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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 361 out of 6,867

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VAERS ID: 1546703 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-15
   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 - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Electric shock sensation, Hypoaesthesia, Muscular weakness, Musculoskeletal disorder, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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:
CDC Split Type:

Write-up: Tingling, numbness on both arms would change to fingers, legs, toes. Like an electric shock that would come and go. Muscle weakness. Legs would give out under me. Would seem worse when not moving.


VAERS ID: 1546721 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-13
Onset:2021-07-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Dyspnoea exertional, Erythema, Fear, Hyperhidrosis, Painful respiration
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: I lost my breath constantly for 2 days. I got up from my bed and walked 4 feet to my closet and was completely out of breath. I could not breathe in deeply because my chest hurt so badly. If I got excited in any manner I lost all breath, turned beet red, and begin to sweat profusely. Each episode lasted about 5 minutes, I had to sit down in front of fresh air and be completely still until my breath came back. I could not go out anywhere because as soon as I began walking I would lose breath immediately and begin to sweat profusely. I am now fearful to get my 2nd shot because the 2nd dose is more intense. If I experienced this on the first dose then will I wind up on a ventilator on the 2nd dose?


VAERS ID: 1549024 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-12
Onset:2021-07-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Constipation, Depression, Hypoaesthesia, Paraesthesia, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), Sexual dysfunction (broad)

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

Write-up: numbness from hips to armpits, tingling in fingers, couldn''t sleep, constipated, depression


VAERS ID: 1549196 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Inappropriate schedule of product administration, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Upon documentation of second dose in our state covid vaccination portal, it was shown that the patient had received his first dose on a day inconsistent with the date on the card he presented, and only 5 days prior to this administration. Recent analysis of the state vaccine portal now shows that he has received additional doses of both the Pfizer and the Janssen vaccines at multiple other locations.


VAERS ID: 1549357 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: A red raised bump/scab at sight of injection that has not gone away since administered a month ago. It does not hurt/ itch.


VAERS ID: 1549619 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-20
Onset:2021-07-15
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: Shortness of breath Fast heartbeat Migraine headaches


VAERS ID: 1549685 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-15
Onset:2021-07-15
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Blood test, Catheterisation cardiac normal, Echocardiogram, Electrocardiogram, Myocardial infarction, Neck pain, Positron emission tomogram
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Arthritis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: sertraline 100mg qd ursodiol 750mg qd
Current Illness:
Preexisting Conditions: primary biliary cirrhosis
Allergies: cleocin
Diagnostic Lab Data: cardiac cath 7/15/21 echocadiogram 7/15/21 multiple ekg''s over next week scheduled for pet scan 8/13/21 blood work while in hospital
CDC Split Type:

Write-up: Myocardial Infarction suffered on July 15,2021 with no risk factors or family history. Official diagnosis was a non stemi MI. Cardiac cath revealed no coronary artery disease. Currently continue to be evaluated with tests and on heart medications. Not sure if this is related or not but have had severe left neck pain which began about May/June. I have taken sterorids for this pain and am currently in physical therapy.


VAERS ID: 1554074 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-14
Onset:2021-07-15
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Cough, Dyspnoea, Fatigue, Malaise
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Pt said he is not doing well and is extremely tired and has severe chest pains and a bad cough. Pt has experienced trouble breathing. Pt was admitted to the hospital on 7/15


VAERS ID: 1555219 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2020-12-20
Onset:2021-07-15
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Allergy to arthropod bite, Arthropod bite, Autoimmune disorder, Cellulitis
SMQs:, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, probiotic
Current Illness: None known
Preexisting Conditions: None known
Allergies: Peanut allergy
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I have been experiencing very significant autoimmune reactions to mosquito bites since receiving the Covid vaccine. Most recently, in July I had to go to urgent care and was diagnosed with cellulitis due to one (mosquito) bug bite. On 08/10/2021, I got 17 mosquito bites and all have significant reactions that did not happen previous to receiving the vaccine.


VAERS ID: 1556277 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-09
Onset:2021-07-15
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acne, Dry skin, Rash, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Skin rash all over body, followed by dry peeling skin, now acne on face


VAERS ID: 1558384 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Eczema, 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: Vitamin C
Current Illness:
Preexisting Conditions:
Allergies: Eggs, peaches, soy, dairy, nuts, penicillin, kiwi
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe, full body eczema. Began 1 day after injection of second shot. Persisted for more than 2 weeks. Severe, extreme eczema on torso, legs, face, neck, chest, arms and feet. Even with a history of eczema, the most severe eczema I have experienced in almost 5 years. The rash began at the injection site and spread across my entire body.


VAERS ID: 1569172 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-12
Onset:2021-07-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH DD12FR / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angioedema, Full blood count, Metabolic function test
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: G6PD, Sickle Cell Trait.
Allergies: Sulfa Based Medications.
Diagnostic Lab Data: Complete Blood Count, Basic Metabolic Panel. Medications: 1. Epinephrine, 2. Diphenhydramine, 3. Methylprednisolone, 4. Albuterol, 5. Famotidine, 6. Lidocaine.
CDC Split Type:

Write-up: Angioedema.


VAERS ID: 1573590 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 00000 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Wrong patient
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: Wrong Patient (documentation in EMR)-


VAERS ID: 1574044 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Dizziness, Fatigue, Influenza like illness, Presyncope, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xigduo XR 5mg/1000mg, Trulicity 1.5mg/0.5ml pen, lisinopril 20mg, omeprazole 40mg, atorvastatin 20mg
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: NKDA, NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, loss of appetite, fatigue, flu-like symptoms, dizzy (almost pasted out) starting 18 hours after receiving vaccine until 48 hours after vaccine received.


VAERS ID: 1574493 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Allergy test negative, Diarrhoea, Headache, Nausea, Pain in extremity, Paraesthesia oral
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot, tetnus shot -arm swelling, rash, flu like symptoms
Other Medications: High blood pressure medication, half of anxiety medication
Current Illness: None
Preexisting Conditions: weakened immune system, fibromyalgia, High blood pressure
Allergies: antibiotics, Inseds, grass, latex, bees, wasps, tetnus,
Diagnostic Lab Data: Tested to see if could be allergic to PEG. Not allergic.
CDC Split Type:

Write-up: Tingling in mouth and on tongue, Went to alergiest, went to walk-in clinic, took benedryl. Soreness in right arm (lasted for 6 days), headaches, nausea, diarrhea (nausea and diarrhea lasted for 1-2 days).


VAERS ID: 1575095 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-24
Onset:2021-07-15
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram, Myocardial infarction, Thrombosis, X-ray
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), 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? No
Previous Vaccinations:
Other Medications: NO
Current Illness: Spinal Stenosis
Preexisting Conditions: Spinal Stenosis for since 2007
Allergies: NO
Diagnostic Lab Data: cat scans / x rays.
CDC Split Type:

Write-up: On July 13 brother suffered blood clot & heart attack, stayed in hospital 3 days.


VAERS ID: 1578415 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-06
Onset:2021-07-15
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 OT / IM

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

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

Write-up: Admit for COVID. Vaccine completed Jan 2021. Treated with O2, LMWH, steroids, lasix, zinc. Discharged home.


VAERS ID: 1582320 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-01-21
Onset:2021-07-15
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Ultrasound on 8/5/2021
CDC Split Type:

Write-up: Developed superficial blood clot is left lower extremity


VAERS ID: 1582389 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-15
Onset:2021-07-15
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angioedema, Face oedema, Tongue oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Crestor
Current Illness: High cholesterol
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Not performed
CDC Split Type:

Write-up: Myofacial edema and idiopathic angioedema of face, lips and tongue.


VAERS ID: 1582822 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-07
Onset:2021-07-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0962319-07684 / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0956153-07684 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Cough, Hypertension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypertension (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: Valsartin, Avastostatin, Coreg, Multiple Vitamin for women over 50,
Current Illness: none
Preexisting Conditions: high blood pressure, rapid heart (controlled)
Allergies: Percocet
Diagnostic Lab Data: X-ray of chest - negative Increase of blood pressure medication (doubled) to per day from previously
CDC Split Type:

Write-up: coughing, diminished but still present Increase/spiking blood pressure, somewhat controlled now


VAERS ID: 1586607 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-14
Onset:2021-07-15
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Fatigue, Feeling abnormal, Pain in extremity, Pyrexia, Retinal detachment, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Accidents and injuries (broad), Retinal disorders (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions:
Allergies: Sulphur drugs; Cipro; fluoroquinolones
Diagnostic Lab Data: No blood tests done. Covid test was on 21 JUL2021
CDC Split Type: vsafe

Write-up: Sore arm on left arm at the time for vaccine. 15 JUL2021torn retina on Left -eye. date or procedure on 29 Jul 2021. 19 Jul2021 Covid symptoms. Diagnosed with Covid. Tested positive. Fever associated with Covid. Extremely tired and brain fog lasted 3 weeks after Covid.


VAERS ID: 1591434 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 RA / IM

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

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

Write-up: Tingling/numbness in right hand (some arm as injection) within minutes of injection. Numbness/tingling progressed to right foot/ lower leg approximately 15 minutes afterward. Occasional pain accompanying the numbness and tingling. Contacted doctor the following day-was advised to take antihistamine, anti inflammatory, turmeric, alpha lipoid acid, quercetin, vitamin D, vitamin B complex for a week. Followed that for a week, symptoms did not go away, so continued taking again. 5 weeks later, symptoms are still present but slightly less.


VAERS ID: 1591516 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Axillary vein thrombosis, Deep vein thrombosis, Discomfort, Joint swelling, Paraesthesia, Peripheral swelling, Skin discolouration, Subclavian vein thrombosis, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
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: Duplex Ultrasound-08/02/2021 DVT UE Right subclavian vein -occlusive Right axillary vein-non occlusive
CDC Split Type:

Write-up: Right arm swole up from shoulder to wrist. Enlarged, discolored. Shoulder Pain. Discomfort. Tingling.


VAERS ID: 1591807 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-12
Onset:2021-07-15
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood cholesterol increased, Condition aggravated, Tinnitus
SMQs:, Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Hearing impairment (narrow), Lipodystrophy (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: Viibryd; Lisinopril; Rosuvastatin; Pantoprazole; Fenofibrate; Gabapentin; Coq10
Current Illness:
Preexisting Conditions: Hypertension; Depression; Anxiety; High cholesterol.
Allergies: Wheat
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: Elevated blood pressure, Tinnitus; I was prescribed medication for the blood pressure. Also, I will be seeing a ENT doctor soon. My blood pressure has improved with the medicine, but the ringing in my ear has continued.


VAERS ID: 1617841 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-02-06
Onset:2021-07-15
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine present, Inflammation, SARS-CoV-2 test negative, Swelling, Urine analysis
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: none
Preexisting Conditions: Kidney Stones
Allergies: KNA
Diagnostic Lab Data: Negative Urine Test, Negative COVID test
CDC Split Type:

Write-up: Possible Proctitis Inflammation and swelling on both sides above penis . 10 Days earlier blood in urine with what was thought to be a Kidney Stone


VAERS ID: 1623367 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-06
Onset:2021-07-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Systemic lupus erythematosus
SMQs:, Systemic lupus erythematosus (narrow), Arthritis (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: vitamin D, C and Zinc
Current Illness: SLE Lupus,
Preexisting Conditions: SLE lupus
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: 1 week after 2nd vaccine I developed severe joint pain, caused a lupus flare-up still dealing with joint pain, and I am unable make full fist on right hand


VAERS ID: 1623569 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-15
Onset:2021-07-15
   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: 1623743 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-08
Onset:2021-07-15
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Illness
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 29 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen 325mg-PRN, Allopurinol 300mg, daily-11AM ASA 81mg, daily-11AM Bupropion SR150mg-daily-11AM Clonidine 0.1mg-PRN Ensure-3 x a day with meals Finasteride 5mg- 11AM Lasix 40mg daily-11AM Gabapentin 600mg-3 x a day Hydroxyurea 500
Current Illness: Skin cancers treated by dermatologist, Dr. Lin
Preexisting Conditions: Hypertension, Neuropathy, late effects CVA
Allergies: Nitrofurontoin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: On 1/18/21 resident received first dose-Pfizer On 2/8/21 resident received second dose-Pfizer


VAERS ID: 1623917 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-20
Onset:2021-07-15
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen 500mg-PRN Albuterol HFA 90MCG-PRN Ambrisentan 5mg-1130AM-daily ASA 81mg-1130AM-daily Budesonide 0.5mg/2ml 1130AM-daily Bumetanide 1.5mg-1130AM-daily Bumetanide 1mg-4PM-daily Ensure-1130AM-daily Ferrous Sulfate 325MG-twice dail
Current Illness: None
Preexisting Conditions: Asthma with COPD Hypertension Sarcoidosis AFIB Congestive heart failure Anemia Hypoxemia
Allergies: Adhesive Tape Augmentin Etodalac Morphine
Diagnostic Lab Data: Resident was asymptomatic diagnosed with covid-19 on 7/21/21, date of test 7/19/21
CDC Split Type:

Write-up: Resident was asymptomatic diagnosed with covid-19 on 7/21/21, date of test 7/19/21


VAERS ID: 1628432 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-22
Onset:2021-07-15
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Tinnitus, Left ear greater than Right, first noted on date above. No history of similar symptoms in the past. Has progressed bilaterally but is still mild. Worse in the early morning, and in evening as well as when attempting to sleep.


VAERS ID: 1632351 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-11
Onset:2021-07-15
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012620A / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis, Taste disorder
SMQs:, Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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: Simvastatin, Levothyroxin, multi vitamin, vitamin b12, arreds , biotin, baby aspirin, citra cal, Omega 3.
Current Illness: None
Preexisting Conditions: Under active thyroid, High cholesterol
Allergies: Triple antibiotic cream, bacitracin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Paralysis of the right side of my face, altered tastes Bells Palsy Prescriptions Prednisone 14 days Doxycycline 14 days Valtrex 7 days Paralysis was gone by 4 weeks


VAERS ID: 1632458 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-01
Onset:2021-07-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Headache
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: Two weeks after getting the vaccine, I had 2 days where I was extremely "out of it" with some balance issues, lack of energy, and minor headaches. I had been surfing and thought that I had a concussion. I did not recall any specific event while surfing that would have caused the concussion but i had bumped my head a few times. I am reporting this now because two weeks after my second dose, I had the same reaction except it was much worse and I was not surfing, so I now thing the original side effect was from the vaccine.


VAERS ID: 1632662 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-16
Onset:2021-07-15
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / SYR

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

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

Write-up: I am having long term rashes on my skin that pop up, then get tiny sores (almost like chicken pox) and then the skin becomes a scratchy, rough path. I currently have 3 patches and several other pocks.


VAERS ID: 1633356 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-23
Onset:2021-07-15
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9531 / 2 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: IIIrd nerve paralysis
SMQs:, Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Third nerve cranial palsy


VAERS ID: 1633619 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Headache, Joint range of motion decreased, Limb discomfort, Muscle spasms, Muscle tightness, Muscular weakness, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: none
Preexisting Conditions: none
Allergies: no
Diagnostic Lab Data: Working with doctors now. So far, all blood work is normal. Still getting some more bloodwork completed and seeing a neurologist as well.
CDC Split Type:

Write-up: Day after first dose, had muscle aches and joint pain. Legs felt very heavy and weak. Not tired, no headache. Few days later, started to have pins/needles in hands and feet. Goes away when shift positions. Had worst headache at the end of July. Stood out from other headaches. Felt like someone repeatedly taking a hammer to my head. Headache gone the next day. During this time, since the 1st dose, I have continued to have muscle pain. Joint pain has subsided. Muscle pain the first week after the shot felt like I was on the verge of a charley horse that never actually happened. That subsided a bit to more moderate muscle pain that has continued on and off to this very day. Mostly cramping in calf muscles and hamstrings feel incredibly tight. Calves feel likeI have 2-3 pound weights attached to them. Still getting pins and needles more frequently than I ever remember prior to getting the vaccine. Important to note, that I am still able to exercise. It hasn''t stopped my exercise routine, but it has limited my range of motion and what I can I can do to a degree.


VAERS ID: 1636434 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-07-09
Onset:2021-07-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test, Computerised tomogram, Dizziness, Dizziness postural, Dysarthria, Eye disorder, Fatigue, Gait disturbance, Headache, Migraine, Mobility decreased, Pain
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Corneal disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall 30 mg
Current Illness: none
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: blood test CT test
CDC Split Type:

Write-up: 4-days after getting the vaccine shot, I was really tired and had extreme fatigue. This lasted a couple of days and then on July 18, I woke up in horrible pain with a migraine. I could barely walk and was slurring my speech. We went to urgent care where I was told to go immediately to the ER for a CT scan and stroke test. For more than 36-hours, I couldn''t open my eyes or do anything. It was the most crippling headache I have ever had and I didn''t even get out of bed for those two-days. In the five-weeks since, I am regularly dizzy or lightheaded when walking or standing up - never experienced this before. I also don''t have near the energy I had prior to getting the vaccine and some days are extremely fatigued. The migraine left after 48-hours, mild headaches from time-to-time, the fatigue and dizziness is what I am still experiencing.


VAERS ID: 1636477 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Pain in extremity
SMQs:, Lipodystrophy (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: None
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Saw my gyno at my annual exam a few weeks ago. Waiting until 8 weeks after my shot to have my yearly mammogram. It is scheduled for Sept 17. Hoping the pain is gone by then.
CDC Split Type:

Write-up: I had pain in the left arm for several days after first shot. Expected that. After the second shot I had the same pain but it spread into my left breast. The pain is worse this time, constant throughout the day and going into week 6 with no change. The arm pain has subsided but not the breast and under arm pain.


VAERS ID: 1636889 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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

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

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


VAERS ID: 1636905 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-02-17
Onset:2021-07-15
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Atrial flutter, Colonoscopy, Echocardiogram, Electrocardiogram
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? Yes
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: Diltiazem, , for PSVT; Cetirizine, ; CBD Oil, ; Standard Process Catalyn 2160, ; Vitamin C,
Current Illness: NA
Preexisting Conditions: Prostate cancer, PSVT
Allergies: NA
Diagnostic Lab Data: ECG, Echo 08/10/2021
CDC Split Type:

Write-up: Experienced typical atrial flutter during colonoscopy on 07/15/2021. It was verified on 08/10/2021 at hospital.


VAERS ID: 1639698 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-02
Onset:2021-07-15
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Cardiac flutter, Chest pain, Dyspnoea, Heart rate, Herpes zoster, Mastoid disorder, Pruritus
SMQs:, Anaphylactic reaction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOSARTAN; ATORVASTATIN; ASPIRIN [ACETYLSALICYLIC ACID]
Current Illness: Penicillin allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Colorectal cancer
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: 116/72 and no signs of an abnormal rhythm.; Test Name: Heart rate; Result Unstructured Data: Heart Rate up to about 105 from a resting normal 72-74 bpm
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: fluttering of the heart; bit hard to catch a breath; Mastoid popped out; began as itchy; Odd Chest pain/odd feeling in the middle of the chest/between a slight push on the chest; She just come down with shingles /behind the left ear; This spontaneous case was reported by a consumer and describes the occurrence of CARDIAC FLUTTER (fluttering of the heart) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007b21a and 044b21a) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Colorectal cancer. Concurrent medical conditions included Penicillin allergy. Concomitant products included LOSARTAN from 01-Jan-2019 to an unknown date and ASPIRIN [ACETYLSALICYLIC ACID] from 01-Jan-2019 to an unknown date for Blood pressure high, ATORVASTATIN from 01-Jan-2019 to an unknown date for Hypertension. On 02-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-Jul-2021, the patient experienced HERPES ZOSTER (She just come down with shingles /behind the left ear). On 31-Jul-2021, the patient experienced CHEST PAIN (Odd Chest pain/odd feeling in the middle of the chest/between a slight push on the chest). On an unknown date, the patient experienced CARDIAC FLUTTER (fluttering of the heart) (seriousness criterion medically significant), DYSPNOEA (bit hard to catch a breath), MASTOID DISORDER (Mastoid popped out) and PRURITUS (began as itchy). The patient was treated with ACYCLOVIR [ACICLOVIR] for Shingles, at an unspecified dose and frequency. On 28-Jul-2021, HERPES ZOSTER (She just come down with shingles /behind the left ear) had resolved. At the time of the report, CARDIAC FLUTTER (fluttering of the heart), DYSPNOEA (bit hard to catch a breath), CHEST PAIN (Odd Chest pain/odd feeling in the middle of the chest/between a slight push on the chest), MASTOID DISORDER (Mastoid popped out) and PRURITUS (began as itchy) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: 116/72 (normal) 116/72 and no signs of an abnormal rhythm.. On an unknown date, Heart rate: 105 (High) Heart Rate up to about 105 from a resting normal 72-74 bpm. No treatment was reported. Patient experienced odd feeling in the middle of the chest, hard to explain, it''s between a slight push on the chest and a fluttering of the heart at the same time, it was a bit hard to catch a breath, she stopped what she was doing, relax for a moment and wait until it passes which can be seconds. It seems to come on when lifting items, even her handbag or climbing stairs or walking on an incline. Even walking short distances. She have not sought medical advice at this time. Whether the two are related was unseen at this time, but the timing seems suspicious. This case concerns a 60-year-old female with a serious unexpected event of cardiac flutter, and non-serious dyspnoea, chest pain, mastoid disorder, pruritus, and herpes zoster. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Most recent FOLLOW-UP information incorporated above includes: On 09-Aug-2021: Follow up received, updated reporter details, patient demographics, past medical history, suspect product (batch number, anatomical location), Concomitant medication indication for use and dosage details were added and additional events were added and also updated the start date and outcome for Shingles as recovered.; Sender''s Comments: This case concerns a 60-year-old female with a serious unexpected event of cardiac flutter, and non-serious dyspnoea, chest pain, mastoid disorder, pruritus, and herpes zoster. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1640969 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-07-15
   Days after vaccination:98
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / UNK - / IM

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

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

Write-up: Recovering from surgery spiked a fever whil inpatient.


VAERS ID: 1641298 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium Carb. 500mg 1-2 3xper day as needed.
Current Illness: Gastro-esophageal reflux disease
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: No adverse reaction - just received the J&J vaccine a second dose administered in error. First dose 6/7/2021 and the second 7/15/2021.


VAERS ID: 1641570 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-07-15
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Blood glucose, Blood test, Chest pain, Dizziness, Electrocardiogram, Paraesthesia, Troponin increased, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ritual Prenatal Vitamin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Multiple EKG''s, multiple blood panels( checking horomone levels, glucose, troponin,, etc.) and also had an angiogram performed. I had zero artery blockages. Extremely elevated levels of troponin. When first admitted into the ER around 8:00am, troponin levels were 141, two hours later they were at 10,000. About 4 hours after that they peaked at 26,000. No explanation was given on how that could occur. I am currently on 4 medications as well as a baby asprin. All medications I take once a day. -Metoprolol 25mg -Lisinopril 5mg -Clopidogrel 75mg -Atorvastatin 20mg -Prior to this I have never been prescribed medication or been in the hospital other than child birth.
CDC Split Type:

Write-up: After first dose on 4/25/21 things seemed normal the few days after. 6 days after first dose had sharp pain in my chest with slight dizziness. Spoke with advise nurse and did not go to the ER although it was recommended. Pain stopped after about 20 minutes, no other issues occured. Received my second dose on 5/21/21, and on July 15th while sitting calmly at work the pain came back much more intensely. At first I though it could not be happening again, I was never informed anything like this could occur. The pain was very sharp and intense, I threw up, had tingling in my left hand. Felt a bit dizzy. This lasted a solid 45 minutes. I was taking to the ER.


VAERS ID: 1642982 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-07-15
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210715; Test Name: SARS-CoV-2 IgG antibody test; Result Unstructured Data: NEGATIVE.
CDC Split Type: USJNJFOC20210852955

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 58 year old white not Hispanic or Latino male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and expiry: UNKNOWN) dose was not reported, 1 total, administered on 01-JUN-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 15-JUL-2021, the patient did Sars-Cov-2 Antibody(Ab), IgGX test which was negative (confirmed immunological vaccine failure) and the patient stated that he was worried that he received a fraudulent dose of the vaccine. The patient said that he was additionally suspicious because the pharmacy was a very small facility that he found on the CDC website at a time where no other location had the Janssen Covid-19 Vaccine. The patient also said that he rebooked his original appointment to several weeks later and the facility still had a supply, during a time when other facilities were running out within days. The patient stated that he did not see the dose get drawn up in front of him from a vial and also he did not experienced any side effects. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint:90000191025.; Sender''s Comments: V0:20210852955-COVID-19 VACCINE AD26.COV2.S-Confirmed Immunological vaccine failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1644279 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-15
Onset:2021-07-15
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Body temperature fluctuation, Headache, Influenza like illness, Pain, Skin discolouration, Vaccination site discolouration
SMQs:, Hypotonic-hyporesponsive episode (broad), Arthritis (broad)

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

Write-up: dime sized bleached out mark were the tattoo was red in color; I have a bleached out spot on my tattoo where I got my second vaccine/ I do not know of it bled so much it left that spot bare of ink or it was from the shot itself; could not maintain a normal temperature it fluctuated; flu-like symptoms; whole body aches; joints hurt; headache; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOLOURATION (I have a bleached out spot on my tattoo where I got my second vaccine/ I do not know of it bled so much it left that spot bare of ink or it was from the shot itself), BODY TEMPERATURE FLUCTUATION (could not maintain a normal temperature it fluctuated), INFLUENZA LIKE ILLNESS (flu-like symptoms), SKIN DISCOLOURATION (dime sized bleached out mark were the tattoo was red in color) and PAIN (whole body aches) in a 36-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 078C21A and 050C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 15-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Jul-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Jul-2021, the patient experienced BODY TEMPERATURE FLUCTUATION (could not maintain a normal temperature it fluctuated), INFLUENZA LIKE ILLNESS (flu-like symptoms), PAIN (whole body aches), ARTHRALGIA (joints hurt) and HEADACHE (headache). On 16-Jul-2021, the patient experienced VACCINATION SITE DISCOLOURATION (I have a bleached out spot on my tattoo where I got my second vaccine/ I do not know of it bled so much it left that spot bare of ink or it was from the shot itself). On an unknown date, the patient experienced SKIN DISCOLOURATION (dime sized bleached out mark were the tattoo was red in color). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) at an unspecified dose and frequency. On 17-Jul-2021, BODY TEMPERATURE FLUCTUATION (could not maintain a normal temperature it fluctuated), INFLUENZA LIKE ILLNESS (flu-like symptoms), PAIN (whole body aches), ARTHRALGIA (joints hurt) and HEADACHE (headache) had resolved. At the time of the report, VACCINATION SITE DISCOLOURATION (I have a bleached out spot on my tattoo where I got my second vaccine/ I do not know of it bled so much it left that spot bare of ink or it was from the shot itself) and SKIN DISCOLOURATION (dime sized bleached out mark were the tattoo was red in color) outcome was unknown. No concomitant medications were provided. This case was linked to MOD-2021-285512 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 12-Aug-2021: Significant follow-up information contains: reporter details, patient age,gender and added events-pain, arthralgia, influenza like illness, headache, body temp fluctuations, erythema, vaccination site discoloration


VAERS ID: 1644366 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-07-15
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Hypoxia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210715; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: positive
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: COVID-19; Dyspnoea; Hypoxia; This case was received via regulatory Authority (Reference number: 1490338) on 03-Aug-2021 and was forwarded to the company on 03-Aug-2021. This regulatory authority case was reported by an other health care professional and describes the occurrence of COVID-19 (COVID-19), DYSPNOEA (Dyspnoea) and HYPOXIA (Hypoxia) in an 84-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 018B21A) for COVID-19 vaccination. No Medical History information was reported. On 31-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced COVID-19 (COVID-19) (seriousness criterion hospitalization), DYSPNOEA (Dyspnoea) (seriousness criterion hospitalization) and HYPOXIA (Hypoxia) (seriousness criteria hospitalization and medically significant). The patient was hospitalized on 19-Jul-2021 due to DYSPNOEA and HYPOXIA. At the time of the report, COVID-19 (COVID-19), DYSPNOEA (Dyspnoea) and HYPOXIA (Hypoxia) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Jul-2021, SARS-CoV-2 test: positive (Positive) positive. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication information was not provided. The patient tested positive for COVID on 15-07-2021 after being exposed to family member(s) that were also positive. Patient went to the hospital on 19-07-2021 with symptoms of shortness of breath, hypoxia, and dyspnea. Treatment information was not provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (unknown) was not applicable Company Comment Based on the mechanism of action of mRNA-1273 causal association between the event of COVID-19 infection and mRNA-1273 is assessed as not applicable. Based on the current available information and temporal association between the use of the product and the start date of the events dyspnoea and hypoxia, a causal relationship cannot be excluded. However, COVID-19 could be a contributory factor these events.; Sender''s Comments: Based on the mechanism of action of mRNA-1273 causal association between the event of COVID-19 infection and mRNA-1273 is assessed as not applicable. Based on the current available information and temporal association between the use of the product and the start date of the events dyspnoea and hypoxia, a causal relationship cannot be excluded. However, COVID-19 could be a contributory factor these events.


VAERS ID: 1644370 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-07-15
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

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

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

Write-up: Patient thought she was having a stroke and was diagnosed with Bell''s Palsy on the left side of her face; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of BELL''S PALSY (Patient thought she was having a stroke and was diagnosed with Bell''s Palsy on the left side of her face) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced BELL''S PALSY (Patient thought she was having a stroke and was diagnosed with Bell''s Palsy on the left side of her face) (seriousness criterion medically significant). At the time of the report, BELL''S PALSY (Patient thought she was having a stroke and was diagnosed with Bell''s Palsy on the left side of her face) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment medications included steroids and an eye cream. Concomitant medications were not provided. Patient thought she got first vaccine on 30-JUN-2021 or during the 1st week of July 2021. On 15-JUL-2021, she thought she was having a stroke, went to the emergency room and was diagnosed with Bell''s Palsy on the left side of her face. Her left eye was not closing all the way and would not blink at same pace as the right eye. She told that it had gotten better but it was not back to 100 percent. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1645017 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: vaccine which was more than 30 days in the refrigerator (30 days were on 03Jul2021).; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (vaccine which was more than 30 days in the refrigerator (30 days were on 03Jul2021).) in a 55-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (vaccine which was more than 30 days in the refrigerator (30 days were on 03Jul2021).). On 15-Jul-2021, EXPIRED PRODUCT ADMINISTERED (vaccine which was more than 30 days in the refrigerator (30 days were on 03Jul2021).) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was provided by the reporter. No treatment information was reported.


VAERS ID: 1645019 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, 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: USMODERNATX, INC.MOD20212

Write-up: Received a vaccine which was more than 12 days in the refrigerator; Received a vaccine which was more than 12 days in the refrigerator; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 12-Aug-2021 and was forwarded to Moderna on 13-Aug-2021. This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received a vaccine which was more than 12 days in the refrigerator) and PRODUCT STORAGE ERROR (Received a vaccine which was more than 12 days in the refrigerator) in a 41-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 15-Jul-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received a vaccine which was more than 12 days in the refrigerator) and PRODUCT STORAGE ERROR (Received a vaccine which was more than 12 days in the refrigerator). On 15-Jul-2021, EXPIRED PRODUCT ADMINISTERED (Received a vaccine which was more than 12 days in the refrigerator) and PRODUCT STORAGE ERROR (Received a vaccine which was more than 12 days in the refrigerator) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication details was reported. No treatment medication details was reported.


VAERS ID: 1645234 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hyperhidrosis, Product administered to patient of inappropriate age, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Excessive sweating; Feeling feverish; Moderna Covid-19 vaccine administered to a 12 year old; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (Excessive sweating), PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Moderna Covid-19 vaccine administered to a 12 year old) and PYREXIA (Feeling feverish) in a 12-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 051C21A) for COVID-19 vaccination. No Medical History information was reported. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jul-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Moderna Covid-19 vaccine administered to a 12 year old). On 24-Jul-2021, the patient experienced HYPERHIDROSIS (Excessive sweating). 24-Jul-2021, the patient experienced PYREXIA (Feeling feverish). On 15-Jul-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Moderna Covid-19 vaccine administered to a 12 year old) had resolved. At the time of the report, HYPERHIDROSIS (Excessive sweating) and PYREXIA (Feeling feverish) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant drugs were provided No treatment drugs were provided. The patient said that she brought her son to the pharmacy and the Pharmacy Technician asked the Mother if her son who was 12 years of age would like the Pfizer or the Moderna Covid-19 vaccine.. The callers son received his first Moderna Covid-19 dose on 15-Jul-2021.


VAERS ID: 1645433 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-15
   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 EY0854 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SYMBICORT; ELDERBERRY [SAMBUCUS NIGRA]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Pollen allergy (known allergies: pollen)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100912362

Write-up: Cluster of hives on inner right thigh; This is a spontaneous report from a contactable consumer, the patient. A 12-year-old female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: EY0854) via an unspecified route of administration in the right arm on 15Jul2021 at 15:45 (at the age of 12-years-old) as a single dose for COVID-19 immunisation. Medical history included asthma. The patient was allergic to pollen. Concomitant medications included budesonide, formoterol fumarate (SYMBICORT), sambucus nigra (ELDERBERRY) and kids multivit; all taken for unknown indications from an unknown date and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: EW0185) via an unspecified route of administration in the right arm on 17Jun2021 at 15:45 (at the age of 12-years-old) as a single dose for COVID-19 immunisation. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 15Jul2021 at 17:30, the patient experienced cluster of hives on inner right thigh. The event did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measure was taken as a result of the event and included treatment with XYZAL 5mg. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event cluster of hives on inner right thigh was resolving at the time of this report.


VAERS ID: 1645447 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-15
   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 EW0169 / 2 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Burning sensation, Decreased appetite, Diarrhoea, Dizziness, Dyspepsia, Feeling hot, Influenza like illness, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OMEPRAZOLE; LISINOPRIL; PRAVASTATIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood cholesterol abnormal; Blood pressure high (Start date: Like 8-9 years ago); COVID-19; Gastritis (Start date: Like 8-9 years ago)
Allergies:
Diagnostic Lab Data: Test Name: Fever; Result Unstructured Data: Test Result:Unknown results; Test Name: SARS-CoV-2; Test Result: Positive
CDC Split Type: USPFIZER INC202100917654

Write-up: fever; felt hot all over his body; his stomach felt really hot; he is still not hungry; stomach feels like when you get diarrhea; even when I urinate I feel hot, like it burns. Is this normal?; flu-like symptoms; flu-like symptoms including throat pain; I felt light-headed; This is a spontaneous report from a contactable consumer (patient). A 54-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0169), via an unspecified route of administration, administered in Deltoid Right on 15Jul2021 (at the age of 54 years) as dose 2, single for covid-19 immunization at Clinic. Medical history included Covid-19, gastritis (Start date: Like 8-9 years ago), High Blood Pressure (Start date: Like 8-9 years ago), blood cholesterol abnormal. Concomitant medications included omeprazole taken for gastritis from an unspecified start date and ongoing; lisinopril taken for hypertension from an unspecified start date and ongoing; pravastatin taken for blood cholesterol abnormal from an unspecified start date and ongoing. The patient historical vaccine included bnt162b2 for Covid-19 immunisation (Lot: FA6780, vaccinated at the age of 54 years) administered in right hand shoulder, and previously took Alka Seltzer Aspirin for urticaria (Feels like had hives when drank Alka Seltzer Aspirin this occurred like 4-5 years ago). Patient reported that on 15Jul2021 after second dose, that night about 9:00PM he felt a little lightheaded, not a light headache so he took Tylenol and went to bed. Patient stated that on 16Jul2021 he woke up and he had mild sensation of flu-like symptoms including throat pain. On 17Jul2021 he went to work, and everything started like at 16:00: his stomach felt really hot, and he did not want to eat, did not have an appetite but he had to eat either way because he had to work because he was a driver. He got to work at like 14:00 and at 21:00 took Tylenol. On 18Jul2021, he went back home at 02:00AM he got a fever and felt hot all over his body. He again took some Tylenol and right now he feels hot all over his body, and his stomach feels like when you get diarrhea, that sensation in his stomach, which he initially reported as persistent, but later clarified had improved stomach still feels bad, was not comfortable but not as bad, he was still not hungry but knows he had to eat. He clarified that when he urinates or pees it was hot, burning, feels painful, it was weird which was still ongoing but improved, not as much as in the beginning. He still feels fever, hot all over his body and his stomach, but it was better right now; it was not as strong as it was in the beginning. During call reported treatment for those adverse events as Tylenol. Mild sensation of flu-like symptoms including throat pain. After taking Tylenol he got a fever, and his stomach feels like when you get diarrhea, that sensation in his stomach. The events did not result in visit to Emergency Room or Physician Office. The patient underwent lab tests and procedures which included body temperature: unknown results on an unspecified date, sars-cov-2 test: positive on an unspecified date. Therapeutic measures were taken as a result of I felt light-headed, fever, felt hot all over his body with Tylenol (Lot: S190394, Expiry: Aug2022). The clinical outcome of the event I felt light-headed, even when I urinate, I feel hot like it burns, flu-like symptoms, his stomach felt really hot, flu-like symptoms including throat pain, he is still not hungry was resolving, stomach feels like when you get diarrhea, fever, felt hot all over his body was not resolved. Information on the Lot/batch number has been requested.


VAERS ID: 1645484 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Body temperature, Lethargy, Lymphadenopathy, Nausea, Pyrexia, Somnolence
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: RALOXIFENE HCL; CITALOPRAM; CETIRIZINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; Post-traumatic stress disorder (PTSD)
Allergies:
Diagnostic Lab Data: Test Date: 20210715; Test Name: Body temperature; Result Unstructured Data: Test Result:102.6 Units:[degF]
CDC Split Type: USPFIZER INC202100923459

Write-up: Lymph node swelling on the lower left side of neck that''s increasing in size; Lethargic; Nauseated; Fever of 102.6F; couldn''t stay awake and didn''t even have the energy to sit up; couldn''t stay awake and didn''t even have the energy to sit up; This is a spontaneous report from a contactable consumer, the patient. A 44-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 14Jul2021 at 17:00 (at the age of 44-year-old) as a single dose for COVID-19 immunisation. Medical history included anxiety and post-traumatic stress disorder; both from unknown date. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient had no known allergies to medications, food or other products. Concomitant medications included raloxifene hydrochloride (RALOXIFENE HCL), citalopram (MANUFACTURER UNKNOWN) and cetirizine (MANUFACTURER UNKNOWN); all from an unknown date for unspecified indication and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: UNKNOWN) via an unspecified route of administration in the left arm on 25Jun2021 (at the age of 44-year-old) as single dose for COVID-19 immunisation. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 15Jul2021 at 11:15, approximately 18 hours after receiving the second dose, the patient was lethargic, nauseated, and had a fever of 102.6F. Once this started, the patient couldn''t stay awake and didn''t even have the energy to sit up for almost 24 hours. The fever lasted approximately 21 hours before finally breaking. On 16Jul2021, two days after receiving this dose, the patient experienced Lymph node swelling on the lower left side of neck that''s increasing in size. Reported to PCP who suggested the patient to report the reaction. The event resulted in doctor or other healthcare professional office/clinic visit. The patient did not receive any treatment for the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event fever of 102.6F, couldn''t stay awake and didn''t even have the energy to sit up was recovered with sequelae on 16Jul2021 and of the events lethargic, nauseated and experienced Lymph node swelling on the lower left side of neck that''s increasing in size was recovered with sequelae on unknown date in Jul2021. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1646557 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Postmenopause (3-4 years)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101007318

Write-up: She is postmenopausal 3-4 years/had her menstrual cycle from 15Jul2021-30Jul2021; It was heavy with clots; This is a spontaneous report from a contactable physician. A 51-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via an unspecified route of administration on 14Jul2021 (Batch/Lot number was not reported) (at the age of 51-year-old) as dose 1, single for COVID-19 immunization. The patient was not pregnant at time of vaccination. The patient had no COVID-19 prior to vaccination. The patient''s medical history included postmenopausal (3-4 years). Concomitant medications were not reported. The patient received the first vaccine on 14Jul2021, and she had her menstrual cycle from 15Jul2021-30Jul2021. It was heavy with clots. She is postmenopausal 3-4 years. The events resulted in doctor or other healthcare professional office/clinic visit. The patient received treatment for the events which included patient was sent for Ultrasound to r/o other cause of post-menopausal bleeding. It was unknown if the patient has been tested for COVID-19 since the vaccination. The outcome of the events was recovered on 30Jul2021. The lot number for BNT162b2 was not provided and will be requested during follow up.; Sender''s Comments: Based on the information available and a close temporal association, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported event of Postmenopausal bleeding and Heavy periods. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1647240 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-13
Onset:2021-07-15
   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 FA6780 / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Muscle twitching, Sensory disturbance, Suicidal ideation
SMQs:, Peripheral neuropathy (narrow), Suicide/self-injury (narrow), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (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: Immune thrombocytopenic purpura
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Blood Test; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC202101050199

Write-up: Talking about committing suicide; Twitching and vibrating sensation throughout her whole body; Twitching and vibrating sensation throughout her whole body; This is a spontaneous report from a contactable consumer (patient''s fiance). A 60-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose number unknown, via an unspecified route of administration, administered in the left arm on 13Jul2021 (Batch/Lot Number: FA6780, at the age of 60-years-old at vaccination) as a single dose for COVID-19 immunisation. Medical history included ITP (Immune thrombocytopenic purpura). Concomitant medications were not reported. On 13Jul2021, the patient received the BNT162B2 vaccine. Two days later (on 15Jul2021), she started getting a twitching and vibrating sensation throughout her whole body. She has been to numerous doctors but it won''t stop and she was talking about committing suicide now because the twitching and vibrating sensation is constant and it doesn''t let up. She describes it as- like sitting on a washing machine that never stops. She was in extremely bad shape now. The fiance stated that he needed to get her some kind of help because she was ready to commit suicide. It was extremely bad now and the patient needs to get help because this side effect was about killing her. She just can''t cope anymore because the twitching and vibrating sensation doesn''t stop. She was having an extremely hard time coping. The patient had some blood test and was awaiting the results. The outcome of the events talking about committing suicide and twitching and vibrating sensation was not recovered. Follow-up (17Aug2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1651241 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-15
   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 EW0217 / 1 LA / JET

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Eosinophil count, Laboratory test, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Acetominophin
Diagnostic Lab Data: Had labs done Aug 3, 26, and 27. High in Eosinophils.
CDC Split Type:

Write-up: 2 days after receiving the vaccine, my left side of my chest started hurting with pain, pressure, and I went in to the ER thinking I was having a heart attack. The doctor said that I was having inflammation in my chest wall from the vaccine and to get rest. Periocardidis? For two months now I have had constant pain on my left side of my chest that won''t go away.


VAERS ID: 1653287 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysgeusia
SMQs:, Taste and smell 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: ALEVE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Migraine; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021907782

Write-up: Metallic taste in mouth almost immediately after administration of the vaccine.; This is a spontaneous report from a contactable consumer, the patient. A 46-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0196) via an unspecified route of administration in the right arm on 15Jul2021 at 18:15 (at the age of 46-year-old) as a single dose for COVID-19 immunisation. Medical history included migraine and penicillin allergy. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included naproxen sodium (ALEVE) from an unknown date and unknown if ongoing for an unknown indication. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient previously took clindamycin (MANUFACTURER UNKNOWN) and experienced allergy. On 15Jul2021 at 18:15, immediately after the vaccination, the patient experienced a metallic taste in the mouth. The events did not result in doctor or other healthcare professional office/clinic visits, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event metallic taste in the mouth was not recovered at the time of the report.


VAERS ID: 1656015 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-02-21
Onset:2021-07-15
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Endoscopy, Gastrectomy, Gastrointestinal stromal tumour, Magnetic resonance imaging, Surgery
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Non-haematological malignant tumours (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: Losartan hctz 100/25
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Endoscopy, surgery, cat scan and followup MRI
CDC Split Type:

Write-up: Partial gastrectomy to remove GIST tumor from stomach


VAERS ID: 1656349 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-24
Onset:2021-07-15
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Appendicitis, Computerised tomogram, Pain, Rash, Swelling, Weight increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma, seasonal allergies
Allergies: shellfish
Diagnostic Lab Data: CT scan
CDC Split Type: vsafe

Write-up: I had no side effects other then a little bit of swelling. It lasted for 2 days then it went away. I did get a rash around my chest area. My stomach started swelling in July, I thought I was gaining weight then 30 days later I started having pain and I went to hospital and ended up having an appendicitis .


VAERS ID: 1656470 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-28
Onset:2021-07-15
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adnexa uteri pain, Dysmenorrhoea, Hypopnoea
SMQs:, Acute central respiratory depression (narrow), Respiratory failure (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: Ammoxicillin, Nitrofurantoin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe Menstrual cramps, to the point of debilitation. Sudden, Heavy pressure in my Right Ovary and sharp, stabbing pains. Shallow breathing due to pain. Fullness and discomfort continued for a week after my menstrual cycle ended. There was sensitivity to tight pants, where my ovary would feel full and sharp stabbing pains would ensue.


VAERS ID: 1658084 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-07-15
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Colitis, Computerised tomogram thorax, Deep vein thrombosis, Dizziness, Feeling cold, Joint swelling, Pain in extremity, Peripheral swelling, Pulmonary thrombosis, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific inflammation (narrow), Ischaemic colitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: Sonogram; Result Unstructured Data: Confirmed blood clot in the right arm; Test Date: 20210821; Test Name: Chest CT; Result Unstructured Data: confirmed blood clot in each lung in each of the lower lobes
CDC Split Type: USJNJFOC20210857614

Write-up: COLITIS ATTACK; CONFIRMED CLOT IN EACH OF HER TWO LUNG''S LOWER LOBES (1 CLOT IN EACH LUNG); DEEP VEIN THROMBOSIS IN THE RIGHT ARM; DIZZINESS; PAIN IN THE RIGHT ELBOW; PAIN IN THE RIGHT ARM; SWELLING IN THE RIGHT ARM; SWELLING IN THE RIGHT ELBOW; FEELING COLD; This spontaneous report received from a patient concerned a 53 year old white female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1808982, and expiry: UNKNOWN) dose was not reported, 1 total administered on 10-APR-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 15-JUL-2021, the patient experienced swelling in the right arm, swelling in the right elbow, pain in the right elbow, pain in the right arm. On 14-AUG-2021, the patient experienced feeling cold due to the thin blood due to the Eliquis treatment. Laboratory data on 14-AUG-2021 included: Sonogram (NR: not provided) Confirmed blood clot in the right arm. On 16-AUG-2021, the patient experienced confirmed clot in each of her two lung''s lower lobes (1 clot in each lung), deep vein thrombosis in the right arm and dizziness. The patient stated she went to emergency room on 13-AUG-2021, 14-AUG-2021, 16-AUG-2021 and 21-AUG-2021. On 21-AUG-2021, computed tomography of the chest confirmed blood clot in each lung in each of the lower lobes and patient was admitted in hospital due to colitis attack and because of the severity of the clots and got discharged on 26-AUG-2021. The patient was hospitalized for 6 days. The patient was treated with an injection in the hospital (unknown medication) and Eliquis for blood clots after discharge. Eliquis was given orally at 10 mg in the morning and 10 mg in the evening and after 7 days switched to 5mg in the morning and 5 mg in the evening. The patient was on a special diet as per Gastroenterologist. The action taken with covid-19 vaccine was not applicable. The patient was recovering from pain in the right arm, pain in the right elbow, swelling in the right arm, swelling in the right elbow, confirmed clot in each of her two lung''s lower lobes (1 clot in each lung), colitis attack, and deep vein thrombosis in the right arm, and had not recovered from dizziness, and feeling cold. This report was serious (Hospitalization Caused / Prolonged). Sender''s Comments: V0: 20210857614-Covid-19 vaccine-Confirmed clot in each of her two lung''s lower lobes (1 clot in each lung), Colitis attack, Deep vein thrombosis in the right arm, Swelling in the right arm, Swelling in the right elbow, Dizziness. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210857614-Covid-19 vaccine- Pain in the right arm, Pain in the right elbow. This event(s) is labeled per RSI and is therefore considered potentially related.


VAERS ID: 1658564 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-31
Onset:2021-07-15
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Heartburn, cholecystitis.
Allergies: NKA
Diagnostic Lab Data: 7/15/21: covid test: positive.
CDC Split Type:

Write-up: Pt came to ER c/o upper abdominal pain with nausea and vomitingx3 days.


VAERS ID: 1658875 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-13
Onset:2021-07-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Balance disorder, Dizziness, Fatigue, Feeling drunk, Injection site pain, Myalgia, Nasopharyngitis, Pain, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Penicillin - Age 5
Other Medications: Mirtazapine 7.5mg x 1 daily at night before bedtime. Alprazolam 0.5mg x 1 daily at night before bedtime as needed for insomnia. Patient has taken both does for over 5 years
Current Illness: None
Preexisting Conditions: Delayed Sleep Phase Syndrome
Allergies: Penicillin - shortness of breath
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Normal vaccine side effects of fatigue, cold symptoms, and muscle soreness/body aches for the first 36-48 hours post vaccination. Uncommon side effects that developed after the first 48 hours and continued for the next 6-8 days were vertigo/dizziness/light-headedness similar to feeling mildly to extremely intoxicated and unable to walk steady at times. Only other common side effects during this time were pronounced fatigue and soreness at the injection site for 5-6 days. An appointment was made to seek treatment after 5-6 days of these side effects, but side effects cleared up before the date of the appointment (9-10 days post vaccination). No other side effects appear to be present at this time other than new joint pains that may or may not be related to physical exertion or exercise.


VAERS ID: 1661242 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-18
Onset:2021-07-15
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Feeling abnormal, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Dementia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101098250

Write-up: I came down with covid; I came down with covid; Brain fog; This is a spontaneous report from a contactable consumer (patient). A 68-years-old female patient received BNT162B2 (COMIRNATY, Solution for injection, via an unspecified route of administration on 18Feb2021 (Batch/Lot number and expiration date were not reported) as dose 2, single and dose 1 via an unspecified route of administration on 29Jan2021 (Batch/Lot number and expiration date were not reported) as dose 1, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient reported that she came down with COVID (15Jul2021). What was really concerning about that was she did not know if she was super immune or was not as immune. She experienced Covid brain fog (on an unspecified date in 2021). Exactly 21 days apart she saw Health Care Professional when had COVID. The patient further stated that no one knew if you need another booster, she planned on getting the booster on 18Oct2021, eight months from my last vaccine, she did not know whether to continue to wear the mask, she did not want a cold, did not want anything, she believed the shots kept her out of the hospital, believed it could have been a lot worse. The patient questioned Where she stands on being immune, what should be done if a vaccinated person develops COVID-19? The patient stated that she didn''t do a report of adverse reaction. The events I came down with covid were considered as serious (Medically Significant). The outcome of events was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1662409 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-06-11
Onset:2021-07-15
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram normal, Heavy menstrual bleeding, Impaired work ability, Injection site pain, Laboratory test normal, Menstruation irregular, Migraine
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: None
Preexisting Conditions: Irregular periods (about one every other month)
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: When I got the second dose, I had the pain in the site like normal. I got the shot on July 10, and after having finished my last period on July 6, I started another period on July 15 and that lasted until August 7 and it was the heaviest period I''ve ever had, going through one tampon an hour. And for the past month, i have had intense migraines that have made it next to impossible to function at work. I used to have mild migraines as a kid, but that was 10 years ago and I haven''t had them since. I have been to the er for concerns about my symptoms and no one has been able to tell me what is wrong. My labs come back normal, thankfully my heart looks okay on and ekg. I have an gynecology appointment scheduled for next month to start investigating there.


VAERS ID: 1662588 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-28
Onset:2021-07-15
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 2 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Allergy to metals, Food intolerance, Heart rate irregular, Skin irritation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Cardiac arrhythmia terms, nonspecific (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Skin irritated by any type of metal, breaks out in hives from the touch of it. Unable to eat fish, shrimp and chocolate after taking the vaccine. She was never allergic to anything before taking the vaccine. Irregular heart beats.


VAERS ID: 1666181 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-03-17
Onset:2021-07-15
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood creatinine increased, Blood lactic acid, COVID-19, Chest X-ray abnormal, Computerised tomogram head normal, Confusional state, Cough, Disorientation, Fatigue, Gastrointestinal disorder, Platelet count decreased, Pneumonia, SARS-CoV-2 test positive, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine 5 mg PO QD ascorbic acid 500 mg PO QD aspirin 81 mg PO QD insulin isophane 10 units SQ AC insulin lispro moderate sliding scale with meals and at bedtime lisinopril 5 mg PO QD pantoprazole 40 mg PO QD simvastatin 40 mg PO QD
Current Illness: CAD HTN HLD CKD DM GERD Barrett''s esophagus H/o CVA osteoarthritis
Preexisting Conditions: CAD HTN HLD CKD DM GERD Barrett''s esophagus H/o CVA osteoarthritis
Allergies: NKDA
Diagnostic Lab Data: see above
CDC Split Type:

Write-up: Pfizer Dose 1 2/22/2021 (EN6200) Pfizer Dose 2 3/17/2021 (EN6205) COVID Positive 7/21/2021 7/19/21: Presented to ED with GI issues and discharged. 7/21/21: The patient presents with fatigue and 93 y/o patient, he, presents to the emergency department with complaint of weakness that began 4-5 days ago. Pt.''s wife accompanied the patient to the emergency department and provided some history. Pt.''s wife states that the patient had a fever 2 days ago and has intermittent coughs. The patient states that weakness is not a recurring problem for him. Pt. PHx includes Barrett''s esophagus, HTN, and GERD. This is a 93-year-old male with history of coronary artery disease, hypertension, hyperlipidemia and type 2 diabetes mellitus who presented to the emergency department with confusion and cough. Patient reports that he has been coughing for the past few days. Wife reports that he had a temperature of 100? F on Sunday. He woke up this morning around 3:00 a.m. confused and disoriented. He was also feeling very weak. His symptoms are improving. He denies chest pain, dizziness, blurry vision, palpitations, abdominal pain, nausea, vomiting or diarrhea. Patient was fully vaccinated for COVID-19. In the emergency department, patient was found to have a temperature of 99.6?. Labs showed a creatinine of 1.56, lactic acid of 2.2, WBC count of 3.8 and platelets of 87. CT head without contrast showed no acute findings. Chest x-ray showed developed an bibasilar pneumonia. Patient received a dose of IV Rocephin, azithromycin and IV fluids. 7/30/21: Pt discharged with P.o. Zinc sulfate and vitamin-C, P.o. Decadron course, Albuterol HFA, COVID-19 precautions per CDC guidelines, hemodynamically stable for discharge. Will discharge to skilled nursing facility. Patient agrees with plan of care. Follow-up with PCP in 3-5 days


VAERS ID: 1669655 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Rash, Vaccination site pain
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma; Diabetes; Drug allergy (to most antibiotics except Zithromax, sulfur, penicillin, eggs, chicken, turkey, any-sugar free food, cough syrup, red dye, pollen)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: mild breathing problem; dizziness; pain in the injection site; Rash; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (mild breathing problem), DIZZINESS, VACCINATION SITE PAIN, and RASH in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040C21A and 052E21A) for COVID-19 vaccination. Concurrent medical conditions included Diabetes, Asthma, and Patient has allergy to most antibiotics except Zithromax, sulfur, penicillin, eggs, chicken, turkey, any-sugar free food, cough syrup, red dye, pollen. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-Jul-2021, the patient experienced DYSPNOEA (mild breathing problem), DIZZINESS, VACCINATION SITE PAIN, and RASH. At the time of the report, DYSPNOEA (mild breathing problem), DIZZINESS, VACCINATION SITE PAIN, and RASH outcome was unknown. No concomitant medication were provided by the reporter No treatment medication were provided by the reporter This case was linked to MOD-2021-286476 (Patient Link).


VAERS ID: 1673210 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-09
Onset:2021-07-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Abdominal pain upper, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (known allergies: Penicillin)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101051375

Write-up: extreme vaginal bleeding; stomach pain; This is a spontaneous report from a contactable other healthcare professional (patient). A 43-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection; Lot Number: was not reported), via an unspecified route of administration, administrated in left arm on 09Jul2021 14:00 (age at the time of vaccination 43-years-old) as a single dose for COVID-19 immunization. Patient previously received first dose of BNT162b2 vaccine, on an unspecified date as a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient had known allergy to Penicillin. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. On 15Jul2021, the patient experienced extreme vaginal bleeding, and stomach pain. Patient visited to the emergency room for pain, was prescribed antibiotics for a possible infection. The outcome for all the events was not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1674519 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states she has experienced severe migraines starting the day after vaccine. She opted out of getting a 2nd dose.


VAERS ID: 1674754 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-05
Onset:2021-07-15
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Asthenia, Blood pressure fluctuation, Chest X-ray, Computerised tomogram, Dyspnoea, Fatigue, Fluid retention, Heart rate increased, Hypersomnia, Hypoaesthesia, Oedema, Paraesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Dehydration (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hypertension , High Cholesterol
Allergies: None
Diagnostic Lab Data: CAT scan and X-Ray of chest, Scheduled Stress Test , EKG, Echo Cardiogram
CDC Split Type:

Write-up: Severe fatigue, Fluid retention (15 lbs) swelling of legs and stomach. Very high heart rate 118-120. Various BP low then high. Numbing and tingling in arms and legs. Sleeping 18 hrs / day. No energy. Shortness of breathe.


VAERS ID: 1675340 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-13
Onset:2021-07-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Anxiety, Blood glucose increased, Blood glucose normal, Cold sweat, Feeling cold, Feeling hot, Hyperhidrosis, Peripheral coldness, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: As per nursing notes, patient was very anxious at around 1:20 am, Thursday morning, Blood sugar 108 mg/dl, sweating profusely. O2 unable to obtain because fingers were cold. Patient started wheezing, Albuterol nebulizer treatment provided. Breathing improved. Patient claimed she was hot but she was cold and clammy. Provided Albuterol Nebulizer treatment, 3ml. Vitals 98.2-132-22-170/88. Patient was transferred to the ER, left unit @3:38 am.


VAERS ID: 1675598 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-04
Onset:2021-07-15
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 9810 / 1 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6198 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood iron decreased, Fatigue, Full blood count abnormal, Infusion, Iron deficiency, Serum ferritin normal, Transferrin saturation decreased
SMQs:, Haematopoietic leukopenia (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: I take numerous medications and am unable to copy and paste.
Current Illness: None
Preexisting Conditions: Numerous, but did not take iron prior to becoming fully vaccination the middle of March.. Had 1 infusion and am taking iron pills now. after Pfizer vaccines
Allergies:
Diagnostic Lab Data: 7-29 21 Iron-20% Saturation 6% Ferritin - 17 Various components of CBC are flagged either high or low.
CDC Split Type:

Write-up: Very tired. The tiredness had been progressing over time, but iron deficiency showed up in test results. I?m taking iron pills and had one iron infusion. Researched and found others had this condition after having vaccine. Iron retested this week. Video Dr appt. next week to determine course of action.


VAERS ID: 1675684 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injected limb mobility decreased, Pain in extremity
SMQs:, 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: Atenolol amlodipine tylenol metformin
Current Illness: NA
Preexisting Conditions: Hypertension
Allergies: cipro lisinopril
Diagnostic Lab Data:
CDC Split Type:

Write-up: When she tries to left arm, patient has pain and can barely lift. When wakes up it takes a while for her to get it moving. Not sure if how she is sleeping on arm. Hurts in the generally area in the joint. Patient has been rubbing with green alcohol and taking Tylenol. Patient will rotate shoulder from front to back to see if any relief.


VAERS ID: 1675689 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Blood magnesium normal, Blood potassium normal, Blood thyroid stimulating hormone normal, Electrocardiogram normal, Fatigue, Headache, Nausea, Palpitations, Thyroxine free normal, Troponin
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Von Willebrand disease
Allergies: NKDA
Diagnostic Lab Data: EKG normal. Trop neg. Mg 1.7. K 4.0. TSH sl elevated 3.799 with normal free T4 0.94.
CDC Split Type:

Write-up: Palpitations, severe headache, nausea and fatigue day following vaccination with Moderna covid vaccine #2 on 7/14/21. She presented to ED on 7/17/21 with improving palpitations. Headache resolved. EKG normal. Trop neg. Mg 1.7. K 4.0. TSH sl elevated 3.799 with normal free T4 0.94. No treatment recommended. Observation.


VAERS ID: 1677310 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Pain, Pyrexia, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 202107; Test Name: fever; Result Unstructured Data: Test Result:99.3 upto 100; Test Date: 20210715; Test Name: fever; Result Unstructured Data: Test Result:102.1; Test Date: 20210716; Test Name: fever; Result Unstructured Data: Test Result:101.1
CDC Split Type: USPFIZER INC202100917345

Write-up: snotty nose; can''t breathe well out of her nose; body aches; fever; This is a spontaneous report from a contactable consumer (Mother). This consumer reported for 2 patients. This report is for 1st of 2 patients. A 12-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number was unknown), via an unspecified route of administration, administered in Arm Right on 15Jul2021 (at age of 12-year-old) as single dose for COVID-19 immunisation. The patient had no medical history and concomitant medications. The patient experienced fever of 102.1 on the first night on 15Jul2021, 101.1 the next day (16Jul2021), and since then has had a fever ranging from 99.3 up to 100. On 16Jul2021, the patient experienced snotty nose, can''t breathe well out of her nose and body aches. The patient got vaccinated on 15Jul2021 and about an hour later the patient had a huge fever which the caller knew would happen. The patient was snotty, could not breathe well, and had body aches. Caller wondering if these side effects were due to the vaccine. Outcome of the event fever was recovering; snotty nose, can''t breathe well out of her nose, body aches was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1678285 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Louisiana  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: delayed second dose; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (delayed second dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (delayed second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (delayed second dose) 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. Patient got monoclonal antibodies on 27JUL2021, wants to know if there is any interactions and do still need to wait the 90 days even though it is the second dose? No concomitant medications were provided by reporter. No treatment medications were provided by reporter.


VAERS ID: 1679753 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-15
Onset:2021-07-15
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Acute coronary syndrome, Acute myocardial infarction, Blood urea increased, Cardiac arrest, Cardiac tamponade, Cardioversion, Chest X-ray normal, Chest pain, Circulatory collapse, Dizziness, Dry skin, Dyspnoea, Electrocardiogram abnormal, Full blood count normal, Hyperglycaemia, Oedema, Oesophageal rupture, Pain, Pneumonia, Pneumothorax, Pulmonary embolism, SARS-CoV-2 test negative, Sinus tachycardia, Skin warm, Traumatic haemothorax, Troponin, Ventricular fibrillation, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Acute renal failure (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow), Gastrointestinal perforation (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (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: Vitamin D3, Amlodipine
Current Illness:
Preexisting Conditions: High BP
Allergies:
Diagnostic Lab Data: Entire report listed on Item 18.
CDC Split Type:

Write-up: ED Provider Notes at 07/15/21 0625 Procedure Orders 1. Electrical Cardioversion (ED) [409525162] ordered by Dr Post-procedure Diagnoses 1. Ventricular fibrillation seen on cardiac monitor (HCC) [I49.01] Chief Complaint: Chest Pain History: 62 y.o. male with hx of HTN and HLD who presents to the ED BIB wife with intermittent worsening central burning CP beginning a couple weeks ago now feels constant associated with dizziness today. CP is worsened with movement. He went to bed last night with CP, then woke up at 5:45Am with worsened pain. Last night he took pain medication, swallowed grape gum and then had CP. Denies SOB, N/V, hx of smoking or hx of DM. Denies FHX of early death due to MI. He has never had a heart attack before. The history is provided by the patient. The history is limited by the condition of the patient. Chest Pain The chest pain began 1 - 2 weeks ago. Duration of episode(s) is 1 week. Chest pain occurs constantly. The chest pain is worsening. The severity of the chest pain is severe. The quality of the pain is described as burning. Chest pain is worsened by certain positions. Primary symptoms include shortness of breath and dizziness. He describes the dizziness as a sensation of spinning. The dizziness began today. The dizziness has been unchanged since its onset. His past medical history is significant for hyperlipidemia and hypertension. Pertinent negatives for past medical history include no diabetes. Pertinent negatives for family medical history include: no early MI. Home Medications Not on File Allergies: Patient has no known allergies. Past Medical History HTN and HLD. No hx of DM or MI. Past Surgical History Charts reviewed, the patient has no surgical history on file and none reported. Social History No reported use of tobacco products, alcohol or illicit drugs. Family History No reported family history. No early MI in family. ROS: Review of Systems Unable to perform ROS: Acuity of condition Respiratory: Positive for shortness of breath. Cardiovascular: Positive for chest pain (burning constant ). Neurological: Positive for dizziness. Physical Exam: BP (!) 161/92 | Pulse 108 | Resp 27 | SpO2 100% Pulse rate pulse OX: 96 bpm Physical Exam Procedures: Electrical Cardioversion (ED) Sedation: Patient sedated: no Cardioversion basis: emergent Pre-procedure rhythm: ventricular fibrillation Patient position: patient was placed in a supine position Chest area: chest area exposed Electrodes: pads Electrodes placed: anterior-lateral Number of attempts: 1 Attempt 1 mode: synchronous Attempt 1 waveform: biphasic Attempt 1 shock (in Joules): 150 Attempt 1 outcome: conversion to normal sinus rhythm Post-procedure rhythm: normal sinus rhythm Complications: no complications Patient tolerance: patient tolerated the procedure well with no immediate complications EKG: EKG time (0626). sinus tachycardia. Rate: 101 bpm. P waves Normal. Normal PRI. Normal QRS complex. Normal axis. ST Segments: elevation in v1, v2, v3 and v4 . T Waves: non specific changes . The study has been independently viewed by me. The study has been interpreted contemporaneously by me. The EKG appears to be a good tracing. Clinical Impression: myocardial infarction anterior Rhythm Strip #1: Time (0638). Lead II. Rate= 200. Rhythm: ventricular tachycardia. Narrow QRS complexes. Ectopy: none. The study was interpreted by me. EKG #2: EKG time (0646). sinus tachycardia. Rate: 110 bpm. P waves Normal. Normal PRI. Normal QRS complex. Normal axis. ST Segments: elevation in v1, v2, v3, v4 and v5 . T Waves: non specific changes . The study has been independently viewed by me. The study has been interpreted contemporaneously by me. The EKG appears to be a good tracing. Clinical Impression: myocardial infarction anterior when compared to earlier ECG Decision Support: ED Course: 62 y.o. male with hx of HTN and HLD presents with intermittent worsening central burning CP beginning a couple weeks ago now feels constant associated with dizziness today. Initial exam notable for hear regular lungs clear and trace pitting edema. VS reviewed, hypertensive at 171/97, tachycardic at 116 and SPO2 is WNL. DDx includes ACS including STEMI, tension pneumothorax, pulmonary embolism, ruptured esophagus, pneumonia, pericardial tamponade, traumatic hemothorax. 06:26 STEMI activated. Plan to obtain CBC, CMP, troponin and CXR. 06:30 I spoke with Dr. who accepts pt for transfer to cath lab. All transfer paperwork completed. 06:35 Pt suddenly went into V-fib then went into cardiac arrest, one round of compressions was done and he was shocked once into sinus rhythm. We gave magnesium, one ativan then pt''s rate increased to 190, so then we shocked at 150 then pt went back to sinus rhythm, and started an amiodarone bolus 150. --magnesium 2 g IV --amiodarone 1.5 mg/mL IV --heparin BOLUS 5,000 Units IV --heparin 1,000 Units infusion IV --amiodarone 150 mg IV --amiodarone 1 mg IV --Ativan 2 mg IV Critical care time was provided for 35 minutes by the attending physician, exclusive of separately billable procedures and treating other patients. This was necessary to treat or prevent further deterioration of the following condition(s) Circulatory failure which the patient had and/or had a high probability of suddenly developing. Labs and Imaging Reviewed: CBC is WNL. CMP shows elevated BUN at 24, elevated CR at 1.32 and hyperglycemia at 155. Troponin is elevated at 0.04. Covid PCR negative. X-RAY of chest, a 1-view study, image reviewed by me, read by radiology, shows: No evidence of acute chest pathology. Diagnosis and Disposition: Impression: 1. Chest pain, unspecified type 2. Ventricular fibrillation seen on cardiac monitor (HCC) 3. Cardiac arrest (HCC) Condition: stable Disposition: Transfer to Hospital to Cath Lab Scribing for and in the presence of, Dr. Dr., personally performed the services described in this documentation, as scribed ED Notes Nurse at 07/15/21 0626 EKG Nurse at 07/15/21 0627 EKG completed and given to dr. Patient brought directly back to room ED Triage Notes Nurse at 07/15/21 0633 Patient presents to the emergency department with chest pain. Patient states he feels like his pain has been going on for a "couple weeks", worse this morning. States he has been taking tums and peptobsimal with no relief. Patient states the pain is sternal and burning in nature. States palpation made his pain worse. States he feels slightly short of breath "no more than normal." Patient skin is warm and dry.


VAERS ID: 1683729 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Cardiac disorder, Chest discomfort, Dyspnoea, Heart rate, Heart rate increased, Hypertension, Hypoaesthesia, Limb discomfort, Musculoskeletal discomfort, Paraesthesia, Product administered at inappropriate site
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug abuse and dependence (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Medication errors (narrow), Dehydration (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:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210715; Test Name: Blood pressure; Result Unstructured Data: Test Result:unknown results; Comments: Extreme rise in blood pressure; Test Date: 20210715; Test Name: heart rate; Result Unstructured Data: Test Result:178bpm; Test Date: 20210715; Test Name: heart rate; Result Unstructured Data: Test Result:100 bpm
CDC Split Type: USPFIZER INC202101119327

Write-up: administration on the left leg; heart rate as high as 178 bpm/Heart rate over 100 bpm at rest; Extreme rise in blood pressure; Severe numbness in legs, arm; Severe numbness chest; Pinching in Heart; Pinching in Neck; Pinching in Arm/Pinching in Leg; Shortness of Breath/Difficulty Breathing; Chest tightness; Tingling sensation on face/cheeks; This is a spontaneous report from a contactable consumer (patient). A 14-year-old female patient (not pregnant) received the first dose of BNT162B2 via an unspecified route of administration on the left leg on 15Jul2021 at 18:30 (Lot Number: FA6780) at the age of 14-year-old as single dose for COVID-19 immunization. Medically history and concomitant medication were none. known allergy was none. Prior to vaccination, the patient wasn''t diagnosed with COVID-19. Since the vaccination, the patient hadn''t been tested for COVID-19. The patient didn''t received other vaccine within 4 weeks prior to the COVID vaccine. On 15Jul2021 at 09:00 PM, the patient experienced severe numbness in legs, arms and chest. Extreme rise in blood pressure and heart rate as high as 178 bpm. Moderate to Severe symptoms continue as of today (29Aug2021) Pinching in Heart, Neck, Arm and Leg. Shortness of Breath, Difficulty Breathing. Chest tightness. Tingling Sensation on face/cheeks. Heart rate over 100 bpm at rest. We have been to the emergency room 3 times Emergency room twice and (with held) once. The events resulted in emergency room/department or urgent care. No treatment was received. The outcome of vaccine administered at inappropriate site was unknown. The outcome of other events was not recovered.


VAERS ID: 1685173 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-25
Onset:2021-07-15
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal distension, Anaemia, Computerised tomogram abdomen abnormal, Constipation, Electrocardiogram, Gastrointestinal tube insertion, Hiatus hernia, Small intestinal obstruction, Vomiting
SMQs:, Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Long list - of medications
Current Illness: no
Preexisting Conditions: hypertension; heart valve that is a problem; she has a long list of things; Hypo-thyroid; bladder issues; GI issues that started last Fall - had some re-occurrences of nausea, diarrhea and retching - November; CT scan for it in January 2021 to make sure there were no blockages and they didn''t find anything at that time for blockages
Allergies: none
Diagnostic Lab Data: CT scan - Legacy Salmon
CDC Split Type: vsafe

Write-up: She had a lot of pressure in her upper abdomen - like there was no room for her innards. Bloating. And then she vomited after experiencing this pressure - this was at 05:00 am before she had eaten. I talked to the nurse and I took her to Urgent Care - he did an EKG - he thought she needed to go to ED - for a CT scan - to find out about blockage in GI - they did a CT scan and saw there was an obstruction in her small bowel. Emptied her stomach and put in a new GI tube. They admitted her to make sure it had resolved. She was in the hospital for about a week. They gave her treatment for anemia. The obstructions was constipation and she didn''t know that because she had already been using Citricel daily and she thought she was having bowel movements daily. She had a hiatal hernia - it had been there for yours; small bowel obstruction - could have been from scars and adhesions from prior surgeries. It resolved in that week. She uses Miralax daily and Citrucel - daily for bowel movement and they have her on Omeprazole - they think there might be something bleeding with lesions on her hernia.


VAERS ID: 1686228 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-02-16
Onset:2021-07-15
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Menstruation delayed
SMQs:, Fertility disorders (broad)

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

Write-up: Had regular period then had very late period. Went 67 days between periods, no pregnancies.


VAERS ID: 1686752 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-13
Onset:2021-07-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Blood 25-hydroxycholecalciferol decreased, Blood glucose decreased, Blood thyroid stimulating hormone normal, Chest X-ray abnormal, Differential white blood cell count normal, Dizziness, Dizziness exertional, Electrocardiogram normal, Fatigue, Fibrin D dimer normal, Full blood count normal, Glomerular filtration rate normal, Injection site pain, Lymphocyte count, Metabolic function test, Metabolic function test normal, Neurological examination normal, Thyroxine free normal, Troponin T
SMQs:, Anticholinergic syndrome (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (narrow), Infective pneumonia (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: Alpralozam - .5mg x 1 nightly at bedtime for insomnia ($g 2 years) Androgel - 4 pumps x 1 daily ($g 2 years)
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin - shortness of breath
Diagnostic Lab Data: 9/3/2021 - Outpatient Visit to PA due to dizziness and severe fatigue - Baseline neurological exam was normal - CBC w/Auto Differential - all results in normal ranges - Comprehensive Metabolic Panel - Glucose a bit low at 60mg - all other results within normal ranges - Vitamin D 25-hydroxy - 21.7ng/ml - TSH REFLEX FREE T4 - Normal range 9/7/2021 - Outpatient visit to ER due to dizziness and severe fatigue - ECG 12-LEAD - Normal ECG - XR Chest 1 Vw - Mild hazy markings left lower lung adjacent left heart border with lungs otherwise clear. - EGFR - 67 mL/min/1.73 m2 - Differential Auto - Lymphocyte abs: 3.5 K/cumm - all other results within normal ranges - Troponin T high-sensitivity series - Normal (<6 ng/L) - Basic Metabolic Panel - all within normal ranges - CBC w/Auto Differential - all results in normal ranges - D-Dimers Quantitative - normal (<215 ng/mL FEU)
CDC Split Type:

Write-up: Submitting a new report to update my initial report as adverse reactions have not subsided as previously stated Normal expected side effects for 36-48 hours following vaccination. Dizziness, severe fatigue, and pain at injection site for 6-8 days following vaccination. Dizziness and severe fatigue returned for 6 weeks post vaccination whenever patient has exerted himself slightly above normal routine Dizziness and sever fatigue are now (7 weeks to present) presenting after normal activity. 1-2 days of normal activity results in 1-2 days of dizziness and severe fatigue.


VAERS ID: 1687090 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-09
Onset:2021-07-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

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

Write-up: Irregular menstruation. Heavy menstruation when I normally don''t have a monthly cycle


VAERS ID: 1485591 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Malaise
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: Woozy; Generally unwell; Shivering; Chills; This regulatory authority case was reported by a consumer and describes the occurrence of DIZZINESS (Woozy), MALAISE (Generally unwell), CHILLS (Chills) and CHILLS (Shivering) in a 26-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. Concomitant products included DROSPIRENONE, ETHINYLESTRADIOL (LUCETTE) from 2018 to June 2021 for Contraception. On 14-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced CHILLS (Chills) (seriousness criterion medically significant). On an unknown date, the patient experienced DIZZINESS (Woozy) (seriousness criterion medically significant), MALAISE (Generally unwell) (seriousness criterion medically significant) and CHILLS (Shivering) (seriousness criterion medically significant). At the time of the report, DIZZINESS (Woozy), MALAISE (Generally unwell) and CHILLS (Shivering) was resolving and CHILLS (Chills) had resolved with sequelae. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. The patient was not pregnant and not currently breastfeeding The patient was not enrolled in clinical trial. The patient did not test positive for COVID-19 since having the vaccine and has not had symptoms associated with COVID-19. The patient had not underwent a COVID-19 test. No treatment medications were provided. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Very limited information regarding this events has been provided at this time. No further information is expected at this time.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Very limited information regarding this events has been provided at this time. No further information is expected at this time


VAERS ID: 1485594 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-12
Onset:2021-07-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia, Lymphangitis, Muscle spasms, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: feet on right; numbness; tingling in toes; Leg cramps; This regulatory authority case was reported by a consumer and describes the occurrence of LYMPHANGITIS (feet on right), HYPOAESTHESIA (numbness), MUSCLE SPASMS (Leg cramps) and PARAESTHESIA (tingling in toes) in a 23-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 12-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced MUSCLE SPASMS (Leg cramps) (seriousness criterion medically significant). On an unknown date, the patient experienced LYMPHANGITIS (feet on right) (seriousness criterion medically significant), HYPOAESTHESIA (numbness) (seriousness criterion medically significant) and PARAESTHESIA (tingling in toes) (seriousness criterion medically significant). At the time of the report, LYMPHANGITIS (feet on right), HYPOAESTHESIA (numbness) and PARAESTHESIA (tingling in toes) outcome was unknown and MUSCLE SPASMS (Leg cramps) had not resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Concomitant medication of the patient was not reported. The patient had not tested positive for COVID-19 since having the vaccine. No treatment information was provided by the reporter. For mRNA-1273 (Moderna COVID-19 Vaccine) (unknown), the reporter did not provide any causality assessments. Company Comment Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1485595 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003607 / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MILLINETTE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased; Suspected COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: This regulatory authority case was reported by a consumer and describes the occurrence of HEAVY MENSTRUAL BLEEDING (Excessive menstruation) and PAIN (caused intense pain) in a 20-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003607) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased and Suspected COVID-19 on 14-Jul-2021. Concomitant products included ETHINYLESTRADIOL, GESTODENE (MILLINETTE) for Pain management. On 14-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jul-2021, the patient experienced HEAVY MENSTRUAL BLEEDING (Excessive menstruation) (seriousness criterion medically significant). On an unknown date, the patient experienced PAIN (caused intense pain) (seriousness criterion medically significant). At the time of the report, HEAVY MENSTRUAL BLEEDING (Excessive menstruation) had not resolved and PAIN (caused intense pain) outcome was unknown. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided by the reporter. The reporter stated that the patient randomly started bleeding the day after, despite being on the pill and this had never happened before. The colour and texture of blood was also unlike a normal bleed. It caused intense pain (through this not unusual for the patient) per patient report. Patient had not tested positive for COVID-19 since having the vaccine. Patient was not enrolled in clinical trial. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Seriousness of the events are based on the Regulatory Report received, as per medical judgement the events for this case are non serious. No further information is expected at this time.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Seriousness of the events are based on the Regulatory Report received, as per medical judgement the events for this case are non serious. No further information is expected at this time.


VAERS ID: 1486515 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-11
Onset:2021-07-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ARIPIPRAZOLE; FOLIC ACID; LAMOTRIGINE; VENLAFAXINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Loss of balance; This regulatory authority case was reported by a consumer and describes the occurrence of BALANCE DISORDER (Loss of balance) in a 41-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003608) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. Concomitant products included ARIPIPRAZOLE, FOLIC ACID, LAMOTRIGINE and VENLAFAXINE for an unknown indication. On 11-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced BALANCE DISORDER (Loss of balance) (seriousness criterion medically significant). At the time of the report, BALANCE DISORDER (Loss of balance) had not resolved. No treatment information was provided. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. No further information is expected at this time.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. No further information is expected at this time.


VAERS ID: 1486516 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy, SARS-CoV-2 test
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Decreased lactation.
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative; Result Unstructured Data: Tested negative.
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: This regulatory authority case reported by a consumer, describes the occurrence of lymph node pain and lymphadenopathy (lymph node on same side as vaccine was very swollen) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch# 3003608) for COVID-19 vaccination. The patient''s past medical history included decreased lactation. On 14-Jul-2021, patient received second dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On an unknown date, patient received first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Jul 15, 2021, patient experienced lymph node pain (medically significant). On an unknown date, the patient experienced lymphadenopathy/lymph node on same side as vaccine was very swollen (medically significant). At the time of the report, lymph node pain: not resolved and lymphadenopathy (lymph node on same side as vaccine was very swollen) outcome was unknown. Diagnostic results: On an unknown date, SARS-CoV-2 test: negative. The action taken with mRNA-1273 (Moderna COVID-19 vaccine) was unknown. Sender''s comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1486526 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Dysarthria, Illness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Stomach ache; Fainting; Sickness; Slurred speech; This regulatory authority case was reported by a consumer and describes the occurrence of SYNCOPE (Fainting), ILLNESS (Sickness), DYSARTHRIA (Slurred speech) and ABDOMINAL PAIN UPPER (Stomach ache) in a 39-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 14-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced SYNCOPE (Fainting) (seriousness criterion medically significant), ILLNESS (Sickness) (seriousness criterion medically significant) and DYSARTHRIA (Slurred speech) (seriousness criterion medically significant). On an unknown date, the patient experienced ABDOMINAL PAIN UPPER (Stomach ache) (seriousness criterion medically significant). On 15-Jul-2021, SYNCOPE (Fainting) and ILLNESS (Sickness) was resolving and DYSARTHRIA (Slurred speech) and ABDOMINAL PAIN UPPER (Stomach ache) had resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatment information was provided. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1488566 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fear, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Fear; Fainting; This regulatory authority case was reported by an other health care professional and describes the occurrence of SYNCOPE (Fainting) in a 35-year-old male patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003608) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jul-2021, the patient experienced SYNCOPE (Fainting) (seriousness criterion medically significant). On an unknown date, the patient experienced FEAR (Fear). On 15-Jul-2021, SYNCOPE (Fainting) had resolved. At the time of the report, FEAR (Fear) had not resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Patient informed us that they had a vaccine fear and were anxious. Whilst waiting after the vaccine patient fainted for a brief moment. Pharmacist checked that they patient was not having an adverse reaction to vaccine and when felt happy it was a fainting incident patient was monitored by support staff, given water and laid on floor with feet elevated. Privacy screen was put up and once patient felt better they left. Patient has not tested positive for COVID-19 since having the vaccine. Patient was not enrolled in clinical trial. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1488574 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Fainting; This regulatory authority case was reported by a pharmacist and describes the occurrence of SYNCOPE (Fainting) in a male patient of an unknown age who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003608) for COVID-19 vaccination. No Medical History information was reported. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced SYNCOPE (Fainting) (seriousness criterion medically significant). On 15-Jul-2021, SYNCOPE (Fainting) 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 medication information was provided by the reporter. No treatment medication information was provided by the reporter. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1488575 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002621 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hypotension, Syncope, Thrombosis
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Blood clots; Faints; Fainting; This regulatory authority case was reported by an other health care professional and describes the occurrence of THROMBOSIS (Blood clots) and SYNCOPE (Fainting) in a 19-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3002621) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced SYNCOPE (Fainting) (seriousness criterion medically significant). On an unknown date, the patient experienced THROMBOSIS (Blood clots) (seriousness criterion medically significant) and HYPOTENSION (Faints). On 15-Jul-2021, SYNCOPE (Fainting) had resolved. At the time of the report, THROMBOSIS (Blood clots) and HYPOTENSION (Faints) outcome was unknown. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The patient normally faints after vaccination. Patient was fine when asked to lie down on the floor straight with legs elevated and observed for 15 minutes. Later she was asked to sit on the chair for further 5 minutes, she fainted and lost consciousness. Concomitant medication information was not provided. Treatment information was not provided. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. No further information is expected at this time.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. No further information is expected at this time.


VAERS ID: 1488580 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:2021-07-07
Onset:2021-07-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, SARS-CoV-2 test
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210714; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: Negative; Comments: No - Negative COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Headache NOS; Based on the current case data, this case has been classified as invalid. This regulatory authority case was reported by a consumer and describes the occurrence of HEADACHE (Headache NOS) in a patient of an unknown age and gender who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 07-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jul-2021, the patient experienced HEADACHE (Headache NOS) (seriousness criterion medically significant). At the time of the report, HEADACHE (Headache NOS) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Jul-2021, SARS-CoV-2 test: negative (Negative) Negative. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. It was stated that the common side-effects for Moderna started 7 days after 1st vaccine. Not at any point before. Concomitant medications were not reported. No treatment information was provided. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1488586 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Fatigue, Headache, Influenza like illness, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Ache; upset stomach; Flu-like aching; Pain in arm; Throbbing pain; Headache; Fever; Tiredness; This regulatory authority case was reported by a consumer and describes the occurrence of ABDOMINAL DISCOMFORT (upset stomach), INFLUENZA LIKE ILLNESS (Flu-like aching), PAIN (Ache), PAIN IN EXTREMITY (Pain in arm), PAIN (Throbbing pain), HEADACHE (Headache), PYREXIA (Fever) and FATIGUE (Tiredness) in a 40-year-old male patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 15-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced INFLUENZA LIKE ILLNESS (Flu-like aching) (seriousness criterion medically significant), PAIN IN EXTREMITY (Pain in arm) (seriousness criterion medically significant), PAIN (Throbbing pain) (seriousness criterion medically significant), HEADACHE (Headache) (seriousness criterion medically significant), PYREXIA (Fever) (seriousness criterion medically significant) and FATIGUE (Tiredness) (seriousness criterion medically significant). On an unknown date, the patient experienced ABDOMINAL DISCOMFORT (upset stomach) (seriousness criterion medically significant) and PAIN (Ache) (seriousness criterion medically significant). At the time of the report, ABDOMINAL DISCOMFORT (upset stomach) and PAIN (Ache) was resolving and INFLUENZA LIKE ILLNESS (Flu-like aching), PAIN IN EXTREMITY (Pain in arm), PAIN (Throbbing pain), HEADACHE (Headache), PYREXIA (Fever) and FATIGUE (Tiredness) had not resolved. No relevant concomitant medications were reported. No treatment information was provided. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. The events doesn?t seem to be serious by medical judgement, but they were assessed as serious as per regulatory authority report.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. The events doesn?t seem to be serious by medical judgement, but they were assessed as serious as per regulatory authority report.


VAERS ID: 1488590 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003607 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Chills, Headache, Myalgia, Pain in extremity, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ESTROGEN; PARACETAMOL; PROSTAP
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Date: 20210715; Test Name: COVID-19 virus test; Test Result: Negative; Result Unstructured Data: No - Negative COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: This regulatory authority case was reported by a consumer and describes the occurrence of BACK PAIN (Backache), PAIN IN EXTREMITY (Painful arm), HEADACHE (Headache), MYALGIA (Muscle ache), CHILLS (Chills) and PYREXIA (Fever) in a 38-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003607) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. Concomitant products included ESTRADIOL (ESTROGEN) and LEUPRORELIN ACETATE (PROSTAP) for Transgender, PARACETAMOL for an unknown indication. On 15-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced PAIN IN EXTREMITY (Painful arm) (seriousness criterion medically significant). On 16-Jul-2021, the patient experienced BACK PAIN (Backache) (seriousness criterion medically significant), HEADACHE (Headache) (seriousness criterion medically significant), MYALGIA (Muscle ache) (seriousness criterion medically significant), CHILLS (Chills) (seriousness criterion medically significant) and PYREXIA (Fever) (seriousness criterion medically significant). At the time of the report, BACK PAIN (Backache), PAIN IN EXTREMITY (Painful arm), HEADACHE (Headache), MYALGIA (Muscle ache), CHILLS (Chills) and PYREXIA (Fever) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Jul-2021, SARS-CoV-2 test: negative (Negative) No - Negative COVID-19 test. No Treatment medication reported. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. However, the events seem to be non-serious at present until further information is available for assessment.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. However, the events seem to be non-serious at present until further information is available for assessment.


VAERS ID: 1488591 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Menstruation irregular, Nausea, Pallor, Poor quality sleep, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Fertility disorders (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLUOXETINE; IRON; NEXPLANON; PARACETAMOL; CETIRIZINE HYDROCHLORIDE; VITAMIN D 2000
Current Illness: Anemia; Depression; Hay fever
Preexisting Conditions: Medical History/Concurrent Conditions: Function kidney decreased (Poor kidney function); Labyrinthitis; Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Pale skin; Irregular periods; Sleep unwell; Nausea; Pain injection site; Fatigue; This regulatory authority case was reported by a consumer and describes the occurrence of PALLOR (Pale skin), MENSTRUATION IRREGULAR (Irregular periods), POOR QUALITY SLEEP (Sleep unwell), NAUSEA (Nausea), INJECTION SITE PAIN (Pain injection site) and FATIGUE (Fatigue) in a 19-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Function kidney decreased (Poor kidney function), Lactation decreased and Labyrinthitis. Concurrent medical conditions included Depression since 01-Mar-2018, Anemia since 01-Jan-2015 and Hay fever since 01-Apr-2014. Concomitant products included IRON from 01-Jan-2015 to an unknown date for Anemia, ETONOGESTREL (NEXPLANON) from 04-Jun-2021 to an unknown date for Birth control, FLUOXETINE from 01-Mar-2018 to an unknown date for Depression, CETIRIZINE HYDROCHLORIDE from 01-Apr-2014 to an unknown date for Hay fever, PARACETAMOL for Pain, CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000) for an unknown indication. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced MENSTRUATION IRREGULAR (Irregular periods) (serious criterion medically significant), POOR QUALITY SLEEP (Sleep unwell) (serious criterion medically significant), NAUSEA (Nausea) (serious criterion medically significant), INJECTION SITE PAIN (Pain injection site) (serious criterion medically significant), and FATIGUE (Fatigue) (serious criterion medically significant),. On 16-Jul-2021, the patient experienced PALLOR (Pale skin). At the time of the report, PALLOR (Pale skin), MENSTRUATION IRREGULAR (Irregular periods), POOR QUALITY SLEEP (Sleep unwell), INJECTION SITE PAIN (Pain injection site) and FATIGUE (Fatigue) had not resolved and NAUSEA (Nausea) was resolving. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. No Treatment medication reported; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1488592 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling of body temperature change, 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: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Feel cold; Ache; Fatigue; Chills; Pain in arm; This regulatory authority case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain in arm), PAIN (Ache), FATIGUE (Fatigue), CHILLS (Chills) and FEELING OF BODY TEMPERATURE CHANGE (Feel cold) in a 39-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003608) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 15-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced PAIN IN EXTREMITY (Pain in arm) (seriousness criterion medically significant). On 16-Jul-2021, the patient experienced PAIN (Ache) (seriousness criterion medically significant), FATIGUE (Fatigue) (seriousness criterion medically significant) and CHILLS (Chills) (seriousness criterion medically significant). On an unknown date, the patient experienced FEELING OF BODY TEMPERATURE CHANGE (Feel cold) (seriousness criterion medically significant). At the time of the report, PAIN IN EXTREMITY (Pain in arm), PAIN (Ache), FATIGUE (Fatigue) and CHILLS (Chills) had not resolved and FEELING OF BODY TEMPERATURE CHANGE (Feel cold) was resolving. No concomitant medication was provided. No treatment medication was provided. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1488597 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-14
Onset:2021-07-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chromaturia, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PAROXETIN [PAROXETINE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Muscular pains; Brown urine; Headaches; This regulatory authority case was reported by a consumer and describes the occurrence of MYALGIA (Muscular pains), CHROMATURIA (Brown urine) and HEADACHE (Headaches) in a 44-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003608) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. Concomitant products included PAROXETIN [PAROXETINE] from 01-Jan-1996 to an unknown date for Anxiety disorder. On 14-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced MYALGIA (Muscular pains) (seriousness criterion medically significant), CHROMATURIA (Brown urine) (seriousness criterion medically significant) and HEADACHE (Headaches) (seriousness criterion medically significant). On 16-Jul-2021, MYALGIA (Muscular pains), CHROMATURIA (Brown urine) and HEADACHE (Headaches) had resolved. No treatment information was provided. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1488609 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-13
Onset:2021-07-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, SARS-CoV-2 test, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: COVID-19 virus test negative; Test Name: Trop; Result Unstructured Data: Myopericarditis
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Chest pain; This regulatory authority case was reported by an other health care professional and describes the occurrence of CHEST PAIN (Chest pain) in a 21-year-old male patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced CHEST PAIN (Chest pain) (seriousness criteria hospitalization and medically significant). At the time of the report, CHEST PAIN (Chest pain) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: covid-19 virus test negative (Negative) COVID-19 virus test negative. On an unknown date, Troponin: 4137 (High) Myopericarditis. 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. Concomitant product was not provided by the reporter. Patient reported that he experienced started chest pain on Thursday. The patient has not tested positive for COVID-19 since having the vaccine. No treatment information was provided. Company Comment Very limited information regarding this event has been provided at this time. Hospital discharge summary or diagnosis/treatment details are required for further evaluation. Contact details is not available and further follow-up is not possible.; Sender''s Comments: Very limited information regarding this event has been provided at this time. Hospital discharge summary or diagnosis/treatment details are required for further evaluation. Contact details is not available and further follow-up is not possible.


VAERS ID: 1489956 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Headache, Hypoaesthesia, Presyncope
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: headache; Headache recurrent; Near fainting; Numbness facial; Felt faint; Dizzy; Dizziness; This regulatory authority case was reported by a consumer and describes the occurrence of PRESYNCOPE (Near fainting), HYPOAESTHESIA (Numbness facial), DIZZINESS (Felt faint), DIZZINESS (Dizzy), DIZZINESS (Dizziness), HEADACHE (headache) and HEADACHE (Headache recurrent) in a 40-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 15-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 15-Jul-2021, the patient experienced PRESYNCOPE (Near fainting) (seriousness criterion medically significant), HYPOAESTHESIA (Numbness facial) (seriousness criterion medically significant), DIZZINESS (Felt faint) (seriousness criterion medically significant), DIZZINESS (Dizzy) (seriousness criterion medically significant), DIZZINESS (Dizziness) (seriousness criterion medically significant) and HEADACHE (Headache recurrent) (seriousness criterion medically significant). On an unknown date, the patient experienced HEADACHE (headache) (seriousness criterion medically significant). On 15-Jul-2021, PRESYNCOPE (Near fainting) had resolved. On 16-Jul-2021, HYPOAESTHESIA (Numbness facial) had resolved. At the time of the report, DIZZINESS (Felt faint), DIZZINESS (Dizzy), DIZZINESS (Dizziness), HEADACHE (headache) and HEADACHE (Headache recurrent) had not resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Concomitant medications were not provided by the reporter. Treatment information was not provided. It was reported that within 10 minutes of receiving the vaccine patient''s face started to go numb and he felt faint and dizzy. He was able to stand and walk again after around 2 hours. Company comment: This case concerns a 40-year-old female with serious unexpected events of presyncope, dizziness, hypoaesthesia and headache. Event latency 10 minutes after second dose mRNA-1273. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: This case concerns a 40-year-old female with serious unexpected events of presyncope, dizziness, hypoaesthesia and headache. Event latency 10 minutes after second dose mRNA-1273. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


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