CDC Split Type: USPFIZER INC202101076353

Write-up: Tested positive for Covid virus, after being fully vaccinated; Tested positive for Covid virus, after being fully vaccinated; This is a spontaneous report from a contactable consumer. This is 15 of 37, reports on a 59-years-old female. A 59-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EN5318), via an unspecified route of administration on 31Jan2021 as dose 2, single, and received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EH9899) via an unspecified route of administration on 10Jan2021 as dose 1, single for covid-19 immunization at pharmacy. Medical history included ongoing high blood pressure, atrial fibrillation and diabetes. The patient''s concomitant medications were not reported. unknown other products. The patient tested positive for Covid virus, after being fully vaccinated on 31Jul2021. The clinical course reported as follows, she stated 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 lot number provided was EN5318. 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. Caller reclarified later in report that 15% of the breakthrough cases in her county had the same lot number, EN5318, which was concerning. Caller stated, reclarified later in report, she has 37 patients with partial identifiers. Caller stated she cannot provide some identifying details and that she would need to check with her legal department first. Caller provides the details she was allowed to identify. Caller stated unknown or could not provide to other questions. On 31Jul2021, caller stated that covid positive was defined as having both vaccines and testing positive for Covid longer than two weeks after both doses. The patient underwent lab tests and procedures which included body mass index: 34.9 on an unspecified date, sars-cov-2 test: positive on 31Jul2021. The outcome of events was unknown. Lot/batch number is not available despite the follow-up attempts made. Follow-up attempts are completed. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101075254 same reporter/drug/AE, different patient


VAERS ID: 1655617 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-24
Onset:2021-07-31
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6189 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Anaemia macrocytic, Angiogram pulmonary abnormal, Atelectasis, Blood creatinine normal, Blood lactate dehydrogenase increased, Body temperature increased, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chills, Chronic kidney disease, Computerised tomogram thorax abnormal, Condition aggravated, Constipation, Cough, Decreased appetite, Differential white blood cell count, Dizziness, Dyspnoea, Electrocardiogram normal, Exposure to SARS-CoV-2, Fatigue, Feeling cold, Flatulence, Fluid intake restriction, Full blood count, Glaucoma, Glomerular filtration rate decreased, Haemoglobin decreased, Hepatic steatosis, Hot flush, Hyperhidrosis, Hypertension, Hypoalbuminaemia, Hypocalcaemia, Hyponatraemia, Hypothyroidism, Inflammatory marker increased, Leukocytosis, Livedo reticularis, Lung opacity, Nausea, Neck pain, Oropharyngeal pain, Osteoarthritis, Oxygen saturation decreased, Pain, Procalcitonin increased, Pulmonary embolism, Respiratory failure, Respiratory rate, Respiratory rate increased, SARS-CoV-2 test positive, Scan with contrast abnormal, Sepsis, Serum ferritin increased, Surgery, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (broad), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Glaucoma (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypothyroidism (narrow), Vestibular disorders (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Arthritis (narrow), Tumour lysis syndrome (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol, calcium PO, certirizine, cyanobalamin, duloxetine, latanoprost, levothyroxine, lisinopril, timolol maleate
Current Illness: Colectomy 7/27/2021
Preexisting Conditions: PMH of HTN, hypothyroidism, gout, prostate cancer s/p prostatectomy and immune/radiation therapy, colon cancer s/p partial colectomy on 7/27/21 at Hospital
Allergies: NKDA
Diagnostic Lab Data: XR Chest 1 View Result Date: 7/31/2021 Narrative: Exam/Procedure: XR CHEST 1 VIEW ordered by CLINICAL INDICATION: Cough x4 days. TECHNIQUE: XR CHEST 1 VIEW COMPARISON: None. FINDINGS: Cardiomediastinal silhouette is within normal limits. Low lung volumes. Mild left infrahilar patchy airspace opacities. Mild bibasilar atelectasis. No pleural effusion or pneumothorax. IMPRESSION: Mild left infrahilar airspace disease suspicious for atypical infection. CT Angio Pulmonary Embolism Result Date: 7/31/2021 Narrative: Exam/Procedure: CT ANGIO PULMONARY EMBOLISM ordered by CLINICAL INDICATION: PE suspected, high probability. TECHNIQUE: Imaging of the chest was performed from thoracic inlet through upper abdomen, using spiral technique, following administration of IV contrast, Omnipaque 350, 80 mL per the pulmonary angiogram protocol. In addition, 3D images were created and reviewed. TOTAL DLP (Dose-Length Product): 486.99 mGy.cm. Please note: The reported value represents the total of one or more individual components during the CT acquisition on this date and at this time, and as such, the same value may appear in more than one CT report depending on the interpreting/reporting physicians. COMPARISON: Chest x-ray performed same day. FINDINGS: Pulmonary Arteries/Vessels: No pulmonary embolism. Right Heart Strain: No evidence of right heart strain. Pleural/Pericardial space: No pneumothorax. No pleural effusions. No pericardial effusion. Lymph Nodes: No lymphadenopathy within the chest. Lungs: Multiple thin-walled cysts predominantly within the bilateral lower lobes in a peribronchovascular distribution. Peripheral patchy groundglass opacities throughout the lungs. Mild bronchial wall thickening. Mild bibasilar atelectasis. Mediastinum: Otherwise unremarkable. Chest wall: No chest wall hematoma or contusion. Bones: No acute fracture within the chest. Upper Abdomen: Mild perinephric stranding, likely sequela of chronic medical renal disease.. Hepatic steatosis. IMPRESSION: No pulmonary embolism. Peripheral patchy groundglass opacities throughout the lungs concerning for atypical viral infection such as COVID-19. Multiple thin-walled cysts predominantly within the bilateral lower lobes may represent sequela of treated metastatic lung lesions versus underlying cystic lung disease.
CDC Split Type:

Write-up: Patient vaccinated 2/24/2021, admitted 7/31/2021, tested positive for covid 7/31/2021. discharged 8/5/2021 to Home with Home health Event Description: Patient received Pfizer COVID vaccine on 1/30/21 & 2/24/21 (lot #s EL9265 & EN6189, respectively). However, he presented with dyspnea and subsequently tested positive for COVID on 7/31/21 History Of Present Illness Patient is a 77 y.o. male with a PMH of HTN, hypothyroidism, gout, prostate cancer s/p prostatectomy and immune/radiation therapy, colon cancer s/p partial colectomy on 7/27/21 at hospital who presents with a chief complaint of dyspnea. The patient''s wife is present with him at bedside and provides most of the history as the patient falls back asleep quickly with questions. She states that around the time of his surgery she noticed he had developed a cough and after the surgery he wasn''t "bouncing back" like he should. The following evening he ran a temperature of 102.4 degrees. She states she called the surgeons and they advised her to give him tylenol and come into the office next day if the fever recurred. However, he did not have any further fevers. After this he began to develop more difficulty breathing and hot/cold flashes to the extent that this morning she reports he was diaphoretic and breathing very fast and started coughing again so she called 911. The cough has been nonproductive. He denies any HA, rhinorrhea/congestion, ST or change in smell or taste. They have been around other family members that have Covid-19 and believe they were both infected. He was vaccinated for Covid on 2/10/21 and 2/24/21. Of note, he has not had a bowel movement still since his surgery. He endorses anorexia and nausea but no vomiting. He has some abdominal pain since the surgery, worse with movement and in the RLQ. His wife states she has had to force him to drink liquids and he has not eaten much. His wife reports that he has not moved around as much due to his pain but she has been hesitant to give pain medications that would worsen his constipation. She also says that he had two colonoscopies prior to his surgery on 7/19 and 7/23. After the second bowel prep she states he became mottled all over his and his knees and elbows went purple. He would shiver but did not have a fever. These symptoms persisted for roughly one day and then resolved. Review of Systems Constitutional: Positive for chills, diaphoresis, fatigue and fever. HENT: Negative for congestion, rhinorrhea, sinus pressure, sinus pain and sore throat. Some pain in neck/throat with deep breath Eyes: Negative for visual disturbance. Respiratory: Positive for cough and shortness of breath. Cardiovascular: Negative for chest pain, palpitations and leg swelling. Gastrointestinal: Positive for abdominal pain, constipation and nausea. Negative for abdominal distention, diarrhea and vomiting. Genitourinary: Negative for difficulty urinating and dysuria. Musculoskeletal: Negative for joint swelling. Skin: Negative for rash and wound. Neurological: Positive for light-headedness. Negative for weakness, numbness and headaches. Hematological: Does not bruise/bleed easily. Psychiatric/Behavioral: Negative for confusion. ASSESSMENT AND PLAN: Patient is a 77 y.o. male with a PMH of HTN, hypothyroidism, gout, prostate cancer s/p prostatectomy and immune/radiation therapy, colon cancer s/p partial colectomy on 7/27/21 at hospital who presents with a chief complaint of dyspnea. The patient''s wife is present with him at bedside and provides most of the history as the patient falls back asleep quickly with questions. Patient never felt fully normal after his surgery and had a cough for about a day, then a day later had a singular fever up to 102.4 degrees which resolved. However he progressively developed worsening chills, diaphoresis, dyspnea and finally a return of cough. His breathing was rapid this morning and he was very diaphoretic so his wife called 911. He has not had a BM since surgery and has had a poor appetite. Has some abdominal pain worst in the RLQ. They have been exposed to family diagnosed with Covid-19. On admission, the patient was hypoxic with an 02 sat of 88 on RA, now stable on 2L NC to maintain oxygen $g92%, RR intermittently $g20. He is otherwise afebrile and HD stable. Labs on admission significant for leukocytosis (WBC 16.19), Macrocytic anemia (Hgb 11.3, MCV 99) and elevated inflammatory markers. His CMP is largely unremarkable - GFR is slightly reduced at 57 with normal Cr, hypoalbuminemia, hypocalcemia and mild hyponatremia noted, otherwise normal. CXR and CTPE obtained in the ED concerning for infectious etiology. EKG reviewed, NSR, no ST elevation, QTc <500. Covid test ordered. Patient was given a dose of decadron and medicine was consulted for admission. Acute hypoxic respiratory failure due to confirmed Covid-19 infection - patient presents with dyspnea, dry cough, recent fever, chills and diaphoresis, oxygen of 88% on RA on presentation, improved to $g92% on 2L NC (No home baseline oxygen requirement or lung disease) -Meeting sepsis criteria with WBC $g12, RR$g20 - elevated CRP (487.9), LDH (272), Ferritin (976) on admission - CXR personally viewed with increased LLL opacity noted. Report reviewed and notes left infrahilar opacities concerning for possible atypical pneumonia. CTPE performed showed ground glass opacities consistent with evolving pneumonia such as Covid 19, no PE. - s/p 1 dose of decadron in the ED - pro-calcitonin elevated at 2.29, consider initiation of abx if clinically worsening or cultures positive for bacterial source of infection Plan: - blood cultures, UA and culture, PT/INR, D-dimer, lactate, VBG ordered and pending - Continue oxygen supplementation to maintain saturation $g92% - continue dexamethasone, initiate remdesivir per protocol as patient meets criteria due to new oxygen requirement with o2 saturation of 88% on RA - monitor cbc w/diff, crp, PT/INR and LFTs daily - consider tocilizumab if oxygen needs continue to increase - will hold additional antimicrobial therapy at this time Colorectal cancer s/p partial colectomy with possible developing ileus - Reports some anorexia and nausea, no BM since surgery. Spoke with his surgeon and he had some post-op ileus but tolerate PO liquid intake with passage of gas - tender RLQ but overall pain is improving since surgery, non-distended - KUB without signs of obstruction or pneumoperitoneum Plan: - allow PO fluids, start IVF at 75ml/hr x 10 hours due to reduced PO intake, monitor for volume overload - full liquid diet, progress as tolerated - tylenol for pain, bowel regimen as needed - avoid stimulant laxatives or enema due to low-anastomosis and recent surgery Macrocytic anemia - hgb 11.3, down from 12.3 on 7/2 prior to surgery, suspect drop is post-operative, MCV unchanged at 99 - continue home B12 supplementation - continue to monitor with daily labs, transfuse for hgb <7 Chronic stable conditions HTN- continue home lisinopril (Cr 1.24, GFR 57 on admission, appears near baseline, Cr 1.28/ GFR 54 on 7/2, previously Cr 1.15 on 3/2/21) Hypothyroidism - continue home synthroid Glaucoma - continue home timolol drops Gout - continue home allopurinol, no joint swelling or redness at this time, no acute flare Osteoarthritis - continue duloxetine 30mg BID for pain Seasonal Allergies - continue home zyrtec Hospitalization Admit Date/Time: 7/31/2021 7:26 AM Discharge Date: 08/05/21 PCP name and Address: No Pcp None Referring provider name and address: No referring provider defined for this encounter. Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 77 y.o. male with a history of HTN, primary hypothyroidism, gout, prostate cancer S/P surgery + IT/HT, CRC S/P colectomy 7/27 who presented with CoVID-related pneumonia complicated by acute hypoxemic respiratory failure. 1. Acute hypoxic Respiratory failure, due to COVID-19 Pneumonia (POA, Improving) - Onset of symptoms 7/28/2021 - Coronavirus PCR confirmed here in ED. - Blood cultures are pending, no additional antibiotics currently, however pro-calcitonin elevated at 2.29, consider initiation of abx if clinically worsening with special attention to possible intraabdominal sources given recent surgical intervention. - Continue oxygen supplementation to maintain saturation $g88% - Going home with 2L NC - Continue dexamethasone (last day 8/9/2021) - Finish his 5-day course of remdesivir 8/4 without complications - Filed for Pfizer vaccine failure through the FDA portal - He''s advised to follow up with his PCP as scheduled 2. Colorectal cancer s/p partial colectomy with possible developing ileus (POA, Stable) - Reports some anorexia and nausea, no BM since surgery. - KUB without signs of obstruction or pneumoperitoneum. Continues to pass gas - Mechanical soft diet - Tylenol for pain and fevers - Continue with Miralax and psyllium - Avoid stimulant laxatives or enema due to low-anastomosis and recent surgery - Discharged with MOM nightly as needed as well Chronic Medical Conditions 1. Macrocytic anemia - Continue home B12 supplementation. Will continue to monitor with daily labs, transfuse for hgb <7 g/dL. 2. HTN - Continue home lisinopril, added nifedipine for elevated pressures on 8/1 3. Primary Hypothyroidism - Continue home synthroid 4. Glaucoma - Continue home timolol drops 5. Gout - Continue home allopurinol, no joint swelling or redness at this time, no acute flare 6. Osteoarthritis -Continue duloxetine 30mg BID for pain 7. Seasonal Allergies - Continue home zyrtec 8. Overweight - Complicates all aspects of care


VAERS ID: 1655704 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-05
Onset:2021-07-31
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pain
SMQs:

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: Vyvanse 70mg, montelukast 10mg, omeprazole 20mg
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: No adverse events reported by patient''s mother besides body aches and headache for a day or two after vaccination


VAERS ID: 1655716 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-05
Onset:2021-07-31
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse 40 mg, fluoxetine 20mg, aripiprazole 10mg
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: No adverse events were reported by the patient''s mother


VAERS ID: 1656072 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast inflammation, Heart rate irregular, Lymphadenopathy, Mammogram abnormal, Tachycardia, Thrombosis, Ultrasound scan
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Cardiac arrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: age 14 tetanus
Other Medications: atenolol 25mg bid losartin 25mg bid amlodipine 2.5mg qd vitamin D probiotic
Current Illness: none
Preexisting Conditions: hypertension, hyperlipidemia
Allergies: onions, sensitive to several medications, simvistatin hives
Diagnostic Lab Data: left mammogram and ultra sound
CDC Split Type:

Write-up: Tachycardia for 5 hours. Onset several hours after injection. After that, irregular pulse for at least 2 weeks on and off. Abnormal mammogram 2 weeks after injection with inflamed lymph left breast, same side as injection. Confirmed by Radiologist that they had been seeing the swollen nodes in breast caused by vaccine. Also had several small blood clots to inside left cheek of mouth resolved after 3 days.


VAERS ID: 1656371 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-02-09
Onset:2021-07-31
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Pneumonia, SARS-CoV-2 test negative
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), COVID-19 (broad)

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

Write-up: Moderna Covid 19 vaccine EUA Patient hospitalized for pneumonia. Covid negative


VAERS ID: 1656439 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-19
Onset:2021-07-31
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Vaccine breakthrough infection
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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breakthrough Covid infection


VAERS ID: 1656821 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-28
Onset:2021-07-31
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blindness, Chest pain, Dizziness, Dyspnoea, Feeling hot, Hyperhidrosis, Hypotension, Palpitations
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin c, vitamin b12, coq10, l-glutathione
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None; too scared to find out.
CDC Split Type:

Write-up: 2 minutes after vaccination my whole body got extremely hot and I started sweating profusely from head to toe. I felt light headed and lost my sight, I only saw completely black. My blood pressure became extremely low. After 10 minutes it subsided, they gave me gatorade and it helped. I had eaten a full meal before vaccination. 3 days later, I''ve experienced chest pain and heart palpitations as well as shortness of breath after working out, with no history of any kind of asthma or anything like that.


VAERS ID: 1657036 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood potassium decreased, Blood sodium decreased, Burning sensation, Full blood count normal, Hypoaesthesia, Metabolic function test, Neurological examination normal, Pain in extremity, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Hypokalaemia (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Potassium chloride, 40meQ PO daily Salt tabs 3500 mg BID Linzess Flexeril
Current Illness: None identified
Preexisting Conditions: Hyponatremia; H/o low Na 130 range; prev w/u for Addisons dz negative, on salt tabs Migraines Hyperlipidemia Pancreatic cyst Low BMI/underweight Vit D deficiency Osteoporosis (allergic to two bisphosphonates; declined trial of Zometa) Sensorineural hearing loss Low back and hip pain Chronic myalgias; suspected fibromyalgia H/o nephrolithiasis Dyspnea Epigastric pain/GERD
Allergies: Allegra - rash, Amoxicillin, Boniva, Cefzil, Clindamycin, Doxycycline, Fosamax, Hydrocortisone, Iodine, Macrobid - oral cavity swelling, Naprosyn, Naproxen - rash, Penicillin, Prednisone - hives, Sulfa drugs, Zofran
Diagnostic Lab Data: ER labs: CBC normal, BMP with K 2.4 (replaced in ED) and Sodium 126 (baseline 126 - 127)
CDC Split Type:

Write-up: Vaccine received at Publix pharmacy in Tiger Point. Patient developed right arm soreness, numbness in right side of her neck, mid back, hip, down her right anteriolateral leg. She also developed shaking that got better with acupuncture 8/3/2021. Also complained of burning in her bladder one week later. Now, she still has left sided subjective facial numbness (neuro exam normal), that occasional shoots down either leg.


VAERS ID: 1657758 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Rash, Vaccination site pruritus, Vaccination site rash, Vaccination site vesicles
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Rash on the neck and other side of neck, very red; Rash and blister on the site of injection and itchiness; Painful, difficult arm; Rash and blister on the site of injection and itchiness; Rash on the neck and other side of neck, very red; Rash and blister on the site of injection and itchiness; This spontaneous case was reported by a physician and describes the occurrence of ERYTHEMA (Rash on the neck and other side of neck, very red), VACCINATION SITE VESICLES (Rash and blister on the site of injection and itchiness), PAIN IN EXTREMITY (Painful, difficult arm), VACCINATION SITE PRURITUS (Rash and blister on the site of injection and itchiness) and RASH (Rash on the neck and other side of neck, very red) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 033B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Drug allergy (Lidocaine). On 30-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jul-2021, the patient experienced ERYTHEMA (Rash on the neck and other side of neck, very red), VACCINATION SITE VESICLES (Rash and blister on the site of injection and itchiness), PAIN IN EXTREMITY (Painful, difficult arm), VACCINATION SITE PRURITUS (Rash and blister on the site of injection and itchiness), RASH (Rash on the neck and other side of neck, very red) and VACCINATION SITE RASH (Rash and blister on the site of injection and itchiness). The patient was treated with CETIRIZINE HYDROCHLORIDE (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) for Adverse event, at a dose of UNK dosage form and HYDROCORTISONE for Adverse event, at a dose of UNK dosage form. On 01-Aug-2021, PAIN IN EXTREMITY (Painful, difficult arm) had resolved. On 02-Aug-2021, ERYTHEMA (Rash on the neck and other side of neck, very red), VACCINATION SITE VESICLES (Rash and blister on the site of injection and itchiness), VACCINATION SITE PRURITUS (Rash and blister on the site of injection and itchiness), RASH (Rash on the neck and other side of neck, very red) and VACCINATION SITE RASH (Rash and blister on the site of injection and itchiness) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication information was provided Most recent FOLLOW-UP information incorporated above includes: On 17-Aug-2021: TCR Received on 17-AUG-2021 and It included reporter contact details


VAERS ID: 1657939 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-26
Onset:2021-07-31
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal abscess, Blood test, Colonoscopy, Computerised tomogram, Endoscopy, Enteritis, Ultrasound scan
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal perforation (narrow), Gastrointestinal nonspecific inflammation (narrow), Noninfectious diarrhoea (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Cats, dogs, seasonal
Diagnostic Lab Data: CT scans: 8/9/21, 8/23/21 Ultrasound: 8/20/21 Blood tests: 8/9/21, 8/11/21, 8/ 17/21, 8/24/21, 8/30/21 Colonoscopy, endoscopy 9/1/21
CDC Split Type:

Write-up: Abdominal abscess, inflammation of ileum


VAERS ID: 1658773 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-25
Onset:2021-07-31
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Laboratory 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cycle threshold 7/30/21 = 25.5
CDC Split Type:

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


VAERS ID: 1658785 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-10
Onset:2021-07-31
   Days after vaccination:143
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, Polymerase chain reaction
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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: mycophenolate
Current Illness:
Preexisting Conditions: myasthenia gravis
Allergies:
Diagnostic Lab Data: Cycle threshold 7/31/21 = 24.7
CDC Split Type:

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


VAERS ID: 1659120 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-02-06
Onset:2021-07-31
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 LA / SYR

Administered by: Pharmacy       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 mg tablet Take 650 mg by mouth every 4 hours as needed for Pain. albuterol (VENTOLIN HFA) 90 mcg/puff inhaler Inhale 1 puff into the lungs every 4 hours as needed for Wheezing (coughing fit, anxiety).
Current Illness: ? Autism disorder ? BPH with obstruction/lower urinary tract symptoms required straight cath in hospital multiple times 2/2018 ? CHF (congestive heart failure) (HCC) 11/2016 echo done at CMC. EF 60-65% wtih diastolic dysfunction ? CKD (chronic kidney disease), stage III (HCC) baseline Cr ~ 1.6 as of 3/2018 ? COPD (chronic obstructive pulmonary disease) (HCC) ? Coronary artery disease ? Hypertension ? MSSA bacteremia 09/2014 at CMC treated with iv ancef/rifampin. TEE neg for vegetations. ? Small bowel perforation (HCC) 03/2018 microperforation, unclear etiology, hospitalized, managed with bowel rest and antibiotics
Preexisting Conditions: See section 11
Allergies: ? Sulfa Antibiotics ? Turkey [Poultry]
Diagnostic Lab Data: SARS-CoV-2 RNA Resp Ql NAA+probe DETECTED Ordered Test: SARS-CoV-2 RNA Resp Ql NAA+probe Ordered Test Codes: 94500-6 Status: Final Accession Number: 212120014LP-198922 Specimen Source: SOFT TISSUE SAMPLE Specimen Site: ENTIRE NASOPHARYNX(181200003) Specimen Collection Date/Time: 2021-07-31 06:58:00.0 SARS-CoV-2 (COVID-19) RNA [Presence] in Specimen with probe detection (SARS Coronavirus 2 RNA) Detected Ordered Test: SARS-CoV-2 (COVID-19) RNA [Presence] in Specimen with probe detection (SARS Coronavirus 2) Ordered Test Codes: 94309-2 /2019nCoV (L LOCAL) Status: Final Accession Number: 1574472 Specimen Source: Other Specimen Site: Specimen Collection Date/Time: 2021-07-30 00:00:00.0
CDC Split Type:

Write-up: Case completed the 2 dose Covid vaccine series on 2/6/21, then was admitted to hospital for Covid disease on 7/31/2021.


VAERS ID: 1659307 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-27
Onset:2021-07-31
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram ambulatory normal, Electrocardiogram normal, Tachycardia, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Symbicort Albuterol
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: ECG- ER Aug 1st normal Echo-Aug 18th normal Holter monitor- Aug 18 normal
CDC Split Type:

Write-up: PVC heart rhythm lasting for 72 hours straight. Went away for a week and came back for 96 hours straight. Intermittent chest pain, tachycardia, shortness of breath.


VAERS ID: 1662123 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-21
Onset:2021-07-31
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, Chest X-ray, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Anxiety, HTN.
Allergies: NKA
Diagnostic Lab Data: 7/31/21: CXR
CDC Split Type:

Write-up: Pt came to ER c/o abdominal pain test Covid positive 4 days after covid vaccination.


VAERS ID: 1662402 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia
SMQs:, Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient said she lost sense of taste and smell the following day and continued for week. After that could only taste strong flavors and smell strong odors


VAERS ID: 1662627 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, C-reactive protein increased, Cardiac murmur, Chest X-ray normal, Chest discomfort, Chest pain, Condition aggravated, Erythema, Extrasystoles, Full blood count normal, Lip oedema, Metabolic function test, Metabolic function test normal, Palpitations, Prohormone brain natriuretic peptide, Red blood cell sedimentation rate increased, Skin swelling, Troponin T normal, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None, has IUD
Current Illness: None
Preexisting Conditions: GERD, hypertriglyceridemia
Allergies: None known
Diagnostic Lab Data: 8/27/21: ESR 29, CRP normal, Troponin T normal, ProBNP normal, CBC normal, CMP normal, CXR no acute cardiopulmonary process, esp no cardiomegaly or edema. Ordered Holter monitor and echocardiogram.
CDC Split Type:

Write-up: Reports anxiety and feeling "like I had COVID" immediately after vaccine. Reports has had anaphylaxis symptoms since vaccine, has had them every day. These are redness, hives and swelling of random areas of skin on her body which will last 15 minutes (showed me a picture of fairly substantial lower lip edema). Since vaccine has also noted chest pain and palpitations like it will "skip a beat" and then has chest tightness. Pain lasts a few seconds, tightness lasts 10 minutes or so. Loud systolic cardiac murmur noted on exam, loudest at left sternal border, reports had a murmur as a child but has not been told she has one since and comes to the doctor every few months for various things.


VAERS ID: 1662775 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Sore arm, fatigue, chest pain, shortness of breath, took Tylenol.


VAERS ID: 1662816 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-09
Onset:2021-07-31
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9808 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol, insulin, finasteride, MVM, folic acid, furosemide, losartan, lubiprostone, metformin, mirabegron, NTG, omega 3 FA, omeprazole, senna, tamsulosin, Maxide, trospium
Current Illness: none
Preexisting Conditions: ? Arthritis ? Back pain ? Benign prostatic hypertrophy with urinary obstruction ? CAD (coronary artery disease) ? Diabetes (HCC) ? Diabetes mellitus, type 2 (HCC) ? Diverticulitis ? GERD (gastroesophageal reflux disease) ? Gout ? Heart murmur ? HL (hearing loss) tinnitus ? HTN (hypertension) ? Hyperlipidemia ? Neck pain ? Overactive bladder ? Peripheral neuropathy ? Sleep apnea, obstructive ? Thrombophlebitis $g 30 years ago ? Tumor cells
Allergies: iodinated contrast dye
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/9/2021:came to ED with SOB, cough and weakness for 10 days 8/10/2021: pos for COVID - discharged 8/13/2021: admitted with worsening symptoms 8/19/21: discharged to home with home health care and dexamethasone and told to return if worsens


VAERS ID: 1662902 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (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? 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
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anaphylaxis, epinephrine and Benadryl administered, symptoms resolved. hives persisted x 3 days


VAERS ID: 1662919 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Unknown  
Location: Tennessee  
Vaccinated:2021-02-01
Onset:2021-07-31
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, COVID-19, Chest X-ray abnormal, Cough, Decreased appetite, Fatigue, Hyperlipidaemia, Lung opacity, Malaise, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Lipodystrophy (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: Chest xray showed streaky, bilataeral mid to lower lung parenchymal opacities. CTA revealed ground glass opacities in the lung
CDC Split Type:

Write-up: Hx of CAD. hyperlipdemia, presenting to the ED and admitted with COVID has non-productive cough, low grade fever, body aches, malaise, fatuque and poor appetite.


VAERS ID: 1663407 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
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: Anxiety, Depression, Fatigue, Panic attack
SMQs:, Depression (excl suicide and self injury) (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 10 mg/day; Lipitor 20mg/day; Multi-vitamin; Evening Primrose Oil; Omega 3 capsules
Current Illness: Perimenopause
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Extreme anxiety, depression, panic attacks, fatigue.


VAERS ID: 1665555 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Diarrhea; Hives; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea), URTICARIA (Hives) and FATIGUE (Fatigue) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939893) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy and Drug allergy (Codeine). On 30-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jul-2021, the patient experienced DIARRHOEA (Diarrhea), URTICARIA (Hives) and FATIGUE (Fatigue). The patient was treated with LEVOCETIRIZINE DIHYDROCHLORIDE (XYZAL) at an unspecified dose and frequency and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency. At the time of the report, DIARRHOEA (Diarrhea), URTICARIA (Hives) and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided. No lab data provided.


VAERS ID: 1665703 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Pain in extremity, Urine analysis
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MODAFINIL; PROTONIX [OMEPRAZOLE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high (In Family.); Cancer (In Family.); GERD (Event verbatim: GERD/Reflux); High cholesterol (In Family.); Sleep apnoea (Event verbatim: Sleep apnea)
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Urine test; Result Unstructured Data: Test Result:Perfectly clean
CDC Split Type: USPFIZER INC202101070481

Write-up: Pain in arm after second dose of the Covid Vaccine; Dizziness; This is a spontaneous report from a contactable consumer (patient) reported for herself. A 52-year-old female patient received (BNT162B2, Solution for injection, Batch/Lot Number: FA7484), dose 2 via an unspecified route of administration, administered in Left arm on 31Jul2021 (at the age of 52-year-old) as single for covid-19 immunization. Vaccination was given between the time of 16:00 and 17:00. Medical history included Sleep apnoea and GERD/Reflux from an unknown date and unknown if ongoing. Family medical history included high cholesterol, cancer and high blood pressure in family. Additional Vaccines Administered on Same Date of the Pfizer Suspect were reported as none. Prior Vaccinations (within 4 weeks) prior to the first administration date of the suspect vaccine and AEs following prior vaccinations were reported as none. Concomitant medications included ongoing modafinil taken as single for sleep apnoea syndrome and omeprazole (PROTONIX) taken as twice daily for gastrooesophageal reflux disease. Historical vaccine included BNT162B2 (solution for injection, Lot Number: EW0181) dose 1 administered in left arm on 09Jul2021 (at the age of 52-years-old), as single for COVID-19 immunisation and experienced pain in arm after first dose of Covid Vaccine. On 31Jul2021 the patient experienced pain in arm and dizziness after second dose of the covid vaccine. The patient stated that so far she was doing good after her vaccines. Stated that her and her boyfriend had pain in their arms that lingered for days (with the second dose it lasted about 3-4 days). Said so far that was the only side effect she knows of. Stated there was a little bit dizzy also after the second vaccine, but that only lasted about an hour or 45 minutes, otherwise they were doing good. Stated that was wasn''t anything extreme it was just lightheadedness. The AEs does not required a visit to emergency room and physician office. The patient stated that in between her two doses of the vaccine she had a urine test done on an unspecified date in 2021and it was perfectly clean. Outcome of the event dizziness was resolved on 31Jul2021 and pain in arm resolved on an unspecified date in Aug2021.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101070234 Same patient, different drug, different event (split)


VAERS ID: 1666003 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-11
Onset:2021-07-31
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Cough, Decreased appetite, Dyspnoea, Fatigue, Headache, Impaired work ability, Malaise, Nausea, SARS-CoV-2 test positive, Secretion discharge, Somnolence
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: yes, numerous Hydroxychloroquine for RA since 2019 Zinc VIT D Selenium Dexilent Lipitor CoQ10 Cinnamon tumeric
Current Illness: none
Preexisting Conditions: Rheumatoid Arthritis high Cholesterol
Allergies: none
Diagnostic Lab Data: Chest xray Covid test
CDC Split Type:

Write-up: I tested positive for COVID on 8/2/2021 Cough, coughing spasms, thick mucous that I was coughing up- started off as green now is clear, shortness of breath, extreme fatigue, increased sleep, nausea, mild headache at first, decreased appetite, over all feeling of just not feeling right Monoclonal antibody infusion on 8/6/2021 at 1:00PM I was off work for 3 weeks from 8/2/2021 and went back on 8/24/2021 I continue with residual symptoms of cough, shortness of breath and fatigue I was put on Tessalon Perrls which did help some with the coughing, used cough drops, drank lots of water,


VAERS ID: 1666156 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-02-26
Onset:2021-07-31
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot
Other Medications: fluoxetine loratadine atorvastatin Vitamin D Women''s Multi-vitamin
Current Illness: none
Preexisting Conditions: high cholesterol West Nile Virus
Allergies: Sulfa-based medications
Diagnostic Lab Data:
CDC Split Type:

Write-up: Honestly, not sure why I''m filling this out. I responded to a survey that I had been sick with sinus infection since having the Moderna shot. It could be that I had covid again but wasn''t tested for that as by the time I went to the doctor it had been over 10 days. I was given antibiotics for my sinus infection and was better within a couple of days.


VAERS ID: 1666423 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chest pain, Dizziness, Dyspepsia, Headache, Mental disorder, Nervousness
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Pt.''s mother states that after receiving the 2nd dose of Moderna 07/31/2021, started experiencing symptoms 07/31/2021 of chest burning, heartburn, headache, and dizziness lasting 19 days. Primary visit 08/26/2021, recommendation to follow-up if symptoms worsen. Mental "Breakdown" stated son has shown signs of Anxiety and Nervousness. Still continuing to experience symptoms.


VAERS ID: 1666955 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-17
Onset:2021-07-31
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Condition aggravated, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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: swelling and redness at injection site, extending down arm almost to elbow
Other Medications: Enalapril, Hydrochloathiazide, Rovastatin, Fish Oil, Daily multi vitamin
Current Illness:
Preexisting Conditions: Had mastectomy May 3, 2012. No current treatment for cancer. High Blood Pressure, High Cholesterol
Allergies: Benadryl, prednisone, citrus
Diagnostic Lab Data:
CDC Split Type:

Write-up: With my first dose, I had a blood pressure spike on day 4. When I went in for my second dose, I talked to a nurse and a pharmacist and they felt that the blood pressure spike was unrelated as they had not seen any studies indicating that as a reaction, so I went ahead and had my second shot, but my blood pressure spiked starting that night and went high enough that by the second day, as it was still quite high, I called my provider and was given permission to increase my blood pressure medication.


VAERS ID: 1669641 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Cough, Erythema, Fatigue, Feeling abnormal, Feeling hot, Flushing, Hyperhidrosis, Inflammation, Nasopharyngitis, Pruritus, Rhinorrhoea
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy to antibiotic (Amoxicillin); Drug allergy (Niaspan); Drug allergy (Duloxetine); Niacin supplementation
Preexisting Conditions: Medical History/Concurrent Conditions: Cold
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: he was sweating all day; itching all the time on his back/Generalised itching; His spine was inflamed; He had a burning sensation on his spine; He had one red dot on the right side of his spine; I have a bad cold; Cough; Runny nose; Flushing; Feeling hot; felt a little bit tired the morning of his vaccine; felt a little bit strange the morning of his vaccine; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (felt a little bit strange the morning of his vaccine), HYPERHIDROSIS (he was sweating all day), PRURITUS (itching all the time on his back/Generalised itching), INFLAMMATION (His spine was inflamed) and BURNING SENSATION (He had a burning sensation on his spine) in a 56-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939893) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Cold in 2017. Concurrent medical conditions included Allergy to antibiotic (Amoxicillin), Drug allergy (Duloxetine), Niacin supplementation and Drug allergy (Niaspan). On 31-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jul-2021, the patient experienced FEELING ABNORMAL (felt a little bit strange the morning of his vaccine) and FATIGUE (felt a little bit tired the morning of his vaccine). On 01-Aug-2021, the patient experienced NASOPHARYNGITIS (I have a bad cold), COUGH (Cough), RHINORRHOEA (Runny nose), FLUSHING (Flushing) and FEELING HOT (Feeling hot). On 02-Aug-2021, the patient experienced HYPERHIDROSIS (he was sweating all day), PRURITUS (itching all the time on his back/Generalised itching), INFLAMMATION (His spine was inflamed), BURNING SENSATION (He had a burning sensation on his spine) and ERYTHEMA (He had one red dot on the right side of his spine). At the time of the report, FEELING ABNORMAL (felt a little bit strange the morning of his vaccine), HYPERHIDROSIS (he was sweating all day), PRURITUS (itching all the time on his back/Generalised itching), ERYTHEMA (He had one red dot on the right side of his spine), NASOPHARYNGITIS (I have a bad cold), COUGH (Cough), RHINORRHOEA (Runny nose), FLUSHING (Flushing), FEELING HOT (Feeling hot) and FATIGUE (felt a little bit tired the morning of his vaccine) had not resolved and INFLAMMATION (His spine was inflamed) and BURNING SENSATION (He had a burning sensation on his spine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was reported. No treatment medication was reported. Most recent FOLLOW-UP information incorporated above includes: On 19-Aug-2021: Follow-up received , patient demographics , relevant history ( allergy , historical condition) and new events are updated.


VAERS ID: 1670899 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alopecia, Anti-thyroid antibody positive, Arthralgia, Asthenopia, Blood test, Blood thyroid stimulating hormone increased, Condition aggravated, Dizziness, Dysgeusia, Echocardiogram, Electrocardiogram, Feeling abnormal, Feeling hot, Gait disturbance, Gait inability, Hand-eye coordination impaired, Heavy menstrual bleeding, Hyperacusis, Hypertension, Impaired driving ability, Impaired work ability, Menstrual disorder, Palpitations, Parosmia, Photophobia, Pyrexia, Rash, Sensory loss, Skin hypertrophy, Sleep disorder, Tinnitus, Tremor, Vibratory sense increased
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Tirosint SOL 175; Vitamin D 5000IU daily; Calcium Magnesium Citrate 1000 daily; Selenium
Current Illness: None
Preexisting Conditions: Controlled Hashimoto''s for 22 years
Allergies: Almonds; Whey Protein; Wheat; Prednisone; Narcotics/ Pain Medication no toleranc; Xanax reverse reaction; Cortizone causes immediate menstrual cycle to begin and brain fog, apathetic
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme brain fog similar to dementia for two weeks, fever daily for 3 days, sudden menstruation and heavy bright red blood lasting for 10 days, eyes strained by any light, hearing intensified, taste in mouth is that of metal or spoiled milk, sense of smell intensified to the point that I can smell everything beyond anything I have ever experienced, hearing intensified, ringing in the ears for two days, shaking, vibrating and then heart palpitations nonstop causing me to be awake every 45 minutes, unable to walk upstairs, extremely dizzy, cannot work or drive or walk anywhere, Im an artist and lost all ability to control hand eye coordination, and no sensation of other body parts, suddenly warm nonstop when I am usually freezing, skin rash on face and chest and arms thickening skin, loss of hair on head, aches and pains in all joints within 3 days of the vaccine. Finally had to go to hospital and be seen with high blood pressure, EKG, ECHOCARDIOGRAM and blood tests. Blood tests show a TSH of 11.45 and TPO of 307. I have not had numbers that have been close to this since 2002. This is a response to the vaccine, the vaccine purged my body of all thyroxine. Nothing could remove the thyroxine that quickly after taking 150 -175 of Thyroid replacement hormone for 20 years!!!


VAERS ID: 1670927 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dizziness postural, Dyspnoea, Feeling hot, Heart rate increased, Hyperhidrosis, Hypoaesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

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

Write-up: PATIENT CALLED ON 9/1/21 AND STATED WITH THE FIRST VACCINE SHE EXPERIENCED SHORTNESS OF BREATH, INCREASED HEART RATE, WAVES OF SWEAT AND A HOT FEELING COMING OVER HER BODY, NUMBNESS AND TINGLING IN HER EXTREMITIES, DIZZINESS AND DIZZINESS UPON STANDING. THESE SIDE EFFECTS OCCURED AFTER SHE LEFT FACILITY AND LASTED ABOUT 20 MINUTES.


VAERS ID: 1673131 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / -

Administered by: School       Purchased by: ?
Symptoms: Chills, Headache, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100992701

Write-up: Fever; Body aches; Headache; Chills; Left arm pain; This is a spontaneous report from a contactable consumer (patient). A 31-years-old non-pregnant female patient received second dose of bnt162b2 (BNT162B2, solution for injection), via an unspecified route of administration, administered in Arm Left on 31Jul2021 08:00 (Batch/Lot Number: EW0217) (at the age of 31-years-old) as SINGLE for covid-19 immunization and administered at School. It was reported that known allergies as no and other medical history as no. Historical vaccine included first dose of bnt162b2 (BNT162B2, solution for injection), via an unspecified route of administration, administered in Arm Left on 10Jul2021 08:00 (Batch/Lot Number: EW0217) (at the age of 31-years-old) as SINGLE for covid-19 immunization. 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 COVID-19 vaccine. Also, the patient did not receive any other medication within two weeks. The patient noticed that her 1st dose and 2nd dose have the same lot number and she wants to know if it''s normal to have the same lot number for the 1st and 2nd dose. On 31Jul2021 at 21:00 patient experienced fever, body aches, headache, chills and left arm pain. The reporter considered the events as non-serious as no hospitalization is reported. The patient did not received any treatment. The outcome of all the events was recovering. 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: 1673220 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood cholesterol, Body temperature, Chills, Dizziness, Headache, Myalgia, Pain in extremity, Pyrexia, Rash, Rash papular, SARS-CoV-2 test, Vaccination site pain, Vaccination site pruritus, Vaccination site urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Atrial fibrillation; Autonomic dysfunction; Cardiac ablation; Cataracts; COVID-19 pneumonia; Fibromyalgia; GERD; High cholesterol; Hyperhidrosis; Hypertension; Hypothyroidism; Postural orthostatic tachycardia syndrome; Sleep apnea.
Allergies:
Diagnostic Lab Data: Test Name: Cholesterol; Result Unstructured Data: Test Result: High; Test Date: 20210731; Test Name: Body temperature; Result Unstructured Data: Test Result:101.4; Test Date: 2021; Test Name: Nasal Swab, Covid test; Result Unstructured Data: Test Result: Negative.
CDC Split Type: USPFIZER INC202101058104

Write-up: rash (started with hives & itching around the injection site radiating to face, neck, and chest within 24 hours. then onto extremities and abdomen, groin, and buttocks; started with hives, around the site then spread within 24 hours around my face, neck, chest, and arms; itching around the injection site radiating to face, neck, and chest within 24 hours; Now was multiple papular rash especially on extremities; Fever 101.4/Fever chills; chills; dizziness; severe headache x 5 days/intracranial pressure pain; pain the site; sore muscles; sore arm side; This is a spontaneous report from a contactable nurse reporting for herself and a consumer. A 64-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 31Jul2021 13:00 (Lot number: FA6780) administered to left deltoid, at the age of 64 years old as 0.3 mL single dose for COVID-19 immunization. Facility type vaccine was at Pharmacy or Drug Store. Medical history included Autonomic Dysfunction, POTS, A-fib, Hypothyroid, Fibromyalgia, GERD, Hypertension, Sleep Apnea, Cataracts, Hyperhidrosis, High Cholesterol, had Covid virus back on 26Mar2021 prior to vaccine and still with symptoms developed Covid pneumonia and still experiencing symptoms, asthma and a heart ablation. Concomitant mediations were not reported. The patient previously took Codeine, Zoloft, Procardia, Isosorbide and all experienced allergies. On 31Jul2021 13:00, the patient experienced fever 101.4, chills, dizziness, severe headache x 5 days, rash (started with hives & itching around the injection site radiating to face, neck, and chest within 24 hours. then onto extremities and abdomen, groin, and buttocks. Now was multiple papular rash especially on extremities. Fever chills and pain the site. Patient also had the normal side effects, sore arm side and sore muscles on 31Jul2021 13:00. Events were resulted in Emergency room/department or urgent care. Treatment was received for the events included Oral medication, Methylprednisolone 7 day pack and Triamcinolone 0.5% cream. COVID test post vaccination in 2021: Nasal Swab, covid test result: Negative. The outcome of the events were resolving.; Sender''s Comments: As there is limited information in the case provided, the causal association between the events rash, vaccination site urticaria, vaccination site pruritus, rash papular and the suspect drug BNT162B2 can-not be excluded. The impact of this report on the benefit-risk profile of the Pfizer product and on the conduct of the study 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: 1674306 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-08
Onset:2021-07-31
   Days after vaccination:53
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac disorder
SMQs:

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

Write-up: Systemic: Cardiac Disorder (diagnosed by MD)-Severe


VAERS ID: 1674906 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 UN / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Malaise, Pneumonia, SARS-CoV-2 test negative
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), COVID-19 (broad)

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

Write-up: Systemic: covid symptoms/pneumonia-Medium, Additional Details: claims after each shot had cold symptoms and pneumonia. hospital felt it was covid symptoms but they tested her and she was negative.


VAERS ID: 1677364 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Electrocardiogram, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: 202107; Test Name: EKG; Result Unstructured Data: Test Result:Unknown
CDC Split Type: USPFIZER INC202101028272

Write-up: palpitations 3 hours after receiving vaccine; This is a spontaneous report from a non-contactable other healthcare professional. A 39-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 on 31Jul2021 (at the age of 39-year-old) as a single dose for COVID-19 immunisation. Medical history, and concomitant medications of the patient were not reported. Prior to vaccination, it was unknown whether the patient was diagnosed with COVID-19. On 31Jul2021, the patient experienced palpitations 3 hours after receiving vaccine. Still had intermittent palpitations 10 days post vaccine. The event resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of the event palpitations and included treatment with EKG. On an unknown date in Jul2021 the patient underwent EKG (Electrocardiogram) and the result was unknown. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event palpitations was not recovered at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1681652 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-23
Onset:2021-07-31
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Asthenia, Feeling abnormal, Headache, Hypokinesia, Mucosal disorder, Purpura, Pyrexia, Rash, Rash erythematous, Secretion discharge, Somnolence
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: hundreds of dots on the legs, they are bleeding; blood all over his mucous, with a mix of yellow, grey and red mucous; rash/red little dots all over the body; blood all over his mucous, with a mix of yellow, grey and red mucous; sleeping like crazy, sleeping 80 percent of the time; can not move; lack of energy; can not taste anything; feels like "crap"; Fever; Headache; Rash both legs; Rash all over; This spontaneous case was reported by a consumer and describes the occurrence of PURPURA (hundreds of dots on the legs, they are bleeding), MUCOSAL DISORDER (blood all over his mucous, with a mix of yellow, grey and red mucous), RASH ERYTHEMATOUS (rash/red little dots all over the body), SECRETION DISCHARGE (blood all over his mucous, with a mix of yellow, grey and red mucous) and SOMNOLENCE (sleeping like crazy, sleeping 80 percent of the time) in a 54-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 054C21A and 066021A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 23-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 31-Jul-2021, the patient experienced PURPURA (hundreds of dots on the legs, they are bleeding), MUCOSAL DISORDER (blood all over his mucous, with a mix of yellow, grey and red mucous), RASH ERYTHEMATOUS (rash/red little dots all over the body), SECRETION DISCHARGE (blood all over his mucous, with a mix of yellow, grey and red mucous), SOMNOLENCE (sleeping like crazy, sleeping 80 percent of the time), HYPOKINESIA (can not move), ASTHENIA (lack of energy), AGEUSIA (can not taste anything), FEELING ABNORMAL (feels like "crap"), PYREXIA (Fever), HEADACHE (Headache), RASH (Rash both legs) and RASH (Rash all over). At the time of the report, PURPURA (hundreds of dots on the legs, they are bleeding), MUCOSAL DISORDER (blood all over his mucous, with a mix of yellow, grey and red mucous), RASH ERYTHEMATOUS (rash/red little dots all over the body), SECRETION DISCHARGE (blood all over his mucous, with a mix of yellow, grey and red mucous), SOMNOLENCE (sleeping like crazy, sleeping 80 percent of the time), HYPOKINESIA (can not move), ASTHENIA (lack of energy), AGEUSIA (can not taste anything), FEELING ABNORMAL (feels like "crap"), PYREXIA (Fever), HEADACHE (Headache), RASH (Rash both legs) and RASH (Rash all over) had not resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. Relevant concomitant medications included, Immune Vitamins were reported. Treatment information was not provided. Patient said that all the symptoms started 8 days after the first dose and he is still experiencing these symptoms. Most recent FOLLOW-UP information incorporated above includes: On 01-Sep-2021: Follow-up information included updated reporter address and contact details.; 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: 1682845 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-30
Onset:2021-07-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW181 / UNK RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7185 / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Biopsy breast, Breast pain, Breast tenderness, Cardiac disorder, Echocardiogram, Heavy menstrual bleeding, Menopause, Neck pain, Nipple swelling, Pain in extremity, Thrombosis, Vaginal haemorrhage
SMQs:, Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Lipodystrophy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient stated that she had vaginal bleeding. Tenderness and painfulness in her breast. Her breast was heavy. Patient had normal side effects with back pain. Patient stated that she was in menopause. With the second vaccine bleeding was heavier and patient had blood clots. Bleeding lasted 10 days as well. Patient said her nipples are still swollen. Patient stated that she had pain in her arm from the first vaccine and pain in her neck from the second vaccine. Also after the first vaccine the patient complained of heart complications.


VAERS ID: 1682996 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-18
Onset:2021-07-31
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 2 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was exposed 07/29-2021, started having symptoms 07/31/2021 with mild symptom, patient went to ER where he stayed for 1days, lives with his wife who also tested positive.


VAERS ID: 1683017 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-21
Onset:2021-07-31
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Cough, Dehydration, Headache, Hypotension, Nasopharyngitis, Respiratory tract congestion
SMQs:, Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dehydration (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Current Smoker
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PUI''s symptoms started with a cold-like symptoms - congestion, cough, headache.The doctors at the urgent care where they tested sent PUI to Hospital for chest x-ray due to cough and smoking hx. Wife states PUI stayed 1 night in the hospital due to dehydration and low Blood pressure and was discharged the next day.


VAERS ID: 1683028 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-25
Onset:2021-07-31
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Headache, Hypoaesthesia, Muscle twitching, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vit C 1000mg 1 per day
Current Illness: denies
Preexisting Conditions: denies
Allergies: codeine, demerol, latex; intolerance of tachycardia to darvocet
Diagnostic Lab Data: 7/31/2021 CT reported negative by patient, reported blood work negative.
CDC Split Type:

Write-up: Pt reported an immediate headache that lasted 5 days, refractive to OTC treatment. On 5th day, had a syncopal event at work, EMS took to ER on 7/31/2021. Negative organic work up. Developed left upper arm numbness and facial twitching day 10 (5 days after hospital treatment). No meds given at the hospital.


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