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From the 9/10/2021 release of VAERS data:

Found 686,636 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 343 out of 6,867

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VAERS ID: 1518812 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site pruritus, Injection site rash, Injection site warmth, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), 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: Humira 40mg every 2 weeks Ambien 5mg at bedtime Vit D 50 000u/week Vit c 1000mg a day Zinc 50mg a day Probiotic daily
Current Illness:
Preexisting Conditions: Rheumatoid arthritis Diverticulitis Fibromyalgia
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient still had a painful deep lump in her left arm from the first Moderna vaccine. Gave 2nd shot in right arm. she reports that the next morning the pain in her left arm intensified and she experience pain in the right arm from her shoulder to the tip of her fingers. She also had a ras and sever itching at the site of injection and it was hot to the touch for about 48 hours


VAERS ID: 1519566 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-14
Onset:2021-07-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia
SMQs:

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

Write-up: Insomnia


VAERS ID: 1519990 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-29
Onset:2021-07-17
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Antinuclear antibody positive, Erythema, Rash, Rash pruritic, Thyroid function test normal
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness:
Preexisting Conditions:
Allergies: Bee stings.
Diagnostic Lab Data: Thyroid test - normal Ana anti nuclear antibody test - positive
CDC Split Type:

Write-up: An itchy outbreak and redness on back and torso.


VAERS ID: 1519993 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-12
Onset:2021-07-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Computerised tomogram, Dizziness, Dysarthria, Ultrasound Doppler
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient was on amlodipine, escitalopram, and melatonin
Current Illness: Patient had sleep apnea and high blood pressure
Preexisting Conditions: Patient had chronic hypertension
Allergies: no allergies to medication or food products
Diagnostic Lab Data: CAT Scans, Doppler, Angiogram
CDC Split Type:

Write-up: Patient reported experiencing slurred speech on July 17, 2021 (5 days after initial dose). Patient felt extremely dizzy and called 911. While on call, patient had slurred speech and emergency was dispatched. Patient was admitted same day to Hospital in city.


VAERS ID: 1520031 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-02
Onset:2021-07-17
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Sensitive skin, Skin burning sensation
SMQs:, Peripheral neuropathy (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Supplements: Vitamin C. D3, Calcium, Magnesium, Zinc, B12,
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Tested for Shingles and Bacterial infection on July 22, 2021
CDC Split Type:

Write-up: Shingles sores around right ear, right shoulder and under chin appeared after one day of burning and sensitivity along the right side of entire scalp.


VAERS ID: 1520761 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-02-02
Onset:2021-07-17
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Laboratory test normal, Retinal vein occlusion, Visual field defect
SMQs:, Embolic and thrombotic events, venous (narrow), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Retinal 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: nuvaring, pre/pro-biotic, xerac (underarms topical), acanya (facial topical), retinol cream (facial topical)
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa, zithromax
Diagnostic Lab Data: all lab tests are within normal limits
CDC Split Type:

Write-up: first dose received 2/2/21. on 7/17/21 I experienced a blackout spot in the bottom left field of my vision. I was then diagnosed with central retinal vein occlusion after a second event on 7/27/21 that lasted approx. 48 hours.


VAERS ID: 1521181 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Cold sweat, Headache, Pyrexia, Renal pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: Cold sweats, fever (though not as bad as COVID) headache sore joints and kidney ache.
Preexisting Conditions: Joints still hurt, most of my joints feel okay now but my elbows still ache, and hurt. The pain is not subsiding. All other side affects only lasted a few days but elbows are not healing.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: My elbow aches and pains are still present, haven''t tried any treatment other than pain meds. All other symptoms are gone.


VAERS ID: 1523014 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Loss of consciousness, Nausea, Seizure, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: history of absence seizures
Allergies: ham intolerance
Diagnostic Lab Data: vital signs stable after the event and encouraged fluids and food after but no other testing completed at this time.
CDC Split Type:

Write-up: approx 24 hours after vaccine given my daughter passed out and started seizing follow by episode of vomiting. Entire event lasted less than 5 minutes and no problems after that. She had been feeling a little nausea earlier that morning but no other symptoms or concerns


VAERS ID: 1523091 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-07-13
Onset:2021-07-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Lip erythema, Lip pruritus, Lip swelling, Oral disorder
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient reports not taking any medication at the moment.
Current Illness: Patient reports not having any diseases at the moment.
Preexisting Conditions: Patient reports not having a chronic diseases
Allergies: Patient reports no allergies
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient reports the fourth day of the administration with the first dose of Pfizer Vaccine, Itching, redness and swelling on the left side of his lips. He does not receive any treatment according to his father. At the time of receiving the second dose, the lesion was observed on the left side lips


VAERS ID: 1524859 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-15
Onset:2021-07-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Illness, Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100909916

Write-up: achiness; sick for two days/still sick, like very sick; This is a spontaneous report from a contactable consumer reporting for the son. A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 15Jul2021 15:30 (Batch/Lot number was not reported) as dose 1, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The reporter stated the patient went to the pharmacy, he got the vaccine the first dose and he was sick on Sunday (18Jul2021), clarifying he had been sick for two days. The reporter further stated the patient was minor had his 1st vaccine on 15Jul, clarifying had his shot on Thursday (15Jul2021) and it''s Monday (19Jul2021), he was still sick , like very sick and unfortunately he was excited about the camp but now he was at camp, 3 hours from home and he spent all 2 and half days in a nurse''s office and the reporter did not know what to do. Reporter stated the patient got the vaccine on 15Jul2021 about 3:30 pm and he didn''t start to show the achiness, sickness until Saturday morning (17Jul2021), clarifyign he seemed ok like Friday but Saturday, Sunday and today (19Jul2021) were just bad." For lot number, the reporter stated, "EY0 Don''t know if it is a O or a zero 584.". The outcome of the events was not recovered. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1524870 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Chest discomfort, Electrocardiogram, Heart rate, Heart rate increased, Hypertension, Oxygen saturation, Oxygen saturation decreased, Palpitations, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Hypertension (narrow), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202107; Test Name: blood pressure; Result Unstructured Data: Test Result:197/97; Test Date: 202107; Test Name: blood pressure; Result Unstructured Data: Test Result:167/97; Test Date: 20210718; Test Name: CBC, BMP, Troponins; Result Unstructured Data: Test Result:Normal; Test Date: 20210718; Test Name: EKG; Result Unstructured Data: Test Result:Normal; Test Date: 20210718; Test Name: heart rate; Result Unstructured Data: Test Result:120s; Test Date: 20210719; Test Name: heart rate; Result Unstructured Data: Test Result:119; Comments: his heart rate of 119. Caller states he was still trying to calm down and it would go down to 80 but then it would go back to 100; Test Date: 20210719; Test Name: heart rate; Result Unstructured Data: Test Result:60s; Comments: heart rate went back to the 60s; Test Date: 202107; Test Name: pulse/pulse ox; Result Unstructured Data: Test Result:101; Test Date: 202107; Test Name: pulse/pulse ox; Result Unstructured Data: Test Result:101; Test Date: 202107; Test Name: pulse/pulse ox; Result Unstructured Data: Test Result:60s sometimes 50s,; Comments: states his pulse so far at rest is back in the 60s sometimes 50s; Test Date: 20210718; Test Name: pulse/pulse ox; Result Unstructured Data: Test Result:60s; Comments: it was in the 60s like it normally is; Test Date: 20210719; Test Name: pulse/pulse ox; Result Unstructured Data: Test Result:straight back up; Comments: states he could get his pulse to come down but then it would go straight back up for 4.5 hours; Test Date: 20210718; Test Name: O2 sat; Result Unstructured Data: Test Result:88; Test Date: 20210718; Test Name: O2 sat; Result Unstructured Data: Test Result:came back up; Comments: O2 sat came back up, and the pressure was slightly relieved
CDC Split Type: USPFIZER INC202100924648

Write-up: felt a huge pressure in his chest and his hands were white and pale; put his pulse ox on and it was reading 88 for O2 sat and his heart rate was in the 120s; felt a huge pressure in his chest and his hands were white and pale; put his pulse ox on and it was reading 88 for O2 sat and his heart rate was in the 120s; felt a huge pressure in his chest and his hands were white and pale; put his pulse ox on and it was reading 88 for O2 sat and his heart rate was in the 120s; Severe Heart Palpitations; he felt like his heart was pounding though his chest, he was sick, and felt like he was going to pass out; felt like his heart was going to explode out of his chest; blood pressure was 197/97 and his pulse was 101. Caller states they retook his blood pressure and it was 167/97 and pulse was 101; Tachycardia; felt like his heart was going to explode out of his chest; This is a spontaneous report from a contactable pharmacist. A 31-years-old male patient received first dose of bnt162b2 (Solution injection; Batch/Lot Number: EW0185), via an unspecified route of administration, administered in Arm Left on 16Jul2021 at 15:00 as single dose (at the age of 31-years-old) for covid-19 immunisation. The patient medical history and concomitant medications. The patient previously took fluzone (fluconazole) and had difficulty breathing with Fluzone, gotten the Flublock several times. Patient was not allergic to eggs. Patient did not receive any prior vaccinations within 4 weeks. The patient stated that he had his first Covid Vaccine on Friday 16Jul2021, and he started having severe heart palpitations on Saturday and he ended up going to the emergency department (ED). It was stated he felt like his heart was pounding though his chest, he was sick, and felt like he was going to pass out. It was further stated that he didn''t know what it was, but his heart was pounding through his chest. When he got to the ED his blood pressure was 197/97 and his pulse was 101. They retook his blood pressure and it was 167/97 and pulse was 101. The doctor at the ED blew him off and said this was a common reaction to the vaccine, heart palpitations. He wanted to know if that was a common reaction, man, he felt like his heart was going to explode out of his chest. He had more palpitations and then they finally broke. The next day, on 17Jul2021, he had the palpitations again. he tried to walk and get them to calm down, tried laying down and it was still not going down, so he went back to the ED because his heart was still beating through his chest. A day prior to this report (re-ported as yesterday) 03:00 a.m, the palpitations started again, and it lasted 4 hours. He took a video with his phone of his pulse ox showing his heart rate of 119. He was still trying to calm down and it would go down to 80 but then it would go back to 100. He could get his pulse to come down but then it would go straight back up for 4.5 hours and then they finally stopped yesterday around 20:00-21:00. His pulse so far at rest was back in the 60s sometimes 50s, and he was not going through the oh my god he was going to die in his chest. The tachycardia started at 10:30-11:00 on Saturday, and it would go for several hours and then go back to normal, then it would start pounding again and then it was normal overnight, he thought it was over and then Sunday morning he was checking with his pulse ox and it was in the 60s like it normally was. He got in his truck because his friend was coming over and he felt a huge pressure in his chest and his hands were white and pale so went home and put his pulse ox on and it was reading 88 for O2 saturation and his heart rate was in the 120s. He started walking to de-stress himself and his color came back to his hands, but his heart was still pounding, so he walked on the treadmill for 30 minutes, and his O2 sat came back up, and the pressure was slightly relieved. He sat in his recliner and leaned back and tried to do vagal maneuvers and deep breathing, and he felt it started to go down and rev back up again and it wouldn''t stay down and on his pulse ox his heart rate would go down to 70s and 80s and back up to 100s. He did deep breathing and it would go up and down up and down. He decided he didn''t know how much more his heart could take, so he went back to the ED. They did an EKG, CBC, CMP, and Troponins because it was the second day of a high heart rate, but they all came back normal. The troponins were undetectable so no heart damage. They say it was a strong fight or flight reaction and if it doesn''t go away in a few days, he needed to do something else. A day prior to this report (reported as yesterday) he woke up at 03:00 a.m. and his heart was pounding through his chest again. Prior to this, his heart was feeling like it literally was going to explode so he recorded it with his phone going up and down up and down, because when he would get to the ED it was back to normal and it was hard to get a diagnosis. He video taped it several times. A day prior to this report (yesterday) in morning it lasted 4.5 hours and then his heart rate went back to the 60s. It was stated that now for 24 hours it has been back in the 60s and like normal. The 60s was at rest, sometimes dropping down to the 50s, but it stays in the 60 range maybe hits the 70 range. He would say this was serious. For 3 days, he couldn''t do anything, and he thought he was going to die. It was stated that now it appeared to have went away, but it was pretty scary. He has never had that issue randomly show up. The patient under-went lab tests and procedures which included blood pressure measurement: 197/97 and 167/97. On 18Jul2021, blood test was normal, electrocardiogram was normal, heart rate was 120s and oxygen saturation was 88. On 19Jul2021, heart rate was 119. The event blood pressure was 197/97 retook his blood pressure and it was 167/97 resolved on 17Jul2021; Heart rate high, Oxygen saturation decreased and Chest pressure resolved on 19Jul2021; and Palpitations, Tachycardia resolved on 20Jul2021. No further information was provided.; Sender''s Comments: Based on the information currently provided (plausible time association), it cannot be fully excluded that the bnt162b2 might have played a contributory role in triggering the occurrence of reported events. 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: 1524919 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-01
Onset:2021-07-17
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: 20210720; Test Name: Covid; Result Unstructured Data: Test Result:Positive; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202100952865

Write-up: second vaccine administered in Feb2021. 17Jul2021 began covid symptoms; COVID-19; This is a spontaneous report from a contactable consumer (patient). A 58-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), via an unspecified route of administration on an unknown date in Feb2021 (at the age of 58-year-old) (Batch/Lot number was not reported) as dose 2, single at workplace clinic, via an unspecified route of administration in right arm on an unknown date in Jan2021 at 15:00 (at the age of 58-year-old) (Batch/Lot number was not reported) as dose 1, single for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. It was reported that second vaccine administered in Feb2021 and on 17Jul2021 began COVID symptoms. The adverse event was resulted in visit of doctor or other health care professional office/clinic visit. The patient underwent lab tests and procedures which included COVID test (nasal swab test): positive on 20Jul2021. Therapeutic measures were taken as a result of COVID-19. The outcome of the COVID-19 was reported as resolved on an unknown date in 2021. The lot number for the vaccine, (PFIZER-BIONTECH COVID-19 vaccine), was not provided and will be requested during follow up.


VAERS ID: 1525808 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-15
Onset:2021-07-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 - / IM

Administered by: Military       Purchased by: ?
Symptoms: Burning sensation, Condition aggravated, Dyspnoea, Migraine
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications:
Current Illness: Herniated disk of L5-S1
Preexisting Conditions: Herniated disk of L5-S1 Chronic migraines
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient complained of burning sensation of the feet and some intermittent sob not worse with exercise. burning sensation of the feet happened on the 17ths and sob of breath comes and goes starting the 17th and on. Patient also endorsed worsening migraines.


VAERS ID: 1526045 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Confusional state, Diarrhoea, Feeling abnormal, Hallucination, Injection site pain, Myalgia, Pain in extremity, Pyrexia, Speech disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram, Hydroxyzine, Buspirone
Current Illness: None
Preexisting Conditions: Auto immune urticaria due to adverse reaction to antibiotics.
Allergies: Bacctrim, Levaquin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: In less that 24 hours I had 4 bouts of diarrhea, mild fever, and site soreness. After 24 hours I started experiencing ?brain fog? or mental confusion, unable to pull common words while trying to speak. Some visual hallucinations, and extreme leg muscle/joint pains, as I had experienced during my critical adverse reaction to antibiotics in 2015. Almost 3 weeks out from dose 1 of vaccine, 2 days away from receiving 2nd dose and am still experiencing brain fog, hallucinations, and muscle/joint pains.


VAERS ID: 1526128 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Dyspnoea, Electrocardiogram, Fibrin D dimer, Full blood count, Malaise, Metabolic function test, Pruritus, Troponin, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Anthrax 28 yo/1990/ Unknown
Other Medications: Synthroid, Neurontin, Vit, D, Claritin, Singular, MVI, protonix
Current Illness: Hypothyroidism, asthma, obesity
Preexisting Conditions: Hypothyroidism, Asthma, obesity
Allergies: Motrin, Monistat, Norvasc, carrots, Celery, Marshmallow (Weed) , Ragweed, Sunflowers, Sage (Weed), Grasses, Trees, Weeds, Dust, Flowers, Daisys
Diagnostic Lab Data: ER evaluation and treatment on 19 July and 23 July 2021 (EKG, CMP, Tropin, D-Dimer, CBC, Chest X-rays, medications) Provider follow up 20 July 2021 and 27 July 2021.
CDC Split Type:

Write-up: Whole Body itchiness with rash (Hives), Chest pressure with shortness of breath, chest tightness, malaise


VAERS ID: 1526344 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Dysuria, Urine analysis normal
SMQs:, Peripheral neuropathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 07/18/2021: Urinalysis revealed no bacterial infection. 07/21/2021: Urinalysis revealed no bacterial infection.
CDC Split Type:

Write-up: Painful and difficult urinating, similar to UTI. Burning sensation amplified after urinating. Prescribed in Urgent Care antibiotics on 07/18/2021 did not help. Prescribed on 07/21/2021 Fluconazole treated the infection, felt the relief after 1 day.


VAERS ID: 1528560 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-11
Onset:2021-07-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 LA / IM

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

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

Write-up: Numbness and tingling on (L) hand 3rd and 4th digit


VAERS ID: 1528679 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-17
Onset:2021-07-17
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test, CSF protein increased, Guillain-Barre syndrome, Hypoaesthesia, Immunoglobulin therapy, Laboratory test, Lumbar puncture abnormal, Magnetic resonance imaging spinal, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations: Flu Vaccine Ts 2012-13(18 Yr+) allergy
Other Medications: Sertraline; Synthroid
Current Illness: N/A
Preexisting Conditions: Hashimoto''s
Allergies: Flu vaccine, latex
Diagnostic Lab Data: Clinical exam - July 21, 2021 Bloodwork - July 21, 2021 Clinical exam - July 28, 2021 MRI - July 28, 2021 Lumbar puncture - July 28, 2021 Bloodwork - July 28, 2021 through discharge from hospital on August 4, 2021.
CDC Split Type:

Write-up: Symptoms began roughly one month after administration. Symptoms began with numbness and tingling in the feet, moving to the calves, upper legs, arms, hands, and face. Weakness developed in the extremities shortly thereafter. Patient consulted with primary care provider (?PCP?) on July 21, 2021. PCP ordered various laboratory blood tests and recommended patient see a rheumatologist. On July 27, 2021, patient contacted PCP for a neurology referral. Upon receiving referral, Patient contacted Neurology for a consult. Patient described symptoms to via a web portal. On July 28, 2021, ,clinic advised patient to go to the emergency room. Patient visited emergency room at Hospital and Health center on July 28, 2021. Patient was admitted to the hospital with a diagnosis of Guillain-Barr? syndrome on the same day after a clinical examination, MRI of the entire spine, and a lumbar puncture showing elevated protein levels. Patient lost almost all strength in legs and developed saddle paresthesia shortly thereafter. Patient was treated with Immunoglobulin therapy over the course of five days. Patient was discharged from the hospital on August 4, 2021.


VAERS ID: 1529092 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-26
Onset:2021-07-17
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anosmia, Bronchitis, Lower respiratory tract infection, Oropharyngeal pain, SARS-CoV-2 test negative, Sinusitis
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft - 50 mg per day; Adderall XR - 20 mg a day (maybe 30)
Current Illness: no
Preexisting Conditions: no
Allergies: none known
Diagnostic Lab Data: July 23 - COVID test - rapid test - That came back negative.
CDC Split Type: vsafe

Write-up: I had typical reactions - right after the vaccine. Recent health event: Starting July 17, sore throat and sinus infection and then into Bronchitis and chest infection. That was it. It was scary because I lost my sense of smell - but not until after a week after I first noticed symptoms. I went to Urgent Care course of Amoxicillin. It helped with symptoms. My smell loss returned within two days of starting Amoxicillin. I Could still taste sweets and sour - tongue flavors. But I could not smell my child''s dirty diapers.


VAERS ID: 1529164 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-07-12
Onset:2021-07-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Chest pain, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MultiVitamins, medication Ibersartan 300mg
Current Illness: N/A
Preexisting Conditions: HBP
Allergies: Aspirin
Diagnostic Lab Data: I am in the process of having an appointment during this month of August 2021 with my Internist/cardiologist Doctor. I already had a holter test ( 08/04/2021) but I do not have the results at this moment.
CDC Split Type:

Write-up: I am currently active male 58 yrs old. Before the 2nd shot I was able to run, swim and ride bycicle (all racing) without any disconfort. After the 2nd shot( same week) I started experiencing chest pressure or pain, short of breath and tireness during my training sessions. During my running training I most stop because I feel a pressure in my chest. If I stop the pressure disappears, until I resume again it comes once again. Finally I am able to finish my training feeling very tire and without energy. I had recently a EKG and echocardiogram and everything was normal per my Doctor''s statement.


VAERS ID: 1529357 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-08
Onset:2021-07-17
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1085 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Blood test normal, Computerised tomogram head, Computerised tomogram normal
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: High blood pressure.
Allergies: N/A
Diagnostic Lab Data: CT Scan-July 17, 2021. They didn?t find any thing wrong with my brain. Blood work-July 19, 2021. Blood work was normal
CDC Split Type:

Write-up: Got Bells Palsy 1 month and 9 days after my 2nd dose of vaccine. Was not sick before I got Bells Palsy. No signs of infection or viral infection. Not stressed out. No reasons why I got Bells Palsy, only thing different in my life was the vaccine.


VAERS ID: 1530518 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Nasal congestion, Respiratory tract congestion, SARS-CoV-2 test, Secretion discharge, Sinus headache
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210721; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202100934738

Write-up: Started with intense sinus headache in the first 2 days, slight chills, no fever, tiredness. Then felt the chest and congestion come on in day 3-4, now coughing, stuffy nose, mucus; Started with intense sinus headache in the first 2 days, slight chills, no fever, tiredness. Then felt the chest and congestion come on in day 3-4, now coughing, stuffy nose, mucus; Started with intense sinus headache in the first 2 days, slight chills, no fever, tiredness. Then felt the chest and congestion come on in day 3-4, now coughing, stuffy nose, mucus; Started with intense sinus headache in the first 2 days, slight chills, no fever, tiredness. Then felt the chest and congestion come on in day 3-4, now coughing, stuffy nose, mucus; Started with intense sinus headache in the first 2 days, slight chills, no fever, tiredness. Then felt the chest and congestion come on in day 3-4, now coughing, stuffy nose, mucus; Started with intense sinus headache in the first 2 days, slight chills, no fever, tiredness. Then felt the chest and congestion come on in day 3-4, now coughing, stuffy nose, mucus; Started with intense sinus headache in the first 2 days, slight chills, no fever, tiredness. Then felt the chest and congestion come on in day 3-4, now coughing, stuffy nose, mucus; This is a spontaneous report from a non-contactable consumer. A 42-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration on 16Jul2021 10:45 (at the age of 42 years old) as dose number unknown, single for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient has no history of COVID-19 prior vaccination. On 17Jul2021 17:00, the patient started with intense sinus headache in the first 2 days, slight chills, no fever, tiredness. Then felt the chest and congestion come on in day 3-4, now coughing, stuffy nose, mucus. No treatment was received for the events. The patient was covid tested post vaccination via nasal swab on 21Jul2021 with negative results. The outcome of the events was recovering. No follow-up attempts are possible. Information about batch/lot number cannot be obtained. No further information is expected.


VAERS ID: 1530541 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Body temperature, Fatigue, Headache, Malaise, Myalgia, Nasal congestion, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210717; Test Name: Body temperature; Result Unstructured Data: Test Result:100.6-100.8; Test Date: 20210720; Test Name: Covid-19 test; Test Result: Inconclusive ; Test Date: 20210723; Test Name: Covid-19 test; Result Unstructured Data: Test Result:Unknown results; Comments: Pending
CDC Split Type: USPFIZER INC202100942298

Write-up: felt very ill; sustained fever of 100.6-100.8; I am very weakened; exhausted; I have headaches; Muscle aches; Nasal congestion; This is a spontaneous report from a contactable consumer (patient) received via Regulatory Authority. A 47-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in arm right on 12Jul2021 12:30 (Lot Number: EW0173) as DOSE 1, SINGLE for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to vaccination. On 17Jul2021 18:45, approximately 4 -5 days after the first Covid vaccine, the patient felt very ill and had a sustained fever of 100.6-100.8 now for 6 full days that does not go away. Patient was very weakened and exhausted; also had headaches, muscle aches, and nasal congestion. The events resulted in emergency room/department or urgent care. The patient underwent lab tests and procedures which included body temperature: 100.6-100.8 on 17Jul2021; Covid-19 test: inconclusive on 20Jul2021 and unknown results (pending)on 23Jul2021. The outcome of the events was not recovered. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1531208 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram thorax abnormal, Dyspnoea, Echocardiogram abnormal, Fibrin D dimer, Liver function test, Lung infiltration, Oxygen saturation decreased, Peripheral swelling, Pulmonary hypertension, Pyrexia, Right atrial dilatation, White blood cell count increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal
Current Illness: Postpartum Delivery 7/14/21
Preexisting Conditions: N/A
Allergies: Nkda
Diagnostic Lab Data: CT, ECHO, bloodwork
CDC Split Type:

Write-up: Shortness of breath, bilateral leg swelling, chest pain, fever 103, saturation?s in low 80s lead be to the ER and ultimately admission into the hospital. Elevated WBC, d-dimer, LFTs, CT showed bilateral lung infiltrates, ECHO showed dilated right atrium and pulmonary hypertension


VAERS ID: 1531659 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Myasthenia gravis, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Mystenia Gravis
Preexisting Conditions: Hashimotos and Mystenia Gravis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: My head was extremely swollen and has been swollen every morning since the vaccine. It caused me to have a MG Flare. I am not taking number 2 but wish I could.


VAERS ID: 1532006 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-24
Onset:2021-07-17
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Systemic inflammatory response syndrome
SMQs:, Tumour lysis syndrome (broad), Sepsis (broad), Opportunistic infections (broad)

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

Write-up: R65.10 - SIRS (systemic inflammatory response syndrome).


VAERS ID: 1532679 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, 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: Primella Lisinopril HCTZ
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: swollen lymph nodes in injected arm


VAERS ID: 1534043 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-07-13
Onset:2021-07-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstrual 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? No
Previous Vaccinations:
Other Medications: Birth control mini-pill
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I started my menstrual period 2 weeks early, 4 days after COVID-19 Vaccine dose #1. Since it started, I have been bleeding for 3 weeks straight with drastic variations in blood volume every day. This is abnormal for me since my birth control has regulated my periods.


VAERS ID: 1534795 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 UN / IM

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

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

Write-up: Client received Pfizer Dose 1 after receiving Janssen on 03/07/2021. Client attempted to receive Pfizer Dose 2 on 08/07/21. Client was informed that she cannot complete her Pfizer vaccination series because of her previous Janssen vaccination. Client attested that she did not have any adverse reaction to her Pfizer Dose 1.


VAERS ID: 1534804 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 UN / IM

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

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

Write-up: Client received two previous doses of Pfizer prior to receiving this Pfizer dose on 07/17. The previous Pfizer dates were 02/03/2021 and 02/24/2021. Client attempted to receive fourth Pfizer dose today (08/07/2021). Client admitted today to receiving the first two doses at another site and attempted to complete a second series under his doctor''s recommendation. Client did not receive additional Pfizer dose today. Client attests that he did not have any adverse reaction after receiving his third Pfizer dose.


VAERS ID: 1534886 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19 immunisation, Extra dose administered
SMQs:, Medication errors (narrow), COVID-19 (narrow)

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

Write-up: AFTER I administered the SECOND Pfizer IMZ today, 8-7-21, I told the patient not to laminate his vaccine card in case we have to get booster shots. He then informed me that he received the J&J Covid shot in April. He said his dr told him to get the other COVID IMZs for more coverage. I informed him that the CDC is not recommending other shots at this time. He also stated the pharmacist who gave him his first Pfizer shot on 7-17-21 said to get the Pfizer IMZ. I spoke to the patient later, about 12:45 on 8-7-21 and he is doing fine after receiving the second Pfizer IMZ I administered today. I am filling out this form for the 2 Pfizer IMZs both from the same Pharmacy; on on 7-17-21 and the other on 8-7-21 since the patient already received the J&J IMZ in April 2021.


VAERS ID: 1534952 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bronchitis, Cough, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

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

Write-up: Severe coughing, bronchial inflammation, heart palpitations


VAERS ID: 1534991 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 RA / IM

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

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

Write-up: Patient had red bumps all over trunk-arms and legs


VAERS ID: 1535234 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-09
Onset:2021-07-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Injection site erythema, Injection site pain, Injection site swelling, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient experienced localized arm redness, swelling and pain at injection site starting approximately 1 week post vaccination - "covid arm". Lasted a few days before going away completely on it''s own.


VAERS ID: 1536034 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Confusional state, Speech disorder, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Penicillin (estimated 50yrs +), swelling and asthma reaction
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin
Diagnostic Lab Data: Blood Work 07/18/2021
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of Moderna 07/17/2021, starting experiencing symptoms 07/17/2021 that evening of tongue swelling, speech difficulty, and confusion. Primary visit 07/18/2021 resulting in Blood Work and recommendations for Allergy Medications and Prednisone. Still continuing to experience symptoms.


VAERS ID: 1536146 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-01
Onset:2021-07-17
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anti-ganglioside antibody positive, Asthenia, Ataxia, Guillain-Barre syndrome, Immunoglobulin therapy, Lumbar puncture abnormal, Magnetic resonance imaging head normal, Magnetic resonance imaging spinal normal, Miller Fisher syndrome, Ophthalmoplegia
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Ocular motility disorders (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Lumbar puncture with positive GQ1b antibodies. MRI brain and cervical spine negative.
CDC Split Type:

Write-up: Miller Fisher Variant Guillain Barre with ataxia, weakness, ophthalmoplegia. Patient was treated with 5 days of IVIG therapy and was discharged home in good condition with outpatient PT and near full recovery in 2 weeks. Has follow up appointment in 1 week from today.


VAERS ID: 1536164 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0781 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Musculoskeletal stiffness, Pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (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: influenza vaccine- fever
Other Medications: duloxetine, vitamin d, cetirizine, omeprazole
Current Illness: denies
Preexisting Conditions: HTN, pre diabetes PTSD, depression, anxiety, low back pain
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: left shoulder and neck stiffness and pain with movement since first vaccine worsened after second vaccine denies any trauma, illness or increase activity


VAERS ID: 1536290 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Injected limb mobility decreased, Limb discomfort, Muscular weakness, Neck pain, Pain, Pain in extremity, Spinal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allegra, xyzal, ambien, zoloft, singulair, vitaman D3, multivitamin, evening primrose oil,
Current Illness: chronic idiopathic urticaria, lupus, vitiligo, rheumatoid arthritis
Preexisting Conditions: chronic idiopathic urticaria, lupus, vitiligo, rheumatoid arthritis
Allergies: shellfish and mushrooms
Diagnostic Lab Data: No tests have been done. I did talk to my rheumatologist at my last appointment , but she said it would get better. it hasnt
CDC Split Type:

Write-up: My left shoulder and arm feel 20lbs heavier than before. I can only lift my left arm so high before it hurts. I can not hold anything heavy in my left arm. If I lift anything, like a casserole dish, putting it in or taking it out is difficult because my left are is weak and hurts. It also hurts if I lay on my left side. When I reach out with my left arm to open my sliding glass door it hurts and I have to change arms. Sometimes my neck and spine hurt too, more than usual.


VAERS ID: 1536373 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-29
Onset:2021-07-17
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A UN / IM

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid 19 positive


VAERS ID: 1536484 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary normal, C-reactive protein normal, Chest pain, Dyspnoea, Dyspnoea exertional, Electrocardiogram normal, Fibrin D dimer increased, Headache, Heart rate increased, Inflammatory marker test, Pain, Red blood cell sedimentation rate normal, SARS-CoV-2 test negative, Scan with contrast normal, Troponin normal
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: D-dimer 1.32 mcg/mL Troponin-T < 0.01 ng/mL CRP 0.09 mg/dL SARS-CoV-2 PCR negative ESR 3 mm/hr * Final Report * CT-Angio Chest w/ Contrast Post Process Reason For Exam 19 y/o M w sob and chest pain since receiving 2nd dose pfizer vaccine 10 days ago. Elevated d-dimer. r/o PE Report PROCEDURE: CT-Angio Chest w/ Contrast Post Process REPORT FLAG: None REPORT FLAG: None IMPRESSION: No evidence of pulmonary embolism. ECG - normal
CDC Split Type:

Write-up: 19 year old male presents with chest pain. Patient had his second Pfizer vaccine on July 16 and starting next day had a headache and some body aches with some shortness of breath. The headache and body aches resolved by the next day but he has had persistent shortness of breath especially dyspnea with exertion. Is also described intermittent chest pain across his chest. He has had no fevers no coughs no palpitations. He does get some increased heart rate with exertion. He has had no rash no leg pain. He was seen by his pediatrician who ordered a troponin, sed rate CRP and D-dimer and EKG. The inflammatory markers and troponin are normal, the EKG shows a normal sinus rhythm normal axis normal intervals. However the D-dimer is elevated raising potential concern for pulmonary embolus. ED course: Patient overall appears well. His history is concerning for possible pulmonary embolus, however this is not a reported known side effect with the Pfizer vaccine. He does not have evidence of myocarditis or pericarditis on exam or via the laboratory tests or EKG. We will repeat the D-dimer to make sure that the other result was not spurious and check a CBC. If the D-dimer is elevated we will check a CTA. Will discuss with pulmonary. D-dimer continued to be elevated. CTA does not show evidence of a PE. Pt feels better, I have discussed w pulmonary and they will arrange for f/u within 1-2 weeks. Information with the vaccine symptom tracking system will be filed. Patient safe for discharge to home. Discharged in improved condition. Written instructions reviewed with family.


VAERS ID: 1536512 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-07
Onset:2021-07-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Anxiety, C-reactive protein increased, Cardiac imaging procedure abnormal, Chest X-ray normal, Chest discomfort, Chest pain, Diarrhoea, Dyspnoea, Echocardiogram normal, Ejection fraction decreased, Electrocardiogram ST segment elevation, Epstein-Barr virus antibody positive, Fibrin D dimer increased, Haemoglobin decreased, Headache, Hypertension, Immunoglobulin therapy, Inflammatory marker test, Irritability, Limb discomfort, Magnetic resonance imaging heart, Mycoplasma test positive, Myocarditis, Painful respiration, Pyrexia, Red blood cell sedimentation rate increased, SARS-CoV-2 antibody test negative, Troponin T increased, Viral myocarditis, White blood cell count normal
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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), Hostility/aggression (broad), Hypertension (narrow), Cardiomyopathy (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Miralax, tretinoin 0.025% cream
Current Illness: None
Preexisting Conditions: Hypertension, mild intermittent asthma, constipation
Allergies: Seasonal
Diagnostic Lab Data: 7/20/2021: Cardiac MRI: Normal biventricular size and systolic function. No regional wall motion abnormalities. Left ventricular late gadolinium enhancement is present: A mid-myocardial to subepicardial distribution of late gadolinium enhancement is noted at the inferior basal segment.. Otherwise, no significant myocardial hyperintensity on T2-weighted (edema) imaging.Also, myocardial native T1, T2, and extracellular volume fraction are normal. Myocardial diffuse fibrosis, ruled out. Extracellular volume fraction is normal. Myocardial edema, ruled out.No significant myocardial hyperintensity on T2-weighted (edema) imaging. Left ventricular global systolic function, normal Left ventricular late gadolinium enhancement No significant valvular dysfunction. Normal coronary artery origins. No coronary artery aneurysms. Trivial pericardial effusion. 7/20/2021: Echocardiogram: ? Normal valvular function. ? Normal left ventricular size and systolic function. ? Normal indices of diastolic function and longitudinal/circumferential strain. ? Normal proximal coronary arteries. ? Qualitatively normal right ventricular systolic function. ? No pericardial effusion. ? At least one right and one left pulmonary vein connect normally to the left atrium. EBV PCR - Final - July 21, 2021 15:27 EDT - EBV DNA detected by PCR. 2,400 copies of the EBV genome detected per mL which corresponds to 3.4 log10 copies of the EBV genome per mL. A reference range for this test has not been established. Results should be interpreted in the context of other clinical and laboratory information. This test should not be used to diagnose latent or previous EBV infection. People with latent or previous EBV infection may not have detectable EBV DNA by this test. The variability of this test should be considered when interpreting results. Changes of approximately three fold in the quantity of EBV DNA detected may be due to variation in the test rather than actual changes in the level of EBV DNA in the sample. Note: This test was developed and its performance characteristics determined by the Infectious Diseases Diagnostic Division of Hospital. It has not been cleared or approved by the Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. EBV Ab to NA, IgG $g 600 EBV Capsid Antigen, IgG 92.6 Mycoplasma pneumoniae, IgG 118 CRP peak 9.35 mg/dL Troponin T peak 0.23 ng/mL ESR peak 130 mm/hr D-Dimer peak 1.05 mcg/mL
CDC Split Type:

Write-up: Admission Date/Time: 07/19/2021 20:06:00 Discharge Date/Time: 07/23/2021 11:31:21 Chief Complaint chest pain Patient Narrative ILLNESS SEVERITY: The patient is stable, returning to baseline. PATIENT SUMMARY: Reason for Hospitalization: Chest discomfort, myocarditis. Admission HPI: a 13 year old boy with a history of hypertension and mild intermittent asthma who is presenting with several hours of shortness of breath and chest discomfort with deep breaths. 2 days ago prior to presentation, he developed a low grade fever that lasted for 1 day. He did not measure a temperature but took some Motrin. At the same time he was experiencing abdominal pain and diarrhea, the latter of which has persisted. He does not think the diarrhea has been bloody but is unable to describe the color or consistency. The day of presentation, he began experiencing mid-sternal chest discomfort that sometimes worsened with deep breaths, though not every deep breath. It was associated with a mild headache. He denies palpitations, light headedness, orthopnea, or syncope. No other symptoms of illness including cough, congestion, runny nose, itchy eyes, rash, wheezing, or emesis. No known sick contacts. Given the nature of his chest pain, he presented to the ED for further evaluation. Of note, he received his 2nd Pfizer Covid vaccine on July 7. He experienced some mild arm discomfort afterwards but no fevers/myalgias/chest pain in the following days. In the ED, he was well appearing with normal vital signs. He denied any active chest pain or shortness of breath, though continued to endorse mild abdominal discomfort. An EKG was performed which was notable for diffusely elevated ST segments, particularly in leads II and III. Labs are significant for elevated troponin to 0.13, d-dimer to 1.05, ESR of 76, CRP of 9.35, WBC 9, Hgb 11.9, and negative covid antibodies. CXR was benign. Decision was made to admit to Cardiology for close monitoring and further workup. PMH: significant for elevated blood pressures in the past, seen in Nephrology clinic in 2019 with unremarkable workup including renal ultrasound, blood and urine studies. Believed to be in large part attributed to anxiety, though does have a family history of ESRD. Surg: T&A at 4-5 years of age Allergies: NKA Meds: only PRN albuterol (last used 1 year ago) Fam history: + for ESRD, negative for cardiac or autoimmune diseases Social: everyone at home healthy, nobody has had COVID. Going into 8th grade, wants to learn about space Hospital Course: He was admitted to the cardiology floor for continued monitoring of his troponin levels and EKG. His chest pain resolved shortly after admission and he remained asymptomatic through admission. The morning after his admission, his troponin was stable at 0.12 and echocardiogram showed no abnormalities with normal function. Troponins were trended and remained stable. Inflammatory markers were trended and improved. Cardiac MRI performed prior to treatment showed a small area over the posterior LV free wall of late gadolinium enhancement. EKG showed stable ST elevation in inferior and lateral leads. Presentation was most consistent with viral myocarditis. Given increasing troponin, he was treated with IVIG (2g/kgx1) and steroids (5 day total). His inflammatory markers down trended and resolution of symptoms throughout admission (ESR falsely elevated after IVIG), and had improvement in his troponin after treatment with IVIG and steroids. EKG were stable during admission. By time of discharge, patient was well-appearing, vitals stable, demonstrating good PO intake. Chest pain was fully resolved. Follow up with cardiology in place. Discharge instructions and return precautions reviewed with patient and parent, who expressed good understanding and agreement with plan. Given history of elevated blood pressures, also demonstrated during admission here, and evaluation by nephrology in past, he was set up with nephrology follow up as an outpatient. Reasons for new, changed, and discontinued medications: none Reasons for new, changed, and discontinued equipment: NA Relevant Diagnostic Images/Studies: CXR on 7/19 IMPRESSION: Normal chest examination. Diagnosis List 1. Shortness of breath, 07/20/2021 2. Myocarditis, 07/20/2021 Patient Instructions He was admitted for management of myocarditis thought to be due to a virus. He had multiple EKGs, echocardiograms, and a cardiac MRI which showed mild changes but overall good heart function. His chest pain and heart studies improved throughout his stay and he was safe for discharge home. He should take the following medications when going home: - Prednisolone 30 mg twice per day, with last dose on 7/26 in the morning - Famotidine 20mg twice per day, while taking steroids. It is important for him to minimize activity that raises his heart rate for the next 3 months. This will be discussed in more detail at his cardiology appointment. Until then, no strenuous exercise. 8/5/2021 clinic follow up: Cardiology Diagnostics EKG: WNL Echo: Normal function LV short-axis % area change 50.2 % -0.9 54.4 44.9 63.9 LV ejection fraction (area-length) 57.1 % -1.4 63.0 55.0 72.0 Labs noted in right hand column. CRP still elevated (higher than at discharge). Assessment/Plan Since his discharge, he has had headaches every almost every day. He thinks this is improving slowly but he has had about 2-3 headaches a day. He has had Tylenol and Motrin and this helps. He describes the pain as 4-5 /10 on the pain scale. He has not had any chest pain, no dizziness, no palpitations, no syncope. His mother says he is crankier than usual and she is concerned about his headache. The patient is 75% back to normal in terms of energy; 100% back to baseline in terms of appetite; 100% back to normal in terms of sleep; 100% back to baseline in terms of cognition and 50 % back to normal in terms of personality/mood. In summary, he is a 13 yo boy with a recent history of myocarditis. The etiology (viral vs late-post vaccine) is unclear. His LV function has always been WNL but he had an elevated troponin and evidence of myocarditis by Cardiac MRI with LGE. His BP had been noted to be somewhat high. This was checked today by auscultation and was 114/64 RA adult cuff.


VAERS ID: 1536578 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Pharmacy       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium 600mg tablets
Current Illness:
Preexisting Conditions:
Allergies: Cataflam Voltaren
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pains


VAERS ID: 1536877 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-21
Onset:2021-07-17
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Eyelid function disorder, Facial paralysis, Fine motor skill dysfunction, Movement disorder, Neurological examination
SMQs:, Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

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: Vitamin D3, Tumeric Curcumin, Fish Oil, Daily Probiotic, Ativan (prescribed)
Current Illness: None
Preexisting Conditions: Psoriasis, slightly elevated high blood pressure (pre-hypertension 130-140)
Allergies: None
Diagnostic Lab Data: Multiple physical and neurological tests on 7/23
CDC Split Type:

Write-up: Diagnosed with Bell''s Palsy. Complete loss of motor skills and movement on left side of face. Unable to close left eye, unable to raise left eye brow, zero lip movement. Overall, total loss of control over lower cranial facial nerve. Prescribed with anti-viral and steroid. Recovery at about 95% of movement on August 9th, 2021.


VAERS ID: 1537655 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-05-07
Onset:2021-07-17
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Echocardiogram abnormal, Electrocardiogram abnormal, Magnetic resonance imaging, Myocarditis, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG (x5) 7/17/2021 + 7/18/2021 + 7/22/2021 Echocardiogram 7/22/2021 MRI 7/23/2021 RESULTS: Myocarditis & Pericarditis
CDC Split Type:

Write-up: Diagnosed with myocarditis and pericarditis. Symptoms: chest pain Treatment: ibuprofen, colcrys


VAERS ID: 1540750 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Mobility decreased, Neck pain
SMQs:, Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Could hardly move right arm for 3 days. Tender at injection sight. Slight pain in right side of neck for 2 days. Fatigue for 3 days.


VAERS ID: 1540860 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-14
Onset:2021-07-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Immediate post-injection reaction, Migraine
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: Immediately after receiving the second vaccine, I had migraines and terribly painful menstrual cramps. The same symptoms have occurred this month during my menstrual cycle.


VAERS ID: 1541031 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-07
Onset:2021-07-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Military       Purchased by: ?
Symptoms: Anaphylactic reaction, Arthropod sting, Hypersensitivity, Local reaction
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pramipexole PEG Tizanidine Sildenafil Celecoxib
Current Illness: Chronic Back Pain Restless Leg Syndrome
Preexisting Conditions:
Allergies: No prior known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received dose 1 on 9JUN. Was stung by bee on 29 JUN with a local reaction typical of many previous bee stings. Received shot 2 7JUL. Was stung by bee again 17JUL and on this occasion suffered anaphylaxis requiring ER visit, epi pen, and other medications. Patient has never previously had any serious allergic reactions or anaphylaxis. He is concerned that the vaccine may have contributed to his hypersensitivity.


VAERS ID: 1541112 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-09
Onset:2021-07-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Chest pain, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ? acetaminophen (TYLENOL) 500 MG tablet Take 1,000 mg by mouth every morning Do not exceed 4000 mg of acetaminophen/24 hours. If 65 or older, do not exceed 3000 mg of acetaminophen/24 hours. ? albuterol (PROAIR HFA) 90 mcg/Actuation inh
Current Illness: None.
Preexisting Conditions: Allergic rhinitis, cause unspecified Asthma Benign essential tremor BPH w/o urinary obs/LUTS CAD (coronary artery disease) coronary bypass surgery 5/2016 Chronic anticoagulation - patient was started on warfarin postop after bypass surgery for paroxysmal atrial fibrillation GERD (gastroesophageal reflux disease) History of 2019 novel coronavirus disease (COVID-19) - 01/2021, 85y, Received monoclonal antibody treatment History of prostate cancer HLD (hyperlipidemia) HTN (hypertension) Lumbago - he has foremanal stanosis and spondylolithesis and i need to talk to dr to see what will be the best for him. Lumbar spondylosis 08/17/2020 85y Osteoarthrosis, unspecified whether generalized or localized, unspecified site Paroxysmal atrial fibrillation (HCC) - postop after bypass surgery 5/2016 Prediabetes Seasonal allergies Sick sinus syndrome (HCC) - status post permanent pacemaker 5/31/16 Skin cancer - basal cell, squamous
Allergies: Viagra, Cymbalta, Lyrica, Vytorin
Diagnostic Lab Data: Angiogram, chemistries and troponins.
CDC Split Type:

Write-up: Patient developed CP a week later with mildly elevated troponins, initially worked up for ACS. Care team felt inflammatory response to vaccine.


VAERS ID: 1541643 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-13
Onset:2021-07-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Fatigue, Malaise, Muscular weakness, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Cetirizine, Lisinopril, Lithium, Montelukast, Trintellix, Spironolactone, Estradiol, Trazadone, Albuterol, Fluticasone/Salmeterol
Current Illness: none
Preexisting Conditions: Asthma
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: About 3 days after getting the first shot, became very ill with nausea, vomiting, diarrhea, muscle weakness and fatigue. Also, lack of appetite. His symptoms lasted about 4 to 5 days.


VAERS ID: 1541839 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049CZIA / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Loss of consciousness, Pain, Pain in extremity, Paraesthesia, Rash, Rash pruritic, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: -Blacked out in the shower - did not fully lose consciousness, but everything went black. Took a few seconds for vision to come back (7/17). -Arm pain - right arm was numb/tingly all the way down the arm into the fingers (7/17). -Leg pain - right leg was achy and radiated down the entire leg into the foot (7/18). -Rash - rash developed on right arm on day 7 (7/24). Rash was itchy on the first day and did not go away until two days later.


VAERS ID: 1545152 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-08
Onset:2021-07-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO 169 / 1 LA / SYR

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

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

Write-up: Muscle twitching on arms and legs.


VAERS ID: 1545195 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-01
Onset:2021-07-17
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetic
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Stroke


VAERS ID: 1545255 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Injected limb mobility decreased, Injection site pruritus, Injection site swelling, Loss of personal independence in daily activities, Neck pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (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:
Current Illness: None
Preexisting Conditions: None
Allergies: Ampiciline
Diagnostic Lab Data:
CDC Split Type:

Write-up: The next day, the swelling and itching on the injection site appeared, and it has already disappeared by now. However, the pain on my shoulder has not gone away, and it''s getting worse. Many around me told me that they had pain right after inoculation, so I did not even think the pain would be a problem in the beginning. The pain started around the arm, shoulder to the neck, only on the left side, the side I received an injection. Now I cannot extend my arm without feeling pain. When I bend over, the whole left side shoulder through my fingers get tingling, and eventually feel numb. I have to quickly move my body straight back up. I cannot do many of the certain activities that I used to be able to do.


VAERS ID: 1549292 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-30
Onset:2021-07-17
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Thrombosis
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Epidiolex , Alprazolam,Trazodone
Current Illness: Epilepsy. Anxiety
Preexisting Conditions: Trisonometry 18
Allergies: none
Diagnostic Lab Data: Blood Clot
CDC Split Type:

Write-up: Swelling Right Leg


VAERS ID: 1549646 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling cold, Skin discolouration
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Dizzy, felt cold and discoloration of hands.


VAERS ID: 1554082 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Cognitive disorder, Feeling abnormal, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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, 100mg daily
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: Have not seen a doctor yet
CDC Split Type:

Write-up: Muscle weakness in arms and legs within hours of the shot (from shot to present, ongoing) Slightly impaired cognitive functioning, "brain fog" (from shot to present, ongoing) Tingling/pins and needles in lower legs (began 8/9/2021 and ongoing). Periodic at first, now nearly constant Tingling/pins and needles in fingers (began 8/12/2021 and ongoing)


VAERS ID: 1558123 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-30
Onset:2021-07-17
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Helicobacter infection, Helicobacter test positive, Herpes virus test, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: over the counter allergy pils, multi-vitamin, probiotic, folic acid
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: amoxicillin
Diagnostic Lab Data: H PYLORI, IGM ABS- 7/28/21
CDC Split Type:

Write-up: I''m not sure if it is because of vaccine, but three months later (in July) I was having nausea, abdominal pain and overall feeling of unwell. I went to my doctor on 7/20/21 and was tested the following week and learned I had the stomach infection: h pylori disease


VAERS ID: 1571064 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer first dose 6/5/21
Other Medications: Amlodipine 5mg Vit d Garlic Extract Chlorpheniramine Maleate
Current Illness: Hypertension after the first vaccine without history of hypertension prior to the first dose
Preexisting Conditions:
Allergies: White hickory tree Dust mites
Diagnostic Lab Data: Renal Doppler 7/21 Blood test 7/28 EKG 8/11 Holster monitor pending
CDC Split Type:

Write-up: It was the 17 of July, Saturday, when I received my second dose, about 5 mins from receiving the vaccine my heart started pounding. I was feeling warm all my limbs, chest and abdomen. I was trying to remain calm, alert and awake. I didn?t want to pass out because I won?t be able to tell them what?s happening to me. They checked my blood pressure it was 164/106mmHg 114bpm. They gave my 1L of water to drink. I was shivering a little, I?m not sure if it was from the water but it was room temperature though. They kept me there for about hour until it went down some but it was still high when I left 149/101mmHg 88bpm. My activity tolerance went down. I had to sit down in the middle of getting dressed and had to walk slower than my walking pace walking from room to room at home. I had a second episode on Wednesday, July 21, I was getting ready to sleep around 11:45pm, I felt dizzy at first then warm sensation all over my body, abdomen and chest followed by my heart pounding again. 106-119bpm and BP 157/93. I tried to take it manually 160/100 bc I couldn?t believe the machine. I just drank lots of water and tried to calm down. BP went up higher than that but I?m not sure if I believe the reading on the machine. Then I started shivering again. Again I?m not sure if the shivers is from drinking water or something else. It lasted more than an hour until I fell asleep. On week 3 and 4, I woke up with a chest pain on 3 different occasions and one occasion I woke up with my heart beating fast, i remember looking at the clock it was 2:50am. I willed myself back to sleep because I didn?t want a repeat of what had hadn?t before.


VAERS ID: 1574142 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Blister, Chest discomfort, Chest pain, Fatigue, Gastrointestinal tract irritation, Headache, Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth, Paraesthesia oral, Pyrexia, Rash, Skin burning sensation, Tongue discomfort, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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), Noninfectious diarrhoea (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1980 tetanus shot -fever ,swelling arm lymph, breast. 1986 pain medication in hospital blood pressure dropped lost consciousnes
Other Medications: Vitamins- D, C, Magnesium, multivitamin, zinc
Current Illness: none
Preexisting Conditions: post Lyme''s
Allergies: Bees , fire ants, chestnuts , latex , quinoa, erythromycin, penicillin.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sat July 17 -1:30 am woke up upset stomach and headache , drank water ate something went back to sleep woke feeling better. Sunday am - 2.5" very red circle on arm at injection site , flat ,hot, managed with cold cloth, was apparent until Tuesday 20th when it began to fade. Thursday right arm from shoulder to elbow became very itchy and then swelled up very hard, red , hot, (outer surface) original red circle appeared almost purple within it.. broke out in what looked like hives that quickly turned into fluid filled blisters , inner forearm, neck ,between fingers left had and a few on foot. tongue left edge and 1/4 of top surface felt burning and likened to when nova cane is wearing off. extreme heat in arm transferred into chest and digestion and aggravated colon , cortisol suppository was prescribed by PCP. Had to ice 24/7 for 4 days began subsiding July 21st hardness began to break up reduce, simultaneously arms and thighs began to burn as if chemical under skin - took claritin which reduced symptoms 50 % also broke out with rash on foot, this began to subside after 4 days , then left side of tongue began burning similar to right , burning went down into lungs fever of 99.5 at week 3 point lasted 48 hours , tired for several days after.- total time to recover 3.5 weeks.


VAERS ID: 1574436 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-22
Onset:2021-07-17
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, Cough, Nasal congestion, Nasopharyngitis, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: alendronate (FOSAMAX) 70 mg tablet betamethasone valerate (VALISONE) 0.1 % lotion Bifidobacterium infantis (ALIGN) 4 mg capsule calcium citrate-vitamin D2 1,500-200 mg-unit tablet cholecalciferol, vitamin D3, (VITAMIN D3) 1,000 unit capsule
Current Illness:
Preexisting Conditions: Circulatory Hemorrhoids Telangiectasia disorder Digestive IBS (irritable bowel syndrome) Vitamin D deficiency Musculoskeletal Actinic keratosis Keratoacanthoma Other seborrheic keratosis Other Anxiety Insomnia Family history of colonic polyps History of colonic polyps
Allergies: NKA
Diagnostic Lab Data: 08/02/21 2303 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/02/21 1016 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/02/21 2303 COVID-19 PCR Collected: 08/02/21 1016 | Final result | Specimen: Swab from Nares
CDC Split Type:

Write-up: TC from the patient stating he was tested covid pos on 8/2/21. He stated he was tested because he started having cold like symptoms started around 07/17 and was tested pos on 8/2 which was 10 days passed his symptoms. He was advised to call us if he started having new symptoms. He reported still having on and off cough and reported having nasal congestion, loss of smell but still has taste. Reported having achy ness on bilateral leg which he reported is not unusual for him when he is having on and off fever. He reported his temp runs between the range of 98.6-100 F and reported taking tylenol as needed. He denied having SOB,


VAERS ID: 1578409 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-07-17
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, COVID-19 pneumonia, Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admit for COVID pneumonia. Treated w/ remdesivir, tocilizumab, steroids, vit-c, zinc, high-flow O2, plasma, rocephin/doxy. Developed RLE DVT, started Eliquis. DC on 5L home O2.


VAERS ID: 1579397 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO198 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Herpes zoster, Paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Olmesartan Medoxomil-HCTZ
Current Illness: None
Preexisting Conditions: HTN, DM
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 6 hours after the injection, my husband began complaining of tingling and burning over his right scapula and right trap area. I imagined it was an allergic reaction and gave him OTC allergy medications. He continued to complain and three days later appeared a rash of about 3 inches in diameter above his right scapula. I called the my insurance''s virtual urgent care and sent the doctor pictures. I was thinking it was shingles, but she stated it was a reaction to the vaccine and recommended benadryl 3 times daily and alternating ibuprofen and Tylenol for the pain. By Friday morning, I was sure it was shingles as the rash had spread and stopped midline on his back and chest and up the right side of his neck to his ear. So we went to urgent care, and they diagnosed it as shingles and started him on an anitiviral. I thought maybe it was a coincidence (although my first reaction was that the vaccine provoked it and had woke up the virus). But then later I read a report from a study in Spain linking shingle outbreaks to the vaccine. So I thought I should report my husbands case.


VAERS ID: 1582564 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood magnesium normal, Blood thyroid stimulating hormone normal, Bordetella test positive, Fatigue, Feeling abnormal, Full blood count normal, Headache, Metabolic function test, Vitamin B12, Vitamin D
SMQs:, Dementia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec Singulair Ventolin Flonase Symbicort Zoledronic Acid
Current Illness: NONE
Preexisting Conditions: Asthma, COPD, Osteoporosis, Allergic Rhinitis
Allergies: Mold Grass Trees Animal Dander
Diagnostic Lab Data: Heavy Metals, Lyme Antibody, Lyme Western Blot, CBC, CMP, Magnesium, Vitamin B12, Vitamin D, Folatre, TSH-- within normal limits
CDC Split Type:

Write-up: Following day of administration, patient developed headaches, brain fog, and fatigue. Symptoms have persisted 1 month following administration.


VAERS ID: 1586843 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-07
Onset:2021-07-17
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head, Diplopia, Eye pain, Gaze palsy, Giant cell arteritis, Microvascular cranial nerve palsy, Paranasal sinus discomfort
SMQs:, Glaucoma (broad), Optic nerve disorders (broad), Vasculitis (narrow), Ocular motility disorders (narrow), Hypoglycaemia (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: 1) ATORVASTATIN CALCIUM 20MG TAB TAKE ONE TABLET BY ACTIVE MOUTH ONE TIME EACH DAY FOR CHOLESTEROL **WHOLE TABLETS APPROVED** 2) CONTACT LENS CLEANING (CLEAR CARE) SOLN USE A SMALL ACTIVE AMOUNT AT BEDTI
Current Illness:
Preexisting Conditions: Osteoarthritis (SCT 396275006) Vitamin D Deficiency (SCT 34713006) Polyp of colon (SCT 68496003) Obstructive sleep apnea of adult (SCT 1101000119103) Hyperlipidemia (SCT 55822004) Umbilical hernia (SCT 396347007) Ulcer, Central Cornea Allergic rhinitis (SCT 61582004) Knee pain (SCT 30989003) Impaired fasting glucose (SCT 390951007) Hypothyroid (SCT 40930008) Morbid obesity (SCT 238136002)
Allergies: none
Diagnostic Lab Data: Report Exam: CT HEAD W/O CONT, CT MAXILLOFACIAL W/O CONT Scanned in room 9 pt wore mask CT Head and MF w/o per Dr History: increased pain behind both eyes x 5 days/sinus pressure/ medial squint right eye x 4 days. double vision x 4 days Findings: Computed tomographic images of the maxillofacial region as well as the head were obtained in the axial projection with additional sagittal and coronal reformatting. Dose:Up-to-date CT equipment and radiation dose reduction techniques were employed. CTDIvol: 45.9 mGy. DLP: 1262 mGy-cm. Multiple computed tomographic images of the head were obtained without contrast enhancement. There are no mass lesions or bleeds. No subdural or epidural collections of blood or fluid are present. There is no shift of midline structures. The ventricles are not pathologically enlarged. The bony calvarium is intact throughout. The temporal bones and internal auditory canals are unremarkable bilaterally. The pituitary gland and pituitary fossa are unremarkable. Images through the maxillofacial region demonstrate no significant bony abnormalities. Metallic dental work causes extensive streak artifact across the mandibular region and lower maxilla obscuring detail. The paranasal sinuses are well pneumatized and normal bilaterally. The orbits and periorbital regions are unremarkable. The temporomandibular joints are symmetrical and normal bilaterally. The nasopharyngeal airways, tonsillar regions, tongue, and upper pharyngeal regions are unremarkable.
CDC Split Type:

Write-up: MVX (Manuf); Lot#; Exp Date: JSN; 042A21A; 06/21/2021 vaccine info Cranial nerve 6 palsy 2 months after vaccine -Sinus pain refractory to his usual ibuprofen/antihistamine began Saturday and new onset diplopia started Monday -VA 20/20- and 20/20 -IOP 16, 15 -Restriction in right upper, right lateral and right lower gaze of the right eye. Full EOM OS -Binocular horizontal diplopia that goes away with covering 1 eye -Denies recent illness, GCA symptoms -PMHX hypothyroidism and obesity. No DM or HTN (BP today 142/80 - pt reports his BP is usually lower) -Anterior exam wnl -DFE without optic disc swelling or obscuration of vessels -Pt has no other FND. CN II-XII intact except for CN VI -Humphrey visual field: full with no defects


VAERS ID: 1586866 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-10
Onset:2021-07-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 - / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Biopsy skin, Blister, Musculoskeletal pain, Pain in extremity, Rash, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: H&E skin biopsy, 7/29/21: early Pemphigus Vulgaris DIF skin biopsy, 7/29/21: Negative
CDC Split Type:

Write-up: Patient presented to Dermatology, on 7/29/21 with multiple concentric, violaceous, blistering plaques with extreme tenderness and pain located on her bilateral arms, thighs, and buttocks. Oral and vaginal mucosa were not invovled. She denied any additional symptoms. She denied any recent use of medication or supplements prior to appearance of rash. 2 punch biopsies were performed.


VAERS ID: 1587265 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-07-17
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: School       Purchased by: ?
Symptoms: Angiogram, Angiogram normal, Caesarean section, Chorioretinopathy, Computerised tomogram head normal, Exposure during pregnancy, Magnetic resonance imaging spinal normal, Magnetic resonance imaging thoracic normal, Plasmapheresis, Platelet count decreased, Platelet transfusion, Premature delivery, Premature separation of placenta, Third trimester pregnancy, Thrombotic thrombocytopenic purpura
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, arterial (narrow), Retinal disorders (narrow), Renovascular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: prenatal vitamin
Current Illness: none.
Preexisting Conditions: none.
Allergies: none.
Diagnostic Lab Data: Platelets down to nadir of 9,000. MRI of lumbar spine - negative. MRI of thoracic spine - negative. CT brain and CT angiogram - negative.
CDC Split Type:

Write-up: thrombotic thrombocytopenic purpura leading to a placental abruption, emergency c-section at 35 weeks of pregnancy. birth weight was 4lb 4.1oz. Pt received several units of platelets, several days of plasmapheresis. Diagnosed with central serous retinopathy.


VAERS ID: 1589082 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain, Injection site pruritus, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa 20mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Avocado
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: My arm has been sore since my second covid vaccination a month ago. I''m pleased to have been able to receive it, but can''t find anything online about persistent pain at the injection site so I figured I''d report it. It basically feels as if there''s a bruise where I received my shot. Sometimes it hurts worse, sometimes it hurts less. If I brush my hand against it or press on it lightly, it''s very sore/stinging. Sometimes it itches as well.


VAERS ID: 1591268 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-12
Onset:2021-07-17
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 08804U1 / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bronchitis viral, Pain, Pyrexia, SARS-CoV-2 test negative, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone Lyrica Tramadol Methotrexate injections Sympo Aria infusions Vitamin A Folic Acid Tri-Sprinta Losarstan
Current Illness: None besides my autoimmune disease ankylosing spondylitis
Preexisting Conditions: See above
Allergies: None known
Diagnostic Lab Data: 2 rapid COVID-19 tests 1 lab COVID-19 test
CDC Split Type:

Write-up: July 17 2021 I woke up with severe body aches Base headache Could not breath well wheezing Fever max : 101.4 Threw up 1 time empty stomach This went on till Sunday July 18th Barely slept July 18th went to the COVID-19 drive thru testing site, was worried I had breakthrough Covid-19 Tested rapid and lab- both negative Then saw doctor Thursday later that week, got another rapid test- it was negative. Doc said I had some sort of bronchitis virus or attack


VAERS ID: 1602608 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-14
Onset:2021-07-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray normal, Chest discomfort, Chest pain, Decreased appetite, Dry throat, Dysphagia, Dyspnoea, Electrocardiogram normal, Heart rate increased, Influenza virus test negative, Insomnia, Lethargy, Palpitations, Red blood cell count increased, SARS-CoV-2 test negative, Throat tightness, Troponin normal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (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: Prescription strength Vitamin D
Current Illness: Zero
Preexisting Conditions: Zero
Allergies: Histamine sensitive
Diagnostic Lab Data: - COVID test - negative - Flu test - negative - Troponin test - 0 - ECG - normal - chest X-ray - normal - RBC - slightly up - blood test for inflammatory markers - TBD - d dimer - TBD
CDC Split Type:

Write-up: 4 weeks+ of: - chest pressure - random sharp pains in chest - heart pounding - increase heart rate and blood pressure - difficulty breathing and swallowing - shortness of breath - throat pressure - dry throat and tongue - head pressure (back of head through my ears to my nose and down my throat) - lethargy - loss of appetite - difficulty sleeping


VAERS ID: 1602725 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Tri-Sprintec, Spironolactone, Lisinopril, Sertraline
Current Illness: None
Preexisting Conditions: Hypertension, anxiety/depression, MGUS, Anemia, Reynaud''s
Allergies: Norco, Demerol, Tramadol, Vicodin, Codeine
Diagnostic Lab Data: bleeding./A
CDC Split Type:

Write-up: Vaginal bleeding for 3 weeks outside of a period. Stopped for a week and resumed. Continued after second dose also. I take continuous birth control and don''t usual have bleedimg.


VAERS ID: 1628028 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered, No adverse event, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: The patient MAY have received a dose of Janssen vaccine that was administered after the Beyond Use Date. The provider may have given the dose outside of the 6 hour window after the vial was opened. No symptoms or signs. Pt will be contacted and offered to be re-vaccinated to offer full protection, per our Medical Group.


VAERS ID: 1629731 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-15
Onset:2021-07-17
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood test, Liver function test increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase (for allergies)
Current Illness:
Preexisting Conditions:
Allergies: Belladonna (or so I was told, I was quite young). Skin allergies to adhesives (like Band-Aids)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Liver function tests were high when tested after a routine blood draw on 7/17/21 AST: 66 U/L ALT: 98 U/L - 102 U/L They returned to normal by 8/7/21 AST: 36 U/L ALT: 53 U/L


VAERS ID: 1636962 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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

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

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


VAERS ID: 1641516 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood creatine phosphokinase, Fibromyalgia, Joint range of motion decreased, Joint stiffness, Musculoskeletal stiffness, Myalgia, Pain in jaw
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Osteonecrosis (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ck levels from bloodwork pending results
CDC Split Type:

Write-up: Fibromyalgia, TMJ pain and limited range of jaw, upper body muscle, joint and tendon stiffness, soreness, pain


VAERS ID: 1644289 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blindness, Blindness unilateral, Condition aggravated, Diarrhoea, Fatigue, Feeling abnormal, Headache, Nausea, Paraesthesia, Pyrexia, Rash, Vaccination site erythema, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? 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: USMODERNATX, INC.MOD20212

Write-up: Totally blind; Cannot see with right eye,right eye has no vision,left eye''s vision comes and goes; Vaccine messed me up; Symptoms got worst; Tingling in her left arm; Rash that spreaded to the back and front of arm; Redness on her arm at injection site; Fever; Felt fatigued; Nausea; Headache; Blurry vision, had difficulties to fill out the form.; Felt weakness; Diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of BLINDNESS (Totally blind) and BLINDNESS UNILATERAL (Cannot see with right eye, right eye has no vision,left eye''s vision comes and goes) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021C21A) 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 17-Jul-2021, the patient experienced VISION BLURRED (Blurry vision, had difficulties to fill out the form.), ASTHENIA (Felt weakness), DIARRHEA (Diarrhea), PARAESTHESIA (Tingling in her left arm), RASH (Rash that spreaded to the back and front of arm), VACCINATION SITE ERYTHEMA (Redness on her arm at injection site), PYREXIA (Fever), FATIGUE (Felt fatigued), NAUSEA (Nausea) and HEADACHE (Headache). On 18-Jul-2021, the patient experienced CONDITION AGGRAVATED (Symptoms got worst). On an unknown date, the patient experienced BLINDNESS (Totally blind) (seriousness criterion medically significant), BLINDNESS UNILATERAL (Cannot see with right eye,right eye has no vision,left eye''s vision comes and goes) (seriousness criterion medically significant) and FEELING ABNORMAL (Vaccine messed me up). The patient was treated with METOCLOPRAMIDE HYDROCHLORIDE (REGLAN [METOCLOPRAMIDE HYDROCHLORIDE]) at an unspecified dose and frequency and CEPHALEXIN [CEFALEXIN] at an unspecified dose and frequency. At the time of the report, BLINDNESS (Totally blind), BLINDNESS UNILATERAL (Cannot see with right eye,right eye has no vision,left eye''s vision comes and goes), FEELING ABNORMAL (Vaccine messed me up), VISION BLURRED (Blurry vision, had difficulties to fill out the form.), ASTHENIA (Felt weakness), DIARRHEA (Diarrhea), CONDITION AGGRAVATED (Symptoms got worst), PARAESTHESIA (Tingling in her left arm), RASH (Rash that spreaded to the back and front of arm), VACCINATION SITE ERYTHEMA (Redness on her arm at injection site), PYREXIA (Fever), FATIGUE (Felt fatigued), NAUSEA (Nausea) and HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Treatment medications include IV Fluids. Patient reported that she went to ER on 20 Jul 2021. 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. Most recent FOLLOW-UP information incorporated above includes: On 16-Aug-2021: Follow up received on 16-AUG-2021, it contains significant information. Events were added.; 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: 1645321 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-13
Onset:2021-07-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Feeling hot, Feeling of despair, Nervousness
SMQs:, Depression (excl suicide and self injury) (narrow), Hypoglycaemia (broad)

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

Write-up: Nervous; Warmness inside her body; Desperation; Anxiety attack/feelings of anxiety; This spontaneous case was reported by a consumer and describes the occurrence of ANXIETY (Anxiety attack/feelings of anxiety), NERVOUSNESS (Nervous), FEELING HOT (Warmness inside her body) and FEELING OF DESPAIR (Desperation) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047b21a) for COVID-19 vaccination. No Medical History information was reported. On 13-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Jul-2021, the patient experienced ANXIETY (Anxiety attack/feelings of anxiety). On an unknown date, the patient experienced NERVOUSNESS (Nervous), FEELING HOT (Warmness inside her body) and FEELING OF DESPAIR (Desperation). At the time of the report, ANXIETY (Anxiety attack/feelings of anxiety), NERVOUSNESS (Nervous), FEELING HOT (Warmness inside her body) and FEELING OF DESPAIR (Desperation) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. Concomitant medication includes anxiety pills. The patient went to ER and she had a fear before vaccination.


VAERS ID: 1645428 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-07-17
Onset:2021-07-17
   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 ER8731 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Nausea, 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:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: No he is very healthy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100911995

Write-up: Headache; Nauseous; He threw up; This is a spontaneous report from a contactable consumer (parent). A 12-year-old patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: ER8731) via an unspecified route of administration in left arm on 17Jul2021 at 12:00 (at the age of 12-year-old) as single dose for COVID-19 immunization. Patient had no medical history and was very healthy. Concomitant medications were not reported. Patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: unknown) via an unspecified route of administration as single dose for COVID-19 immunization and nothing happened [no adverse event]. On 17Jul2021, after second dose of vaccination when patient got home, he experienced headache and then he was nauseous and then once he threw up. Corrective treatment included Tylenol. Outcome of the events were unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1645450 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-16
Onset:2021-07-17
   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 EW0170 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Headache, Myalgia, Nasal congestion, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (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: VITAMIN D [ERGOCALCIFEROL]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100918042

Write-up: Headache; Chills; Muscle/body aches; Muscle/body aches; Fatigue; Cough; Congestion; This is a spontaneous report from a contactable nurse, the patient. A 61-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0170) via an unspecified route of administration in the arm left on 16Jul2021 at 15:00 (at the age of 61-year-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19. Prior to vaccination, the patient was diagnosed with COVID-19. Concomitant medications included ergocalciferol (VITAMIN D) and multi-vitamin (MANUFACTURER UNKNOWN) for unknown indication from an unknown date. The patient previously received codeine (MANUFACTURER UNKNOWN) and epinephrine (MANUFACTURER UNKNOWN) for unknown indication on an unknown date and experienced drug allergy. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0170) via an unspecified route of administration in the arm left on 18Jun2021 at 15:00 (at the age of 61-year-old) as a single dose for COVID-19 immunisation. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 17Jul2021 at 04:00 the patient experienced headache, chills, muscle/body aches, fatigue, cough and congestion. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the events. The clinical outcome of the event headache, chills, muscle/body aches, fatigue, cough and congestion were recovered on unknown date in Jul2017.


VAERS ID: 1645460 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-07-17
Onset:2021-07-17
   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 FA6780 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Pain in extremity, Urine odour abnormal
SMQs:, Taste and smell disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Caffeine allergy (known allergies: coffee); Fibromyalgia; Latex allergy (known allergies: Latex)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100921106

Write-up: Metallic taste in mouth; constant urine smell; arm soreness; This is a spontaneous report from a contactable consumer, the patient. A 46-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 17Jul2021 at 15:00 (at the age of 46-years-old) as a single dose for COVID-19 immunisation. Medical history included fibromyalgia and allergy to latex and coffee. 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 were not reported. The patient previously took lidocaine hydrochloride (LIDOCAINE), benzocaine (MANUFACTURER UNKNOWN) and experienced drug allergy. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0198) via an unspecified route of administration in the right arm on an unknown date in 2021 as a single dose for COVID-19 immunisation. On 17Jul2021 at 16:00, the patient experienced metallic taste in mouth, constant urine smell and arm soreness. The adverse 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 events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events metallic taste in mouth, constant urine smell and arm soreness was not resolved at the time of this report.


VAERS ID: 1645472 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-17
Onset:2021-07-17
   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 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Nausea, Oropharyngeal pain, Vaccination site pruritus, Vaccination site swelling
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100922460

Write-up: Sore throatChillsNauseaTirednessInjection site itchy and swollen; chills; nausea; Tiredness; Injection site itchy; Injection site swollen; This is a spontaneous report from a non-contactable consumer, the patient. A 31-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0198) via an unspecified route of administration in the left arm on 17Jul2021(at the age of 31-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported. 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 medication was not reported. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0181) via an unspecified route of administration on an unknown date in 2021 as a single dose for COVID-19 immunisation. On 17Jul2021, the patient experienced sore throat, chills, nausea, tiredness, injection site itchy and injection site swollen. The patient did not receive any treatment for the event. The adverse event did not result in a visit to the doctors or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event sore throat, chills, nausea, tiredness, injection site itchy and injection site swollen was recovering at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1645486 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-17
Onset:2021-07-17
   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 FA6780 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypersensitivity, Oropharyngeal pain
SMQs:, Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Allergy (Allergies have been more frequently than before the vaccine.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100923520

Write-up: Throat was sore; Allergies have been more frequently than before the vaccine.; This is a spontaneous report from a contactable consumer, the patient. A 46-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA6780) via an unspecified route of administration in the left arm on 17Jul2021 at 09:30 (at the age of 46-years-old), as a single dose for COVID-19 immunisation. Medical history included allergy. 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 were not reported. On 17Jul2021 at 12:00, the patient experienced "allergies have been more frequently than before the vaccine" and the day of vaccination the throat was sore. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events allergies have been more frequently than before the vaccine and throat was sore were resolving at the time of reporting.


VAERS ID: 1645536 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-16
Onset:2021-07-17
   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 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Vaccination site 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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100934687

Write-up: arm soreness at injection site for 3 days; felt tired since getting the vaccine; This is a spontaneous report from a non-contactable consumer, the patient. A 36-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA6780) via an unspecified route of administration in the left arm on 16Jul2021 (at the age of 36-years-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19. Patient had no known allergies. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. Concomitant medications included herbal tea (MANUFACTURER UNKNOWN), hydration and beauty drops (MANUFACTURER UNKNOWN) from an unknown date for an unspecified indication. On 17Jul2021, the patient experienced arm soreness at injection site for 3 days, felt tired since getting the vaccine. The events 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 events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event arm soreness at injection site for 3 days was recovered on 20Jul2021. Whereas, that of felt tired since getting the vaccine was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1646503 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-23
Onset:2021-07-17
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arthritis; Hypercholesterolemia; Premature ventricular contractions
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101005577

Write-up: tested positive for COVID-19; tested positive for COVID-19; This is a spontaneous report from a contactable consumer (the patient). This adult non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) via an intramuscular route of administration on 02Mar2021 (Lot Number: UNKNOWN) and the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) via an intramuscular route of administration on 23Mar2021 (Lot Number: UNKNOWN), both as single dose for COVID-19 immunization. Medical history included hypercholesterolemia, arthritis and premature ventricular contractions. The patient has no known allergies. The patient did receive other unspecified medications within 2 weeks of vaccination. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. After the second vaccination received on 23Mar2021, the patient tested positive for COVID-19 on 17Jul2021 which resulted in a visit to the doctor or other healthcare professional office/clinic. No treatment was received for the adverse event(s). The clinical outcome of the event(s) "tested positive for COVID-19" was reported as resolved on an unspecified date in 2021. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow-up.


VAERS ID: 1646598 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-15
Onset:2021-07-17
   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 EW0198 / 2 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Loss of personal independence in daily activities, SARS-CoV-2 test
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: 20210726; Test Name: BinaxNOW; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20210728; Test Name: Rapid Test; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101009407

Write-up: Dizziness; Interfered with daily activities/work; This is a spontaneous report from a contactable pharmacist (patient). A 28-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; solution for injection; Lot Number: EW0198) intramuscularly on 15Jul2021 at 15:00 (at the age of 28-years-old) as a single dose in the left arm for COVID-19 immunization. Medical history was reported as none. The patient had no known allergies. It was unknown if the patient was diagnosed with COVID-19 prior to vaccination. Concomitant medications were reported as none (no other medications received within 2 weeks of vaccination). The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; solution for injection; Lot Number: EW0217) intramuscularly on 21Jun2021 at 15:00 (at the age of 28-years-old) as a single dose in the left arm for COVID-19 immunization. On 17Jul2021 at 15:00 the patient experienced dizziness and interfered with daily activities/work. The reporter assessed the events as non-serious. It was reported that a mild case of dizziness occurred 2 days after the first vaccination date and it resolved after about one day (AER: 202101007616). A second case of dizziness started 2 days after the second dose and had not resolved yet. The dizziness was constant and was moderate to severe and interfered with daily activities/work. The events resulted in emergency room/department or urgent care visit. Treatment was not received for the adverse events. The patient underwent lab tests that included: BinaxNOW COVID-19 test (nasal swab) on 26Jul2021 which was negative and a rapid test for COVID-19 which was negative on 28Jul2021. The clinical outcomes of the events dizziness and interfered with daily activities/work were both not recovered/ not resolved. Since the vaccination, the patient had been tested for COVID-19. Follow-up attempts are completed. No further information is expected.; Sender''s Comments: Based on the plausible temporal relation, the association between the event of dizziness and the suspect product of BNT162B2 cannot be completely ruled out. 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: 1646823 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Cardiac failure congestive, Cardiomyopathy, Chest pain, Cough, Dyspnoea, Heart rate, Heart rate increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: METOPROLOL; AMLODIPINE; HYDROCHLOROTHIAZIDE; LEVOTHYROX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high; COVID-19; Hypothyroidism
Allergies:
Diagnostic Lab Data: Test Date: 20210717; Test Name: Heart rate; Result Unstructured Data: Test Result:180 bpm
CDC Split Type: USPFIZER INC202101023377

Write-up: congestive heart failure; Myocardia; I went into afib; Experienced chest pain minutes after shot was administered.; Shortness of breath; Coughing started hours after the dose; High heart rate/heart right went to about 180 bpm; This is a spontaneous report from a contactable consumer (patient). A 31-years-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in right arm on 17Jul2021 at the age of 31 years as single dose for covid-19 immunisation. Medical history included high blood pressure which he was medicated for and was under control, patient had recent tests done and had no issues with his heart, hypothyroidism, covid-19 prior vaccination. Concomitant medications included metoprolol; amlodipine; hydrochlorothiazide; levothyroxine sodium (LEVOTHYROX). Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient experienced chest pain minutes after shot was administered. Chest pain, shortness of breath, and coughing started hours after the dose. Patient was admitted 2 days later to the emergency room with chest pain and high heart rate. Patient went into afib, at the hospital where his heart right went to about 180 bpm. Patient was diagnosed with myocardia and congestive heart failure. Adverse event start time was 17Jul2021 05:00 PM. Duration of hospitalization was 1 day. Treatment received included pill to slow heart rate 3 times, medication change. Adverse events resulted in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care, hospitalization, life threatening illness (immediate risk of death from the event), disability or permanent damage. Since the vaccination, the patient had not been tested for COVID-19. Outcome of events were not recovered. The lot number for BNT162B2 was not provided and will be requested during follow up.


VAERS ID: 1646828 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-24
Onset:2021-07-17
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ATORVASTATIN; GLIMEPIRIDE; LISINOPRIL; HYDROCHLOROTHIAZIDE; METFORMIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood cholesterol abnormal; Blood pressure high; Diabetes
Allergies:
Diagnostic Lab Data: Test Date: 20210717; Test Name: Covid-19; Test Result: Positive
CDC Split Type: USPFIZER INC202101023501

Write-up: tested positive for COVID-19; tested positive for COVID-19; This is a spontaneous report from a contactable Physician. A 67-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via unspecified route single dose for COVID-19 immunization, first dose (Lot number: EW0162, expiration date: 31Jul2021) on 24Apr2021, second dose (Lot number: EW0168, expiration date: 31Aug2021) on 15May2021. Medical history included: diabetes, high blood pressure, cholesterol. Concomitant medications included: atorvastatin, glimepiride, lisinopril, hydrochlorothiazide, metformin. The patient was tested positive for COVID-19 after taking the vaccine on 17Jul2021. The reporter assumed that its delta variant but didn''t know for sure. The patient was sequencing DNA sample.; Sender''s Comments: The possibility of COVI-199, Vaccination failure, being an intercurrent condition cannot be ruled out. The response to the vaccine can vary from one person to another and hence the occurrence of the event post vaccination cannot be completely ruled out.


VAERS ID: 1646832 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-24
Onset:2021-07-17
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anion gap, Anion gap increased, Blood chloride, Blood chloride increased, Blood potassium, Blood potassium decreased, COVID-19, Carbon dioxide, Carbon dioxide decreased, Metabolic function test, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Lactic acidosis (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Infective pneumonia (broad), Hypokalaemia (narrow), 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: FUROSEMIDE; BREO ELLIPTA; CARVEDILOL; INSULIN; LOSARTAN; METFORMIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic kidney disease; Congestive heart failure; COPD; Diabetes; Hypertension
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: anion; Result Unstructured Data: Test Result: 12; Test Date: 2021; Test Name: chloride; Result Unstructured Data: Test Result: High; Test Date: 2021; Test Name: potassium; Result Unstructured Data: Test Result: Low; Test Date: 2021; Test Name: carbon dioxide; Result Unstructured Data: Test Result: Low; Test Date: 2021; Test Name: CMP; Result Unstructured Data: Test Result: unknown results; Test Date: 20210717; Test Name: Covid-19; Test Result: Positive.
CDC Split Type: USPFIZER INC202101023601

Write-up: This is a spontaneous report from a contactable physician. A 66-year-old female patient received the second dose of BNT162B2 at 66-year-old, via an unspecified route of administration on 24Apr2021 (Batch/Lot Number: EW0162; Expiration Date: 31Jul2021) at single dose, and the first dose via an unspecified route of administration on 30Mar2021 (Batch/Lot Number: ER8730; Expiration Date: 30Jul2021) at single dose for COVID-19 immunisation. Medical history included congestive heart failure, chronic obstructive pulmonary disease (COPD), diabetes, high blood pressure, and chronic kidney disease. Concomitant medications included furosemide, BREO ELLIPTA, carvedilol, insulin, losartan, and metformin. The patient had BNT162B2 and was tested positive COVID on 17Jul2021. Reporter assumed that it was delta variant, but did not know for sure. They did not know for sure, so they were sequencing DNA sample. After COVID, patient was put on dexamethasone treatment. It was 6 mg for 10 days. Patient also had not a BMP but a CMP a week before. So, low potassium, high chloride, low carbon dioxide, and a mildly elevated anion gap, the number was 12, anion gap was 12. Outcome of the events was unknown. Based on the information currently available, The casual association between the reported event Covid-19 and suspected vaccine BNT162B2 cannot be completely excluded. The impact of this report on the benefit/risk profile of the product is evaluated as part of 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, as appropriate.


VAERS ID: 1646837 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-24
Onset:2021-07-17
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood chloride, Blood chloride decreased, Blood sodium, Blood sodium decreased, Blood urea, Blood urea increased, COVID-19, Condition aggravated, EGFR status assay, Full blood count, Glomerular filtration rate decreased, Metabolic function test, SARS-CoV-2 test, Vaccination failure, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: BABY ASPIRIN; FUROSEMIDE; AMLODIPINE; ISOSORBIDE; LOSARTAN; METOPROLOL; INSULIN; SIMVASTATIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cholesterol; Congestive heart failure; COPD; Diabetes; Hypertension; Oxygen therapy
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Chloride; Result Unstructured Data: Test Result:Low; Test Date: 2021; Test Name: Sodium; Result Unstructured Data: Test Result:Low; Test Date: 2021; Test Name: BUN; Result Unstructured Data: Test Result:High; Test Date: 2021; Test Name: EGFR; Result Unstructured Data: Test Result:Low; Test Date: 2021; Test Name: CBC; Result Unstructured Data: Test Result:significant for elevated white blood cells; Comments: everything else normal; Test Date: 2021; Test Name: BMP; Result Unstructured Data: Test Result:Significant; Comments: for low sodium, low chloride, high BUN and Low EGFR; Test Date: 20210717; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC202101023853

Write-up: She is still in the hospital, she is on high flow oxygen now, 50 Liters; COVID positive/tested positive; COVID positive/tested positive; elevated white blood cells; low sodium; Low chloride; high BUN; Low EGFR; This is a spontaneous report from a contactable physician. An 85-year-old female patient received the second dose of BNT162B2 (lot number: EW0162, expiration date: 31Jul2021), at the age of 85 years old, on 24Apr2021 and the first dose of BNT162B2 (PFIZER COVID-19 VACCINE, lot number: ER8730, expiration date: 30Jul2021) on 30Mar2021, both at single dose for COVID-19 immunisation. Medical history included cardiac failure congestive, chronic obstructive pulmonary (COPD), diabetes, hypertension, cholesterol and she was on 2 Liters oxygen as needed before COVID. Concomitant medications included acetylsalicylic acid (BABY ASPIRIN) at 81 mg, daily; furosemide at 20 mg, daily; amlodipine at 10 mg, daily; isosorbide at 60 mg, daily; losartan at 50 mg, daily; metoprolol at 25 mg, twice daily; insulin at 12 DF via intravenous; simvastatin at 20 mg, daily. The patient had BNT162B2 and was tested positive (COVID positive) on 17Jul2021. The reporter thought the lot number of three patient were actually different. Reporter assumed that it was a variant but did not know for sure. Public Health did not know for sure, so they were sequencing DNA sample. If it was like a privacy concern, reporter had already discussed all. She was also on home oxygen even before COVID. She was on 2 Liters oxygen as needed before COVID. She was still in the hospital, she was on high flow oxygen now, 50 Liters. After COVID, the patient was put on dexamethasone (treatment). It was originally 6 mg for 10 days and then they escalated it to 20 mg for 5 days and then 10 mg for 5 days, we did the high dose because of the oxygen. The patient underwent lab tests and procedures which included chloride: low, sodium: low, blood urea nitrogen (BUN): high, epidermal growth factor receptor (EGFR): low, complete blood count (CBC): significant for elevated white blood cell, everything else normal, basic metabolic panel (BMP): significant for low sodium, low chloride, high BUN and Low EGFR, all (except COVID-19 test) in 2021, COVID-19 test: positive on 17Jul2021. The outcome of the event high flow oxygen now, 50 Liters was not recovered. The outcome of other events was unknown.; Sender''s Comments: The events Covid 19 and condition aggravated are assessed as possibly related to the suspect drug BNT162B2 based on plausible temporal association but consider also possible contributory effects from patient''s medical history and/or concomitant medications. 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: 1647231 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-28
Onset:2021-07-17
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Eating disorder, Gastroenteritis, SARS-CoV-2 test, Weight, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210807; Test Name: Covid-19 virus test; Test Result: Negative ; Comments: Nasal Swab, Nasopharyngeal; Test Date: 2021; Test Name: weight; Result Unstructured Data: Test Result:Lost 21 lbs
CDC Split Type: USPFIZER INC202101048705

Write-up: Been having acute gastroentinitis for over 4 weeks. From 7/17/21 to present (8/14/21); Can''t eat regular yet; Uneasy stomach; Lost 21 lbs; This is a spontaneous report from a contactable consumer, the patient. A 16-years-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number: EW0182), via an unspecified route of administration, administered in Left arm on 28May2021 as dose 2, single (at the age of 16 years), for covid-19 immunization, at Hospital. Medical history and concomitant medications were not reported. There were no known allergies. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number: EW0173), via an unspecified route of administration, administered in Left arm on 07May2021 as dose 1, single (at the age of 16 years), for covid-19 immunization, at Hospital. There were no other vaccine in four weeks and no other medications in two weeks. The patient reported that, since 17Jul2021, he had been having acute gastroenteritis (for over 4 weeks to present 14Aug2021) and since unknown dates in 2021, he could not eat regular yet, had uneasy stomach and lost 21 lbs. Adverse events resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. The patient did not have Covid prior to vaccination. The patient was tested for covid post vaccination. The patient underwent lab tests and procedures which included Covid-19 virus test (sars-cov-2 test) via Nasal Swab, Nasopharyngeal on 07Aug2021 with negative result and on an unknown date in 2021, measured weight in which realized he lost 21 lbs. Therapeutic measure for Acute gastroenteritis was taken, received IV for dehydration (IV drug was not specified). The outcome for the event Acute gastroenteritis was not recovered at the time of report, however the outcome for the rest of the events was unknown.


VAERS ID: 1651351 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-02-14
Onset:2021-07-17
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Pneumonia, Respiratory syncytial virus infection
SMQs:, Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (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: Multi Vitamin Berberine Caltrate+D Zyrtec L-Methylfolate Levothyroxine Metformin Atorvastatin Glyxambi Carvedilol Temazepan Pioglitazone Setraline Lisinopril Latanoprost drops
Current Illness:
Preexisting Conditions: Diabetes Hypertension Pacemaker ( on demand) Hypothyroidism
Allergies: Bactrim Augmentum Celexa
Diagnostic Lab Data: 7/20/2021
CDC Split Type:

Write-up: RSV/pneumonia 5 months later Sore arm for 1-2 days initially


VAERS ID: 1653293 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-16
Onset:2021-07-17
   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 EW0217 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Dizziness, Dry eye, Flushing, Musculoskeletal stiffness, Nausea, Pain, Pain in extremity, Paraesthesia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Vestibular disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN B-12; VITAMIN C [ASCORBIC ACID]; CALCIUM MAGNESIUM ZINC [CALCIUM;MAGNESIUM;ZINC]; VITAMIN D3; SELENIUM; IODINE; TURMERIC [CURCUMA LONGA RHIZOME]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Drug allergy (known allergies: Decongestants); Hashimoto''s disease (Hashimoto''s); Melanoma (melanoma 20 years ago); Mitral valve prolapse (MVP); Sulfonamide allergy (known allergies: Sulfas)
Allergies:
Diagnostic Lab Data: Test Date: 20210717; Test Name: Body temperature; Result Unstructured Data: Test Result:99.6; Comments: at 04:30
CDC Split Type: USPFIZER INC2021908397

Write-up: Dizziness; Dry eyes; Arm pain and stiff arm on side of injection (left); Pain near right collarbone; Fever 99.6; Arm pain and stiff arm on side of injection (left); Facial flushing/ tingling; Facial flushing/ tingling; Nausea; This is a spontaneous report from a contactable consumer, the patient. A 47-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0217) via an unspecified route of administration in the left arm on 16Jul2021 at 15:00 (at the age of 47-years-old) as a single dose for COVID-19 immunisation. Medical history included hashimoto''s, mitral valve prolapse (MVP), melanoma 20 years ago from an unknown date in 2001 and allergy to sulfas and decongestants. 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 vitamin B12 (MANUFACTURER UNKNOWN), vitamin C (MANUFACTURER UNKNOWN), calcium/ magnesium/ zinc (MANUFACTURER UNKNOWN), vitamin D3 (MANUFACTURER UNKNOWN), selenium (MANUFACTURER UNKNOWN), iodine (MANUFACTURER UNKNOWN) and curcuma longa rhizome (TUMERIC); all taken for unknown indication from unknown date and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0181) via an unspecified route of administration in the left arm on 25Jun2021 at 17:30 (at the age of 47-years-old) as a single dose for COVID-19 immunisation. The patient previously received doxycycline (MANUFACTURER UNKNOWN) for an unknown indication on an unknown date and experienced drug allergy. On 17Jul2021 at 04:30, the patient experienced fever 99.6 (unspecified units), arm pain and stiff arm on side of injection (left), pain near right collarbone, facial flushing/ tingling, dry eyes, nausea and dizziness. Since the vaccination, the patient had not been tested for COVID-19. It was unknown whether any therapeutic measures were taken as a result of the events. The clinical outcome of the events fever 99.6 (unspecified units), arm pain and stiff arm on side of injection (left), pain near right collarbone, facial flushing/ tingling, dry eyes, nausea and dizziness were unknown.


VAERS ID: 1656455 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Computerised tomogram head, Echocardiogram, Electrocardiogram, Fibrin D dimer, Headache, Hemiparesis, International normalised ratio, Myocardial necrosis marker, Prothrombin time, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81mg qd, Pepcid prn, flonase prn, mirtazapine 7.5 mg oral tablet qhs, IBU 600 prn
Current Illness: 7/1/2021 Endocervical curettage Diagnostic hysteroscopy dilation and curettage for postmenopausal bleeding and abnormal pap
Preexisting Conditions: prediabetes, DDD, GERD, HLD, bil knee pain
Allergies: NKDA
Diagnostic Lab Data: ECHO, CT head, EKG, CXR, Cardiac enzymes, d-dimer, PT/INR ordered 8/30/2021
CDC Split Type:

Write-up: left sided upper and lower body weakness, HA, left eye blurred vision; onset 7/17/2021 until today Testing ordered today 8/30/2021


VAERS ID: 1658801 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-09
Onset:2021-07-17
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022BZ1A / 4 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Gait disturbance, Walking aid user, X-ray of pelvis and hip
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin, b12,magnesium
Current Illness:
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: hip xray
CDC Split Type:

Write-up: sudden onset pain in left hip, quick progression from limping to needing a cane


VAERS ID: 1661116 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-04
Onset:2021-07-17
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetes (diagnosed about 15 years ago); Hypertension (diagnosed about 15 years ago)
Preexisting Conditions: Medical History/Concurrent Conditions: Kidney transplant
Allergies:
Diagnostic Lab Data: Test Date: 20210717; Test Name: COVID-19; Test Result: Positive.
CDC Split Type: USPFIZER INC202101057760

Write-up: This is a spontaneous report from a program. A contactable consumer (patient) reported that a 69-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration, administered in right arm on 27Jan2021 (Batch/Lot number: EL926S, as reported) (at the age of 68 years old) as dose 1, single; and via an unspecified route of administration, administered in right arm on 04Mar2021 (Batch/Lot Number: EN6206) (at the age of 68 years old) as dose 2, single for COVID-19 immunisation. Medical history included kidney transplant performed on 29Dec2015, ongoing diabetes, and hypertension (both diagnosed about 15 years ago). There were no concomitant medications. No prior vaccinations (within 4 weeks). The patient experienced fully vaccinated and admitted to the hospital with COVID-19 on 17Jul2021, she received her Pfizer-Biontech COVID-19 vaccine doses in Jan2021 and Feb2021. She reported a history of COVID infection on 17Jul2021. The patient was hospitalized from 17Jul2021 to 21Jul2021 for 4 days. The patient stated that she was treated with an infusion that she can''t pronounce. Event required a visit to Emergency Room and Physician Office. She and her husband were both fully vaccinated and admitted to the hospital with COVID-19. She was admitted for about 4 days and her husband, who had several symptoms, was in the hospital for about 3 weeks. She presented to her local pharmacy, yesterday, for the ''booster dose'' but was denied. The pharmacist told her she had to wait 90 days after the infusion. She wanted to know why and when can she get her booster dose. The patient underwent lab tests and procedures which included COVID-19 test positive on 17Jul2021. The outcome of the event was recovered in Jul2021. On 17Aug2021, additional information from product quality included 17Aug2021 11:36 AM added ID-052326. Based on reporter providing lot number as EL926S it is not clear if the lot number is one of the ones provided above or EL9265. Added lot number EN6206 to product grid above. 17Aug2021 11:15 AM added ID-052326: Duplicate received in ID 6240336: Description of complaint: Hospitalized with Covid 19 after both doses of Pfizer Covid 19 Vaccine. Additional lot numbers: EL926S, documented as provided by the caller, EN6206. Processing for additional lot number provided in duplicate. Added AER#.16Aug2021 05:17 PM initial Product Name: Pfizer Covid 19 Vaccine NDC Number: Not Provided. COMPOUND BNT 162 COVID-19 VACCINE SUSPENSION FOR INTRAMUSCULAR 2ML MULTIPLE DOSE VIAL X 1 Lot # EL9262 (as reported)". Follow-up attempts are completed. No further information is expected.


VAERS ID: 1663197 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-07-16
Onset:2021-07-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Dyspnoea, Limb injury, Mobility decreased, Muscle spasms, Palpitations, Platelet count decreased
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Cardiomyopathy (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? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium Citrate
Current Illness: none identified
Preexisting Conditions: Raynaud''s phenomenon
Allergies: NKA
Diagnostic Lab Data: My platelets were evaluated on 8/27/2021 and determined to be below normal limits. Although I have had low platelets in the past, the readings were much lower than normal.
CDC Split Type:

Write-up: I received the vaccine on 7/16/2021. Early the next morning, I experienced severe heart palpitations and could not catch my breath. Approximately 2 weeks later, I experienced severe muscular cramps and experienced a shoulder injury at work (left arm) at which time I could not move my arm for several days. I subsequently experienced lower than normal platelet counts (125) and have encountered severe bruising. For example, I have developed bruising where my sock line is.


VAERS ID: 1666661 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-22
Onset:2021-07-17
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenopia, Blepharospasm, Dry eye, Eye pain, Eyelid disorder
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Glaucoma (broad), Corneal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Dehydration (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: multi vitamin, fish oil, vitamin D
Current Illness: none
Preexisting Conditions: none
Allergies: cleaning products
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 8 weeks after my second Moderna dose I started to have some eyelid issues. My eyelids started to feel heavy and by the end of the day my eyes were stinging. About 2 1/2 weeks after symptoms started I had an appointment with an Optometrist (8/4/21) who diagnosed dry eye syndrome and gave me artificial tears to lubricate my eyes. Three days later (8/7/21) my eyelids dropped onto my eyes and I was unable to open my eyes except for a small slit. I went to the emergency room following day (8/8/21) but they didn''t know what was going on. On 7/2/21 I''d had Dysport injections in my forehead, and around my eyes and they thought maybe this was causing my eyelids to drop. The gave me some ointment to put in my eyes and referred me to another eye clinic. I called my Optometrist and told him what had happened and he referred me to an Ophthalmology doctor (8/11/21) who diagnosed a condition called Benign Essential Blephorospasm. When I try to open my eyes my eyelids spasm and won''t open. Treatment involves Botox injections in the eyelids to stop the spasms and I have had three treatments on the following dates: 8/11/21, 8/17/21, 8/24/21. I can open my eyes a little now and see down but when I try to open my eyes all the way the eyelids spasm and I''m unable to open my eyes all the way. I have been referred to a neurologist and my appointment is scheduled for 10/7/21.


VAERS ID: 1672382 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-17
Onset:2021-07-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Functional gastrointestinal disorder, Headache, Pain in extremity
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Stomach problems; Intestinal problems; Diarrhea; Bad headaches; Arm was hurting; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm was hurting), ABDOMINAL DISCOMFORT (Stomach problems), FUNCTIONAL GASTROINTESTINAL DISORDER (Intestinal problems), DIARRHOEA (Diarrhea) and HEADACHE (Bad headaches) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 17-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Jul-2021, the patient experienced PAIN IN EXTREMITY (Arm was hurting). On 29-Jul-2021, the patient experienced ABDOMINAL DISCOMFORT (Stomach problems), FUNCTIONAL GASTROINTESTINAL DISORDER (Intestinal problems), DIARRHOEA (Diarrhea) and HEADACHE (Bad headaches). At the time of the report, PAIN IN EXTREMITY (Arm was hurting), ABDOMINAL DISCOMFORT (Stomach problems), FUNCTIONAL GASTROINTESTINAL DISORDER (Intestinal problems), DIARRHOEA (Diarrhea) and HEADACHE (Bad headaches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided. Treatment product information was not provided.


VAERS ID: 1683060 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-07
Onset:2021-07-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED and was subsequently hospitalized for NSTEMI within 6 weeks of receiving COVID vaccination.


VAERS ID: 1683602 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-07-17
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product dose omission issue
SMQs:, Medication errors (broad)

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

Write-up: Probably 39 days since first dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Probably 39 days since first dose) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003C21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Jul-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Probably 39 days since first dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Probably 39 days since first dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not provided. Treatment information was not provided.


VAERS ID: 1683745 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-16
Onset:2021-07-17
   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 EW0198 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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: MIRENA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy; Ulcerative colitis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101152754

Write-up: Never experience bleeding during the period because of IUD but did after receiving both vaccine shots; This is a spontaneous report from a contactable consumer, the patient. A 27-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0198) via an unspecified route of administration in the left arm on 16Jul2021 at 19:00 (at the age of 27-years-old) and second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3181) via an unspecified route of administration in the left arm on an unknown date in 2021 (at the age of 27-years-old) as a single dose for COVID-19 immunisation. Medical history included ulcerative colitis and penicillin allergy. 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-19 vaccine. Concomitant medication included levonorgestrel (MIRENA) intra uterine device (IUD) for an unknown indication from an unknown date and unknown if ongoing. On 17Jul2021 at 12:00, the patient experienced bleeding during her period. It was reported that the patient had never experienced bleeding during her period because of the IUD but did after receiving both vaccine shots. The event did not result in doctor or other healthcare professional office/clinic, 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 never experienced bleeding during the period because of IUD but did after receiving both vaccine shots was not resolved at the time of the report.


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