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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 352 out of 6,867

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VAERS ID: 1526162 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (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: zinc
Current Illness: hypothyroid disorder
Preexisting Conditions: hypothyroid disorder
Allergies: penicillin
Diagnostic Lab Data: I went to the urgent care in city on 7/17/21 in regards to the numbness. The doctor scheduled an MRI which is for 8/5/21. I will see the results sometime after.
CDC Split Type:

Write-up: I had numbness in my hands and legs, starting 2 days after the injection. The numbness comes and goes and is mostly in my right hand and foot, though at times the left side is still affected. I also have occasional mild pain in my arms and legs.


VAERS ID: 1526177 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-06
Onset:2021-07-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram thorax abnormal, Deep vein thrombosis, Pulmonary embolism, Pulmonary thrombosis, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril-hczt
Current Illness: n/a
Preexisting Conditions: Hypertension
Allergies: n/a
Diagnostic Lab Data: Ultrasound of leg and CAT scan of chest on 7/21. Diagnoses with blood clots.
CDC Split Type:

Write-up: Bloods developed in left leg and both lungs. Diagnosed with Deep Vein Thrombosis and Pulmonary Emboli. Went to ER at Hospital late night Wednesday 7/21 and was admitted. Ultrasound of leg and CAT scan used to diagnose blood clots. Was admitted and started on heparin IV and discharged on Saturday.


VAERS ID: 1526205 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-15
Onset:2021-07-16
   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 EU0198 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Heart rate decreased
SMQs:, Arrhythmia related investigations, signs and symptoms (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderral
Current Illness: none
Preexisting Conditions: none
Allergies: latex, cipro, tetracycline, nickel, gold, soy
Diagnostic Lab Data:
CDC Split Type:

Write-up: My resting heart rate is usually in the upper 70''s/low 80''s but has been in low 60''s and 50''s and upper 40''s since the vaccine.


VAERS ID: 1526211 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Patient reports had chest pain from chest into back ( I thought I was having a heart attack). Patient reports this pain lasted for 6 hours the night she received her COVID 19 vaccine. Patient also reports had nausea and vomiting for 2 hours the night of her COVID 19 vaccine. Pt reports she discussed the above with her allergist doctor and he advised her not to receive the second COVID 19 vaccine.


VAERS ID: 1526247 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gastritis
SMQs:, Gastrointestinal nonspecific inflammation (narrow)

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

Write-up: Diagnosed with Gastritis on 07/19/2021 at Urgent Care. Prescribed Ondansetron ODT same day. Medicine initially helped with first dose that day but symptoms reappeared after taking 2nd dose later that night. I discontinued use of medication after 2nd dose. Symptoms have not gone away but are not as severe (almost 3 weeks later).


VAERS ID: 1526740 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Haemorrhage, Life expectancy shortened, Organ failure, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: no known allergies
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Hcw from Dr office called to say patient, who received Janssen Johnson and Johnson COVID 19 vaccine here on 7/16/2021 was not expected to live. Hcw continued to say that patient was in good health prior to the vaccine. Patients organs started shutting down soon after receiving the vaccine. I deduced that she had been in the hospital longer than one week ( not exactly sure ). Hcw said patient is an employee. Patient is at a Hospital. She had been Life Lined there. Patient was having blood clots and uncontrolled bleeding. Hcw was letting us know of patients condition and cautioned use of that specific vaccine.


VAERS ID: 1528993 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-27
Onset:2021-07-16
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Injection site bruising, Injection site discolouration, Injection site pain, Injection site pruritus, Injection site reaction, Injection site warmth, Rash erythematous, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Kidney stone recently (in January)
Allergies: Benadryl (Hallucinations)
Diagnostic Lab Data: N/A
CDC Split Type: vsafe

Write-up: Rash developed on left shoulder in July, close to injection site, size of a fist, red, hot, squishy, tiny blisters. Appeared to be bruised with white center, itching and burning sensation. Extreme fatigue at the same time as the rash occurred. Went to ER, given steroid cream, went to dermatologist, inconclusive but they advised to continue steroid cream. Has continued to subside. Name of steroid cream is Kenalog.


VAERS ID: 1529246 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
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: No adverse reaction noted.
CDC Split Type:

Write-up: Patient received 1st dose of Moderna Covid 19 Vaccine on 06/24/2021, Follow up appointment made for 2nd dose of Moderna Covid 19 vaccine on 07/22/2021 but Patient presented too early for her second dose on 07/16/21 which was not caught. Patient received 2nd dose of Moderna Covid Vaccine on 06/16/2021. No apparent injury or adverse reaction noted.


VAERS ID: 1529336 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-07-16
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Chest pain, Full blood count, Hypoaesthesia, Lipids, Loss of consciousness, Magnetic resonance imaging head, Metabolic function test, Paraesthesia
SMQs:, Torsade de pointes/QT prolongation (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: NONE
Preexisting Conditions: HX OF A BRAIN CYST
Allergies: NKDA
Diagnostic Lab Data: CBC, CMP, TSH, LIPID PANEL, EKG, MRI OF THE BRAIN. PT WILL BE REFERRED TO A NEUROLOGIST AND CARDILOGIST.
CDC Split Type:

Write-up: Pt. reports he passed out while sitting down at Dinner on 07/16/21. He denied any seizure like episode and syncopal episode was witnessed by his father. He states prior to passing out he had some chest pain and had numbness/tingling to fingers when he woke up. Pt. stated lasted about 20 seconds.


VAERS ID: 1529346 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Dizziness, Ear pain, Hypoaesthesia, Nodule, Ultrasound scan
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Sexual dysfunction (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: Shingles, Flu
Other Medications: Vitamin C, Calcium, Fish oil
Current Illness: No
Preexisting Conditions: Thyroid
Allergies: Naproxen, Lavacicle, shellfish, Caltrain, Latic, Diary
Diagnostic Lab Data: ultrasound, blood work
CDC Split Type: vsafe

Write-up: Within 15 mins I started to get light headed and dizzy. I went to urgent care. My left side went numb. I had a big lump in my neck and I had ear pain on my right side.


VAERS ID: 1529370 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-07-15
Onset:2021-07-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Pain in extremity
SMQs:, 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:

Write-up: sore arm, headache, tired the next day.


VAERS ID: 1529858 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-14
Onset:2021-07-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Joint swelling, Mobility decreased, Nodule, Pain in extremity, Peripheral swelling, Screaming
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamin, fish oil, calcium, vitamin d3
Current Illness: Celiac disease
Preexisting Conditions: Celiac disease
Allergies: Bananas and gluten
Diagnostic Lab Data:
CDC Split Type:

Write-up: My left elbow, wrist and pinky finger was in extreme pain. My left middle finger swelled up and was painful. I was unable to make a fist for 2-1/2 was. Also my left outer knee was extremely painful and a week later my knee cap. My left ankle swelled and my left toes hurt. I started to form nods on my left pinky and middle finger. I was in such extreme pain I would scream especially at night. A week later my right fingers started to hurt and my right pinky swelled. I felt like I aged 30 years with rheumatoid arthritis. I was hiking 4 miles in the mountains and running upstairs until that shot. I didn?t have health insurance until Aug 1 and finally saw the doctor on Aug 3 and started steroids and pain meds. The steroids and the swelling went down and I FINALLY am starting to feel normal.


VAERS ID: 1529874 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash
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: BENADRYL AND RUBBING ALCOHOL PER PT
Current Illness: NONE
Preexisting Conditions:
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rashes on the inner left arm close to injectiion site and patient has being using rubbing alcohol


VAERS ID: 1530514 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia, Lymphadenopathy, Paraesthesia, Vaccination site swelling
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100919331

Write-up: numbness and tingling in the fingertips; swelling in the lymph nodes on the whole left side and under the armpit; numbness and tingling in the fingertips; swelling in the lymph nodes on the whole left side and under the armpit where she got the vaccine; This is a spontaneous report from a contactable Pharmacist. A female patient of an unspecified age received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot number was not reported), via an unspecified route of administration on 16Jul2021 as dose 2, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient previously took first dose of bnt162b2 on 25Jun2021 for COVID-19 immunization. On 16Jul2021, the patient experienced numbness and tingling in the fingertips, swelling in the lymph nodes on the whole left side and under the armpit. Reporter stated they have a patient who received the second dose of the Pfizer Covid-19 vaccine on 16Jul2021, 3 days ago and experienced swelling in the lymph nodes on the whole left side and under the armpit where she got the vaccine and has had numbness and tingling in the fingertips. They did noticed this in the paperwork they hand out, the information sheet that this has been reported with the swelling of the lymph nodes at the injection site as a reaction. Wondering what the next step is or if they should refer her to the physician or is there a waiting period for resolving. Was calling to see what the recommendations are from Pfizer. This was her second dose. She had the first dose on 25Jun and had no issues. Outcome of the events was unknown. Information about the Lot/batch number has been requested. Follow-up (PRD/SRD 03Aug2021): No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1530515 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-07-16
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E0181 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Erythema, Nodule, Pain in extremity, Palpitations, Pruritus
SMQs:, Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; COVID-19; Heart disease, unspecified; Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100921142

Write-up: Palpitations; very short of breath; chest pain; sore arm; knot on the arm; redness and itching to the arm; redness and itching to the arm; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 50-year-old non-pregnant female patient received bnt162b2 (BNT162B2 PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number: E0181), via an unspecified route of administration in arm right on an unspecified date as dose 1, single for COVID-19 immunisation. The medical history of the patient included asthma, heart disease, HTN and covid-19. The patient had no known allergies. The concomitant medications of the patient were not reported. The other medications in two weeks were reported as yes. No other vaccine in four weeks. The patient was not pregnant at the time of vaccination. The covid prior vaccination was reported as yes. The patient had not been covid tested post vaccination. On 16Jul2021 at 05:45, the patient experienced palpitations, very short of breath, chest pain, sore arm, knot on the arm, redness and itching to the arm. Therapeutic measures were taken as a result of events that included breathing treatments. The outcome of all the events was reported as resolving.


VAERS ID: 1531705 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-05-12
Onset:2021-07-16
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Musculoskeletal discomfort
SMQs:, Rhabdomyolysis/myopathy (broad)

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

Write-up: The muscle of the should that was injected has deuterated significantly without reason or injury and is going to require an Orthopedic surgeon.


VAERS ID: 1531908 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-14
Onset:2021-07-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia, Sleep disorder
SMQs:

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

Write-up: Ongoing insomnia, can only sleep an hour at a time with OTC sleep meds, get jolted to wake up constantly


VAERS ID: 1534082 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-13
Onset:2021-07-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Psoriasis, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PREMARIN; LEVOTHYROXIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100951778

Write-up: small rash on back of right thigh. similar to psoriasis; small rash on back of right thigh. similar to psoriasis; This is a spontaneous report from a contactable consumer (patient). A 60-year-old female patient (non-pregnant) received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: Ew0183), via an unspecified route of administration, administered in right arm on 13Jul2021 16:45 as single dose for COVID-19 immunization. The patient''s medical history included hypothyroidism. The patient had no known allergies. The patient''s concomitant medications included estrogens conjugated (PREMARIN) and levothyroxine sodium (LEVOTHYROXIN). Facility where the most recent COVID-19 vaccine was administered was other. The patient did not received any other vaccines within 4 weeks prior to the COVID vaccine. The patient experienced small rash on back of right thigh, similar to psoriasis on 16Jul2021 at 12:00. No treatment was received for the event. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. The outcome of the events was not recovered. The events was reported as non-serious. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1534962 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Eye infection, Headache, Hypoaesthesia, Nausea, Neck pain, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular infections (narrow), Arthritis (broad), Sexual dysfunction (broad)

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

Write-up: Severe headaches Cervical pain Upper back pain Nauseas Vomiting Finger on right hand was numbed Chills Eye infection


VAERS ID: 1536258 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-16
Onset:2021-07-16
   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 EW0169 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Eye irritation, Hypersensitivity, Laboratory test abnormal, Lip swelling, Paraesthesia oral, Pyrexia, Renal impairment, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Medical emergency called to for allergic reaction. Patient followed up with PCP and laboratory tests were obtained and showed impaired renal function.
CDC Split Type:

Write-up: Patient''s eyes began to burn, experienced dizziness and lip tingling/swelling. Patient also experienced fever, diarrhea, vomiting.


VAERS ID: 1536570 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-25
Onset:2021-07-16
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anticoagulant therapy, Deep vein thrombosis, Joint swelling, Microembolism, Pain in extremity, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: Not reported
Current Illness: Not reported
Preexisting Conditions: Not reported
Allergies: Unkown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports having right calf pain that she sought medical treatment for on approximately 7/16/2021 and was told she had "microclots" in her R leg. Patient reports having a follow-up ultrasound of her right leg in late July early August 2021 due to continued pain in her calf and swelling of her right ankle and was diagnosed with DVT, deep veing thrombosis, and was told there were 4 clots in her leg. Patient was placed on eliquis (apixaban) for treatment. Patient reports being very healthy and that she has never had any clotting problems prior to this event. As of 8/9/21 patient still has ankle swelling but otherwise starting to improve overall.


VAERS ID: 1536652 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-06-08
Onset:2021-07-16
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA CT7456 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Injury associated with device
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Medication errors (broad), Sexual dysfunction (broad)

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

Write-up: Patient presents with numbness of tip of right thumb, extending into CMC joint. Numbness is strongest felt at distal site of thumb joint. As it radiates towards right wrist, it begins to lessen in severity. Patient is a healthcare provider as well. She did experience needlestick injury to this thumb resulting in keflex antibiotic for treatment, however problem ongoing prior to injury. She is concerned regarding this symptom as several staff members in her office are experiencing the same, as well as her father in law. Problem ongoing for the past three weeks. Patient was vaccinated five weeks prior to R thumb numbness.


VAERS ID: 1536890 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Dyspnoea, Pneumonitis, Productive cough, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Asthma Inhaler - Client unsure of medication name.
Current Illness:
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: The client reported she developed "shortness of breath, a runny nose, phlegm, and a cough" 2 days after receiving the first COVID vaccine Pfizer. The client stated the symptoms lasted 4 days. The client denied any dizziness. The client has a history of asthma and uses an inhaler as needed. The client did seek care in the emergency department for her initial symptoms. The client states she was prescribed oral steroids and her inhaler medication was changed. The client was unsure of the medication names. The client stated she was diagnosed with lung inflammation. The client has no known allergies.


VAERS ID: 1537175 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-16
   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 EW0191 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Injected limb mobility decreased, Lymph node pain, Lymphadenopathy, Migraine, Pruritus, Throat irritation
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oral birth control.
Current Illness: Shortness of breath
Preexisting Conditions:
Allergies: Tetracycline, Ciprofloxacin, and Toradol
Diagnostic Lab Data:
CDC Split Type:

Write-up: The client reported that she developed dizziness 24 hours after the vaccine which lasted 6-7 days. The client also reported development of left axillary lymph node swelling and pain that lasted one week. The client states the pain caused her to be unable to lift her left arm. The client reported development of itchiness in her throat and chest 1-2 days after the vaccine that is still present. Lastly, the client reported onset of a migraine 1-2 days after the vaccine which lasted 5 days. The client took Maxalt for the Migraine. The client has taken Claritin each night, but states this has provided no significant relief of her throat and chest itchiness. The client has not followed up with a PCPC or allergist. The client has a history of a hysterectomy 2.5 months ago and has had constant shortness of breath since. The client has seen her doctor regarding the shortness of breath without any conclusion on the cause of relief. The client takes oral birth control medication. She has a history of allergies to Tetracycline, Ciprofloxacin, and Toradol. The allergic reaction to these medications consists of nausea and vomiting.


VAERS ID: 1545150 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hypomenorrhoea, Pain
SMQs:, Fertility disorders (broad)

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

Write-up: I was on Day 2 of my menstrual cycle when I received my 1st shot. About 6 hours later, my period abruptly stopped. My cycle last 5-6 days, so this was very unusual. Other side effects were typical- chills (no fever), headache, body aches, and tiredness.


VAERS ID: 1545571 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products
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:

Write-up: *Patient scheduled by facility for 1 dose COVID vaccine.*Client give Moderna dose on 07-16-21.*Later review showed that client had received Janssen vaccine on 06/10/2021.*Inadvertent dose


VAERS ID: 1545583 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products
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: Patient scheduled by facility for 1 dose COVID vaccine.*Client give Moderna dose on 07-16-21.*Later review showed that client had received Jansenn vaccine on 06/10/2021.*Inadvertant dose


VAERS ID: 1549556 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-02-04
Onset:2021-07-16
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Positive Covid by PCR on 7/16/21
CDC Split Type:

Write-up: Covid like symptoms with positive test result


VAERS ID: 1549705 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-28
Onset:2021-07-16
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Positive COVID-19 PCR 7/16/2021
CDC Split Type:

Write-up: identified in outbreak investigation


VAERS ID: 1551489 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-21
Onset:2021-07-16
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Arthralgia, Blood uric acid, C-reactive protein, Mean platelet volume, Mean platelet volume normal
SMQs:, Liver related investigations, signs and symptoms (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Obesity
Allergies:
Diagnostic Lab Data: Date: 07/28/2021 Uric acid: 9,7 mg/dL ALT: 63 U/L C-reactive protein: 7,43 mg/L MPV : 7,90 fL
CDC Split Type:

Write-up: I had severe knee pains and overall joint pain. I had blood and urine work ordered by doctor.


VAERS ID: 1553897 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-15
Onset:2021-07-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Lymphadenopathy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: chest pain, SOB, prolonged fatigue, myalgia, lymphadenopathy


VAERS ID: 1554516 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-14
Onset:2021-07-16
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, Arthralgia, COVID-19, Cough, Dry throat, Dyspnoea, Exposure to SARS-CoV-2, Fatigue, Feeling abnormal, Lymphadenopathy, Nasal congestion, Palpitations, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Sinus disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (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: anxiety and blood pressure meds and stomach meds
Current Illness: no
Preexisting Conditions: yes
Allergies: no
Diagnostic Lab Data: COVID test - 18th of July - positive result
CDC Split Type: vsafe

Write-up: I had to go get tested for COVID because I came down with it after my vaccine (three months after). I had very stuffed up sinuses; severe fatigue; brain fog and runny nose and dry throat. I had joint pain. I did lose my sense of taste and smell. I had a fever. I had a little shortness of breath but not much. I had some heart racing. My lymph nodes were swollen in my neck. I had a mild cough. It lasted for about 18 days and I still feel bad. I am having lingering symptoms. I still have fatigue and joint pain and some sinus issues. I did regain my sense of taste and smell. For treatment :I stayed home and take things at home but no formal treatment - I took Nyquil and Theraflu. I got COVID from someone else who was vaccinated. I''m probably about 75% better. We quarantined. Note: I had a tetanus shot - on Tuesday, July 13th, right before I got COVID.


VAERS ID: 1569079 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-16
Onset:2021-07-16
   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 EW0176 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Chest discomfort, Chills, Condition aggravated, Diarrhoea, Epistaxis, Headache, Heart rate increased, Injection site bruising, Injection site pain, Injection site swelling, Injection site warmth, Lymphadenopathy, Mobility decreased, Myalgia, Nausea, Oropharyngeal pain, Pain in extremity, Paranasal sinus discomfort, Pyrexia, Rash, Rash erythematous, Rash pruritic
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus Tdap - Arm Rash (red, swollen, itching), Whole Body Itching - Age 40''s - Benadryl 25mg
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Hashimoto''s, Graves, Meniere''s
Allergies: Demoral, Ibuprofen, Penicillin, Sulfa, IVP Dye, Zofran
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 7/16/21 Pfizer Lot #EW0176 2PM Health Center/Clinic Friday Side Effects: Headache, arm sore (6/10), swollen and warm to touch at injection site Saturday side Effects: Headache, arm sore (9/10) (hard to move) and swollen at injection site, chills, sore throat Sunday Side Effects: Headache, arm sore (4/10) Monday Side Effects: Mild soreness at injection site only Other: Bruise at injection site for 16 days Medications taken: Tylenol 500mg every 5-6 hours as needed 8/6/21 Pfizer Lot #EW0168 2PM Health Center/Clinic Friday Side Effects: Headache, arm sore (5/10) and swollen at injection site, extreme nausea Saturday Side Effects: Headache, arm sore (7/10) and swollen and warm to touch at injection site, chills, sore throat, swollen neck glands, sinus pressure, fever (up to 101.2), muscle aches (calves specifically), joint pain (wrist, fingers, toes specifically), extreme nausea, elevated heart rate (up to 145 standing still), chest pressure Sunday Side Effects: Headache, arm sore (2/10), swollen neck glands, sinus pressure, fever (up to 100.4), diarrhea, abdominal pain, chest pressure Monday Side Effects: Itchy, red rash on vaccine arm, bloody nose, diarrhea, abdominal pain, chest pressure Tuesday Side Effects: Itchy, red rash on vaccine arm, abdominal pain Wednesday Side Effects: Red rash on vaccine arm, abdominal pain Thursday Side Effects: Rash on vaccine arm Friday Side Effects: Rash on vaccine arm Medications Taken: Tylenol 500mg every 4-6 hours as needed Benadryl 12.5mg


VAERS ID: 1569094 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-20
Onset:2021-07-16
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous
SMQs:, Termination of pregnancy and risk of abortion (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: Zoloft, buspar, multivitamin, probiotic
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was 3 weeks pregnant at the time of the 2nd moderna shot. Due date was set for 1/9/22. Discovered I was miscarrying at 15 weeks (7/16/21). Contact from the V-safe program reached out and suggested I submit a report.


VAERS ID: 1574329 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-14
Onset:2021-07-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN L2074214 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Chest X-ray, Computerised tomogram, Dyskinesia, Ear pain, Electrocardiogram, Eyelid function disorder, Facial paralysis, Full blood count, Magnetic resonance imaging, Neck pain, Oropharyngeal pain, Pain in jaw, Scan with contrast, Tinnitus, Tongue movement disturbance
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Periorbital and eyelid disorders (narrow), Osteonecrosis (broad), Ocular motility disorders (narrow), Arthritis (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: Vit. D, Super B complex, Fish oil
Current Illness: None
Preexisting Conditions: Osteoarthritis
Allergies: No known allergies
Diagnostic Lab Data: 7/16/21 Chest x-ray, CBC, CAT scan with and without contrast, EKG. 7/22/21 MRI
CDC Split Type:

Write-up: 7/16/21 0200 sharp pain in neck, and throat. 0700 right eye won?t close, mouth not responding on right side , tongue deviated to the right. Right side of face unresponsive to movement. Pain in right ear, ringing in right ear, pain behind right ear along with right neck and jaw pain. ER visit. Diagnosis: Bell?s Palsy.


VAERS ID: 1575267 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-13
Onset:2021-07-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Assessment at Physical Therapy office
CDC Split Type:

Write-up: Vertigo, I have done some physical therapy and still I have vertigo.


VAERS ID: 1575474 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Pain
SMQs:, 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:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Not applicable
CDC Split Type:

Write-up: Pain and hard to raise past shoulder. Patient has taken tylenol and tried to stretch it and it is still in pain.


VAERS ID: 1577934 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-07-16
   Days after vaccination:101
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Electrocardiogram abnormal, Ventricular extrasystoles
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular Vitamin D
Current Illness:
Preexisting Conditions: Allergy induced asthma
Allergies: X-ray dye
Diagnostic Lab Data: EKG monitor
CDC Split Type:

Write-up: Arrhythmia and PVCs


VAERS ID: 1577981 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-07-16
   Days after vaccination:101
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Electrocardiogram, Ventricular extrasystoles
SMQs:, Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular Vitamin D
Current Illness:
Preexisting Conditions: Allergy induced asthma
Allergies: X-ray dye
Diagnostic Lab Data: EKG monitor 8/10/21
CDC Split Type:

Write-up: Heart arrhythmia and PVCs


VAERS ID: 1578297 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-26
Onset:2021-07-16
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 7/16/2021 Tested positive for Covid 19
CDC Split Type:

Write-up: Dose 1. 5/3/2021 Dose 2. 5/26/2021


VAERS ID: 1578394 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anti-myelin-associated glycoprotein antibodies positive, Aphasia, Autoimmune thyroiditis, Central nervous system lesion, Cerebral disorder, Electroencephalogram abnormal, Encephalitis, Encephalopathy, Magnetic resonance imaging head abnormal, Mental status changes, Nervous system disorder, Pleocytosis, Scan with contrast abnormal, Seizure
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Cardiomyopathy (broad), Demyelination (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune 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? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: claritan, eczema cream, multivitamins
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: See above
CDC Split Type:

Write-up: 2 weeks later after receiving the vaccine, patient was noted to have presented with altered mental status, seizures seen on the EEG (highly abnormal EEG with lateralized discharges) as well as higher cortical deficit of aphasia. She was initially admitted from 7/16 and discharged on 7/22. Workup showed MRI brain w/ w/o contrast done which showed signal abnormality in R precuneus cortex and subcortical white matter. Patient was started on Keppra, received antibiotics initially for possible bacterial infections but was ruled out. Initially was sent home on acyclovir for possible HSV encephalitis. She had improved and had returned back to baseline at time of discharge. She had then re-admitted on 7/30 for one day only for issues with her midline that she was sent home with for prolonged antiviral therapy. Patient was readmitted again on 8/5 and discharged on 8/11. At that time, she was noted to have had repeat of worsening encephalopathy and aphasia, with new enhancing brain lesion but resolution of older lesion, plus some mild CSF pleocytosis, we treated her with high dose Solumedrol for 5 days and sent her home on a high-dose, slow oral steroid taper. The working diagnosis remained SREAT/Hashimoto?s encephalitis, but results came back that show that she is positive for anti-MOG (myelin oligodendrocyte glycoprotein) antibodies in her serum. There is some concern for post-vaccination trigger for this autoimmune CNS disorder?although the diagnosis still remains somewhat unclear.


VAERS ID: 1582994 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-06
Onset:2021-07-16
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Computerised tomogram abdomen abnormal, Computerised tomogram normal, Endoscopy, Haematemesis, Haemoglobin decreased, Laboratory test abnormal, Lipase increased, Nausea, Oesophageal rupture, Pain, Pancreatitis, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (narrow), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation (narrow), Gastrointestinal haemorrhage (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Abilify; Prozac; Levothyroxine; Folic Acid; Prilosec; Adderall; Norco; Humira; Methotrexate
Current Illness: No
Preexisting Conditions: Rheumatoid Arthritis; Hypothyroidism
Allergies: Penicillin; Avelox; Cipro
Diagnostic Lab Data: 7/18/21 CT scan pancreatitis. 7/18/21 Labs high lipase numbers, hemoglobin dropped to 10. 7/18/21 Endoscopy small tear in esophagus.
CDC Split Type: vsafe

Write-up: Friday July 16, 2021, about 10:30-11:00 pm I started having abdominal pain that radiating through to my back. I could not sleep and was up all night in pain. It felt like I was being sawed in half. At 05:00am Saturday morning I went to the ER, I was given pain medication that did not help with the pain. I had a CT that was "normal". I was discharged home by 10:00am Saturday. Saturday night I started having nausea and vomiting into Sunday morning. My spouse contacted a doctor that suggested I go back to a different ER, which I went to on Sunday 10:00am. At this point I was vomiting blood. I was taken to medical center by ambulance. The CT scan showed pancreatitis. I had labs done showed lipase numbers were high. By 02:00pm Sunday I was admitted to a step-down unit in the hospital. On Tuesday I received an endoscopy to make sure there was nothing else going on in esophagus or stomach. I had a small tear in esophagus that had started to heal itself. My lipase numbers started to come back down. I went home from hospital on Wednesday afternoon. I have not had any symptoms come back since leaving the hospital.


VAERS ID: 1584216 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-02-11
Onset:2021-07-16
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 100mg Junel Fe birth control Levothyroxine 25mcg
Current Illness: None
Preexisting Conditions: Hypothyroidism Depression Anxiety ADHD combined type
Allergies: Latex
Diagnostic Lab Data: Echocardiogram was ordered and Holter monitor study is being done now 8.18.2021
CDC Split Type:

Write-up: Elevated heartrate for 2 1/2 hours.


VAERS ID: 1584224 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-26
Onset:2021-07-16
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anti-thyroid antibody, Basedow's disease, Blood thyroid stimulating hormone, Dyspnoea, Fatigue, Hyperthyroidism, Laboratory test abnormal, Thyroxine, Tri-iodothyronine
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Hypothyroidism (broad), Hyperthyroidism (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Heart murmur
Preexisting Conditions: None
Allergies: Iodine, seafood
Diagnostic Lab Data: TSH, T3, T4, TRAB test all out of range
CDC Split Type:

Write-up: About 4 months after the vaccination started to have sob, fatigue. Later confirmed lab test for hyperthyroidism, Graves disease.


VAERS ID: 1586984 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM

Administered by: Work       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 COVID-19 vaccine administered through vaccine administrator, University Health, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1586987 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM

Administered by: Work       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 COVID-19 vaccine administered through vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1586990 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM

Administered by: Work       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 COVID-19 vaccine administered through vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1586994 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 LA / IM

Administered by: Work       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 COVID-19 vaccine administered through vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1586995 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1586999 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587002 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through a vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587004 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through vaccine administrator, HCF, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587006 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587009 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587013 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 LA / IM

Administered by: Work       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 COVID-19 vaccine administered through vaccine administrator, HCF, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587015 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587017 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through Catalent''s vaccine administrator between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587019 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587020 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: 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 COVID-19 vaccine administered through vaccine administrator, HCF, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587023 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through Catalent''s vaccine administrator between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587029 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: 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 COVID-19 vaccine administered June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587032 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 COVID-19 vaccine administered through vaccine administrator, between June 25 and July 30 came from the lot number 039K20A. It was discovered that this particular lot was beyond its frozen expiration date by five (5) up to forty (40) days. A case was opened with Moderna (Case #: MOD21-126790). Please refer to this case number if you would like to contact Moderna directly. Moderna confirmed that the vaccine doses administered maintained the activity necessary to protect against the COVID-19 virus. Moderna also confirmed there is no danger to anyone''s health from receiving a vaccine past its frozen expiration date. No adverse reactions were identified.


VAERS ID: 1587151 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot lead to a blood infection
Other Medications: na
Current Illness: asthma (copd) controlled
Preexisting Conditions: asthma (copd) controlled
Allergies: na
Diagnostic Lab Data: na
CDC Split Type:

Write-up: about 20 minutes post ima, the patient noticed that her arm began to become discolored (dark grey in color) and continued to get darker over several days. the area in size was 3 inches by 6 inches. the spot lasted about 4 weeks long. a week after the shot the patient got a bug bite on her leg and then got a large bruise over the area that was approximately 4 inches by 5 inches. there is still a large bruise over the area. Recommended to patient to hold off on second shot until we have more information. the primary doctor said she needs to get it but should check with her pulmonary doctor, the pulmonary dr said she needs to get the shot but that she needs to ask more questions before doing so.


VAERS ID: 1591517 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 19 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Blood test, Cardiac flutter, Chills, Malaise, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartin, Rosuvastatin
Current Illness: COVID in January. (I have had worse colds than that. Certainly easier than my reaction to the vaccine.)
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I had a blood test that determined that I had a lot of natural antibodies against the virus, but the government insisted that I get the vaccine anyway. Both shots made me ill for at least 5 days.l
CDC Split Type:

Write-up: chills, fever, fluttering heart, faintness, dipping BP, ill for 5 days


VAERS ID: 1593182 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-12
Onset:2021-07-16
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pradaxa, amlodipine, bupropion, atorvastatin, hydrochlorthiazide, lorazepam, adderall
Current Illness: dry cough
Preexisting Conditions: hypertension, anti thrombin 3 deficiency, BP II
Allergies: none
Diagnostic Lab Data: covid test 7-19-2021
CDC Split Type:

Write-up: I developed a severe cough I was given a covid test still waiting for results. I was given an inhaler and cough medicine.


VAERS ID: 1602560 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-15
Onset:2021-07-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Mobility decreased
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allopurinol losartin
Current Illness: none
Preexisting Conditions: IGA nephropathy Prostate cancer
Allergies: sulfa drugs
Diagnostic Lab Data: none
CDC Split Type:

Write-up: numbness in arm loss of mobility of arm


VAERS ID: 1602587 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-07-15
Onset:2021-07-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Chest pain, Dizziness, Gait disturbance, Haemorrhage, Mobility decreased, Nausea, Neuralgia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: I experienced pain in my chest/heart throughout my life but I don?t know if it was a health condition or something like stress caused.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The night after I got the first dose, I lost a lot of blood from my chains and my heart experienced a bit of pain. This happened for a few days and went away. Similar thing happened after my second dose on 8/5 for two days. But heart pain still persists. A new thing that came up is that my left leg feels like I pulled a nerve. I can?t bend down or life things as good as I used to. It is painful to walk too. Occasionally I get lightheaded and feel like vomiting.


VAERS ID: 1617689 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Axillary pain, Discomfort, Headache, Injection site pruritus, Pain, Pain in extremity
SMQs:, 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: Sinusitis; Diverticulitis
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, arm pain, sensation of heaviness, itchy in the are of injection, lower arm pain (axial) side pain. After second dose and weeks after I still have pain under axillary and side pain.


VAERS ID: 1623621 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 182186 / 1 LA / IM

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

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

Write-up: 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: 1623633 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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

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

Write-up: 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: 1627956 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-15
Onset:2021-07-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness exertional, Electrocardiogram, Electrocardiogram ambulatory, Fatigue, Heart rate increased, Hyperhidrosis, Laboratory test, Oxygen saturation abnormal, Palpitations, Pyrexia, Tachycardia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Emegality for migraines
Current Illness:
Preexisting Conditions: Anxiety
Allergies: Amoxicillin
Diagnostic Lab Data: Labs. EKG,
CDC Split Type: vsafe

Write-up: My very first symptom was tachycardia, it was around dinner I noticed my heart beating fast and I had a low grade fever. I went to sleep and went to work the next morning I was walking from parking lot to the ICU my heart rate was in 140''s and then after an hour my heart was still racing, I was sweating, shaking and chills and I still had a low grade fever. I had dizziness when I was exerting myself. All my symptoms went away within 24 hours except my tachardia, and I was fatigued. Then on Tuesday my heart rate was getting higher in 160s. I saw my doctor, the only time my heart rate is normal when I''m lying down. I went to ER because I couldn''t even get a reading on my pulse oximeter. I was referred to a cardiologist. I wore a monitor for 2 weeks, They put me on metoprolol. I''m waiting to see a cardiologist for a full work up.


VAERS ID: 1628067 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO172 / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Pharyngeal swelling, Swelling, Swollen tongue, X-ray abnormal
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Stage 4 breast cancer, Type 2 Diabetes, HTN, Angioedema, exertional asthma, eczema
Allergies: Red dye, nickel, dust mites
Diagnostic Lab Data: Received X-Ray of throat confirmed throat swelling 07/17/21 at health emergency dept.
CDC Split Type:

Write-up: Throat swelling, tongue swelling, and swelling under the left axilla. I went to the emergency dept., then transported via EMS to hospitals.


VAERS ID: 1628178 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menopause, Menstruation irregular, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Generic version of Allegra (allergy medicine)
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: n/a.. Note: I marked unknown to item 20 because now it is unknown if I will be able to have a second dose in order for the vaccine to be effective and at the same time not adversely impact my body.
CDC Split Type:

Write-up: I am in the beginning stages of menopause, so it is never normal for me to have more than one period in the same month. It started almost immediately after the vaccination (only one week after my last one ended) and I am old enough to tell that my body was not prepared for it at all. In a time of life where heart palpitations are normal, an unexpected side effect that has not studied, was disappointing. I have had several vaccines for travel and was not expecting to have such a reaction to this one. Also, I started my period a week early the following month and because of timing, I couldn''t risk it a second time and ended up having to cancel the second dose.


VAERS ID: 1628596 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 RA / IM

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

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

Write-up: Patient states that vaccine caused her skin to ''wrinkle'' and has had itching since receiving vaccine. She says she has not contacted her primary care doctor.


VAERS ID: 1628826 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-14
Onset:2021-07-16
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose decreased, Blood test, Colonoscopy, Fatigue, Glycosylated haemoglobin decreased, Hypotension, Weight decreased
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Hypoglycaemia (narrow), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol; amlodipine besylate; carvedilol; edarbyclor; Jardiance; metformin; Motegrity; Prevadent 5000 toothpaste; Crestor; Insulin Flex Touch; Vascepa; Vesicare; Victoza; baby aspirin; magnesium
Current Illness:
Preexisting Conditions: Type 2 Diabetes; Arthritis; Hypertension
Allergies:
Diagnostic Lab Data: Blood work
CDC Split Type: vsafe

Write-up: Five months after the second dose of the vaccine I experienced very low blood pressure and very low blood sugar. I had had a Colonoscopy prior to the episode, and I had lost some weight. My blood pressure and Diabetes medications have been adjusted. I am still very fatigued and tired after six weeks, and I am scheduled to see a Cardiologist again. I had seen him a month before. My A1C was very low but it has improved since then. My weight has stabilized. I am scheduled to have a Nuclear Stress Test in September of 2021.


VAERS ID: 1632291 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: There was tingling/numbness in the right hand fingers. There has been a burning in the right hand that comes and goes.


VAERS ID: 1632862 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 OT / SYR

Administered by: Public       Purchased by: ?
Symptoms: Facial paralysis, Hypoaesthesia, Magnetic resonance imaging
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Nothing came in MRI 07/17/2021
CDC Split Type:

Write-up: Num right side of body , face moving one side kind of stroke


VAERS ID: 1632866 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-30
Onset:2021-07-16
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain lower, Chest X-ray, Cough, Dyspnoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension, Type 2 Diabetes
Allergies: E-mycin
Diagnostic Lab Data: CXR, covid test
CDC Split Type:

Write-up: Cough, SOB, left lower quadrant abdominal pain.


VAERS ID: 1632887 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-27
Onset:2021-07-16
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Dizziness, Fatigue, SARS-CoV-2 test
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (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: Chicken pox
Allergies: NKA
Diagnostic Lab Data: Cxr, covid test
CDC Split Type:

Write-up: Dizziness, weakness, fatigue.


VAERS ID: 1633368 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Headache, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Oropharyngeal allergic conditions (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NP thyroid, citalopram
Current Illness: none known
Preexisting Conditions: Hashimoto''s thyroiditis, depression
Allergies: sulfa, quinolones, promethazine
Diagnostic Lab Data:
CDC Split Type:

Write-up: headaches, severe fatigue, tongue swelling, brain fog


VAERS ID: 1636366 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-07-16
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes mellitus, HTN
Allergies: PCN, sulfa
Diagnostic Lab Data: CXR, covid test
CDC Split Type:

Write-up: Difficulty breathing and cough.


VAERS ID: 1636893 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 182186 / 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: 1636896 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-16
Onset:2021-07-16
   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: No adverse event
SMQs:

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

Write-up: None stated.


VAERS ID: 1641755 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-19
Onset:2021-07-16
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, Cardiac failure congestive, Condition aggravated, Dyspnoea, Oedema, Polyuria, SARS-CoV-2 test positive, Tachycardia
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tubulointerstitial diseases (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 07/16/2021: Patient presents to ER with shortness of breath, edema, tachycardia, positive COVID test, and in atrial fibrillation. Acute exacerbation of CHF. 07/17/2021: Diuresis went well and patient back at baseline. Discharged.


VAERS ID: 1644483 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Unknown  
Location: California  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 - / OT

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

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

Write-up: 10 patients received doses from 1 vial after spending more than 30 days on the refrigerator//Patient7: Second Dose-Vaccine administered BUD (on day 32); This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (10 patients received doses from 1 vial after spending more than 30 days on the refrigerator//Patient7: Second Dose-Vaccine administered BUD (on day 32)) in a 48-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021C21A) for COVID-19 vaccination. 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 16-Jul-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (10 patients received doses from 1 vial after spending more than 30 days on the refrigerator//Patient7: Second Dose-Vaccine administered BUD (on day 32)). At the time of the report, EXPIRED PRODUCT ADMINISTERED (10 patients received doses from 1 vial after spending more than 30 days on the refrigerator//Patient7: Second Dose-Vaccine administered BUD (on day 32)) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided by the reporter. No treatment information was provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 09-Aug-2021: Followup received and added patient demographics. On 10-Aug-2021: Follow up received and Vaccine information updated.


VAERS ID: 1645054 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia, Pain in extremity, Vaccination site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (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: Dead arm; soreness at vaccination site; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (Dead arm), VACCINATION SITE PAIN (soreness at vaccination site) and PAIN IN EXTREMITY (sore arm) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 16-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Jul-2021, the patient experienced HYPOAESTHESIA (Dead arm), VACCINATION SITE PAIN (soreness at vaccination site) and PAIN IN EXTREMITY (sore arm). The patient was treated with ACETYLSALICYLIC ACID, CAFFEINE, PARACETAMOL (EXCEDRIN [ACETYLSALICYLIC ACID;CAFFEINE;PARACETAMOL]) for Adverse event, at an unspecified dose and frequency. At the time of the report, HYPOAESTHESIA (Dead arm), VACCINATION SITE PAIN (soreness at vaccination site) and PAIN IN EXTREMITY (sore arm) outcome was unknown. No concomitant medications were reported by the reporter.


VAERS ID: 1645411 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-14
Onset:2021-07-16
   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 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Vaccination site pain
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: SYNTHROID; ELAVIL [AMITRIPTYLINE HYDROCHLORIDE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100908495

Write-up: Morning nausea; Mild pain at injection site 48 and 72 hours later; This is a spontaneous report from a non-contactable consumer, the patient. A 51-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0198) via an unspecified route of administration in the left arm on 14Jul2021 at 19:45 (at the age of 51-years-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19 since prior to the vaccination, the patient was diagnosed with COVID-19 on an unknown date. The patient did not have any allergies to medications, food, or other products. Concomitant medications included levothyroxine sodium (SYNTHROID) 100 mcg and amitriptyline hydrochloride (ELAVIL) 25 mg. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 16Jul2021 at 04:00, 48 hours after vaccination, the patient experienced mild pain at injection site. On 17Jul2021, 72 hours after vaccination, the patient experienced morning nausea. Since the vaccination, the patient had not been tested for COVID-19. The events did not result in a visit to the doctors or other healthcare professional office/clinic visit, and emergency room/department or urgent care. No therapeutic measures were taken as a result of the events. The clinical outcome of the events mild pain at injection site and nausea was resolving at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1645418 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-16
Onset:2021-07-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Headache, Myalgia, Pain in extremity, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE; CYTOMEL; POTASSIUM; ZINC; CYANOCOBALAMIN; VITAMIN D [VITAMIN D NOS]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hashimoto''s disease; Meniere''s disease; TMJ syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100909636

Write-up: Dizzy; Weakness; Arm was still sore; Chills; Muscle aches; Headache; No rash but Itchy from head to toe; This is a spontaneous report from a contactable consumer, the patient. A 61-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA7485) via an unspecified route of administration in the left arm on 16Jul2021 at 10:30 (at the age of 61-years-old) as a single dose for COVID-19 immunisation. Medical history included hashimoto''s disease, meniere''s disease, TMJ syndrome and fibro. 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 medications included levothyroxine (MANUFACTURER UNKNOWN), liothyronine sodium (CYTOMEL), potassium (MANUFACTURER UNKNOWN), zinc (MANUFACTURER UNKNOWN), cyanocobalamin (MANUFACTURER UNKNOWN) and vitamin d nos (VITAMIN D) all from an unknown date for an unspecified indication. The patient previously took prednisone (MANUFACTURER UNKNOWN) from an unknown date for an unspecified indication and experienced drug allergy. On 16Jul2021 at 10:45, the patient experienced day 3 arm was still sore, chills, muscle aches, weakness, headache, dizzy, no rash but itchy from head to toe. 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 events day 3 arm was still sore, chills, muscle aches, weakness, headache, dizzy, no rash but itchy from head to toe was not recovered.


VAERS ID: 1645420 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-15
Onset:2021-07-16
   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: Body temperature, Chills, Hyperhidrosis, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: LEVOTHYROXINE; FENOFIBRATE
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: Test Date: 20210716; Test Name: Body temperature; Result Unstructured Data: Test Result:101.5
CDC Split Type: USPFIZER INC202100909669

Write-up: 101.5 fever for 3 days; nausea; debilitating aches and pains over entire body; excessive sweating and chills; excessive sweating and chills; This is a spontaneous report from a contactable consumer, the patient. A 52-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 15Jul2021 at 17:45 (at the age of 52-years-old), as a single dose for COVID-19 immunisation. Medical history included COVID-19. The patient had no known allergies to medications, food or other products. Prior to the vaccination, the patient was diagnosed with COVID-19. Concomitant medications included levothyroxine (MANUFACTURER UNKNOWN) and fenofibrate (MANUFACTURER UNKNOWN); both for unspecified indication from unknown dates, unknown if ongoing. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 16Jul2021 at 09:00, the patient experienced 101.5 fever for 3 days, nausea, debilitating aches and pains over entire body, excessive sweating and chills. 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 101.5 fever was recovered on 18Jul2021, which lasted for 3 days. The clinical outcome of the events nausea, debilitating aches and pains over entire body, excessive sweating and chills was recovering at the time of the report.


VAERS ID: 1645430 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-16
Onset:2021-07-16
   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 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Faeces soft, Limb discomfort, Myalgia, Vaccination site erythema, Vaccination site swelling, Vaccination site warmth
SMQs:, Rhabdomyolysis/myopathy (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100912041

Write-up: soft stool; felt the heaviness in my arm; the injection site is red warm there''s mild swelling; the injection site is red warm there''s mild swelling; the injection site is red warm there''s mild swelling; it''s firm and hard to the touch as pain in the muscle of my arm and it''s tender; This is a spontaneous report from a contactable consumer (reported for herself). A 47-years-old female patient received bnt162b2 (Pfizer-BioNTech COVID-19 Vaccine, solution for injection), dose 1 via an unspecified route of administration on 16Jul2021 (at the age of 47-years-old) (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. It was reported that after directly after receiving the vaccine the patient felt the heaviness in her arm, she also felt the needle was still in her arm even though it was not. it''s been over 24 hours and the injection site were red warm there''s mild swelling it''s firm and hard to the touch as pain in the muscle of her arm and it was tender and it would hurt to move her arm a little bit as well. She also had a soft stool, and she don''t know if that''s related to the injection or not. The outcome of all the events was unknown. The lot number for the vaccine, [bnt162b2], was not provided and will be requested during follow up


VAERS ID: 1645523 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-09
Onset:2021-07-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Chest discomfort, Cough, Fatigue, Headache, Influenza like illness, Nausea, Oropharyngeal pain, Pain, Paraesthesia, Swelling, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to arthropod bite (Mesquite); Allergy to grains (wheat barley Rye); Bipolar disorder (IBS bipolar); Celiac disease; Fruit allergy (Jalapeno); Gastritis; Hiatal hernia; Major depression; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100930726

Write-up: Stomach cramps; nausea; headaches; chest heavy; sore throat; some swolling; body aches; coughing; tingling sensation on hands, feet and ankles; Moody tired feeling; Like I''m comin down with the flu; Puking; This is a spontaneous report from a contactable consumer, the patient. A 52-year-old non-pregnant female patient of received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA6780) via an unspecified route of administration in the right arm on 09Jul2021 (at the age of 52-year-old)as a single dose for COVID-19 immunisation. Medical history included celiac disease, IBS bipolar, major depression, gastritis and hiatal hernia . The patient previously took paracetamol (TYLENOL), acetylsalicylic acid (ASPIRIN), celecoxib(CELEBREX), amoxicillin (MANUFACTURER UNKNOWN) and experienced drug allergy. The patient has known allergy to penicillin, wheat, barley, rye, jalapeno and mesquite. The patient received other vaccine within four weeks prior to the vaccination. The patient received shingles shot (MANUFACTURER UNKNOWN) on 21Jun2021. On 16Jul2021 at 12:00 the patient experienced stomach cramps, puking, nausea, headaches, chest heavy, sore throat, some swelling, body aches, coughing, tingling sensation on hands, feet and ankles, moody tired feeling like she was coming down with the flu. Therapeutic measures were not taken as a result of the events. The events did not result in doctor 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 events stomach cramps, puking, nausea, headaches, chest heavy, sore throat, some swelling, body aches, coughing, tingling sensation on hands, feet and ankles, moody tired feeling like she was coming down with the flu was not recovered at the time of report.


VAERS ID: 1646071 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-16
Onset:2021-07-16
   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: Confusional state, Head injury, Hyperhidrosis, Palpitations, Seizure, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: VYVANSE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100978914

Write-up: fainted; seizure; heart racing; head still hurts to touch; sweating; shaking; extremely confused; This is a spontaneous report received from a contactable consumer (patient). A 23-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0198), via an unspecified route of administration, administered in left arm on 16Jul2021 at 16:00 (at the age of 23-years-old) as dose 2, single for COVID-19 immunisation. The patient previously received the first dose of bnt162b2 (Lot no: EW1198) on 24Jun2021. The patient medical history was not reported. The patient was not COVID tested post vaccination. The patient had no known allergies. Concomitant medications included lisdexamfetamine mesilate (VYVANSE) taken for attention deficit hyperactivity disorder (ADHD), start and stop date were not reported, and unspecified birth control. The patient reported that after receiving her 2nd vaccination dose, she fainted and had a seizure in the pharmacy. Initially after receiving the shot, she felt normal for 30 seconds. She was browsing because they instructed her to wait 10 mins. She started to feel her heart racing as if she just sprinted, and she felt confused. She was worried she was going to be sick, so she went to sit back down in the patient area. That was all she remembered. She woke up to pharmacists and bystanders helping her. She was told that she landed on her head and had a seizure in the fetal position. Her head still hurts to touch that area the day of reporting. She was shaking and sweating after waking up and was extremely confused. Her head hurt so badly. There was a very nice pharmacist and bystander who helped keep her calm until the EMS arrived. Nothing like this has ever happened to her before and she did not have allergies. She was completely fine after her first dose. The events were treated with EMS care. The outcome of events was recovering.


VAERS ID: 1646477 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-07-16
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: no
Allergies:
Diagnostic Lab Data: Test Date: 20210715; Test Name: Nasal Swab; Test Result: Positive; Test Date: 20210719; Test Name: Nasal Swab; Test Result: Positive; Test Date: 20210723; Test Name: Nasal Swab; Test Result: Negative.
CDC Split Type: USPFIZER INC202101001045

Write-up: This is a spontaneous report from a non-contactable consumer. A 29-year-old non-pregnant female patient received second dose BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) via an unspecified route of administration, administered in Arm Left on an unknown date in Apr2021 (Batch/Lot number was not reported, age at vaccination: 28-year-old) as dose 2, single and dose 1 via an unspecified route of administration, administered in Arm Left on an unknown date in Mar2021 (Batch/Lot number was not reported, age at vaccination: 28-year-old) as dose 1, single for covid-19 immunisation administered in clinic. The patient was not pregnant at the time of vaccination. No medical history was reported. The patient had no known allergies. The 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 and has been tested for covid-19 since the vaccination. On 16Jul2021, the patient contracted covid-19 and tested positive for at least 10 days. No treatment was received for the event. The patient underwent lab tests and procedures which included nasal swab test on 15Jul2021 and result was positive, on 19Jul2021 and result was positive, on 23Jul2021 and result was negative. The outcome of event contracted covid-19 and tested positive for at least 10 days (covid-19) was recovered on an unknown date in Jul2021. No follow up attempts are possible. No further information is expected.


VAERS ID: 1646604 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-15
Onset:2021-07-16
   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 EW0198 / 1 RA / -

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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Latex allergy (Latex (skin)); Shellfish allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101010062

Write-up: Swollen painful glands in the neck.; This is a spontaneous report from a non-contactable consumer, the patient. A 51-year-old male patient 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 15Jul2021 at 16:00 (at the age of 51-year-old) as a single dose for COVID-19 immunisation. Medical history included allergy to latex (skin) and shellfish. Concomitant medications were not reported. 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. On 16Jul2021 at 00:00, the patient experienced swollen painful glands in the neck. The event resulted in doctor or other healthcare professional office/clinic visit. 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 swollen painful glands in the neck was recovering at the time of report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1647096 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-06
Onset:2021-07-16
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Allergy to vaccine, Arthralgia, Headache, Malaise, Nasal congestion, Nausea, Neck pain, Paranasal sinus discomfort, Secretion discharge, Sinus pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergic reaction (She has had allergy reactions for decades and knows to what to do); Allergy to molds (for decades); Hives (Initially she had to delay getting the vaccine because she was having hives.); Milk allergy (Allergic to milk and milk byproducts); Reflex sympathetic dystrophy of the upper limb (Nerve reflection dystrophy bilateral hands and arms); Weight increased (She has gained weight prior to getting the vaccines.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101041374

Write-up: sinus pain; Experienced "a mold-like allergic reaction"; Sinus pressure; Headache that eventually involved my entire head, neck, and shoulders/bad headache in forehead that went to the back and side; headache that eventually involved my entire head, neck, and shoulders/ She had neck and shoulder pain; headache that eventually involved my entire head, neck, and shoulders/ She had neck and shoulder pain; Nausea; Congestion that resulted in a really thick heavy mucus when I was able to clear my sinuses; Congestion that resulted in a really thick heavy mucus when I was able to clear my sinuses; I had extensive hives for about 11 weeks; Sick; This is a spontaneous report from a Pfizer sponsored program received from a contactable consumer (patient). A 62-year-old female patient received bnt162b2 (BNT162B2 reported as PFIZER-BIONTECH COVID-19 VACCINE), dose 1 at vaccination age of 62-year-old via an unspecified route of administration in the left arm on 16Jul2021 at 12:00 (Lot Number: EW0181) as dose 1, single; and dose 2 at vaccination age of 62-year-old via an unspecified route of administration in the right arm on 06Aug2021 12:00 (Lot Number: EW0181) as dose 2, single for covid-19 immunisation (if she gets Covid her illness will be reduced). Medical history included nerve reflection dystrophy bilateral hands and arms (reflex sympathetic dystrophy of the upper limb) from 1985 to an unknown date, allergic to milk and milk byproducts, gained weight prior to getting the vaccines, has had allergy reactions for decades and knows to what to do, and has had a mold allergy for decades. Initially she had to delay getting the vaccine because she was having hives. There were no concomitant medications. The patient previously received shingles vaccine ten weeks prior (2021). She received the vaccine in a pharmacy/drug store. She did not received other vaccines on the same day as the Pfizer suspect. The patient reported that she had a "mold-like allergic reaction" to both doses of the Pfizer BioNTech Covid-19 Vaccine. She inquired if there is mold with what is mixed together. She does not know how many days the vaccine was in a liquid form. She assumes when mixed there is a dry and wet component. She mentioned that she experienced the same allergic reaction within 3 to 4 hours after both doses of the vaccine. Initially sinus pressure, headache that eventually involved her entire head, neck, and shoulders, nausea, and congestion that resulted in a really thick heavy mucus when she was able to clear her sinuses (16Jul2021). She mentioned that the symptoms took 4 days to resolve after the first dose and 3 to 3.5 days to resolve after the second dose. She added that the headache across her sinuses and over her head around the back lasted for 2.5 - 3 days. She had neck and shoulder pain and nausea which she described as heavy ache. She stated that this reaction mimics a classic reaction to mold. She added that she has had a mold allergy for decades and it has been years since she has been this sick with an allergic reaction. She further mentioned that in both doses, she had sinus pressure and thick mucus formation. She hasn''t had this in a long time. She had an onset of sinus pain (06Aug2021). She has had a recurring headache since then. She mentioned that her neighbor flooded the bathroom floor and she feel that there is mold between the flooring. She thinks she is currently being exposed to mold. She also stated that she received the injection at noon and was sick by 1500 (2021). She was sick for 2.5 days. She developed a bad headache in her forehead that went to the back and sides. This lasted for 2.5 days. She still has a headache but cannot rule out if it is related or not. She also had nausea after the second dose (06Aug2021). The patient suspects there may either be a mold component to the vaccine or that the vaccine was stored improperly resulting in microbial growth in the vial. Usually all of her reactions are about that long. That tells her there is a lot of mold in the vaccine. The patient also inquired if the vaccine contains any kind of mold or milk or milk byproducts and requested a review of the vaccine ingredients. The patient had extensive hives for about 11 weeks (2021) and she was cautioned at one time about inert ingredients when restarting vitamins and medications again. She did not seek treatment since she has had allergy reactions for decades and knows to what to do. The adverse events did not result in emergency room visit or physician''s visit. The patient does not have relevant tests. The patient mentioned that she takes pain and other medications. The outcome of the event urticaria was unknown, for the event feeling sick, congestion nasal and allergy to vaccine were recovered on an unspecified date in 2021, for the event headache was recovered on Jul2021, as for the event sinus pain was recovered on Aug2021 while the outcome of the events was recovered on 19Jul2021.


VAERS ID: 1647396 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:2021-02-23
Onset:2021-07-16
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210716; Test Name: NAAT Covid test; Result Unstructured Data: Test Result: Positive.
CDC Split Type: USPFIZER INC202101076345

Write-up: Tested positive for Covid virus, after being fully vaccinated; Tested positive for Covid virus, after being fully vaccinated; This is a spontaneous report from a contactable consumer or other non HCP. This consumer reported similar events for 37 patients. This report is for 7th patient of 37 patients. A 71-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number: EL9266, expiry date was unknown), via an unspecified route of administration on 23Feb2021 as dose 2, single and first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number: EN5318, expiry date was unknown), via an unspecified route of administration, at an unknown administration site on 28Jan2021 as dose 1, single for covid-19 immunization, at physician''s office. The patient medical history was not reported. The patient''s concomitant medications were not reported. It was stated that, on 16Jul2021, the patient was tested positive for covid virus, after being fully vaccinated. Covid positive was defined as having both vaccines and testing positive for Covid longer than two weeks after both doses. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 16Jul2021. The outcome of the event was unknown at the time of report. Follow-up attempts are completed. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101075254 same reporter/drug/AE, different patients


VAERS ID: 1653285 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-15
Onset:2021-07-16
   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 - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (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:
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 INC2021907687

Write-up: Muscle aches; Chills; This is a spontaneous report from a non-contactable consumer, the patient. A 18-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE;Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 15Jul2021 at 10:00 (at the age of 18-years-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19 as prior to the vaccination, the patient was diagnosed with COVID-19. Concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 16Jul2021 at 05:00 the patient experienced muscle aches and chills. The events 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. No therapeutic measures were taken as a result of the reported events. The clinical outcome of the event muscle aches and chills was recovering at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1653290 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-14
Onset:2021-07-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Maternal exposure during pregnancy, Myalgia, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: PLAQUENIL [HYDROXYCHLOROQUINE SULFATE]; ASPIRIN [ACETYLSALICYLIC ACID]; PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]; D3
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; Depression; Lupus erythematosus; Pregnancy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021908090

Write-up: is_pregnant: Yes; Mild headache; sore arm muscle around injection site; inexplicable pain in muscle on underside of upper arm, near armpit. Cannot extend arm fully, feels as if muscle is shortened or very tense/strained/muscle pain; This is a spontaneous report from a non-contactable consumer. This consumer reported information for both mother and fetus/baby. This is a maternal report. A 37-years-old pregnant female patient received bnt162b2 (Pfizer-BioNTech Covid-19 mRNA Vaccine, Solution for injection, Batch/Lot number was not reported), dose 1 via an unspecified route of administration, administered in Arm Left on 14Jul2021 14:00 as DOSE 1, SINGLE for covid-19 immunisation (Age at vaccination 37 year). Medical history included systemic lupus erythematosus, pregnancy, depression, anxiety. Concomitant medication(s) included hydroxychloroquine sulfate (PLAQUENIL [HYDROXYCHLOROQUINE SULFATE]); aspirin [acetylsalicylic acid] (ASPIRIN [ACETYLSALICYLIC ACID]), prenatal vita, D3. No other vaccine in four weeks. No covid prior vaccination. No Known allergies. No covid tested post vaccination. On 16Jul2021 20:45 patient experienced mild headache, sore arm muscle around injection site, inexplicable pain in muscle on underside of upper arm, near armpit. cannot extend arm fully, feels as if muscle is shortened or very tense/strained/muscle pain and patient was pregnent. The mother reported she became pregnant while taking bnt162b2. The mother was 18 Weeks pregnant at the onset of the event. The mother was due to deliver on 15Dec2021. The mother delivered the pregnancy on 15Dec2021. No treatment required for AE. The outcome for pregnancy was unknown for all other events it was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1655995 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-21
Onset:2021-07-16
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001A21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide Tabs Benazepril HCL Tabs Esomeprazole Mag (Nexium) Caps Levocetirizine Dihydro Tabs Fluticasone Propionate nasal spray Hydroxyurea Caps Folic Acid Tabs Aspirin Low dose FML Drops - Fluorometholone Opth Sus Daily Senio
Current Illness: None
Preexisting Conditions: Essential Thrombocytosis
Allergies: None
Diagnostic Lab Data: LabCorp/Helix SARS-COV-2 RNA, QL NAAT, RT PCR/TMA (COVID-19
CDC Split Type:

Write-up: Tested positive for Covid-19 on July 16, 2021


VAERS ID: 1656130 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-14
Onset:2021-07-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal X-ray, Blood creatinine increased, Blood urea increased, Blood urine present, Computerised tomogram thorax normal, Glomerular filtration rate decreased, Haematuria, International normalised ratio increased, Metabolic function test, Protein urine, Ultrasound kidney abnormal, Urine analysis abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver-related coagulation and bleeding disturbances (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Retroperitoneal fibrosis (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Coumadin (Due to heart valve) Sodium ascorbate, kirkland signature multi vitimins, Kirkland signature Calcium, vitamin D and Zinc.
Current Illness:
Preexisting Conditions: Heart valve replaced on 2007.
Allergies:
Diagnostic Lab Data: 7/17/2021, urgent care visit urinalysis showed gross hematuria and 30ml/dl UA protein in urine. 7/17 XR Abdomen AP SUP and Upright (Normal) 7/27 urinalysis, gross hematuria, no protein. Basic Metabolic panel, BUN 39 and Creatinine 2.48, eGFR 27. 7/29 CT KUB, (Normal), Referred to Nephrologist . 8/2 Dr ordered Cytology, Urine (Normal) US Renal Kidney, (Kidney''s showed up bright on US.) All other results looked to be normal. 8/4 INR ordered (Elevated INR at 3.6) Reduced INR to 2.3 on 8/9 Urinalysis still showing blood in urine and elevated BUN and Creatinine , 2.4 on 8/19, 8/23 Urinalysis still showing blood in urine and elevated BUN and Creatinine. 2.0 INR on 8/26.
CDC Split Type:

Write-up: on 7/16/2021 I had blood in my urine.


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