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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 377 out of 6,867

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VAERS ID: 1490282 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-10
Onset:2021-07-13
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 - / -

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

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

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


VAERS ID: 1490461 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-02-25
Onset:2021-07-13
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, SARS-CoV-2 test positive
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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: CHF, CAD, hypertension, hyperlipemia, pacemaker, sleep apnea, rheumatoid arthritis, a fib
Allergies: Beta Blocker- Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID-19 positive, COVID pneumonia and admission to inpatient hospital


VAERS ID: 1490519 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

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

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

Write-up: Mild tinnitus that began the day following vaccination. I have never previously experienced ringing of the ears nor any other sort of ear injury or hearing issues. It has remained relatively constant since the onset.


VAERS ID: 1490596 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 8889 / 7+ LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 8889 / 7+ LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest discomfort, Electrocardiogram
SMQs:, Anaphylactic reaction (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: Shrimp
Diagnostic Lab Data: EKG 7/21/21 Blood work 7/21/21 Chest X-ray 7/21/21
CDC Split Type:

Write-up: First day after the second vaccine I experienced chest tightness. I am still feeling this 10 days later.


VAERS ID: 1490606 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

Administered by: Pharmacy       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: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 06/17/2021. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490649 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-06-29
Onset:2021-07-13
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / N/A - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Chest discomfort, Chest pain, Dyspnoea, Echocardiogram normal, Ejection fraction normal, Electrocardiogram ST segment elevation, Haemodynamic test normal, Pain, Pericarditis, Troponin I, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: baclofen 10mg bid carbamazepine 200mg TID citalopram 40mg daily fluticasone nasal spray bid PRN Allergy eye drops, PRN daily
Current Illness:
Preexisting Conditions: Epilepsy
Allergies: aspirin
Diagnostic Lab Data: 7/18: CK total 281, troponin I high sens <3, WBC 6.4, Afebrile, stable vitals with HR 70s-80s, RR 35-18, BP 121/58 ECG diffuse ST elevation and P wave depression
CDC Split Type:

Write-up: Diagnosed with pericarditis Presented to the emergency department on 7/18/2021 with chest pain (substernal) and does not radiate, but reports heaviness and pressure. The pain was severe at onset. This is exacerbated by exercise but are relieved by nitroglycerine and fentanyl. Family history of CAD. Also reports shortness of breath. Pain onset was abrupt while riding his bicycle. ECG shows diffuse ST selevation in multiple coronary distributions with P depression. Bedside ECHO showed normal heart. EF was ~60%. Hemodynamically stable. Given one dose of Toradol., SL nitro 0.4mg Admitted to the hospital Started on colchicine 0.6mg bid and ibuprofen 600mg tid with plan of 10 days of treatment.


VAERS ID: 1490654 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       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: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer on 06/17/2021. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490656 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blister, Condition aggravated, Pain, Pain in extremity, Purpura, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estazolam 2 MG Tab TAKE 1 2 (ONE HALF) TABLET BY MOUTH AT BEDTIME AS NEEDED cyanocobalamin (VITAMIN B-12) 500 MCG Tab Take 500 mcg by mouth every day. vitamin D (CHOLECALCIFEROL) 1000 UNIT Tab Take 1,000 Units by mouth 2 Times a Day.
Current Illness: None
Preexisting Conditions: Chronic low back pain ? Fatigue ? Chronic pain of left knee ? Primary osteoarthritis of left knee ? Barrett''s esophagus ? Primary osteoarthritis of both hands ? Gastroesophageal reflux disease with esophagitis ? Insomnia ? History of colon cance ? BPH (benign prostatic hyperplasia)
Allergies: None at the time of vaccine.
Diagnostic Lab Data: Multiple tests pending 7/21/2021 to evaluate purpura.
CDC Split Type:

Write-up: 2nd moderna vaccine given 7/12, that night developed some mild low back pain. The next morning the pain was more severe and associated with left leg pain (throbbing). He developed a rash as well (purpura with some bulla) on the buttocks which then traveled down his leg and into the left foot (not painful/pruritic). No fever, chills or other adverse SE.


VAERS ID: 1490679 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, 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:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 06/17/2021. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490715 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       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: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Describe the adverse events, treatment, and outcomes?: enter: ?Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.?


VAERS ID: 1490918 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fall, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 25 mg
Current Illness: none
Preexisting Conditions: hypoglycemia
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT WAS GIVEN THE COVID VACCINE AND DIDN''T WAIT THE FULL 15 MINUTES. WHEN THE PATIENT WENT TO LEAVE SHE PASSED OUT AND LANNDED FACE FIRST ON THE FLOOR.


VAERS ID: 1490995 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Pharmacy       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: pt received dose not stored according to manufacturer


VAERS ID: 1491461 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-21
Onset:2021-07-13
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Incomplete course of vaccination
SMQs:, Medication errors (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Progesterone 200 mg q hs Estradiol gel 0.06/100g - 2 pumps q hs Ambien 0.5 mg q hs
Current Illness:
Preexisting Conditions: Chronic Insomnia
Allergies: Sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: shingles on D 22 post vaccine. Confirmed diagnosis of shingles on D 23 post vaccine. Second dose of vaccine postponed pending recovery from shingles


VAERS ID: 1491656 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysphonia, Feeling abnormal, Hypertension, Intensive care, Lip swelling, Swelling, Wheezing, White blood cell count normal
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Eosinophilic pneumonia (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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol inhaler, Amlodipine 5mg QDay, Cholecalciferol 25mcg BID, Diclofenac gel PRN, Glipizide 5mg BIS, Meclizine 12.5mg PRN, Metformin 1000mg BID, Pravastatin 40mg QDay
Current Illness: n/a
Preexisting Conditions: DM HTN HLD Breast cancer in situ Shingles in V1 distribution with anterior scleritis (May 2021, resolved)
Allergies: Lisinopril - cough Atorvastatin - cough Valsartan - throat swelling Mag Ox tablets - throat swelling
Diagnostic Lab Data: 7/13/21 WBC 6.0
CDC Split Type:

Write-up: Pt reports that she had a globus sensation and some shortness of breath PRIOR to receiving the vaccine. She was monitored 15 minutes post-injection without incident. When she walked out to the hallway to go home she reported that she felt like she was going into anaphylaxis and a Rapid Response was called overhead. She was complaining of feeling like her hands and feet were swelling and that he voice was hoarse. Her lips were noted to be large and her husband confirmed that they looked larger than normal. She was found to be hypertensive to 196/109 so analyphylactic shock was ruled out and she was not treated with an epi pen. She was transferred to the ER. Exam found scattered wheezing, mildly protuberant lower lip, no tongue swelling, no drooling. She was treated with IV solumedrol 125mg, IV benadryl, IV famotidine, and a racemic epi nebulizer. ENT came and visualized her airway via NPL and found no oropharyngeal or laryngeal edema. She was admitted to the MICU for 48-hour anaphylaxis observation and continued on steroids and anti-histamines. By the following morning she was feeling well.


VAERS ID: 1493594 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-06
Onset:2021-07-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 13975 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: C-reactive protein normal, Chest pain, Dyspnoea, Fibrin D dimer normal, Hypoaesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Microgestin
Current Illness: none
Preexisting Conditions: none
Allergies: amoxicillin
Diagnostic Lab Data: D-dimer, CRP, and Sed Rate-results normal . Chest Xray ordered but not yet complete.
CDC Split Type:

Write-up: 1. Chest pains and tingling 2. Pt said she got covid vaccine J&J two weeks ago. She has chest pain. Was hiking in the mountains is back from trip and still has. Yesterday had tingling in hands and toes comes randomly either makes hands go numb or make them tingle. Some Sob when she was traveling not when hiking but when she was in bed. Chest pain last 30 min to hour comes and goes. Happends when she is laying down and when she is moving. 3. Got home three days ago. No SOB since coming home. But has chest pain every day. Has random bruise on right ankle not sure how she got not sure if it is related. Not dizzy or lightheaded


VAERS ID: 1493620 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dizziness, Dyspnoea, Fatigue, Headache, Injection site pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: No medication prescribe.
Current Illness: Before filling out this document. NO
Preexisting Conditions: No sickness
Allergies: None before the mandatory vaccine that my boss make take by the University.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms after and until now are injection site pain, tiredness, headache, shortness of breath when I move around and I have a habit of running every morning. Since the vaccine I lack of more air. I have dizziness and before I didn''t have any, also I have slight chest pains and tiredness which previously I didn''t have.


VAERS ID: 1493631 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown (QM)  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Impaired work ability
SMQs:

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

Write-up: Severe headache, had to take off work 2 days


VAERS ID: 1493635 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-15
Onset:2021-07-13
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 UN / SYR

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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized for COVID-19 pneumonia


VAERS ID: 1493647 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-15
Onset:2021-07-13
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Full blood count abnormal, Platelet count decreased, Platelet transfusion, Thrombocytopenia
SMQs:, Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: bupropion ER 300 mg daily vit D3 1000 units daily colace 100 mg twice daily loratidine 10 mg daily valacyclovir 1 gm daily MVI daily sertraline 150 mg daily
Current Illness:
Preexisting Conditions:
Allergies: No know allergy
Diagnostic Lab Data: Tranfusion 1 unit of PLTs on 7/21, CBC,s daily
CDC Split Type:

Write-up: Thrombocytopenia - Platelet count on 3/12/21 = 143. On 7/20/21 PLT =17, 6 and 15 on 7/21/21 and 31 on 7/22/21. Extensive bruising which was resolving on day 3 of admission.


VAERS ID: 1493648 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-07
Onset:2021-07-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Erythema, Headache, Herpes zoster, Inflammation, Pain, Rash erythematous, Skin warm, Vertigo
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Vestibular disorders (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol , Losartan, Vitamin D, probiotic
Current Illness: Fibromyalgia, osteoarthritis, Hypertension
Preexisting Conditions: Fibromyalgia, osteoarthritis
Allergies: NKA
Diagnostic Lab Data: See above.
CDC Split Type:

Write-up: 1. Day after injection, I had local reaction to upper arm of redness, inflammation and warmth to skin in more than 1 spot. No treatment 2. The day after the injection, I woke up with a headache and vertigo. Took Ibuprofen for headache, no other treatment 3. 6 days later I noticed red bumps that then over the next few days turned into blisters. I was experiencing a right sided headache and sharp, shooting pains. On Saturday, 7/ 17/2021, I went and was diagnosed with shingles. I was prescribed Valacyclovir 1gm TID for 7 days. ( however, nothing was given for pain or inflammation. On Monday, 07/19/21 I went to my pcp who again confirmed Shingles, and prescribed Gabapentin 300mg BID for pain and Prednisone (tapered dose) for inflammation.


VAERS ID: 1493678 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / IM

Administered by: Pharmacy       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: ?Pt received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the pt will need to be re-vaccinated.?


VAERS ID: 1493737 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       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: ?Pt received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the pt will need to be re-vaccinated.?


VAERS ID: 1493744 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       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: Pt received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the pt will need to be re-vaccinated


VAERS ID: 1493895 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Tingling and numbness in the arms, fingers and legs


VAERS ID: 1494106 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysphagia, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: albuterol percocet. lasiv xanax
Current Illness: none listed
Preexisting Conditions: none listed
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: an few hours after receiving the vaccination she developed tingling and numbness to feet and hands. The evening of the day she received the vaccine she developed difficulty swallowing. Trout symptom resolved after 2 doses of benadrly and 8 hours.


VAERS ID: 1494170 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / SYR

Administered by: Pharmacy       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: ?Pt received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the pt will need to be re-vaccinated.? Pt received replacement dose on 7/21/21


VAERS ID: 1494174 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood calcium decreased, Blood parathyroid hormone increased, Blood test, Chills, Hypersensitivity, Hypoaesthesia, Joint contracture, Nausea, Pyrexia, Sleep disorder, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B12
Current Illness: none
Preexisting Conditions: eczema
Allergies: none
Diagnostic Lab Data: blood work
CDC Split Type: vsafe

Write-up: After the 2nd dose, that evening I went to bed with a low grade fever of 99 degrees and chills. I woke up at 2am, feeling chills and nausea. After I threw up, both hands started to have uncontrollable clenchings. My legs started to feel a little numb but I could walk. I also had pain on my left side of my stomach. I went to the ER, one of the nurses grabbed my hands to try to straighten them out. They gave me an IV containing calcium, 2 TUMS orally, and Benadryl. I did feel so much better. I did get discharged with a diagnosed with Covid vaccine allergic reaction, low calcium levels, and allergies. I did follow up with my PCP and they wanted to check my calcium levels which showed low calcium and high PTH (parathyroid). I was prescribed 1200mg of calcium daily. I am to follow up with an endocrinologist.


VAERS ID: 1494328 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: no signs or symptoms after event.


VAERS ID: 1494363 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-20
Onset:2021-07-13
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Electrocardiogram abnormal, Myocardial infarction, Stent placement, Troponin
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Plavix 75mg ,Norvasc 2.5mg , Adderall, clonazepam , Prozac 15mg, sinaside multivitamin, red cherry extract, 1000mg green tea extract ,levothyroxine 2,5 micrograms, tumic, probotic
Current Illness:
Preexisting Conditions: Lupus, Rheynaulds,
Allergies:
Diagnostic Lab Data: bloond work Tripone was . Stint was put in . Ekg
CDC Split Type:

Write-up: Heart attack


VAERS ID: 1498056 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2020-12-22
Onset:2021-07-13
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dyspnoea, Head discomfort, Headache, Lethargy, Oropharyngeal pain, Pain, Respiratory tract congestion, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Hypoglycaemia (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, metoprolol succinate, losartan, amlodipine, atorvastatin, loratadine, sertraline, pioglitazide, metformin, semaglutide, Vitamin A, Vitamin D3, Vitamin B12, ferrous sulfate
Current Illness: N/A
Preexisting Conditions: Hypothyroidism, essential hypertension, diabetes mellitus, morbid obesity
Allergies: Penicillins, topical chlorhexidine
Diagnostic Lab Data: COVID-19 Antigen (7/13/21)
CDC Split Type:

Write-up: Diagnosis of COVID-19 with head and chest congestion, shortness of breath, loss of taste and smell, sneezing, coughing, sore throat, lethargy, body aches, occasional headache


VAERS ID: 1498068 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Thrombosis
SMQs:, Acute pancreatitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I was taking levothyroxine, low dose aspirin
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: 7/13/2021- Stomach pain, blood clotting


VAERS ID: 1498109 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, 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: CONTRACEPTIVE IMPLANT -PATIENT AND MOTHER UNABLE TO GIVE NAME
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE REPORTED
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 16YR FEMALE GIVEN 1ST DOSE OF MODERNA. PATIENT/MOTHER REPORTS PATIENT HAD SORENESS IN ARM FOR FEW DAYS THAT RESOLVED WITH NO ADVERSE EFFECTS


VAERS ID: 1498127 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-06
Onset:2021-07-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0505 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0139 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain, Injection site pruritus, Injection site reaction, Injection site swelling, Pain, Ultrasound Doppler, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Tramadol, ketorolac, meperidine, codeine, benadryl
Diagnostic Lab Data: doppler of right arm 7/23/21- pending results
CDC Split Type:

Write-up: Welts on right upper arm 7 days after 2nd dose that was itchy. 7/22 started having pain and swelling on right upper arm and pain lifting up arm


VAERS ID: 1498155 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: 7/14/2021: No labs. Evaluation at an Urgent Care Facility Initiated. Diagnosis- Allergic Reaction. Medications Dispensed - Hydroxyzine Pamoate
CDC Split Type:

Write-up: Vaccinated workers on 7/12. Patient noted itching of hands on evening of 7/12. Woke the mornig of 7/13 with slightly swollen hands. On 7/14, woke with swelling of both hands and feet and severe itching of hands.


VAERS ID: 1498282 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-08
Onset:2021-07-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Face injury, Full blood count, Metabolic function test, Seizure, Troponin, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zonisamide multivitamin
Current Illness: none
Preexisting Conditions: seizure disorder x2 years
Allergies: NKA
Diagnostic Lab Data: Normal BMP, Troponin, CBC normalother than WBC of 13.1. Normal Zonisamide level.
CDC Split Type:

Write-up: Pt had vaccine on 7/8 and had a seizure on 7/13. He was at work and was found with blood on his ear and a mark on his face. He had no memory of the incident. Last seizure was at least 7 months prior.


VAERS ID: 1498294 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Computerised tomogram thorax, Dysphagia, Laboratory test
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: OMEPRAZOLE, ZENZEDI, CLONIDINE, VISTARIL, LEVOTHYROXINE SODIUM, ESCITALOPRAM, SINGULAIR
Current Illness:
Preexisting Conditions: HYPOTHYROIDISM, ATTENTION DEFICIT HYPERACTIVITY DISORDER, GENERALIZED ANXIETY DISORDER, ESOPHAGEAL REFLUX
Allergies:
Diagnostic Lab Data: CTA CHEST, CHEST XRAY, RIB XRAY, STERNUM XRAY, LABS
CDC Split Type:

Write-up: CHEST PAIN, DIFFICULTY SWALLOWING


VAERS ID: 1498308 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-14
Onset:2021-07-13
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Enlarged uvula, Oral mucosal erythema, Oral pruritus, Oropharyngeal pain, Retching, Streptococcus test, Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prilosec, Wellbutrin, Hydroxyzine, Allegra, Montelukast, Xolair (1st dose on June 11th), Vitamin D3, and Biotin.
Current Illness: None
Preexisting Conditions: Allergies and Acid Reflux
Allergies: Penicillin, Trees, and Latex
Diagnostic Lab Data: Strep Test
CDC Split Type:

Write-up: On July 13th I had a very sore throat. I had a strep test and it came back negative. Throughout the night, my mouth and throat became itchy and red. My uvula swelled it was gagging me. I went to the doctor in the morning and received a steroid shot and mouthwash to reduce the pain and swelling. After about 48 hours I began to feel better. I''m not sure this was caused by the COVID-19 vaccination, but I had never had this type of reaction before.


VAERS ID: 1498368 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: NA
Current Illness: None
Preexisting Conditions: ecigarette use / tobacco use
Allergies: NKDA
Diagnostic Lab Data: NA
CDC Split Type: NA

Write-up: nausea, emesis and cough within 24 hrs vaccine admin


VAERS ID: 1498392 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-07-13
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, Asthenia, Chills, Cough, Myalgia, Nasal congestion, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1000mg daily supplement of zinc, magnesium & calcium
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: COVID-19 PCR test administered 7/14/21 & confirmed presence of COVID-19 on 7/16/21
CDC Split Type:

Write-up: 7/13/21: sore throat, low energy, cough 7/14/21: low energy, cough, fever, muscle aches, chills, loss of taste & smell - PCR test administered 7/15/21: low energy, cough, fever, no taste or smell, sore from coughing fits 7/16/21: energy regained, fever gone, occasional cough, stuffy nose, no taste or smell 7/17/21-present: occasional cough, occasional stuffy nose, very little taste or smell


VAERS ID: 1498413 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-18
Onset:2021-07-13
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Electromyogram, Guillain-Barre syndrome, Magnetic resonance imaging
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Gabapentin Allopurinol
Current Illness: None
Preexisting Conditions: Hypertension Lumbar degenerative disc disease Gout
Allergies: None
Diagnostic Lab Data: MRI EMG/NCS Hospitalization
CDC Split Type:

Write-up: Guillain -Barre


VAERS ID: 1498481 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-14
Onset:2021-07-13
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tamsulosin HCl Oral (Capsule 0.4 mg), daily. Tacrolimus Oral (Capsule 0.5 mg), 2x a day. Sildenafil Citrate Oral (Tablet 50 mg), daily. Omeprazole Oral (Capsule Delayed Release 20 mg), daily. Mycophenolate Mofetil Oral 2000 mg. Losartan
Current Illness: PAST MEDICAL HISTORY: Coronary artery disease Diabetes mellitus on insulin Hyperlipidemia Chronic back pain Essential hypertension Congestive heart failure with unspecified EF PAST SURGICAL HISTORY: Cardiac PCI Heart transplant in May 2020 Prostatectomy Knee surgery
Preexisting Conditions: Diabetes, HTN, CHF
Allergies: PCN, Lisinopril
Diagnostic Lab Data: SARS AG, IFA (+) on 7/20/21
CDC Split Type:

Write-up: CHIEF COMPLAINT: 64 years old gentleman who was recently admitted at another facility with Covid infection discharged 4 days ago presents with shortness of breath HISTORY OF PRESENT ILLNESS: He tested positive for Covid on the 13th of this month (July) and had been at a Medical Center up until last Friday. He did fairly well and was eventually discharged on 2 days of doxycycline. He cannot recall if was given convalescent plasma or remdesivir. He was not discharged on dexamethasone on oxygen. Immediately the next day he felt increasingly short of breath which has progressively gotten worse. When he came to emergency department his oxygen saturations were 89% on room air. Denies any fevers chills but he does have a nonproductive cough.


VAERS ID: 1498539 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-31
Onset:2021-07-13
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: valsartan, insulin degludec, Symbicort, atenolol, albuterol
Current Illness:
Preexisting Conditions: chronic diastolic CHF, paroxysmal afib (s/p ablation), type 2 diabetes, hypertension, hyperlipidemia, OSA
Allergies: penicillin, sodium nitrite-sodium thiosulfate
Diagnostic Lab Data: SARS CoV 2 PCR Detected 7/13/2021
CDC Split Type:

Write-up: Hospitalization due to COVID-19 infection


VAERS ID: 1500553 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-07-13
Submitted: 0000-00-00
Entered: 2021-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Blood test, Chest X-ray, Chest pain, Dizziness, Hypoaesthesia, Pain in extremity, Paraesthesia, Pyrexia, Syncope, Urine analysis
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker; Pollen allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Birth control (She stopped her birth control 2 months ago); Comments: Patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210716; Test Name: Chest X-ray; Result Unstructured Data: Normal; Test Date: 20210716; Test Name: Urine analysis; Result Unstructured Data: Normal; Test Date: 20210716; Test Name: Blood test; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210738815

Write-up: PAIN IN RIGHT ARM; PAIN IN KNEE; CHEST PAIN; TINGLING; NUMBNESS; FEELING LIKE SHE IS GOING TO FAINT; FEVER; FAINTING; This spontaneous report received from a patient concerned a 26 year old White, Non-Hispanic/Latino female. The patient''s height, and weight were not reported. The patient''s past medical history included birth control stopped 2 months ago, and concurrent conditions included pollen allergy, non alcohol user, and non smoker, and other pre-existing medical conditions included patient had no drug abuse or illicit drug usage. The patient experienced drug allergy when treated with benzoyl peroxide. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808986, expiry: UNKNOWN) dose was not reported, 1 total, administered on 13-JUL-2021 in right arm for prophylactic vaccination. No concomitant medications were reported. On 13-JUL-2021, after receiving the vaccine patient reported fainting and fever on the day of injection. On 14-JUL-2021, the day after vaccination patient had chest pain, tingling and numbness and feeling like patient was going to faint. Patient went to the emergency room on the 14-JUL-2021 and patient was told patient was ok. On 16-JUL-2021, patient started feeling pain on the right arm and knee (side of injection). Patient mentioned patient was travelling after few days on a long flight to Germany. Patient mentioned that patient was very healthy. Laboratory data included: Blood test (NR: not provided) Normal, Chest X-ray (NR: not provided) Normal, and Urine analysis (NR: not provided) Normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever, recovered with sequelae from chest pain, and had not recovered from fainting, tingling, numbness, pain in right arm, pain in knee, and feeling like she is going to faint. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210738815-covid-19 vaccine ad26.cov2.s -fainting. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1500998 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chills, Dizziness, Feeling cold, Immediate post-injection reaction, Pain in extremity, Pruritus, Rash erythematous, Throat tightness, Tremor, Vaccination site pain
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: Fibromyalgia, Sjogrens syndrome, RA, MCAS/POTS, IBD, CF, migraine, spondylolisthesis L5/S1, osteoarthritis L4/L5 - L5/S1 - C5/6 - C6-7, chronic GERD, barretts esophagus.
Allergies: E.Mycin, paprika, all hot peppers, mild black pepper, other food-related flushing reactions that I have not yet figured out the cause, cannot use NSAIDs due to gut issues (see below).
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: Immediate severe burning pain from vaccine site up the right side of my neck to my head, and same down my arm almost to my hand. Throat also felt tight but no restriction of respiration. Shaking, cold/chills, dizzy after a few minutes, mostly subsided in 30min, but arm pain remained. Pain still present, red/purple rash appeared 24hr after vaccine as well as intense


VAERS ID: 1501013 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Blood glucose decreased, Decreased appetite, Dizziness, Echocardiogram, Electrocardiogram, Fatigue, Headache, Immediate post-injection reaction, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (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: High Blood Pressure
Preexisting Conditions: Occasional nerve pain in left foot
Allergies: codeine, penicillin, latex
Diagnostic Lab Data: See above. I was treated by doctor in the ER. I went to my family physician on July 15. I have had EkGs, heart ultrasound, and I''m scheduled to see a cardiologist on August 3, 2021.
CDC Split Type:

Write-up: Dizziness immediately, bad headache, heart palpitations at 4Pm and through the night. I went to urgent care 0500 7/14/21. I was told that I might have side effects and anxiety. No appetite for about 5 days with palpitations and fatigue. I now have low blood sugar.


VAERS ID: 1501109 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Oropharyngeal pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Nausea, diarrhea, chills, body aches, shortness of breath, fatigue, muscle aches, headache, sore throat


VAERS ID: 1501185 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-09
Onset:2021-07-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Hypoacusis, Magnetic resonance imaging, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Vitamins and Vitamin D
Current Illness:
Preexisting Conditions:
Allergies: Sulfa,, Levaquin, Keflex, and Clindamycin
Diagnostic Lab Data: Had an MRI last week Weds recommended after seeing ENT Doctor
CDC Split Type:

Write-up: Next morning after getting a shot around 4am my head shook for a few seconds and stopped. And then about 4 days later I noticed a slight change of my hearing on my right ear. Went to get it checked and even had MRI done and no explanation. Only event that took place is the shot.


VAERS ID: 1501337 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-25
Onset:2021-07-13
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Aphasia, Cardiac failure acute, Cardiac failure congestive, Cardiac ventricular thrombosis, Cerebellar stroke, Cerebrovascular accident, Computerised tomogram head, Echocardiogram, Hemiplegia, Immobile, Magnetic resonance imaging head
SMQs:, Cardiac failure (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin
Current Illness:
Preexisting Conditions: Diabetes, HTN, HLD
Allergies: NKDA
Diagnostic Lab Data: CT scan brain 7/13, MRI brain 7/17, TTE 7/15/2021.
CDC Split Type:

Write-up: Acute CHF with LV thrombus, multiple strokes involving MCA and left cerebellar stroke, aphasia, left-sided paralysis, immobility. Patient was given tPA, clinical symptoms still progressed. In rehab facility now.


VAERS ID: 1501399 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-05
Onset:2021-07-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, CSF protein increased, Guillain-Barre syndrome, Immunoglobulin therapy, Lumbar puncture, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: buproprion xl 150mg po daily marijuana once at bedtime via pipe or gummy Controlled Labs, Red Light, Weight, Test & Digestion Aid (took one dose one day prior to symptoms) Contains: Hibiscus sabdariffa Extract (Flower) (4:1) 450 mg ** Oliv
Current Illness: none
Preexisting Conditions: general anxiety disorder chronic low back pain with sciatica
Allergies: methylprednisolone 2017 given Medrol dose pack for flu and developed bilateral leg weakness
Diagnostic Lab Data: 7/19/21 Lumbar puncture elevated protein
CDC Split Type:

Write-up: Guillain Barre Syndrome; 7/18/21 gabapentin started 7/19/21 IVIG (Privigen) 30g IV for total of 5 days 7/20/21 symptoms worse 7/21/21 -7/23/21 symptoms gradually improved 7/24/21 Patient is doing better. Strength continues to improve. Tingling in feet resolved. Minimal in fingers. No other complaints. discharged from hospital.


VAERS ID: 1501432 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute myocardial infarction, Blood lactic acid, Blood test, Brain natriuretic peptide increased, Cardiac failure acute, Catheterisation cardiac, Chest discomfort, Chest pain, Computerised tomogram thorax, Dyspnoea, Echocardiogram abnormal, Ejection fraction, Malaise, Pulmonary oedema, Troponin increased, Ventricular hypokinesia
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On the day of admission (7/21) he had several indicators pointing to acute heart failure (BNP 1,800, up from 200), Lactic acid was high at 10, and NSTEMI was initially diagnosed due to slightly elevated Troponin, but a cardiac catheterization found his coronary arteries to be completely patent. His echocardiogram revealed a global hypokinesia and his LVEF was 30%. CT chest ruled out pulmonary embolism, only found pulmonary edema.
CDC Split Type:

Write-up: He felt slightly unwell after the first dose of vaccine but recovered after a day or two On evening of 2nd dose, he developed severe chest pain, shortness of breath, and generalized malaise, without fever or cough. He requested to see me after 5 days of symptoms getting worse such that he felt short of breath doing very little, like walking just up a few steps, or talking, I saw him on 7/19. his physical exam was grossly normal, although he reported presence of pressure on the chest and shortness of breath with walking and talking. After blood test finding elevated BNP, I tried to get him to schedule an echo, and sent Rx for diuretic. But he got too short of breath at home and called 911. When the ambulance arrived, he was not to the hospital I was affiliated with, but another hospital nearer to his home, so I have no direct assess to his record, but at the time of discharge 4 days later, I spoke to his discharging hospitalist to obtain the full medical course, in addition to his own account.


VAERS ID: 1501732 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-11
Onset:2021-07-13
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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

Write-up: long term care facility requested vaccination for new resident, patient vaccinated with Janssen 07/13/2021. When entering vaccination in state registry it was noted that the patient had previously received a dose of Pfizer 06/11/2021. The facility acknowledged they were aware of the Pfizer being ordered but did not have confirmation of the administration. Pt was unable to answer if previously vaccinated and the previous facility was unable to locate confirmation of administration just the order. Unsure if patient ever received Pfizer.


VAERS ID: 1501765 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Seated in observation room after receiving 1st dose of Pfizer COVID 19 vaccine, pt reported feeling lightheaded and sweaty. RN elevated her feet onto a second chair facing the patient while 2nd RN obtained vital signs. Pt was hypotensive with BP 72/44. Otherwise vital signs were within normal limits. Pt remained with her feet elevated for several minutes and reported feeling better. Pt tolerated lowering her feet to the floor. BP was 97/67 She ate some of her lunch and then tolerated standing and walking. Left ambulatory, asymptomatic.


VAERS ID: 1501794 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-30
Onset:2021-07-13
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Diarrhoea, Fatigue, Hyposmia, Hypoxia, Lethargy, Lung infiltration, Myalgia, Nausea, Productive cough, SARS-CoV-2 test positive, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol, Finacea, Breo Ellipta, Zyrtec, Clobetasol, Diltiazem, Eliquis, flonase, mirena, Triamcinolone
Current Illness: None
Preexisting Conditions: Anxiety, Asthma, Atrial fibrillation, Depression, Obesity,
Allergies: NKDA
Diagnostic Lab Data: COVID-19 RT-PCR Collected and resulted on 7/20/2021 - Positive.
CDC Split Type:

Write-up: Patient received full COVID vaccine series on 3/9/2021 and 3/30/2021. Patient became symptomatic with COVID symptoms on 7/13/2021. Symptoms include mild productive cough, fatigue, muscle aches, decreased smell. patient was tested for COVID-19 on 7/20/2021 via RT-PCR which returned positive. Patient was offered monoclonal antibody therapy and declined. Patient was seen in Emergency SErvices on 7/23/2021 for increased nausea, vomiting and diarrhea and increasing lethargy. She received IV fluids and Zofran. Oxygen saturations in mid-90s on room air. Patient discharged home. Patient returned to emergency services on 7/24/2021 and found to be significantly hypoxic requiring supplemental oxygen via nasal cannula at 2 Liters. Patient was subsequently admitted to the hospital for additional treatment. Chest x-ray with bilateral patchy infiltrates, being trearted with dexamethason/remdesivir. Patient remains admitted to the hospital at the time of this report.


VAERS ID: 1501866 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-09
Onset:2021-07-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Epistaxis, Musculoskeletal chest pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Repeating nose bleedings - no medication was needed, stopped by itself Slight pains in left-sided intercostal space (left side of the chest) - moderate pains, no treatment needed


VAERS ID: 1501895 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-16
Onset:2021-07-13
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Cough, Headache, Lethargy, Pyrexia, SARS-CoV-2 test negative, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), 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: Levothyroxine; Phentermine; Prilosec OTC; 4000 IU of Vit D
Current Illness: no
Preexisting Conditions: chest cough for about two years; Hashimoto''s disease
Allergies: sensitivity to Valtrex medication
Diagnostic Lab Data: Urgent Care - I had them do a COVID test - rapid and PCR and both turned out to be negative.
CDC Split Type: vsafe

Write-up: Severe headache and coughing significantly (increased coughing) resulting vomiting on occasion. Extreme lethargy and a slight fever. Duration: lasted about six days. And the course of treatment recommended by the doctor: rest and lots of fluids and a fever reducer. Wednesday, July 14th, Urgent Care - when I sought care, I had them do a COVID test - rapid and PCR and both turned out to be negative.


VAERS ID: 1501915 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 LA / IM

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

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

Write-up: Patient who is 14 years old received incorrect second dose of COVID-19 vaccine. First dose was Pfizer and second dose was Moderna. No adverse reactions have been noted since administration.


VAERS ID: 1502767 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-01-18
Onset:2021-07-13
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood sodium decreased, Blood test abnormal, Bone disorder, Colonoscopy, Computerised tomogram, Condition aggravated, Constipation, Endoscopy, Headache, Neck pain, Pain in extremity, Vertigo
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Vestibular disorders (narrow), Chronic kidney disease (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? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: OMEPROZOLE 20 MG ONCE A DAY; Symacort Inhaler - two puffs in the am and two puffs evening; Linzeff 200 mg once a day; Miralax - one to 2 cps a day PRN - I was taking pretty much every day. Delcasate (I think I was taking it) - stool soften
Current Illness: no
Preexisting Conditions: GERD; asthma; Constipation; Osteopenia
Allergies: No severe reactions but - sulfa, Boniva; Wellbutrin - these are on my list not to take again
Diagnostic Lab Data: ER- one time for severe pain and another time for even more pain. third time, I also went to ER - last Friday 16th - to Wednesday July 21st During the course of the ER visits - lots of blood tests; x-ray of lungs (while in hospital) - low sodium - there were a whole bunch of values that were off - some low and some high. Dr said that my blood tests were off from where they are normally are.
CDC Split Type: vsafe

Write-up: Symptoms have been - severe pain in my left upper arm/shoulder (trapezius area) and around my neck and sometimes around my whole head. One evening also on my right upper arm. I had vertigo - low sodium - 118 was my level. ER three different times and a hospitalization. That could have been caused by an anti-depressant I had been on - I was taking Zoloft - 50 mg once a day - and that could have contributed to the low sodium. I was so constipated that I was taking Miralax etc and I was drinking 120-180 ounces a day of water so that could have caused it, also. Not related to this, I had a colonoscopy and endoscopy (June 10th) and CT scan (29th of June) - about my constipation - under care of an endocrinologist. Those test came back negative - no negative findings. I still have to take Oxycodone every night - two pills. I have never had to take medication for pain besides Advil before this. First hospitalization, as well. They have switched some of the things I''m taking for the constipation - I am still doing Miralax but I am on Senokot - two tablets twice a day instead of Colace. They have taken me off Linzess - now I take Amitiza 8 mcg twice a day. I don''t take Zoloft - Mirtazapine 7.5 mg once a day. I won''t be taking the infusion again - Reclast - I use to be on Prolia (that had helped my bone density - but I couldn''t keep taking it) but they had stopped that and started this new one. The Reclast infusion didn''t work for me. Next year, I won''t do it again. I see my Primary care doctor tomorrow for follow up.


VAERS ID: 1503485 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-16
Onset:2021-07-13
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Bacterial vaginosis, Blood pressure increased, Blood thyroid stimulating hormone decreased, Illusion, Menstruation irregular, Muscular weakness, Palpitations, Thyroid function test abnormal, Thyroxine decreased, Tri-iodothyronine increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Armour Thyroid
Current Illness: None
Preexisting Conditions: Hashimotos Disease
Allergies: Eggs, dairy, gluten, prawns
Diagnostic Lab Data: Thyroid panel - TSH 1.2, T4 1.2, T3 5.7 Positive for BV
CDC Split Type:

Write-up: Abdominal pain began 7/29 and treatment for BV began 7/12. Thyroid panel on 7/9 showed high out of range T3 with TSH and T4 in healthy range. On 7/13 symptoms of heart palpitations, muscle weakness, vision distortion, and elevated blood pressure began suddenly during work. I have history of stroke caused by thyroid storms. Immediately took atenolol, a beta blocker, and called my endocrinologist to prescribe it for the next 30 days. Switched from armour thyroid back to levothyroxine. Atenolol has caused other side effects, heart palpitations are mild and not gone, menstrual cycle is highly irregular. Waiting 6 weeks from the change to levothyroxine for next thyroid panel, continuing atenolol until thyroid levels are in range.


VAERS ID: 1505239 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-01
Onset:2021-07-13
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Headache, Pain in extremity, Pulmonary pain, Renal pain
SMQs:, Retroperitoneal fibrosis (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: N/A
Current Illness: N/A
Preexisting Conditions: Allergies
Allergies: Septra
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in arm, pain in back, headaches, pain in kidney, pain in lung, minor spotting on wrist.


VAERS ID: 1505295 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / UNK RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Duloxetine Levothyroxine Bupropion
Current Illness: none
Preexisting Conditions: Hypothyroidism Depression
Allergies: none
Diagnostic Lab Data: Dr. appt scheduled with Dr. 7/30/2021.
CDC Split Type:

Write-up: onset of Tinnitus, temporary loss of hearing in right ear. within 2 hours after vaccine. regained hearing within an hour. on July 26, 2021 at 800 pm sudden hear loss in left ear. gained hearing back. tinnitus continues with no relief.


VAERS ID: 1505423 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-30
Onset:2021-07-13
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Limb discomfort, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Arm feels sore and uncomfortable several days after the vaccine


VAERS ID: 1505453 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Gait disturbance, Groin pain, Nasal oedema, Pain, Tenderness, Ultrasound scan normal
SMQs:, Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Osteonecrosis (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Methadone - 10mg tablets - Take 1 tablet by mouth every 8hrs as needed Tizanidine - 4mg tablets - Take 1 tablet by mouth every 8hrs as needed Sertraline - 100mg tablets - Take 1 tablet by mouth every day
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 7-19-21 @ Emergency Room, an ultrasound was done on my groin area and hip to check for a blood clot, and the test was negative.
CDC Split Type:

Write-up: After receiving my Covid 19, Johnson and Johnson, shot in my left arm, on 7-13-21 ,I got observed for 15 min and then i was told i was okay to leave. As soon as i stood up from sitting down, my left hip started to hurt. It was a sharp deep pain. I was able to walk with a limp for a couple of days, and then the pain became so intense in my groin area and hip area on the left side, i could no longer use my left leg because of the pain , and was taken to Urgent care on 7-15-21, was seen, and was told that the Covid shot was probably causing the pain in my hip and groin because of the inflammation that the shot causes , and it was my body thinking I actually had covid, which i didn''t, but because of the shot, my body thought so. No medication was prescribe, was told if the pain hasn''t gone away within 3 days to return to the urgent care, or emergency room. Well the pain kept getting worse and by 7-19-21,I was no longer able to put any pressure on my left leg, so I was taken to the emergency room, where they gave me a shot of pain medicine in my top right thigh, and given Robaxin 500mg to help with the pressure in my groin and hip. They also did an ultrasound in the groin area and found no blood clots. Also in the last week my nose on the left side is swollen and tender, never had any issues with my nose before the shot, nor my hip or groin in that much pain until the shot.


VAERS ID: 1505590 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-28
Onset:2021-07-13
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-COV-2 XPRESS PCR positive 7/13/21 Cycle threshold 16.7 on 7/13/21
CDC Split Type:

Write-up: Hospitalization with COVID-19 Reporting per EUA


VAERS ID: 1506969 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-22
Onset:2021-07-13
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cardiac disorder, Hypoaesthesia
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? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Developed numbness on the right side of her body on 07/13/21. The client''s husband stated she woke up with numbness along the right side of her body on 07/13/21. The client went to urgent care and was subsequently admitted to hospital for five days. The client stated she saw two neurologists. One of the neurologists thought her symptoms were related to a stroke, and stated they are currently treating her as if she had a stroke. The client is currently taking Aspirin and Atorvastatin. The client reports persistent numbness along her right side from her knee to her foot, which has improved, but not resolved. The client''s husband stated the doctor approved for the client to receive the 2nd dose COVID vaccine Pfizer. The client''s husband noted the client was also diagnosed with a "hole in her heart" while in the hospital. The client is scheduled to follow up with a cardiologist tomorrow. The client denied any shortness of breath after receiving the 1st COVID vaccine Pfizer. The client denies any chronic conditions.


VAERS ID: 1508953 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Hypoaesthesia, Muscle tightness, Paraesthesia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021887409

Write-up: tingling; tightness in her neck and throat; tightness in her neck and throat; numbness and tingling on the left side of her neck; really anxious; This is a spontaneous report from a contactable Pharmacist via Medical Information Team. A 36-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number: EW0217; Expiration date: Sep2021), via an unspecified route of administration in left deltoid on 13Jul2021 at 10:47 (at the age of 36 years old) as dose 1, 0.3 mL single for covid-19 immunisation.The patient medical history and concomitant medications were not reported. The patient not had history of previous immunization with the Pfizer vaccine considered as suspect. The patient did not receive additional vaccines on same date of the Pfizer suspect.The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 13Jul2021 patient experienced tingling, tightness in her neck and throat, tightness in her neck and throat, numbness and tingling on the left side of her neck, really anxious. Reporter stated that she was a pharmacist and administered the vaccine to a patient who experienced tingling and tightness in her neck and throat on 13Jul2021.Tingling in the neck and throat included she did not let them know until the 15-minute observation period was over. She just kind of felt like her throat was tight and tingling in her neck. Reporter was not sure if she was still experiencing this now. Reporter stated that the patient was describing it as kind of a tight feeling but was not struggling to breathe. She was still breathing and everything, she was just really anxious. She just stood up and walked to the counter. She has been sitting there about 25 minutes. Reporter stated that the tightness has gone away now, the patient has been sitting at the pharmacy for 45 minutes and she was not struggling to breathe, and she was able to swallow water. The patient does still have some numbness and tingling on the left side of her neck. Reporter stated that the patient was now stating that the numbness and tightness have gone away but she was feeling tingling in her neck, on the side of administration, which was the left side. No family medical history relevant to adverse events was provided and no relevant tests were performed. The patient did not visit emergency room or physician office. Relatedness of drug to tingling in neck and throat and throat tightness and numbness reaction: Related as per source of assessment: Primary Source Reporter, method of assessment: Global Introspection.The outcome of events was unknown.


VAERS ID: 1508961 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: RAMIPRIL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high (.)
Allergies:
Diagnostic Lab Data: Test Name: Temperature; Result Unstructured Data: Test Result:100.5.
CDC Split Type: USPFIZER INC2021887572

Write-up: little fever; This is a spontaneous report from a contactable consumer (patient himself). A 41-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: EW0196, Expiry date: Unknown), via an unspecified route of administration in Arm Left on 12Jul2021 17:30 (at the age of 41-years-old) as dose 2, single for COVID-19 immunisation. Medical history included Blood pressure high. Patient had not received any other vaccines within 4 weeks prior to the COVID vaccine. No prior vaccinations. The patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: EW0217, Expiry date: Unknown) via an unspecified route of administration in Arm Left on 12Jul2021 17:30 as dose 1, single for COVID-19 immunisation and experienced no adverse event. Concomitant medication included ramipril (RAMIPRIL) taken for hypertension, started three years ago. On 13Jul2021, the patient experienced little fever. He wanted to know the temperature range of the body after receiving dose of the vaccine. Caller stated he know having this little bit of fever is kind of normal. Patient asked, what was the normal range of temperature. Stated the fever began a couple of hours ago today, 13Jul2021. He did not feel bad, just took his temperature and it was 100.5. The patient underwent lab tests and procedures which included temperature: 100.5 on unspecified date. No vaccine administered at Military Facility. The clinical outcome of event was unknown.


VAERS ID: 1508981 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021887745

Write-up: Today has itchiness and redness like a rash/ itching bad all over, pretty bad, and is getting red kind of; Today has itchiness and redness like a rash/ itching bad all over, pretty bad, and is getting red kind of; Today has itchiness and redness like a rash/ itching bad all over, pretty bad, and is getting red kind of; This is a spontaneous report from a contactable consumer (patient). A 32-years-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: solution for injection, Lot number: not reported) via an unspecified route of administration on 12Jul2021 as DOSE 2, SINGLE for covid-19 immunization. The patient medical history and concomitant medications were not reported. Historical vaccine included previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot number: not reported) via an unspecified route of administration on an unspecified date as DOSE 1, SINGLE for covid-19 immunization and did not experience any adverse event. Caller was calling about the Pfizer Covid-19 Vaccine, he stated he was calling about his symptoms, he had his second dose of the COVID-19 vaccine on yesterday (12Jul2021) and today (13Jul2021) had itchiness and redness like a rash, like he read on the paper of things that could happen. He would like to know how to slow this down or stop this reaction and also reported that he was itching bad all over, pretty bad, and is getting red kind of. The outcome of the events was unknown. Information on lot/batch number has been requested.


VAERS ID: 1509034 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Tuberculin test
SMQs:, Dementia (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: Fall; Shoulder injury
Allergies:
Diagnostic Lab Data: Test Date: 2020; Test Name: TB test; Result Unstructured Data: Test Result:Unknown result
CDC Split Type: USPFIZER INC2021889350

Write-up: Caller wanted to know if he got the right medication since the second dose "did not hurt"?/Caller mentioned he "did not have any response; This is a spontaneous report from a non-contactable consumer or other non hcp (patient). A 72-years-old male patient received BNT162B2 (Pfizer-Biontech Covid-19 Vaccine, Formulation: solution for injection, Batch/Lot Number unspecified, expiration date unspecified), via an unspecified route of administration, administered in Arm Right on 13Jul2021 as DOSE 2, SINGLE for covid-19 immunization. Previously the patient received BNT162B2 (Pfizer-Biontech Covid-19 Vaccine, Formulation: solution for injection, Batch/Lot Number unspecified, expiration date unspecified), via an unspecified route of ad-ministration, administered in Arm Right on an unknown date as DOSE 1, SINGLE for covid-19 immunization. Medical history included patient fall on an unknown date, limb injury from an unknown date. The patient''s concomitant medications were not reported. On 13Jul2021, the patient wanted to know if he got the right medication since the second dose did not hurt caller mentioned he did not have any response. Patient also expressed concern if the dose was properly administered (feeling abnormal). On an unknown date in 2020, the patient underwent lab tests which included tuberculin test and result were unknown. The outcome of the event was reported as unknown at the time of report. No follow up attempt was possible. No further information is expected.


VAERS ID: 1509090 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-11
Onset:2021-07-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Joint swelling, Peripheral swelling, Rash, Swelling face, Tonsillar hypertrophy
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CEPHALEXINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: UTI
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021894913

Write-up: Rash and swelling on face, feet/toes, arms, fingers, and a little on back; Tonsils slightly swollen; Rash and swelling on face, feet/toes, arms, fingers, and a little on back; swelling on face, feet/toes, arms, fingers, and a little on back; swelling on arms, fingers; This is a spontaneous report received from a contactable consumer (patient) or other non hcp. A 15-years-old (non-pregnant) female patient received BNT162B2 (PFIZER-COVID-19 VACCINE, Batch/Lot number and Expiration date was not reported), dose 1 via an unspecified route of administration, administered in Arm Left on 11Jul2021 13:30 (at the age of 15-years-old) as dose 1, single for covid-19 immunization.Medical history included urinary tract infection from an unknown date and unknown if ongoing. Concomitant medication(s) included cefalexin taken for urinary tract infection, start and stop date were not reported.The patient previously took azithromycin for drug hypersensitivity and experienced rash, azithromycin for drug hypersensitivity and experienced swelling. On 13Jul2021 at 06:00 the patient experienced rash and swelling on face, feet/toes, arms, fingers, and a little on back, tonsils slightly swollen, joint swelling, swelling on arms, fingers. Adverse event resulted in patient visited Emergency room, department or urgent care. patient received treatment with Zyrtec.The patient did not tested for covid before and prior to vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Device Date: 14Jul2021.The outcome of the events was recovering. Information about lot/batch number has been requested.


VAERS ID: 1509094 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-09
Onset:2021-07-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021895129

Write-up: he has these spots on his body/showed her a red spot; circular spots on the other arm and there is a deep one the one arm and in the other leg and all over the body; This is a spontaneous report from a contactable pharmacist. A 26-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), dose unknown via an unspecified route of administration on 09Jul2021 (at the age of 26 years old) (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On 13Jul2021 14:00, the patient has these spots on his body. The patient came in and it looks like he has these spots on his body. He got the vaccine 09Jul2021. He showed her a red spot near where it would have been given, that looks like it is likely from it. But then there are bullet spots on the other arm and down on his foot. They almost look like targets and are pretty circular. The patient is there now. The reporter clarified the spot that she thought was where it was given was actually on his other arm. It looks like circular spots on the other arm and there is a deep one the one arm and in the other leg and all over the body. The spots first occurred not shortly after lunch time, yesterday, around 2:00PM. He had gotten the vaccine last Thursday and a few days had passed since then. Patient clarifies they were all on the arm, in both arms. The reporter considered the events as non-serious. The outcome of the events was unknown. Information regarding the lot/batch number has been requested.


VAERS ID: 1509111 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Breast pain
SMQs:, Lipodystrophy (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: Hypertension (other_medical_history: Hypertension); Penicillin allergy (known_allergies: Pcn)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021899064

Write-up: Left underarm and left breast pain; Left underarm and left breast pain; This is a spontaneous report from a contactable other hcp (patient). A 59-year-old non-pregnant female patient received first dose of bnt162b2 (BNT162B2, Solution for injection, Lot number: Fa6780), via an unspecified route of administration, administered in Arm Left on 12Jul2021 16:30 as DOSE 1, SINGLE for covid-19 immunisation. Medical history included hypertension and Penicillin allergy. Prior to vaccination patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. patient received within 2 weeks of vaccination: Blood pressure meds. The patient experienced left underarm and left breast pain on 13Jul2021. The outcome of the events was not recovered.


VAERS ID: 1509275 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 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? 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: Error: Patient Too Young for Vaccine Administered-


VAERS ID: 1509444 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Patient Too Young for Vaccine Administered-


VAERS ID: 1509456 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Limb injury, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Arthritis (broad)

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

Write-up: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1509540 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 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.


VAERS ID: 1509614 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-19
Onset:2021-07-13
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 LA / IM

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

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

Write-up: Became symptomatic, rapid antigen positive.


VAERS ID: 1509633 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-21
Onset:2021-07-13
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Headache, Malaise, Nausea, Pain, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Nervous Aphasia From Stroke Circulatory Atrial Fibrillation Paroxysmal (HCC) Hypertensive Heart Disease Without Hear
Allergies: Adhesive tape, lisinopril, naproxen
Diagnostic Lab Data: Coronavirus 2 PCR Detect, V symptomatic POSITIVE
CDC Split Type:

Write-up: Patient reports being ill since 7/13/21 with fever, cough, n/v, chills, headache. Better now, only left with lingering body aches.


VAERS ID: 1509861 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-10
Onset:2021-07-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test, Computerised tomogram, Dyspnoea, Electrocardiogram, Palpitations, Pericarditis, Sensory disturbance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Blood Test 07/23/2021 Cat Scan 07/23/2021 EKG 07/23/2021
CDC Split Type:

Write-up: Pt. states that after receiving the 2nd dose of Moderna 07/10/2021, started experiencing symptoms 07/13/2021 of shortness of breath, heart palpations, weakness, and throbbing through the back. ER visit 07/17th,20th, 23rd/2021, acute-pericarditis sent home with 600mg Ibuprofen


VAERS ID: 1509951 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 RA / 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 that the vaccines were kept in the freezer for 11 days longer than the two week standard time. Patient was notified and given the option for additional dose.


VAERS ID: 1511984 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-07-13
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210713; Test Name: PCR; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021892798

Write-up: Tested positive for COVID-19 in July2021; Tested positive for COVID-19 in July2021; This is a spontaneous report from a contactable consumer. A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE lot/batch number and expiration date not reported) via an unspecified route of administration on May2021 as single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 13Jul2021 the patient tested positive for covid-19 in July2021. COVID test type post vaccination: PCR (nasal swab): positive. No treatment was received for the event. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Outcome of the event was recovering. lot/batch number and expiration date not reported


VAERS ID: 1512014 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood pressure measurement, Dizziness, Heart rate, Heart rate decreased, Heart rate increased, Hypertension, Muscular weakness, Pain in extremity, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (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: LISINOPRIL; IBUPROFEN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Back pain; Blood pressure high (The caller has been on the Lisinopril since 2018 and started at 40 mg and went down to 5mg); Fall; High cholesterol; Rib fracture
Allergies:
Diagnostic Lab Data: Test Date: 20210714; Test Name: blood pressure and it was 138/90 which is high for me lately; Result Unstructured Data: Test Result:130-135/75; Test Date: 20210714; Test Name: blood pressure and it was 138/90 which is high for me lately; Result Unstructured Data: Test Result:138/90; Test Date: 20210714; Test Name: heart rate went from the 50s to the 120s; Result Unstructured Data: Test Result:115; Test Date: 20210714; Test Name: heart rate went from the 50s to the 120s; Result Unstructured Data: Test Result:120; Test Date: 20210714; Test Name: heart rate went from the 50s to the 120s; Result Unstructured Data: Test Result:55-65; Test Date: 20210714; Test Name: heart rate went from the 50s to the 120s; Result Unstructured Data: Test Result:his heart rate went from the 50s to the 120s
CDC Split Type: USPFIZER INC2021894392

Write-up: heart rate went from the 50s to the 120s; Heart racing; His heart rate went from 120 beats to in the 70s and 50s; blood pressure and it was 138/90 which is high for me lately; Dizzy; whole body is weak; my legs were kind of weak; my arm was a little tender, little sore; This is a spontaneous report from a contactable consumer (patient). A 48-year-old male patient received dose 1 of BNT162B2 (Pfizer-BIONTECH COVID-19 Vaccine), via an unspecified route of administration, administered in the left arm on 13Jul2021 at 12:05 PM (Batch/Lot number reported as EW0181 or FW0181) single, for COVID-19 immunization (also reported as to be precautionary and his wife is a teacher). Medical history included blood pressure high from 2018 to an unknown date (the caller has been on the lisinopril since 2018 and started at 40 mg and went down to 5mg), high cholesterol from 2018 to an unknown date, back pain from 03Jul2021 to an unknown date, rib fracture from an unknown date and unknown if ongoing, and fall from 03Jul2021 to an unknown date. Concomitant medications included lisinopril taken for hypertension from 2018 and ongoing; and ibuprofen taken for pain from 03Jul2021 to an unspecified stop date. The patient had no history of all previous immunization with the Pfizer vaccine considered as suspect, did not have additional vaccines administered on the same date of the Pfizer vaccine, and did not have prior vaccinations (within 4 weeks). The patient had whooping cough vaccine 6 years ago and had a sore arm for 3 days. The patient experienced ''muscular weakness'' and ''pain in extremity'' on 13Jul2021; and ''heart rate increased'', ''palpitations'', ''heart rate decreased'', ''hypertension aggravated'', ''dizziness'', and ''asthenia'' on 14Jul2021. The patient inquired about additional information regarding side effects of the Pfizer COVID-19 vaccine. He received his first dose on 13Jul2021 and reported that this morning, while taking a shower, his heart rate went from the 50''s to the 120''s. The patient stated that yesterday (13Jul2021) about 12 in the afternoon, he got his first dose of the vaccine. He sat in the place for 30 minutes after the fact, the only thing was his legs were kind of weak but the tech said that was normal so he walked out and continued his day. He drank an electrolyte drink and around about a gallon of water. The patient didn''t have a fever, sweats, or chills. He did cardio (stationary bike ride) for about 30 mins, but he''d been taking it easy because on 03Jul2021, he injured his ribs from a fall down a flight of stairs. There were no fractures and he has been taking ibuprofen 600mg twice a day for pain. The pain wasn''t bad enough to take that, so he discontinued taking it 5 days ago. He had nothing in his system except for lisinopril that he takes for high blood pressure. The patient further stated that about 8 hours after the vaccine, he had a few glasses of wine last between 6pm-7pm and his arm was a little tender, little sore, but everything else was fine. He was inquiring if there were other reports of this happening. The patient didn''t have any rapid pulse when he got the vaccine. His legs feeling weak was improved but after that episode with his heart his whole body was weak, he hasn''t felt right since that happened. According to the patient, he did his normal routine this morning. The patient woke up this morning at 7:00am and felt okay. He went to take a shower and his heart rate went from his average of 50-55 beats per minute and started racing. The patient checked his pulse it was about 125 and rapidly getting faster. Also stated that when he was turning the shower on this morning and was washing his hair and face, he could feel his neck pulsating where his pulse was. The caller felt weak and dizzy and then his heart rate went from 120 beats to in the 70s and 50s. Stated that he doesn''t drink coffee, but drinks herbal tea. As soon as he got in the shower, he was washing his face and hair and he felt his neck (where you take a pulse), it felt like it was beating fast. He checked it and it was 115, 120. He has a monitor that he wears. It was just out of the blue. He had no stress and no anxiety. It happened all of a sudden, it was strange. The patient didn''t know if it was a combination of the few glasses of wine or what. This reaction was so long after the fact and he took his blood pressure medicine at 5:30 last night. Stated that he has been on lisinopril since 2018 and started at 40 mg and went down to 5mg. He tried to calm down, he took the electrolyte drink, a Xanax, and drank water and then in 15-20 minutes, it calmed his heart rate down. The patient''s heart rate was back down in the 50s but he didn''t feel 100%. The caller''s blood pressure was okay. He thought he would go to the ER so he started driving and saw his heart rate going down so he drove home and checked his blood pressure and it was 138/90 which was high for him lately. But his pulse started coming down so he rechecked his blood pressure and it was 130-135/75 with a pulse around 55-65. It''s been like that since and stated that he''s fine. He was asking why it took almost 24 hours for these to happen. The events did not require a visit to the Emergency Room or Physician''s Office. The patient''s heart rate and blood pressure had been fine since the episode. The patient underwent laboratory tests and procedures which included blood pressure measurement: 130-135/75 and 138/90 on 14Jul2021, heart rate: 115, 120, 55-65, his heart rate went from the 50s to the 120s on 14Jul2021. The patient stated that he was scheduled for an ECHO and stress test on Friday, but wanted to call Pfizer too. Outcome of the events heart rate increased was recovered on an unspecified date, for hypertension was recovered in Jul2021, for palpitations was not recovered, for muscular weakness was recovering (also reported as ongoing), while for the other events was unknown. Information regarding the batch/lot number has been requested.


VAERS ID: 1512448 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-09
Onset:2021-07-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: EKG done on 7/29, positive for pericarditis. Troponin drawn 7/29. Results not back yet at time of filing report. Patient will continue to follow up for serial re-evaluation of sx''s
CDC Split Type:

Write-up: Patient with pericarditis on EKG, Persistent chest pain, increases with activity.


VAERS ID: 1512920 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-01
Onset:2021-07-13
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident, Facial paresis, Neurological symptom
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Immune-mediated/autoimmune 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? 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: R29.90 - Stroke-like symptom I63.9 - Cerebrovascular accident aborted by administration of thrombolytic agent (CMS/HCC) R29.810 - Facial weakness


VAERS ID: 1513137 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 / 2 RA / 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: given after the beyond-use-dating due to the vaccine being stored improperly


VAERS ID: 1513174 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 / 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: given after the beyond-use-dating due to the vaccine being stored improperly


VAERS ID: 1513189 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 / 2 LA / 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: 1513191 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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: 1513638 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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: 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: given after the beyond-use-dating due to the vaccine being stored improperly


VAERS ID: 1513660 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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: 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: 1513668 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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: 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: 1513894 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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: 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: 1514222 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-22
Onset:2021-07-13
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray abnormal, Lymphadenopathy, Pneumonitis, Pneumothorax, Rash
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Amoldipine 5mg Hydroxychloroqune 200mg Prednison 5mg Noretthindrone Acerate Vitamin D FaBB (B12)
Current Illness:
Preexisting Conditions: Sjogren High Blood Pressure Asthma
Allergies: Penicillin Citrus Beef
Diagnostic Lab Data: 7/14/21 - Chest Xray
CDC Split Type:

Write-up: Lymph nodes swelling, inflammation lung, collaped lung, rash on face


VAERS ID: 1514471 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-12
Onset:2021-07-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Fatigue, Headache, Pain, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: Medical History/Concurrent Conditions: Pollen allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210714; Test Name: fever; Result Unstructured Data: Test Result:102 Fahrenheit
CDC Split Type: USPFIZER INC202100911303

Write-up: itchy full body hives; 102 degree fever; minorly ill (general body soreness/fatigue/headache); minorly ill (general body soreness/fatigue/headache); minorly ill (general body soreness/fatigue/headache)/low grade headache; This is a spontaneous report from a contactable consumer (patient). A 24-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), dose 2 via an unspecified route of administration, administered in arm left on 12Jul2021 (at the age of 24-year-old) as single dose for COVID-19 immunisation. Medical history included season allergies for pollen. Concomitant medications were not reported. No other vaccine in four weeks. No other medications in two weeks. The patient previously received 1st single dose in left arm of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 21Jun2021 (at the age of 24-year-old) for COVID-19 immunisation. Patient felt minorly ill (general body soreness/fatigue/headache) on Tuesday 13Jul2021 and felt better on Wed (14Jul2021) during the day with low grade headache as main symptom. Wed night, patient had a 102 degree fever which dissipated by noon on Thurs. Thursday night (15Jul2021 20:00), patient developed itchy full body hives which still had currently. Patent was taking diphenhydramine hydrochloride (BENADRYL) and prescribed prednisone steroid to prevent itchiness. Essentially stayed in bed the majority of the week and ate very basic meals - not aware of anything that would have triggered these hives and have never had hives before. AE resulted in doctor or other healthcare professional office/clinic visit. No covid prior vaccination. No covid tested post vaccination. The outcome of the event Hives was not recovered, of the event Fever was recovered on 15Jul2021, of other events was recovering. Information about Lot/Batch number have been requested.


VAERS ID: 1514770 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 FA7485 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Gait disturbance, Pain, Peripheral swelling, SARS-CoV-2 test, Vaccination site pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TOPIRAMATE; GABAPENTIN; THYROXINE; ESTRADIOL; SINGULAIR; PRAVASTATIN; METFORMIN; HYDROCODONE
Current Illness: Diabetic
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (she caught Covid one time prior); Pain; Sinusitis; Thyroiditis
Allergies:
Diagnostic Lab Data: Test Name: covid test; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC2021893583

Write-up: body hurting/body hurts/body aches; can hardly walk; weakness; swollen arm/; Swollen arm where the injection was given; This is a spontaneous report from a contactable consumer (patient herself). A 58-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: FA7485), via an unspecified route of administration, administered in left arm on 13Jul2021 (age at vaccination: 58 years) as DOSE 1, SINGLE for covid-19 immunisation. The patient''s medical history included covid-19, ongoing diabetes mellitus, sinusitis, thyroiditis and pain. Concomitant medication(s) included topiramate (has been on for a couple of years) taken for headache; gabapentin (has been on for a few years); levothyroxine sodium (THYROXINE) (has been on for a couple of years) taken for thyroiditis; estradiol; montelukast sodium (SINGULAIR) 10mg taken for sinusitis; pravastatin; metformin 500mg taken for diabetes mellitus and hydrocodone taken for pain in her back and down her legs. On 13Jul2021, the patient''s body was hurting/body hurts/body aches, can hardly walk, weakness, swollen arm where the injection was given which started yesterday evening and has gone down some since she soaked it. The patient stated that body pain started last night, or actually yesterday when she was at work; weakness started yesterday evening, it was about the same and has not gotten better. There was no treatment was given for the adverse events. There was no history of all previous immunization with the Pfizer vaccine considered as suspect. There were no additional vaccines administered on same date of the Pfizer suspect. The adverse events did not require a visit to emergency room and physician''s office. There were no other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient underwent lab tests and procedures which included sars-cov-2 test was positive on an unknown date. The outcome of the event pain, gait disturbance, asthenia, was not recovered; peripheral swelling, vaccination site pain was recovering. There was no product quality complaint (PQC) present.


VAERS ID: 1515089 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 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: 1515102 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 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: 1515111 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-13
Onset:2021-07-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Pt was given J&J vaccine while lying down. patient passed out in waiting area 15 min after COVID vaccine was administered. wife was with patient in waiting area. Patient was sitting in chair when passed out. wife lowered him to floor. no injury sustained. pt was attended to by clinic staff. patient transferred to cot and recovered in separate room. vitals were taken, pt monitored in clinic for approx. 1 hour. pt discharged in wife''s company after he was awake, alert, had eaten some crackers and drank some juice. pt did report he has a history of passing out when giving blood in past.


VAERS ID: 1515123 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 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: 1515139 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-13
Onset:2021-07-13
   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 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: 1515578 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-09
Onset:2021-07-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cardiac function test normal, Headache, Hypertension, Laboratory test normal, Musculoskeletal pain, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: cholesterol
Allergies: NKDA
Diagnostic Lab Data: cardiac work up and labs- normal
CDC Split Type:

Write-up: Severe head pain; sudden high blood pressure, nausea, MSK pain


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