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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 369 out of 6,867

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VAERS ID: 1513141 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-23
Onset:2021-07-14
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Inflammatory marker test, Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: minocycline, zyrtec and occasional advil
Current Illness: none - occasional migraines
Preexisting Conditions: migraines
Allergies: Sulfa drugs, cephlexin
Diagnostic Lab Data: Blood tests for inflammation all returned normal
CDC Split Type:

Write-up: Swelling and pain in knees


VAERS ID: 1513155 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

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

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

Write-up: given after the beyond-use-dating due to the vaccine being stored improperly


VAERS ID: 1513167 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Intentional product use issue, Product storage error
SMQs:, Drug abuse and dependence (broad), Depression (excl suicide and self injury) (broad), 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: given after the beyond-use-dating due to the vaccine being stored improperly


VAERS ID: 1513444 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-30
Onset:2021-07-14
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abortion threatened
SMQs:, Termination of pregnancy and risk of abortion (narrow)

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

Write-up: O20.0 - Threatened abortion


VAERS ID: 1513689 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Incorrect product administration duration, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: given after the beyond-use-dating due to the vaccine being stored improperly


VAERS ID: 1513881 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Incorrect product administration duration, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: given after the beyond-use-dating due to the vaccine being stored improperly


VAERS ID: 1514790 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Hypoaesthesia, Hypoaesthesia oral, Lethargy, Migraine, Pain, Pruritus, Rash erythematous, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Insect bite allergy (allergic to insect bites, shellfish); Shellfish allergy (allergic to insect bites, shellfish)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021901013

Write-up: had heavy breathing/shortness of breath; itching/ hands and feet were red and itchy; and a rash on her hands and feet/ hands and feet were red and itchy; lethargy; migraines; body aches; hives on her face/ face and neck she had welts; numbness on her face, hands, lips and feet/ numbness in her face lips and tongue; numbness on her face, hands, lips and feet; This is a spontaneous report from a contactable consumer reporting for self, via the Pfizer-sponsored program. A 58-years-old female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 1 via an unspecified route of administration in left shoulder on 14Jul2021 (Batch/Lot Number: ER8731) as a single dose for COVID-19 immunization. Medical history included allergic to insect bites, shellfish, and she had COVID in Mar2020. Concomitant medication(s) were none. There were no vaccinations in the 4 weeks prior. The patient previously took epinephrine (EPIPEN) for severe allergic reaction and pneumonia vaccine on 23May2020 (at age 57 years old) and experienced migraines. The patient reported she had many side effects after her first dose such as numbness, itching, migraines, body aches, lethargy, hives on her face, and a rash on her hands and feet. She had the numbness on her face, hands, lips and feet started immediately after administering the vaccine (14Jul2021). She took Tylenol so it wouldn''t get worse and she took Benadryl because her hands and feet were red and she also experienced body aches (onset 14Jul2021). She states she has an EPIPEN she carries just in case of a severe allergic reaction because she was allergic to insect bites, shellfish, and things like that, but she did not use it after she received the vaccine. She only took Benadryl. She also had heavy breathing/shortness of breath as a symptom. On her face and neck she had welts and she didn''t see the rest of her body because she had pajamas on. When she got up to use the restroom she was trying to figure out why she was itching. She saw welts on her face and neck. Her hands and feet were red and itchy. There was no investigation assessment. At the time of the report, the numbness in her face lips and tongue was gone (recovered in Jul2021) but the numbness in feet and hands remain (not recovered). There was no treatment for this event. The welts on her face and neck had started 30 mins after she departed got in the car and went home, and had gone away on 14Jul2021, after Benadryl (recovered). The migraines had started about 6pm on 14Jul2021; they were dulling and were going away, but was still on the back of the head. It was persisting (not recovered). Treatment for the migraines was just the Tylenol. The body aches were treated with Tylenol and were ongoing (not recovered). The events did not require a visit to the Emergency Room or Physician''s office. She wanted to know when these symptoms would go away .If she takes dose 2, she wanted to know what can she do as preparation for this because she heard the second one is worse.


VAERS ID: 1515150 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / IM

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? 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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.


VAERS ID: 1515303 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Alopecia, Arthralgia, Chills, Fatigue, Influenza like illness, Mobility decreased, Pain
SMQs:, Parkinson-like events (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Reported 100.8 temp, chills and flu like symptoms. Could not get out of bed. Day 2 went to work but very achy and tired. She had Covid in April and was hospitalized. I have been having terrible joint pain and have lost 3/4 of my hair. Joint, hands, neck and back pain increasing and debilitating.


VAERS ID: 1515308 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-01-04
Onset:2021-07-14
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase, Aspartate aminotransferase, Hepatic function abnormal, Ultrasound liver normal
SMQs:, Liver related investigations, signs and symptoms (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lexapro birth control pill OTC Calcium OTC Vitamin D OTC Vitamin B12
Current Illness:
Preexisting Conditions: dysthymia, otosclerosis
Allergies: sulfa, avocado; gluten and dairy intolerance
Diagnostic Lab Data: AST 101 on 7/22/2021; repeated at 104 on 7/28/2021 ALT 162 on 7/22/2021; repeated at 196 on 7/28/2021; Liver ultrasound on 7/27/2021 normal. Started taking vitamin supplements one month prior to event. No other known causes of liver dysfunction.
CDC Split Type:

Write-up: Abnormal liver function as noted during routine annual physical.


VAERS ID: 1515325 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-10
Onset:2021-07-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SC

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Contusion, Gait disturbance, Joint swelling, Loss of personal independence in daily activities, Mobility decreased, Myalgia, Pain, Pain in extremity, Sleep disorder, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Yes, Limb immobilization, body bruising, cough, fatigue
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On July 28 I had to go to the emergency room at hospital due to the intense pain and the appearance of the bruises, a Rheumatology Specialist observed me, they indicate that the x-ray results came out fine, general exam did too, and I am still waiting for more results
CDC Split Type:

Write-up: Third day after the vaccine by 7 at two mid night, Saturation was 88 for about an hour, then my muscles start to ache, stopping making movements as my wrist swelled. I could not close my hands, the pain would move to different parts of my body, when it was on my leg I started to limp. I can''t lift my arms, I can''t sleep because of the pain. 3 days ago, I noticed bruises all over my body they hurt. I''m not the young woman I was before, I''m totally inefficient, I can''t do anything on my own, I wasn''t like this before.


VAERS ID: 1515408 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-07-14
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, COVID-19, COVID-19 pneumonia, Chest pain, Cough, Diabetes mellitus inadequate control, Dyspnoea, Fatigue, Hallucination, Hypoxia, Influenza like illness, Malaise, Pain
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: pregabalin, metformin, insulin regular, insulin glargine, acet
Current Illness: diabetes
Preexisting Conditions: diabetes 1, neuropathy, pericarditis, morbid obesity
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 7.17.21: patient diagnosed with COVID-19 3 days prior, presents to ED with worsening "flu like symptoms" over past 2 weeks including fatigue, malaise, generalized body aches, dyspnea, dry cough, and CP, and hallucinations over last 24 hrs. Patient was previously vaccinated with COVID-19 J&J vaccine on 4/6/21. Diagnosed with: COVID-19 pneumonia, acute resp distress with hypoxia, poorly controlled DM. received remdesivir. 7/22/21: discharged


VAERS ID: 1515499 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       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: n/a
Current Illness: n/a
Preexisting Conditions: Patient has history of fainting per patient''s mother (ie. blood work, blood test, seeing cuts/scrapes)
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type: N/A

Write-up: After patient fainted following the first dose of the Pfizer COVID-19 vaccine, 9-1-1 was called immediately and the paramedics came. Patient woke up and felt better.


VAERS ID: 1515610 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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? 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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.


VAERS ID: 1515624 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2020-12-24
Onset:2021-07-14
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Decreased appetite, Fatigue, Headache, Oropharyngeal pain, Pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NP Thyroid 120mg 1 tab daily OTC Vitamins daily - vit c, vit d, zinc daily probiotic daily allergy OTC (zyrtec)
Current Illness: n/a
Preexisting Conditions: hypothyroidism
Allergies: n/a
Diagnostic Lab Data: Seguin Family Medicine
CDC Split Type:

Write-up: Wed, 7/14/21 - headache, body aches, fatigue, low appetite Thurs, 7/15/21 - body aches, fatigue, cough, sore throat, low appetite Fri, 7/16/21 - body aches, headache, fatigue, cough, loss of smell/taste, tested positive for COVID-19 via nasal swab


VAERS ID: 1517959 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear congestion, Hypoacusis
SMQs:, Hearing impairment (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: MELOXICAM; GINGER [ZINGIBER OFFICINALE]; VITAMIN C [ASCORBIC ACID]; VITAMIN B12 [VITAMIN B12 NOS]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100908515

Write-up: lost some ability to hear as well as I could before the vaccination; Right ear congestion; This is a spontaneous report from a contactable consumer (patient). A 70-years-old male patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0180), via an intramuscular route on 13Jul2021 (at the age of 70-years) as dose 2, single in the left arm for COVID-19 immunisation. The patient medical history was not reported. The patient had no known allergies. The patient concomitant medications included Meloxicam, ginger, B12 and vitamin C from an unknown date and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: Unknown), via an unspecified route on unspecified date as dose 1, single in the left arm for COVID-19 immunisation. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 14Jul2021, the patient experienced right ear congestion the next day after 2nd dose vaccine and it still persist today and also lost some ability to hear as well as he could before the vaccination. Event resulted in Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care, Hospitalization, Prolongation of existing hospitalization (vaccine received during existing hospitalization), Life threatening illness (immediate risk of death from the event), Disability or permanent damage. The patient did not received treatment for events (as reported). The outcome of the events was not resolved. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1517991 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-24
Onset:2021-07-14
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 2 RA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210717; Test Name: Covid test; Test Result: Positive
CDC Split Type: USPFIZER INC202100916931

Write-up: Colleague became COVID positive on 17Jul2021; Colleague became COVID positive on 17Jul2021; This is a spontaneous report from a contactable other hcp. A 40-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot No: EK5730; Expiration Date: 31Mar2021), via intramuscular in right arm on 24Mar2021 (at the age of 40-years-old) as second dose, single for COVID-19 immunization. Patient received first dose of (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot No: EJ1685), via intramuscular in left arm on 03Mar2021 as first dose, single for COVID-19 immunization. Medical history and concomitant medications were not reported. It was unknown if the patient had known allergies. It was unknown if patient experienced COVID prior vaccination. It was unknown if patient received other vaccine in four weeks. It was reported that on 14Jul2021, the colleague (patient) became COVID positive on 17Jul2021. Event resulted in doctor or other healthcare professional office/clinic visit. Treatment for the event was given as antibiotic and steroids. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 17Jul2021. Report received from a Product Complaint Group included that this is a notification generated from the gQTS system. As part of the LOE simplification process, the following Complaint Records were classified as Product Use Attributes // Lack of Effect and have been moved to Closed (No Investigation) state referencing a previously completed investigation for the same product and lot as per the ''One and Done'' business process according to in PQS Q1215 and/or Q1252. Refer to the below table (Parent) Brand/Trade - Name: COMPOUND BNT162 COVID-19 VACCINE SUSPENSION FOR INTRAMUSCULAR 2ML MULTIPLE DOSE VIAL X 1, Lot-# (CR): ER8737, Conclusion of Previously Completed Investigation. The complaint for lack of effect of the PFIZERBIONTECH COVID-19 VACCINE lot ER8737 was investigated. The investigation included a review of manufacturing and packaging batch records, deviation investigations, and an analysis of complaint history for the reported lot. The final scope included the reported finished goods lot ER8737, fill lot EW3426, and the formulated drug 5861480 5857105 product lot EP8586. A complaint sample was not returned, and photographs were not received. No related quality issues were id. When more than one investigation is found in the family, the Conclusion field could result in repeating rows in the table. If the Conclusion is blank in the table above, then the investigation record is likely an Offline Contractor Investigation and the conclusion must be obtained directly from the child investigation record(s) of the linked Complaint Record. In material information (CI grid), Material # and Material Description fields are applicable to non-SAP sites and will be blank on the report for investigation records created under SAP sites. Material # (SAP) and Material Description (SAP) fields are applicable to SAP sites and will be blank on the report for investigation records created under non-SAP sites. Investigation decision pfizer reviewed this complaint and agrees with the site assignment, investigation decision, classification, sub-classification, and priority. The reported lot number is valid, and an investigation will be performed. The complaint and its classification have been reviewed. No immediate containment action is required. The complaint, its priority, and its classification have been reviewed and determined to be appropriate. A full investigation will be performed. This is a complaint for lack of effect of lot EK5730 of the PFIZER-BIONTECH COVID-19 VACCINE. The initial scope of this investigation is limited to the reported finished goods lot EK5730 pending review of lot genealogy. The investigation will include a review of the returned complaint sample (if received) and reserve samples, if necessary. Reviewed On (GMT): 26Jan2021. Investigation findings the initial scope of the investigation was limited to the reported finished goods lot. The final scope was expanded to include the reported finished goods lot EK5730, fill lot EK3313, and the formulated drug product lot EK3312. Manufacturing and packaging batch records were reviewed for the reported complaint lot. Pfizer did not receive photographs or a complaint sample for examination. The complaint was not confirmed. There were no planned or unplanned deviations recorded during the manufacture of the complaint lot and associate manufacturing lots that may have caused a complaint of this nature. A review of the manufacturing records confirmed processing steps were performed within pre-established parameters. All raw materials and amounts used in the manufacture of the batch were of the correct weight and identity. The drug product is stored at controlled refrigeration throughout the manufacturing process and a log is maintained documenting the elapsed time out of refrigeration. A review of the logs confirmed that all times were within allowable limits. The product also requires storage in ultra-low temperature freezers following the packaging of the product. A review of the freezer temperature log for the reported batch confirmed that all freezer temperatures were within allowable limits. The results of all analytical tests performed at the time of lot release confirmed that the batch continues to meet potency specifications. Root Cause Analysis/Identify pfizer Kalamazoo Quality Operations could not indicate a probable root cause for the complaint to be related to the production process of the involved batch. Review of the manufacturing and packaging batch records and release test results confirmed that the batch continues to meet potency specifications. It is unknown how the product was handled, stored, or administered after it left the Pfizer Kalamazoo site. Impact analysis based on the results of this investigation, the manufacturing and packaging batches remain acceptable, and the reported complaint is not representative of the lot. No regulatory notification is needed. There were no corrective actions as a result of this complaint investigation. The results of all tests, inspections, and in-process controls have been reviewed and all results met the established requirements prior to the release of the reported batch for distribution. The complaint for lack of effect of the PFIZER-BIONTECH COVID-19 VACCINE lot EK5730 was investigated. The investigation included a review of manufacturing and packaging batch records, deviation investigations, and an analysis of complaint history for the reported lot. The final scope included the reported finished goods lot EK5730, fill lot EK3313, and the formulated drug product lot EK3312. A complaint sample was not returned, and photographs were not received. No related quality issues were identified during the investigation. There is no impact to product quality. No root cause or corrective/preventative actions were identified as the complaint was not confirmed. All release testing performed prior to the release of the reported batch was within specifications. Manufacturing batch records complete acceptable. The bulk manufacturing batch record for the complaint batch was reviewed as part of this investigation and found to be acceptable. All processing steps were performed within pre-established parameters. The review of the manufacturing record confirmed that all in process checks, all line startup and end of batch challenges, and all line clearance and cleaning activities were completed satisfactorily. All raw materials used in the complaint batch were of the correct weight and identity. All the manufacturing temperatures mix speeds and mixing times were within acceptable ranges. In-process appearance and specific gravity test results were all within acceptable ranges. A review of the solution filtration documentation confirmed that all materials, filters and Water for Injection (WFI) were used within their expiration dates, and that all the filtration times, pH results, and pressure specifications were met. The manufacturing processes of raw material usage, solution formulation and filtration were all found to be acceptable. All manufacturing parameters met established requirements. A log is maintained throughout the manufacturing process of the amount of elapsed time that the product is out of refrigeration. A review of the elapsed time tracking logs confirmed that all times were within allowable limits. Packaging batch records: complete -acceptable. The review of the packaging record confirmed that all in process checks, all line startup and end of batch challenges, and all line clearance and cleaning activities were completed satisfactorily. Audits are performed on the finished packaged units by Packaging Operations personnel at regular intervals throughout the final packaging process. This is done in order to ensure that all required labeling and packaging is present, complete, and meets all establishments requirements. During the audits, inspectors visually check the appearance of the finished product for defects. The Pfizer-BioNTech COVID-19 Vaccine vials are loaded into trays containing 195 vials each. Five trays are then banded together into a bundle. The vaccine requires ultra-low temperature freezer storage. Prior to loading, freezer temperatures were verified to between -67?C and -73?C. Freezer shelves were then loaded with bundles of product. During the freezing phase, which occurs 60 hours after loading, the temperature of the freezers is monitored. If the temperature is greater than the expected temperature, supervision is notified. A review of the log for the reported batch confirmed that all freezer temperatures were acceptable. Samples are then stored until the product is released for distribution. There were no issues recorded during the packaging or storage process which may have impacted the quality of the batch and potency of the drug product. Reserve sample testing result: A reserve sample was not sent to the QC-lab to determine the amount of active ingredient since the complaint was received within six months of the release date of the involved batch. The results of all analytical tests performed at the time of lot release were confirmed to be within registered specifications. All available stability results for this product were within registered specification and stability studies (including accelerated studies) are ongoing for this product. Lot trend assmt. And rationale the complaint history for the reported PFIZER-BIONTECH COVID-19 VACCINE lot EK5730 was reviewed. As of 11Feb2021, there were a total of five complaints for this lot and classification. No lot specific trend was identified that would require additional investigation. Lot Trend Actions Taken was not applicable. Outcome of the event was recovering.; Sender''s Comments: The vaccine efficacy varies from one patient to another and can be affected by different factors; however, a contributory role of the suspect vaccine BNT162B2 to the vaccination failure cannot be ruled out.


VAERS ID: 1518016 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-23
Onset:2021-07-14
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Exposure to COVID-19 (She was in contact with the person who had the Coronavirus on 11Jul2021.)
Allergies:
Diagnostic Lab Data: Test Date: 20210714; Test Name: Covid 19 virus test; Test Result: Positive
CDC Split Type: USPFIZER INC202100918625

Write-up: achy; tested positive for the Coronavirus after receiving the Covid 19 vaccine; tested positive for the Coronavirus after receiving the Covid 19 vaccine; This is a spontaneous report from a contactable consumer (patient). A 32-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose 1 via an unspecified route of administration on 30Jan2021 (Batch/Lot Number: EN5318; Expiration Date: 31May2021) as single dose, dose 2 via an unspecified route of administration, administered in Arm Left on 23Feb2021 (Batch/Lot Number: EL9264; Expiration Date: 31May2021) as single dose, both at the age of 31-year-old for COVID-19 immunization. Patient''s Medical History (including any illness at time of vaccination) was none. Predisposing factor included Contact with infected person (She was in contact with the person who had the Coronavirus on 11Jul2021). There were no concomitant medications. The patient did not receive any additional vaccines on same date of the Pfizer suspect. The patient did not receive any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient did not have any AE(s) following prior vaccinations. The patient reported that she and some friends got the Coronavirus after being exposed to it and she and her friends all had received the Covid 19 vaccine. She reports 4 people who were together for a couple hours. She was in contact with the person who had the Coronavirus on 11Jul2021. She tested positive for the Coronavirus on 14Jul2021. She reported being achy on an unspecified date. The AE(s) did not require a visit to Emergency Room or Doctor''s office. Outcome of the events was unknown. Summary and Conclusion of product quality Investigation of lot EN5318: The initial scope of the investigation was limited to the reported finished goods lot EN5318, fill lot EN5317, and the formulated drug product lot EN5316. Based on the results of the investigation, the scope was not expanded. Manufacturing and packaging batch records were examined for the reported complaint batch. Pfizer (city) QO did not receive photographs or a complaint sample for examination. The complaint was not confirmed. No probable root cause for the complaint related to the manufacturing process of the reported lot was identified. There were no corrective actions taken as a result of this complaint investigation. No related quality issues were identified during the investigation. There were no planned or unplanned deviations recorded during the manufacture of the complaint lot and associated manufacturing lots that may have caused a complaint of this nature. A review of the manufacturing records confirmed processing steps were performed within pre-established parameters. All raw materials and amounts used in the manufacture of the batch were of the correct weight and identity. The drug product is stored at controlled refrigeration throughout the manufacturing process and a log is maintained documenting the elapsed time out of refrigeration. A review of the logs confirmed that all times were within allowable limits. The product also requires storage in ultra-low temperature freezers following the packaging of the product. A review of the freezer temperature log for the reported batch confirmed that all freezer temperatures were within allowable limits. The results of all analytical tests performed at the time of lot release confirmed that the batch meets potency specifications. There was no impact to the quality of the lot. It is unknown how the product was handled, stored, or administered after it left the (city) site. The complaint for lack of effect of the Pfizer-biontech Covid-19 vaccine injectable lot EN5318 was investigated. The investigation included reviewing manufacturing and packaging batch records, deviation investigations, and an analysis of complaint history for the reported lot. The final scope was determined to be the reported finished goods lot EN5318, fill lot EN5317, and the formulated drug product lot EN5316. A complaint sample was not returned. No related quality issues were identified during the investigation. There is no impact on product quality. No root cause or CAPA were identified as the complaint was not confirmed. All release testing performed prior to the release of the reported batch was within specifications. Summary and Conclusion of product quality Investigation of lot EL9264: The initial scope of the investigation was limited to the reported finished goods lot. The final scope was expanded to include the reported finished goods lot EL9264, fill lot EL9255, and the formulated drug product lot EL9246. Manufacturing and packaging batch records were reviewed for the reported complaint lot. Pfizer (city) QO did not receive photographs or a complaint sample for examination. The complaint was not confirmed. There were no planned or unplanned deviations recorded during the manufacture of the complaint lot and associated manufacturing lots that may have caused a complaint of this nature. A review of the manufacturing records confirmed processing steps were performed within pre-established parameters. During formulation of PBS Buffer, there was an undercharge of disodium hydrogen phosphate dihydrate, but this was found to have no impact on product quality. All other raw materials used in the complaint batch were of the correct weight and identity. The drug product is stored at controlled refrigeration throughout the manufacturing process and a log is maintained documenting the elapsed time out of refrigeration. A review of the logs confirmed that all times were within allowable limits. The product also requires storage in ultra-low temperature freezers following the packaging of the product. A review of the freezer temperature log for the reported batch confirmed that all freezer temperatures were within allowable limits. The results of all analytical tests performed at the time of lot release confirmed that the batch meets potency specifications. The complaint for lack of effect of the PFIZER-BIONTECH COVID-19 VACCINE lot EL9264 was investigated. The investigation included a review of manufacturing and packaging batch records, deviation investigations, and an analysis of complaint history for the reported lot and product type. The final scope included the reported finished goods lot EL9264, fill lot EL9255, and the formulated drug product lot EL9246. A complaint sample was not returned. No related quality issues were identified during the investigation. There is no impact on product quality. No root cause or CAPA were identified as the complaint was not confirmed. All release testing performed prior to the release of the reported batch was within specifications. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1518461 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen-Codeine #3 PRN
Current Illness: No illness, but fractured calcaneus and fractured radius head (incident date: 06/27/2021)
Preexisting Conditions: Very mild asthma, had COVID 19 starting 10/13/2020
Allergies: NKA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: First symptom: shortness of breath: started during the first 15 mins after shot, but was manageable (have asthma and was comparing to that for difficultly level) Second and third: started 30 to 45 minutes after shot, tightness in chest, no pain. Heart palpitations, pulse not bounding. All symptoms subsided within 1 hour 15 minutes to 1 hour 30 minutes after shot.


VAERS ID: 1518462 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-03-20
Onset:2021-07-14
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Colonoscopy abnormal, Haematochezia, Haemorrhoids
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific inflammation (broad), Ischaemic colitis (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: Vitamin C, D3 with, k2 drops, magnesium, zinc
Current Illness:
Preexisting Conditions:
Allergies: Prednisone
Diagnostic Lab Data: July 20th colonoscopy.
CDC Split Type:

Write-up: On July 14th I had a lot of bright red bloody stool. I was instructed by my Dr. to go to the ER. The bleeding stopped within 12 hours. I had a colonoscopy on July 20th. That test showed an internal small hemmoroid that wasn?t bleeding and no other issues of concern. My blood work was good at the ER also. I?m healthy and have regular bowel movements, I eat a Whole Foods, sugar free gluten free diet. I?m very healthy and active on no medications, and take regular supplements for preventative healthcare. I?m still having episodes of bright red blood in my stool. It could be the hemmoroid but I felt the need to report this as I?m concerned this is related to the vaccine. The colonoscopy showed nothing other than the small hemmoroid that wasn?t bleeding and my stools are still regular. Are other people having this symptom or occurrence?


VAERS ID: 1519525 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

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

Write-up: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.


VAERS ID: 1519541 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

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

Write-up: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.


VAERS ID: 1519560 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

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

Write-up: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.


VAERS ID: 1519586 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

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

Write-up: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.


VAERS ID: 1519867 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / UNK LA / IM

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? 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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.


VAERS ID: 1519891 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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? 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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.


VAERS ID: 1519987 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, No adverse event, Product administered to patient of inappropriate age
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient was given the Moderna vaccine in error, because she is only 14 years of age. Patient has not experienced any symptoms or adverse reaction outside of the normal pain at the injection point and upper arm area.


VAERS ID: 1520012 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: None
CDC Split Type:

Write-up: None


VAERS ID: 1520045 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, No adverse event, Product administered to patient of inappropriate age
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Patient was given the Moderna vaccine in error, because she is only 15 years of age. Patient has not experienced any symptoms or adverse reaction outside of the normal pain at the injection point and upper arm area.


VAERS ID: 1520960 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-21
Onset:2021-07-14
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Axillary mass, Biopsy breast abnormal, Breast mass, Diffuse large B-cell lymphoma, Mammogram abnormal, Ultrasound breast abnormal
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Breast tumours of unspecified malignancy (broad), Malignant lymphomas (narrow), Haematological malignant tumours (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multi-vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 7/14: mammogram 7/22: ultrasound 7/28: biopsy 8/3: pet/ct scan
CDC Split Type:

Write-up: I had a mammogram done on 7/14 and the image shows three lumps in my left breast and under left arm, I was called back to get a ultrasound scan which showed potential malignancy, I had a biopsy done on 7/28 and the results confirmed existence of Diffuse Large B-Cell Lymphoma.


VAERS ID: 1523048 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Malaise, Pain
SMQs:, Arthritis (broad)

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

Write-up: Systemic: Body Aches Generalized-Severe, Systemic: Headache-Severe, Systemic: Joint Pain-Severe, Additional Details: She said it felt like how she did when she was diagnosed with COVID


VAERS ID: 1523336 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cellulitis, Erythema, Herpes zoster, Injection site swelling, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, Coreg, Lamotrigine ,lisinopril
Current Illness:
Preexisting Conditions: HTN, LBP, Epilepsy
Allergies: morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash, redness, swelling to site with pain in arm. Dx shingles, cellulitis. Rx Valacyclovir, Gabapentin, Keflex. taking otc Benadryl


VAERS ID: 1523355 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dyspnoea
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? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: no known allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient states that 1 day after vaccination he began experiencing shortness of breath and chest pain upon exertion. He states he works out frequently and was at the gym lifting weights post vaccination and noticed the shortness of breath. Later the same week he also had chest pain accompanying the shortness of breath upon exertion. Both resolved with rest. The symptoms lasted approximately 2 weeks, and have since resolved. The patient did not seek any medical care, but asked about it when he presented for his 2nd dose. Second dose not administered, recommended to consult with PCP before getting 2nd vaccination.


VAERS ID: 1523884 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN EW0191 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
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: The patient was brought to a popup clinic for his second Pfizer COVID19 vaccine by his mother 7/14/21, and a dose was administered that day. On July 23rd 2021 it was discovered during data entry that the patient had received his first Pfizer COVID19 vaccine dose 7/6/21, 8 days prior to dose 2. Both doses were recorded on the patient''s vaccine card. NP, notified the patient''s mother, who reported she brought her son in for dose 2 on 7/14 because she thought it was time. NP advised patient''s mother per Dr and CDC guidelines that no further doses are recommended at this time, and to follow up with booster dose if and when it is recommended. in the future..


VAERS ID: 1524787 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-14
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210714; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210800428

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a consumer concerned a 26 year old male of unspecified race & ethnicity. Initial information was processed along with additional information received on 30-JUL-2021. 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) 1 total, dose was administered on MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 14-JUL-2021, the patient experienced sore throat, cough, loss of taste and possibly a fever. On the same day, he was tested positive for covid-19 infection (suspected covid-19 infection and suspected clinical vaccination failure). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000187910. The suspected product quality complaint has been confirmed to be not voided (meet PQC criteria) in investigation result. based on the PQC evaluation/investigation performed.; Sender''s Comments: V0:20210800428-JANSSEN COVID-19 VACCINE Ad26.COV2.S- Suspected clinical vaccination 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: 1525198 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Unknown  
Location: North Carolina  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Heart rate irregular, Hypoaesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), 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: None
Current Illness: None
Preexisting Conditions: Asma,Copd
Allergies: Ct scan contrast,penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Numbness on arms legs and left side face with pain tight cheat and irregular heart beat.


VAERS ID: 1525352 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-01
Onset:2021-07-14
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Coronary arterial stent insertion, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Other ischaemic heart disease (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydroxyzine
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Hospital stay, Angiogram, and all heart related tests.
CDC Split Type:

Write-up: Heart Attack - 2 day stay in the hospital. - Stent placement in my heart. - Now I''m on life long medication...


VAERS ID: 1525374 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-05
Onset:2021-07-14
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Balance disorder, Blood pressure increased, CSF protein increased, Computerised tomogram head normal, Computerised tomogram spine, Computerised tomogram thorax, Echocardiogram, Gait disturbance, Hypoaesthesia, Impaired work ability, Lumbar puncture, Magnetic resonance imaging head normal, Magnetic resonance imaging spinal abnormal, Magnetic resonance imaging thoracic, Monoplegia, Orthosis user, Paraesthesia, Respiratory viral panel, Scan with contrast abnormal, Spinal osteoarthritis, Stenosis, Walking aid user
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Arthritis (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Restasis drops for dry eyes
Current Illness: none
Preexisting Conditions: borderline hypertension since about 2011. Treated with medication until Feb. 2021, when Dr. discontinued it as unnecessary.
Allergies: eggs, avocados
Diagnostic Lab Data: Thurs 7/15: CT scan of head showed no acute abnormality. Fri 7/16: brain MRI showed no acute changes. MRI chest, lower back . Echocardiogram. Lumbar puncture showed elevated proteins but no leukocytosis or organisms. Viral panel was pending as of date of discharge. Sat 7/17: CT scan of lower back. Sun 7/18: CT scan of chest. Mon 7/19: MRI cervical with contrast. Cervical MRI showed degenerative cervical spondylosis w/multilevel stenosis and no spinal cord lesion.
CDC Split Type:

Write-up: On Wed., July 14, my left hand started tingling. As the morning progressed, my hand and arm started feeling numb. Mid-afternoon, my left foot began feeling numb; the numbness spread up my entire leg. By the time I got home (6 pm), I needed assistance to get into the house, because my left leg wasn?t working and my foot was dragging. On Thursday July 15, I went to a local clinic; they immediately sent me to the ER. I was then transported to the ER, where I was admitted. Over the next five days I had CT scans of head, neck and spine; MRI?s of the same; a lumbar puncture; and an echocardiogram. I was given acyclovir; solumedrol; and heparin and amlodipine because my BP was elevated (180/100 Thursday afternoon). With the help of a physical therapist and a walker, I was able to get around, and my balance and stability improved, although the numbness in my arm and leg remained. At discharge, I was given a walker and an AFO brace to assist my walking. I was unable to return to work until August 4, 2021.


VAERS ID: 1525817 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-02-16
Onset:2021-07-14
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Ear discomfort, Nausea, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient''s wife reports he has been having ear issues for 3-4 weeks and been on ATBs. He is now experiencing worsened fever, shortness of breath, n/v. He is immunocompromised after having kidney transplant. Reports to ED. Admitted to hospital.


VAERS ID: 1526164 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-01
Onset:2021-07-14
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Headache, Influenza like illness, Oropharyngeal pain, Pain, Pharyngeal swelling, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allergy medicine, Xolair injection every month, vitamins, Prempro for hot flashes
Current Illness: None
Preexisting Conditions: Asthma, Thalassemia
Allergies: all animals, Sulfa, Morphine
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: I felt like having the flu, my body was aching, I had a fever for 3 or 4 days, I felt like crap, I was exhausted, I pretty much slept for like a week. I did not go to the doctor because I was expecting to be sick. On 07/14/2021 I went to the doctor because I had a fever again and my throat was pretty much closed up and really sore, a never ending headache, brain foggy. Every day I have like a giant headache and very foggy which is very annoying. They gave me antibiotics and did not do any medical tests which is very annoying.


VAERS ID: 1526301 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Bone pain, Immune-mediated adverse reaction, Pain in extremity, Pyrexia, Spinal pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, topiramate, trazadone, zofran, domperidone
Current Illness: None
Preexisting Conditions: Lupus, fibromyalgia, degenerative bone disease, gastroparesis,
Allergies: Morphine, ibuprofen, epinephrine, corn, rice, millet
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fever up to 102 only lasted 2 days. Excruciating bone pain throughout spine lower back, hips, tops of thighs. This pain has lasted about three to four days and resolved on its own with Tylenol heating pads and hot baths. I did not seek other medical care during the first vaccination. The second vaccine had the same adverse effects, except the bone pain has not gone away and it continues to this very current day. The bone pain was even worse and with the second vaccine the bone pain needed to be treated with gabapentin through the care of my rheumatologist and needed to be followed up with visits with my rheumatologist after a visit to the emergency department, where it was determined that it was an immune system reaction.


VAERS ID: 1526320 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 3 LA / IM

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

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

Write-up: Patient received a 3rd dose of Moderna. 1st dose on 1/8/21, 2nd dose on 2/5/21, and 3rd dose on 7/14/21.


VAERS ID: 1526364 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-09
Onset:2021-07-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast discolouration, Breast swelling, Breast tenderness, Ear discomfort, Facial pain, Headache, Hypoacusis, Nodule, Peripheral swelling, Swelling face, Tenderness, Vitreous floaters
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Retinal disorders (narrow), Hearing impairment (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Posterior Vitreous Detachment a month before having the second dose, inflammation in the nerve of my inner ear in March
Preexisting Conditions: Chronic chemical pneumonitis diagnosed back in 2012 thyroid disorder
Allergies: Pollen, cigarette smoke, pet hair
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: 5 days after getting the second dose I had some issues with headaches, I took Tylenol for that, then my ears were clogged and developed a painful growth behind my ear like a nodule. Also, my face swelled up and that lasted for about a week and a half. 30 minutes after getting the dose my breasts change color to pink and they were swollen and tender. Both underneath my armpits are very tender. My feet swelled up the same night. They are still swollen on and off. After taking both doses I noticed that there was an increase of floaters but that lasted only the first day. Moderate headaches on and off. My face was sore. I went to urgent care to take care of the nodule behind my ear. I had problems hearing with that right ear. They had trouble seeing anything on the outside so they said that it must be something on the inside. They told me to take Ibuprofen sodium for the nodule behind the ear.


VAERS ID: 1528235 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-15
Onset:2021-07-14
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Pulmonary embolism, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: MAGNESIUM SULFATE; VITAMIN D NOS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Pain back; Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100962841

Write-up: On July 15 I had surgery to remove significant blood clots from my heart and lungs as a result from a saddle pulmonary embolism. I have done testing to eliminate Cancer, Hereditary and red blood cells; On July 15 I had surgery to remove significant blood clots from my heart and lungs as a result from a saddle pulmonary embolism. I have done testing to eliminate Cancer, Hereditary and red blood cells; This is a spontaneous report from a contactable consumer (patient). A 59-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number: EW0153; Expiry date: unknown) via an unspecified route of administration, administered in arm right on 15Apr2021 13:00 (at age of 59-year-old) as dose 2, single for COVID-19 immunization. Medical history included chronic low back pain from multiple back surgeries and allergy to sulfa from an unknown date and unknown if ongoing. Concomitant medications included magnesium sulfate, Vitamin D Nos taken for an unspecified indication. The patient had previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number: EN6207; Expiry date: unknown) on 25Mar2021 at 13:00 (at age of 59-year-old) as dose 1 single for COVID-19 immunization. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. It was reported that, on July 15 patient had surgery to remove significant blood clots from his heart and lungs as a result from a saddle pulmonary embolism which was reported on 14Jul2021 (at 04:00). patient had done testing to eliminate cancer, hereditary and red blood cells for as a cause 8 days. The adverse event resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. The patient was hospitalized due to adverse event. Therapeutic measures were taken as a result of adverse event as patient underwent surgery (to remove significant blood clots from heart and lungs as a result from a saddle pulmonary embolism) on 15Jul2021 and unspecified medication. The outcome of events was resolving.


VAERS ID: 1528683 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-12
Onset:2021-07-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cardiac stress test normal, Chest pain, Ejection fraction normal, Hyperaemia, Magnetic resonance imaging abnormal, Magnetic resonance imaging heart, Myocardial fibrosis, Troponin
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ibuprofen, minocycline
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: 7/28/2021:Troponin 0.460; 7/29/2021: CMRI: IMPRESSION: 1. Normal right ventricular size, RVEDV = 92 cc/m2. Normal right ventricular systolic function, RV EF = 54%. 2. Normal left ventricular size, LVEDV = 84 cc/m2. Normal left ventricular systolic function, LV EF = 58%, with no regional wall motion abnormalities. 3. No evidence of high signal intensity on T2 weighted imaging to suggest edema, T1 early post-contrast imaging to suggest hyperemia, or late gadolinium enhancement imaging to suggest myocardial fibrosis. The patient does not meet CMR criteria for myocarditis. 4. Normal origins of the left and right coronary arteries, without evidence of dilation or aneurysm. 8/4/2021: stess test, normal
CDC Split Type:

Write-up: chest pain starting 2 days after second dose


VAERS ID: 1528755 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
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: none
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Mother completed form with birthdate of 10-05-2008. She filled in age-12 years old. Daughter''s actual age is 10-05-2009.


VAERS ID: 1529208 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-28
Onset:2021-07-14
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Fatigue, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/04/21pfizer,Lot# 2nd dose: 01/28/21,Pfizer,Lot# Diagnosed covid positive:0 Symptom onset:07/14/21 Exposure:UNKNOWN Symptoms:fever, fatigue, loss of smell/taste sore throat,runny nose.


VAERS ID: 1530559 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Illness, Myalgia, Nausea, Pain, Pain in extremity, Parosmia, Productive cough, Vomiting, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Taste and smell disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bell''s palsy (History: The caller had an episode of Bell''s Palsy a month before she received the vaccine.); Blood pressure high (Diagnosed at least a decade ago.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100944516

Write-up: sick for week; has lost 10 pounds in the last week; stopped throbbing hurting 2 days later; smells are terrible; arm certain muscles hurt; Nausea; forces herself to throw up she throws up a yellow liquid; coughs and coughs up a clear mucus and spits it out; coughs and coughs up a clear mucus and spits it out; extreme fatigue; Chills; body aches; her left arm was extraordinarily painful from the top all the way to her fingers; This is a spontaneous report from a contactable consumer (patient, self-reporting). A 53-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot number: EW0198 and expiration dates were not reported), via an unspecified route of administration in arm left on 14Jul2021 at 14:30 (at the age of 53-Years) as single dose for COVID-19 immunisation. Medical history included hypertension from an unknown date and unknown if ongoing Diagnosed at least a decade ago, bell''s palsy from an unknown date and unknown if ongoing. The caller had an episode of Bell''s Palsy a month before she received the vaccine. No history of all previous immunization with the Pfizer vaccine. No other additional vaccines administered on same date. No prior vaccinations within 4 weeks. The patient''s concomitant medications were not reported. The patient experienced nausea on 21Jul2021, her left arm was extraordinarily painful from the top all the way to her fingers on 14Jul2021, chills on 16Jul2021, body aches on 16Jul2021, extreme fatigue on 17Jul2021, forces herself to throw up she throws up a yellow liquid on 21Jul2021, coughs and coughs up a clear mucus and spits it out on 17Jul2021, coughs and coughs up a clear mucus and spits it out on 17Jul2021, sick for week and has lost 10 pounds in the last week, stopped throbbing hurting 2 days later, smells are terrible, arm certain muscles hurt all on an unspecified date. Clinical course reported as the caller is calling about the first COVID vaccine. The caller called her doctor in a panic today because she has been sick for week. The caller has lost 10 pounds in the last week. The caller got the shot the Wednesday before this past one. At first the caller was fine but then her left arm was extraordinarily painful from the top all the way to her fingers. This started 2 hours after the shot, but the actual injection site never hurt. Now, if you touch the patient arm certain muscles hurt but it doesn''t hurt on its own its just tender when you touch it. The patient arm stopped throbbing hurting 2 days later and nauseous and doesn''t want to eat and the smells are terrible. The caller forces herself to throw up, she throws up a yellow liquid. The caller threw up Wednesday night and yesterday and feels like she will today but she hasn''t yet. The patient coughs, and coughs up a clear mucus and spits it out and it has a salty taste to it and coughs it right up and sounds worse than it is because her throat doesn''t hurt or nothing, but its like a chunks of clear mucus. The patient hasn''t been coughing as much but has been coughing up the same amount but not as often. The patient hasn''t had the energy to cook, she has been so tired and fatigued. The caller''s second dose is due 04Aug2021. The caller asked her doctor if she should get a COVID test and her doctor said that was sounds like this was a reaction to the vaccine and it should clear up in about 2 weeks. If the caller doesn''t feel well on 04Aug2021 the doctor told the caller not to get the second dose at that time. The doctor has had about 4 to 5 patients with the same thing as the caller. said the caller may feel bad for a couple of days but its been over a week now. Doctor gave the caller some medicine for the nausea. Therapeutic measures were taken as a result of nausea. The outcome of the events Illness, weight decreased, pain, parosmia, myalgia were unknown and pain in extremity, productive cough, cough were recovering and nausea, chills, body aches, fatigue, vomiting were not recovered. Description of Product Complaint: The caller asked her doctor if she should get a covid test and her doctor said that is sounds like this is a reaction to the vaccine and it should clear up in about 2 weeks. NDC and expiration date unknown.


VAERS ID: 1532034 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure fluctuation, Diarrhoea, Dizziness, Fatigue, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)

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

Write-up: Fluctuating BP, tiredness, dizziness, diarrhea, and stiffness of throat.


VAERS ID: 1532277 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Malaise, Pain, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Malaise, suspected fever, headache, body ache, chills, diarrhea, drowsiness


VAERS ID: 1534042 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-12
Onset:2021-07-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast swelling, Condition aggravated, Neuralgia, Rheumatoid arthritis, Skin lesion
SMQs:, Angioedema (broad), Peripheral neuropathy (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Autoimmune disorder; Bell''s palsy; Morton''s neuroma
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy; Latex allergy (skin lesion); Nerve pain; Neurosurgery; Numbness; Topical adhesive allergy (skin lesions)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100942260

Write-up: rheumatoid arthritis; Nerve pain in her face from the Bells palsy and the nerve pain from Morton''s Neuroma that she had in both feet activated; Nerve pain in her face from the Bells palsy and the nerve pain from Morton''s Neuroma that she had in both feet activated; Skin lesions on her face; Breast swelling; This is a spontaneous report from a contactable consumer (patient) via Medical information team. A 51-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in Arm Right on 12Jul2021 (Lot Number: EY0584) as DOSE 2, SINGLE for covid-19 immunization. Medical history included ongoing Bell''s palsy, autoimmune issue and Morton''s neuroma, nerve surgery in 2015 prior to vaccination, all kinds of allergies and numbness and neuralgia that happened on that right side, Numbness, nerve pain and allergic to latex and adhesive (extreme nearly life threatening reaction to latex and adhesives). The patient''s concomitant medications were not reported. The patient previously took BNT162B2 on 19-JUN-2021 dose 1, lot number: EW0180, vaccine was administered on her left side for dose 1, lot number: EW0180, vaccine was administered on her left side for COVID-19 immunization and experienced barely sore. The patient previously took Z-pak for skin lesion and made her sick. The patient had a flare up of nerve pain, skin lesions and breast swelling on 14Jul2021. The flare up of what her healthcare professional suspects could be an underlying autoimmune issue but the underlying autoimmune issue ranges from what she suspects is going to be rheumatoid arthritis but she has entered into the process of getting examined by a dermatologist and rheumatologist and is on that path now. The nerve pain in her face from the Bells palsy and the nerve pain from Morton''s Neuroma that she had in both feet activated as well as skin lesions on her face and all of that came out after the 2nd dose. The patient was sent in the process of investigating and knows it is underlying either severe allergies or autoimmune issue and she is on the path to get a formal diagnosis. The patient was previously treated her for things when she had skin lesions with the adhesive and latex and said it was infection but it was not and she was treated with antibiotics that made her sick and that was drawn out and gave her anti-inflammatories and by that time the issue had run it''s course and there was no official diagnosis and was told it must be something she ate or came into contact with. The patient could not get into see her HCP until Wednesday 21Jul2021 and can think of nothing else and did not go to the emergency room; states she felt she needed to get the Pfizer COVID Vaccine because she works in the public and there are a lot of unmasked people that she comes in close proximity with and she can''t say anything to them and does not want to be attacked by customers and pretends she does not see they wear no masks and works in retail and they want service and she does not know what they believe but they come in close contact with her and they are people that love to travel, go out to eat, and go to the gym. States the customers she has are in high risk areas and she does not know if they had the vaccine or not but she has exposure to people and wanted to protect herself and to not bring anything to her family and always worries about that. The events resulted in physician office visit. The patient had no prior vaccinations (within 4 weeks). The outcome of events was recovering. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1534773 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-02
Onset:2021-07-14
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Magnetic resonance imaging normal, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: 07/16/2021 - MRI - negative
CDC Split Type:

Write-up: Left arm and left leg tingling and swelling sensation, numbness. No loss of strength. Symptoms came on at the two week post vaccination date and lasted four days resulting in me going to the ER. Doctors ruled our Stroke, Aneurism, Baer Syndrome after performing an MRI. They sent me home undiagnosed and said if it get worse go back to an ER or Hospital. Symptoms declined for two weeks and have now reappeared essentially four weeks after the vacinnation


VAERS ID: 1535113 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

Life Threatening? No
Birth Defect? Yes
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: My menstrual cycle started the day after 7 days early. It was extremely heavy and the cramps where more intense than ever. It also lasted 11 days.


VAERS ID: 1535163 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-07
Onset:2021-07-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Palpitations, Visual impairment, Vitreous floaters
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (narrow), 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: SYNTHROID 0.15MG, TORSEMIDE 20MG, EPLERENONE 50MG, ATORVASTATIN 80MG, NOVOLOG INSULIN, CANDESARTAIN 8MG, BISOPROLOL 10MG, METOPROLOL TARTRATE 25MG, LEVEMIR,
Current Illness:
Preexisting Conditions: DIABETES, CARDIAC
Allergies: CODEINE, LANTUS, SOME PRESERVATIVES, ADHESIVES,
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: CHEST PALPITATIONS WHEN SWALLOWING/SHARP CHEST PAINS. SMALL BLIND SPOTS/FLOATING BLIND SPOTS IN VISION


VAERS ID: 1535528 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-06-23
Onset:2021-07-14
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster, Pain, Pruritus, Rash, Skin sensitisation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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:
CDC Split Type:

Write-up: Developed terrible itchiness, then significant sensitivity, then pain and rashes on the right thigh. This was diagnosed as shingles, which has lasted several weeks and is still continuing. Treatment has included a course of Prednisone.


VAERS ID: 1535920 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Breast swelling, Lymphoedema
SMQs:, Angioedema (broad), Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (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: Metoprolal, Amalodipin, Clopidogrel
Current Illness: None
Preexisting Conditions: Afib, Stroke - 10 years ago
Allergies: Penicillin, Arithromycin, Bactrim, Codeine, Valium, Torodal, Rocephin, Keflex, Levaquin,Aspirin
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Phone call from patient stating she had lymphedema on left side. Patient diagnosed by primary care physician. through appointment. Patient stated she just called her PCPs office and described the symptoms. Swelling went into her left breast. Patient had lumpectomies in the past but only a needle biopsy on the left side.


VAERS ID: 1536096 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-06
Onset:2021-07-14
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram thorax abnormal, Condition aggravated, Deep vein thrombosis, Dyspnoea, Pulmonary embolism, Scan with contrast abnormal, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro, Nexium, simvastatin, multivitamin, fish oil
Current Illness: No
Preexisting Conditions: Acid reflux, high cholesterol
Allergies: None known
Diagnostic Lab Data: Chest CAT scan showing clots in all lobes of both lungs. Ultrasound showed non-occlusive clot in posterior tibial vein in right calf.
CDC Split Type:

Write-up: Multi-lobe pulmonary embolism. Only symptom was shortness of breath doing household chores. I had a nearly identical event nine years prior. Reported to ER. CT scan with contrast confirmed diagnosis. Started on Eliquis anticoagulation. Ultrasound of legs showed non-occlusive clot in posterior tibial vein in right calf. Stayed overnight in hospital. Released the next day. This event is likely not related to the Covid vaccine, but I reported this to V-Safe, and they called back and asked me to fill out this form.


VAERS ID: 1536465 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-07-12
Onset:2021-07-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Lymph nodes swollen to the size of a tennis ball and this lasted for a week and I was prescribed medicine and the swelling went down. The swelling has gone down but not all the way.


VAERS ID: 1540438 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-07
Onset:2021-07-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: mildly elevated heart rate compared to normal. not true tachycardia, but baseline typically in 60s, and was in 80s-90s for a few weeks. self limited


VAERS ID: 1544691 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-14
Onset:2021-07-14
   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 EW0178 / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation 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:

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1544948 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-29
Onset:2021-07-14
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM6207 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site pain, 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: Prozac, Ambien, Valtrex, Pramipexole, Lorazipan
Current Illness: NONE
Preexisting Conditions: On July 14, out of nowhere, my left arm, the arm where I received the second Covid-19 Pfizer vaccine, started hurting and aching so badly. I could not lift my arm above my head. I could not reach for a glass in the cabinet for a drink. I could not brush my teeth with my left arm it hurt so badly. I thought I had just pulled a muscle. When it continued to hurt, after a week or two, I felt around the back of my arm, and it was huge. I had a close family friend look at it. He is a neurosurgeon.. He said it was my deltoid muscle that was very very swollen. I am considered very overweight, and don''t work out at all. The doctor said it was clearly from the vaccine and I needed to work it out. He showed me exercises to do so. It has been a week now...it is better, but still sore and swollen,
Allergies: Stomach gets queezy on arithromiacin, augmintin, line of meds
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Extreme soreness and swelling in deltoid muscle in left arm in site where vaccination was given. This swelling and soreness did not appear until over 3 1/2 months later! Pain so severe I could not lift arm over my head, nor reach for a glass of water or brush teeth with left arm. Treatment: arm exercisises


VAERS ID: 1545147 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 LA / IM

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

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

Write-up: SAME DAY OF VACCINE, PT REPORTS ARM SORENESS. 1 MONTH LATER PT RETURNS FOR SECOND DOSE AND REPORTS ARM IS STILL SORE IN DELTOID REGION, PAIN SCORE 2/10


VAERS ID: 1545618 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (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: sertraline 75mg, Abilify 10mg, Lamictal 100mg, prenatal vitamin (folic acid)
Current Illness: hair loss
Preexisting Conditions: anxiety, depression
Allergies: none known
Diagnostic Lab Data: discussed with clinical provider in office w/parent
CDC Split Type:

Write-up: pt given Moderna vaccine at 16 years old which is not currently approved by FDA


VAERS ID: 1546708 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-07-09
Onset:2021-07-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Dizziness postural, Fatigue, Feeling abnormal, Full blood count normal, Headache, Inflammatory marker test, Influenza virus test negative, Laboratory test normal, Magnetic resonance imaging head normal, Metabolic function test normal, Muscular weakness, Musculoskeletal stiffness, Neuropathy peripheral, Pain, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I''ve had 2 repeat Covid tests, a flu swab, all negative. I''ve had a CBC, CMP, various autoimmune and inflammatory labs drawn, all normal. I''ve even had a brain MRI which was negative. This has all been done between July 15th and August 6th, 2021.
CDC Split Type:

Write-up: (I am Covid pneumonia recovered from March this year. I also had the monoclonal antibody IV injection.) Five days after my first shot, I began to have severe body-wide aches, joint pain, headaches, neck stiffness, fatigue, brain fog initially. Then two weeks later, developed neuropathy bilaterally in feet ascending to knees with leg weakness. Also, have neuropathy in my hands and occasionally in the back. When I turn my head left or right all the way, if I can, I become dizzy.


VAERS ID: 1548787 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphthous ulcer
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Systemic: canker sores in mouth-Mild


VAERS ID: 1548931 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 LA / IM

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

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

Write-up: I requested the vaccine be given in 2 increments due to many adverse reactions to meds. The pharmacist agree to do so. After the first injection (.01 I think) things seemed fine after the 10 minute wait so we proceeded with the rest of the dose. I waited the required 10 minutes. As I was leaving the store I because nauseated and lightheaded. I thought maybe I needed something to eat so bought myself 2 peaches and left the store. ON the five minute drive to my house I started itching on my face, neck, and arms and only then did I realize I was having a reaction. When I got home I looked in the mirror has had a rash on my face, neck, and arms. (Should have taken a pic!!!). It lasted about an hour and a half. I told the pharmacy, she was not concerned and when I told her I probably should not take the second dose a month later she said that would be up to me.


VAERS ID: 1549134 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-07-07
Onset:2021-07-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is feeling like her chest hurts. Mom says pulse was 130 at resting the other day. She thinks the patient feels this about 3 to 4 times per week. She has the patient rest when these symptoms happen


VAERS ID: 1550852 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

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

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

Write-up: Chills, fever 100.5 F, fatigued, pinching/shooting pain type headache, very sore left arm. All of these symptoms lasted about 24 hours. I took Tylenol for pain 2 times in this period. However, the pinching/shooting pain type headache persisted on and off for two weeks. I did not take anything for treatment of the headaches.


VAERS ID: 1553644 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Electromyogram, Muscle twitching, Sensory disturbance
SMQs:, Peripheral neuropathy (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None that day
Current Illness: Psoriasis
Preexisting Conditions: Migraine
Allergies: Levaquin, afrinol, doxycycline
Diagnostic Lab Data: Bloods tests and EMG
CDC Split Type:

Write-up: Random muscle twitching and sensation of vibrations in head and body. Now 4 weeks later it has NOT improved.


VAERS ID: 1558293 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-07-14
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Rash, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albterol HFA 180?.Asprin 81 mg?.vitamin B12 ?diphenhydramine 25mg?eletriptan 20mg?Nexium 40 mg? estradiol 0.1 mg/gm cream?levalbuterol 1.25 MG/3ml..levothyroxine 75 MCG ? Metformin. 500 mg?.mirabegron Er 25mg 24 hrs?Multivitamin adult? Va
Current Illness: None
Preexisting Conditions: Asthma?.COPD?.arthritis?degenerative. Disc disease?.chronic cluster migraines?. Heart valve leakage?.
Allergies: Penecillin..morphine?epinephrine..sulfur?latex
Diagnostic Lab Data: Covid nasal swab confirmed infection on July 19, 2021
CDC Split Type:

Write-up: No symptoms after dose #1 only after dose #2 came down with Covid and had Covid Rash starting about July 28th or 29th 2021.


VAERS ID: 1573853 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-10
Onset:2021-07-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood alkaline phosphatase increased, Blood creatinine normal, Blood culture, Blood lactic acid normal, Blood potassium normal, Blood sodium decreased, Chest X-ray normal, Chills, Chronic hepatitis B, Coagulation test normal, Computerised tomogram abdomen abnormal, Cough, Culture urine, Fatigue, Full blood count abnormal, Gallbladder enlargement, Haemoglobin decreased, Headache, Hepatic cyst, Hydronephrosis, Hyperhidrosis, Hypochromic anaemia, Hyponatraemia, Infection, Leukaemia, Lymphoma, Mean cell haemoglobin decreased, Mean cell volume decreased, Metabolic function test abnormal, Platelet count normal, Protein urine present, Pyrexia, Red blood cells urine, Respiratory viral panel, Retroperitoneal lymphadenopathy, SARS-CoV-2 test negative, Specific gravity urine normal, Swelling, Troponin normal, Ultrasound abdomen abnormal, Ultrasound scan normal, Urine analysis abnormal, Urine ketone body present, Urine leukocyte esterase positive, White blood cell count normal, White blood cells urine positive
SMQs:, Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Liver neoplasms, benign (incl cysts and polyps) (narrow), Liver infections (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (narrow), Biliary system related investigations, signs and symptoms (broad), Gallbladder related disorders (narrow), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Malignant lymphomas (narrow), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Haematological malignant tumours (narrow), Opportunistic infections (broad), COVID-19 (broad)

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

Write-up: ED visit, Non-prescription medication, Prescription medication No significant past medical history who presents to the ED with 2-week history of fever, chills, fatigue, sweating and frontal headache. The patient states that 4 days after getting her Covid Pfizer vaccine//2021 she started developing the symptoms on a daily basis. The symptoms have been constant with no day/night variations. The patient has been taking Tylenol and Advil with mild improvement in symptoms. Patient also reports some "swelling" at the side of her neck, but no URI symptoms or problems with swallowing. She did report also dry cough with no CP, SOB, palp, wheezing, or hemoptysis; On presentation the patient had mild fever 37.9, heart rate 122, BP 80/52, she received 1 L bolus of Plasma-Lyte and pressure responded. CBC showed mild hypochromic microcytic anemia Hgb 11.3, MCH 25.1, MCV 78.2, platelets 295, no leukocytosis WBC 7.4. Her metabolic panel showed mild hyponatremia NA 132, K4.7, CR 0.9. There was mild AST 84 and ALT 69 elevation with normal bilirubin 0.6, alk phos 241. Lactate x2 normal. Troponin x1 normal. Normal coagulation panel. Negative Covid and respiratory panel. UA showed SG 1.020, trace ketones, protein, leukocyte Estrace, 1-5 WBC and RBC. Blood and urine cultures were sent. Patient was started on Vanco and Zosyn. Chest x-ray normal. Abdominal ultrasound shows GB wall thickening 6.9 mm, negative sonographic Murphy sign. Mild hydronephrosis of right kidney.. Portal lymph node. Borderline enlarged liver 18.2 cm. Left liver cyst 2.2 x 1.6 x 2.3 cm; Extensive workup was done and patient presented with diagnosis of chronic Hepatitis B and extensive retrorperitoneal lymphadenopathy on CT abdomen. Patient followed by Infectious disease and oncology for differential diagnosis of lymphadenopathy that included infection x lymphoma/leukemia.


VAERS ID: 1574160 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-14
Onset:2021-07-14
   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 EW0181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cervical vertebral fracture, Fall, Fatigue, Feeling abnormal, Gait inability, Headache, Impaired work ability, Intervertebral disc protrusion, Limb discomfort, Lymphadenopathy, Magnetic resonance imaging, Muscle spasms, Muscular weakness, Neck surgery, Open fracture, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Osteoporosis/osteopenia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Metformin. Celebrex. Aspirin. Metoporal. Muscle relaxer. Protonic. Gabapentan, finofibrate
Current Illness: None
Preexisting Conditions: Diabetics, heart disease, high blood pressure, high cholesterol. Fibroi myalgia. Arthritis,
Allergies: Penecillen morfen
Diagnostic Lab Data: Blood work, MRI, muscle tests.
CDC Split Type:

Write-up: 7 14 2021 went to get shot took almost an hr. Home office had to approve my shot. That day some arm pain. That night had tingling in left leg. Limp nodes swollen. On the 15th got up legs felt funny, walking a little difficult. Diabetes was in the 250 range, blood pressures was 179/99, up and down. Weakness in legs and arms, fatigue. From then until the 20th of July, steadily worse. I fell twice on the 19th and 20th, because of my inability the walk. Went to Medical ER. After testing me they said i had a compound neck fracture. That was cause by the vaccine. They took me by Ambulance to Hospital, on July 22nd I had beck surgery tie repair 3 vertebrates in my neck, my spinal cord was bulging thrust, the damaged vertebrate. I was told to report this by 3 different Dr I saw in the hospitals. In still not walking correctly, brain fog, muscle spasms in legs and arms. Limp nodes still swollen, constantvhead ache. I haven''t worked in over a month. I am selfvertebrate. Without insurance


VAERS ID: 1574170 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-12
Onset:2021-07-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood thyroid stimulating hormone, Full blood count, Hypoaesthesia, Metabolic function test
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir, Advair, Alprazolam
Current Illness: Anxiety
Preexisting Conditions: Asthma
Allergies: Azithromycin, lincomycin, peanuts, penicillin, soy
Diagnostic Lab Data: CBC, CMP, TSH were drawn.
CDC Split Type:

Write-up: Patient is a new patient. Patient reports left arm numbness and weakness after receiving 2nd dose of COVID-19 at a different facility on 7/3/21


VAERS ID: 1574322 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-05
Onset:2021-07-14
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 RA / 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? 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: COVID-19 infection


VAERS ID: 1574530 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-10
Onset:2021-07-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / SYR

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

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

Write-up: Vesicular rash left areola, left ear lobe, face, trunk, legs


VAERS ID: 1578018 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-28
Onset:2021-07-14
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 UN / UN

Administered by: Other       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, COVID-19, COVID-19 pneumonia, Cough, Diarrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admit 7/14. Vaccine 3/7, 3/28. H/O DM Type II, CAD, HTN. Admit for weakness, diarrhea, cough. COVID +, COVID PNA, acute kidney injury reason for admission. Tx w/abx, steroids, fluids. Did not require O2. DC''d home.


VAERS ID: 1578171 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-09
Onset:2021-07-14
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Intermenstrual bleeding, Menstrual disorder
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: Daily vitamin, birth control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Period type bleeding in between cycles lasts for days. No warning when it comes and is not normal for me


VAERS ID: 1578364 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-10
Onset:2021-07-14
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 UN / UN

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

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

Write-up: Admit for COVID pneumonia. Vaccine completed Feb or Mar 2021. Treated w/ O2, remdesivir, steroids, Rocephin, azithromycin. Discharged home.


VAERS ID: 1578428 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-30
Onset:2021-07-14
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ADMIT FOR PNA. / 2 OT / IM

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admit for Pna. COVID not diagnosed until 2 days after admit. After dx, treated with O2, steroids, remdesivir, tociluzimab, rocephin and azithro. Declined intubation, palliative onboard early. Deteriorated over hospital course and discharged to inpatient hospice service.


VAERS ID: 1578435 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-24
Onset:2021-07-14
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 OT / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admit for COVID pneumonia. Vaccine completed June 24th. Treated w/ O2, steroids, zinc, vit-c, home dose of eliquis. Discharged with home O2.


VAERS ID: 1578440 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-26
Onset:2021-07-14
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19, General physical health deterioration, Septic shock
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? 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 and AKI. Vaccine completed Feb 2021. Treated w/ steroids, O2, vit-c, vit-D, zinc, Rocephin, cefepime, Vanc, no remdesivir d/t AKI. Still admitted at time of review 7/29; condition deteriorating to septic shock.


VAERS ID: 1578640 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-29
Onset:2021-07-14
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Cough, Headache, Impaired work ability, Lung disorder, SARS-CoV-2 test, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirena IUD, Meloxicam 7.5 mg PRN daily
Current Illness: Respiratory cold end of December 2020
Preexisting Conditions: R hip pain/issues. Bronchitis every ~2ish years.
Allergies: Clindamycin
Diagnostic Lab Data: Rapid COVID test, and PCR Covid test negative
CDC Split Type:

Write-up: Developed chest tightness consistent with how I get when I get bronchitis. Had to leave work due to symptoms. Woke up a few hours later with headache, dry cough. When to urgent care for my usual bronchitis meds and covid test. Overall took about 2 weeks to get back to normal lung function.


VAERS ID: 1579183 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-03
Onset:2021-07-14
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Drainage, Eye pain, Eye swelling, Herpes zoster, Periorbital swelling, Rash, Scab, Viral infection, Viral rash, Visual impairment
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot in 2010 or sometime around that year. Eye swelled up.
Other Medications: Juice plus, calcium, omega, hair and nail growth supplement
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Scab on scalp started in early to mid July. Then more came. The dr said it was a small case of shingles. Soon after my eye started getting the scabs around it. I went to the eye dr to make sure shingles was not in my eye as my vision was having trouble. He checked and didn''t see any in the eye but said it was around it and gave me shingles medicine. I also had a rash all over my torso that went to the under side of my arms around the same time. My eye got worse, scabs, sharp pains in the eyeball, draining eye, swollen. a week later so I went to the primary care again and he said it was an unknown virus on my eye and my torso and arms were an unknown viral rash. He gave me predisone and prespription eye drops and I started to get relief and the rash went away. this past week my eyebrow started to scab over and is spreading farther. My eye puffy at times and my eyeball has some pain. My nostril on the opposite side is having scab inside as well. My back is also experiencing pain, not debilitating. I contacted my primary care doctor again today and the dr is to get in touch with me about it.


VAERS ID: 1582379 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-07-14
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough, Fatigue, Influenza like illness, Nasopharyngitis, SARS-CoV-2 test negative, Sinus disorder, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

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

Write-up: Got Cold/Flu like symptoms 3 month after shot. Approx 2 weeks of slight fatigue and sinus issues, Prolonged cough also. 14 days does if AntiBiotics fixed issue, Infected spouse, also tested negative COVID. All better now.


VAERS ID: 1582407 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-19
Onset:2021-07-14
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast pain, Heavy menstrual bleeding, Pain in extremity, Premenstrual pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: probiotics
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: healing on my own without medical care so far.
CDC Split Type:

Write-up: I noticed my periods became heavier because of the vaccines especially the first few days. I also had menstral cramps between periods which I have never had before the vaccines. My breasts were horribly sore also. I feel this vaccine messed up my hormones. It should not be for women. It should be removed. Since the moment I got this shot I had horrible pain as the tech was putting in the liquid and left my arm in pain for months.


VAERS ID: 1582820 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049CZ1A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Back pain, Condition aggravated, Fatigue, Grip strength decreased, Joint swelling, Mobility decreased, Neck pain, Pain, Pain in extremity, Rheumatoid arthritis
SMQs:, Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: None
Preexisting Conditions: Rheumatoid Arthritis; Endometriosis, Uterine Fibroids, Ovarian Cysts
Allergies: Latex, Peanuts, Tree Nuts
Diagnostic Lab Data: None - I do not have health insurance so I was unable to afford to go get tested
CDC Split Type:

Write-up: Right arm pain, Fatigue, Body Aches, My Rheumatoid Arthritis Symptoms which had been in remission started again: Terrible Weakness and Pain in both hands and arms, difficulty raising arms over head, joint pain all over body, swollen joints especially knuckles in hands, unable to grip with hands, leg pain, knee joint/ankle pain, increased back and neck pain - Pain symptoms worse in the morning w extreme fatigue in mid afternoon and evening. After a few weeks I went and got Prednisone from doctor, this helped alleviate some of the pain and symptoms. Still having pain - not back to where I was before I got the 1st Moderna Shot on July 13, 2021


VAERS ID: 1582911 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-07
Onset:2021-07-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Gout
SMQs:, Arthritis (narrow)

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

Write-up: A week after receiving COVID vaccine I had Gout for the first time.


VAERS ID: 1586820 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-15
Onset:2021-07-14
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cardiac discomfort, Dizziness, Feeling abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (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: Losartan, 50 mg... Hydrochlorothiazide, 25 mg... Vitamin D weekly supplement
Current Illness: None
Preexisting Conditions: Am concerned I may have an undiagnosed auto-immune disease that I will begin to explore. Current dr. has me doing PT type exercises for my right shoulder problem pointing to a rotator cuff issue since I was a pre-teen. This is what has flared up to include my neck now. My neck trouble was discovered in 2017 after a bad fall with my C3 slipping onto my C4. The episode I had in mid July had me with painful trouble moving, using my neck and arm. Also had no energy. I worked through it, but am experiencing a flare up again since the weekend. Am now being forced to follow up here because I am concerned. Still very grateful for the vaccinations.
Allergies: None
Diagnostic Lab Data: There haven''t been any tests. I did express my ongoing pain to my doctor during a visit in late May. He walked me through doing a couple of physical therapy type exercises for my troubling right shoulder pain. It''s still bothersome and reached a bad peak in mid July when I felt very tired, slept longer and had excruciating shoulder and neck pain with limited range of motion. I had to cancel a hair appointment because I couldn''t imagine being able to handle putting my neck back for hair washing. Another strange round of pain has started over the weekend pushing me to respond to the CDC phone call and make the report.
CDC Split Type:

Write-up: At time of the second shot, immediately after receiving it, I felt what I can only describe as a sizzling feeling through the top of my head and my heart clenching. I got dizzy and just leaned back and started breathing slowly. I assumed it was nerves and worked through it.


VAERS ID: 1592014 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Gingival erythema, Gingival swelling, Head injury, Headache, Sinusitis, Skin laceration, Suture insertion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Gingival disorders (narrow), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fainting : transfer to emergency room for gash on forehead after hitting head on floor; glue suture about 1 inch Headaches, fatigue, faint: 4- 6 days following vaccine Swollen/red gums: 6 days after vaccine; treated with antibiotics Sinus Infection: 6 days after vaccine; treated with antibiotics


VAERS ID: 1594379 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-07-14
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Feeling hot, Hypersomnia, Night sweats, Paranasal sinus discomfort, Productive cough, Rhinorrhoea, Sneezing, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Infective pneumonia (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: Allergy multiple (The patient was out due to allergies a few weeks ago.)
Preexisting Conditions: Comments: Patient takes medication for allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210717; Test Name: Body temperature; Result Unstructured Data: 91.7 F; Test Date: 20210717; Test Name: Body temperature; Result Unstructured Data: 97.8 F
CDC Split Type: USJNJFOC20210834039

Write-up: FEELS LIKE BURNING UP; WAKING UP IN SWEAT; RUNNY NOSE; SINUS PRESSURE; SNEEZING; WET COUGHING YELLOW MUCUS; SLEPT FOR 18 HOURS STRAIGHT; DRAINAGE WONT STOP; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: allergies, and other pre-existing medical conditions included: Patient takes medication for allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204B21A, expiry: UNKNOWN) dose was not reported, administered on 13-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-JUL-2021, the patient experienced feels like burning up. On 14-JUL-2021, the patient experienced waking up in sweat. On 14-JUL-2021, the patient experienced runny nose. On 14-JUL-2021, the patient experienced sinus pressure. On 14-JUL-2021, the patient experienced sneezing. On 14-JUL-2021, the patient experienced wet coughing yellow mucus. On 14-JUL-2021, the patient experienced slept for 18 hours straight. On 14-JUL-2021, the patient experienced drainage wont stop. On 17-JUL-2021, Laboratory data included: Body temperature (NR: not provided) 97.8 F, 91.7 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feels like burning up, waking up in sweat, runny nose, sinus pressure, sneezing, slept for 18 hours straight, and drainage wont stop, and the outcome of wet coughing yellow mucus was not reported. This report was non-serious.


VAERS ID: 1602695 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-07-14
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Nasal discomfort, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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: Spironolactone, Atarax, Donnatal, Lomotil, Klonopin, Cambia, Fiorinal, Botox for Migraines.
Current Illness: Migraine/Clusters Asthma Post-Infectious IBS after C-Diff
Preexisting Conditions: Migraines/Clusters Asthma IBS-D Recurrent C-Diff
Allergies: Soy, red meat, milk, lettuce. Erythremicine, Sulfa based drugs, red-dye, codeine, Doxcycycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Constant sneezing and irritation of right nostril, with slight runny nose, for approximately 10 days less than 90 days from second dose of Moderna.


VAERS ID: 1602918 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: SULFA, CIPRO,NITROFURANTOIN
Diagnostic Lab Data: dermatologist and primary care dr confirmed rash from covid vaccine
CDC Split Type:

Write-up: rosacea reaction rash on face confirmed by dermatologist, burning down arm and hand, rash on shoulder


VAERS ID: 1617507 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-09
Onset:2021-07-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054CZIA / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Intermenstrual 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: Levothyroxine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Menstrual spotting when it''s not time for my period


VAERS ID: 1617732 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-12
Onset:2021-07-14
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram head, Echocardiogram, Magnetic resonance imaging head, Ultrasound Doppler
SMQs:, Hearing impairment (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: advair, vitamin d, lexapro
Current Illness: none
Preexisting Conditions: asthma
Allergies: none known
Diagnostic Lab Data: CT scan of head, MRI of head, echocardiogram, carotid artery sonogram, blood work
CDC Split Type:

Write-up: Bell''s Palsy


VAERS ID: 1623649 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-14
Onset:2021-07-14
   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: 1623930 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-02-05
Onset:2021-07-14
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Antibody test positive, Antinuclear antibody negative, Blood creatine phosphokinase normal, Blood thyroid stimulating hormone normal, C-reactive protein decreased, Full blood count normal, Glucose tolerance test normal, Glycosylated haemoglobin normal, Immunology test, Magnetic resonance imaging head normal, Metabolic function test normal, Neuropathy peripheral, Paraesthesia, Red blood cell sedimentation rate normal, Scan with contrast normal, Vitamin B12 normal
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Vasculitis (broad), Hypersensitivity (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: B12 - 544pg/mL (normal) CK - 48 U/L (normal) CRP - <0.5mg/dL (normal) ESR - 8 MM/HR RA - <8.6 IU/mL Lyme - antibody screen was positive, but IgG/IgM Western Blot was negative Glucose Tolerance - normal A1C - 5.3% (normal) Brain MRI with and without Contrast - Normal Comprehensive Metabolic Panel - all results normal Complete Blood Count - all results normal TSH - 2.08 mIU/L ANA - negative
CDC Split Type:

Write-up: These symptoms may not be related to my COVID vaccine, as it was 6 months ago. But beginning on July 14 2021 I developed neuropathy first in my left hand, then my right hand 2 weeks later, along with parasethesias all over the body. It does seem to be improving now, but it''s been going on for almost 6 weeks.


VAERS ID: 1624031 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-13
Onset:2021-07-14
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Blood sodium decreased, Blood thyroid stimulating hormone, Cognitive disorder, Differential white blood cell count, Dizziness, Electrocardiogram, Fall, Full blood count, Gait disturbance, Head injury, International normalised ratio, Metabolic function test, Nausea, Neutrophil count decreased, Pericardial effusion, Prothrombin time, Syncope, Troponin, Urine analysis, White blood cell count decreased
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Gabapentin, Alprazolam, Acetaminophen
Current Illness: None
Preexisting Conditions: Fibromyalgia, mood disorders.
Allergies: None
Diagnostic Lab Data: Protime INR, troponin, APTT, TSH, Urinalysis, CMP, CBC with Diff, EKG 12-Lead.
CDC Split Type: vsafe

Write-up: A month later I had gone out for a walk at 9 AM 07/14/2021 and I came back in and I got lightheaded and fainted and stumbled and hit my head really hard. I went to the hospital and I was checked in for a couple of days with a really low sodium level and so they sent me to see a cardiologist to see what was causing the fainting and they diagnosed me with pericardial effusion which I don''t have a history with that. I had low white blood cells and neutrophils and I''ve had both before but not at the same time. I see Dr. tomorrow 08/24/2021 to follow up for the next steps. I''m having Nausea, Dizziness, and having cognitive problems from the fall and I''m working with a neurologist. This is still ongoing and hasn''t been resolved.


VAERS ID: 1625049 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-03
Onset:2021-07-14
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Alopecia
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: Vitamin D, Vitamin C, Iron
Current Illness:
Preexisting Conditions: Alopecia Areata (in remission at time of vaccine)
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Total hair loss in the course of five days.


VAERS ID: 1628267 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-12
Onset:2021-07-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, Fertility disorders (broad)

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

Write-up: I got my period 2 days after and had it for 40 days.


VAERS ID: 1629862 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-06-14
Onset:2021-07-14
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0U3B21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Aspergillus infection, Blood test, Cough, Drainage, Fatigue, Feeling cold, Influenza like illness, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Endometriosis (24mo))
Allergies: None
Diagnostic Lab Data: 8/12 Blood Tests 8/23 ENT diagnosis
CDC Split Type:

Write-up: flu-like symptoms for three days. Fever, chills, both ears draining, cough and fatigue. Day four symptoms started clearing but extreme fatigue and left ear still draining. Day five back to work normal schedule still extreme waves of fatigue and left ear draining. Day seven trip to at Clinic and she said residuals from shot stay home a few days. Day twelve same symptoms saw Staff and took a z-pack and steroids. day nineteen no affect from steroids except to stop ear drainage for a week. Referred To ENT specialist and Dr. found aspergillus growing in my left ear. Day forty-one same symptoms but ear being treated and no longer draining.


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