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From the 10/15/2021 release of VAERS data:

Found 800,916 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 383 out of 8,010

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VAERS ID: 1694160 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Echocardiogram abnormal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Intensive care, Pericardial effusion, Pericarditis, Troponin increased
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponin I: 8/27: 0.16, 0.31, 0.39, 0.67; 8/28: 0.89, 0.21 Echo obtained on 8/27 showing overall normal ventricular function, but a small apical pericardial effusion without hemodynamic significance. EKG obtained and showed diffuse ST elevation consistent with pericarditis. Repeat EKG was normal sinus rhythm with no evidence of ST elevations.
CDC Split Type:

Write-up: Transferred from outside ED and admitted to the pediatric step down ICU on 8/26 for chest pain and abnormal EKG. CV/RESP: Chest pain resolved with ibuprofen given at outside ED and was not required during admission. EKG obtained and showed diffuse ST elevation consistent with pericarditis. Initial troponin <0.02 but increased to 0.39 on 8/27. Cardiology consulted. Echo obtained on 8/27 showing overall normal ventricular function, but a small apical pericardial effusion without hemodynamic significance. Started on ibuprofen 400mg tid and Pepcid 20mg bid on 8/27. Troponin increased to 0.81 overnight 8/27. Repeat troponin on 8/28 was 0.21. Repeat EKG was normal sinus rhythm with no evidence of ST elevations. Patient remains without chest pain and denies dyspnea.


VAERS ID: 1694168 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Neck pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

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

Write-up: Patient developed marked neck and thoracic back pain 1 day following injection. She has required treatment with muscle relaxer, IM ketorolac, and narcotics


VAERS ID: 1694721 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-26
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 3 RA / ID

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoacusis, Pain in jaw, Sinus pain, Temporomandibular joint syndrome, Upper-airway cough syndrome, X-ray
SMQs:, Hearing impairment (narrow), Osteonecrosis (broad), Arthritis (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: Biosil - 100 mg. Calcium - 2000 mg. daily (1000 mg. am & pm) Curamin (2706 mg. curcumin, boswellia, DLPA) (am & pm) Estradiol - .5 mg, Levothyroxin .025 mg. Magnesium glycinate (Albion) - 400 mg. Multivitamin Probiotic Vitamin C - 2000 mg.
Current Illness:
Preexisting Conditions: Hypothyroidism (diagnosed 2006)
Allergies: Amoxicillin
Diagnostic Lab Data: Physical exams
CDC Split Type:

Write-up: Jaw pain in my right jaw for a week before going to the Dentist for an examination. Had also had post-nasal drip on the right side for about a week. Was taking occasional Sudafed and using Flonase to help with sinus pain. Read about jaw pain online and found that a sinus infection could express itself as jaw pain. After the Dentist''s examination and reviewing x-rays, he recommended that I see my Primary Care Physician about a possible sinus infection. Saw my PCP the same day. He was skeptical that a sinus infection could cause jaw pain and suspected TMJ instead. When he looking in the right nostril and saw redness, he prescribed Cefdinir (300 mg.) for 10 days followed by an anti-inflammatory twice daily for 5 days afterwards. I finished the antibiotic 9/12/21. Jaw pain is diminished. Post-nasal drip has stopped, although I have muffled hearing, for which I continue to use Flonase on my PCP''s recommendation. I had muffled hearing before, so this is not new. He recommended that I see an ENT if the problem continues.


VAERS ID: 1695004 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Headache, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Multi-vitamin
Current Illness: Covid diagnosis on 8/13/2021 with quarantine end date of 8/19/2021.
Preexisting Conditions: n/a
Allergies: PCN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, nausea, headache, body aches, shortness of breath from 11am until 8pm the next day. Shortness of breath and persistent cough when speaking at length since 1st dose.


VAERS ID: 1695282 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Blood test, Cognitive disorder, Depression, Disorientation, Dyspnoea, Fatigue, Headache, Lethargy, Myalgia, Panic attack
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: valaciclovir
Current Illness: n/a
Preexisting Conditions: Post covid issues 8 months.
Allergies: n/a
Diagnostic Lab Data: full array blood tests
CDC Split Type:

Write-up: extremes fatigue, lethargy, tiredness, weakness, pains (muscle, joints, headache), depression, panic attacks, disorientation, disabled cognitive functions, shortness of breath


VAERS ID: 1695351 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-08-26
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product packaging quantity issue
SMQs:

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

Write-up: A full untouched 10 dose Moderna COVID-19 vaccine only having enough for four doses which were administered to four patients; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT PACKAGING QUANTITY ISSUE (A full untouched 10 dose Moderna COVID-19 vaccine only having enough for four doses which were administered to four patients) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, the patient experienced PRODUCT PACKAGING QUANTITY ISSUE (A full untouched 10 dose Moderna COVID-19 vaccine only having enough for four doses which were administered to four patients). On 26-Aug-2021, PRODUCT PACKAGING QUANTITY ISSUE (A full untouched 10 dose Moderna COVID-19 vaccine only having enough for four doses which were administered to four patients) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The reporter stated that they were not sure of what exactly occurred as the facility was sent a sealed vial and only 4 doses were contained within it. There were no doses withdrawn from the vial at their pharmacy and therefore she do not believe that the patients received expired product. Most recent FOLLOW-UP information incorporated above includes: On 07-Sep-2021: New event-product packaging issue added.


VAERS ID: 1695354 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Feeling hot, Hypersensitivity, Myalgia, Nasopharyngitis, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Angioedema (broad), Eosinophilic pneumonia (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Nose dripping; Feeling hot; Feel like they have a bad cold; Feel like they have a bad allergies; Cold chills; Right arm very sore; This spontaneous case was reported by a consumer and describes the occurrence of RHINORRHOEA (Nose dripping), FEELING HOT (Feeling hot), NASOPHARYNGITIS (Feel like they have a bad cold), HYPERSENSITIVITY (Feel like they have a bad allergies) and CHILLS (Cold chills) in an 86-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in April 2021. On 25-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, the patient experienced RHINORRHOEA (Nose dripping), FEELING HOT (Feeling hot), NASOPHARYNGITIS (Feel like they have a bad cold), HYPERSENSITIVITY (Feel like they have a bad allergies), CHILLS (Cold chills) and MYALGIA (Right arm very sore). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, RHINORRHOEA (Nose dripping), FEELING HOT (Feeling hot), NASOPHARYNGITIS (Feel like they have a bad cold), HYPERSENSITIVITY (Feel like they have a bad allergies), CHILLS (Cold chills) and MYALGIA (Right arm very sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The concomitant medication includes blood thinner and the patient was on a lot of daily medications but did not felt like going through them at this time.


VAERS ID: 1695449 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Decreased appetite, Dyspepsia, Eating disorder, Illness, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: She is feeling like she is anorexic; when she eats something, she becomes ill and feels sick; any food she is eating is not sitting well; worried about developing an eating disorder from the vaccine; she just started throwing; This spontaneous case was reported by a consumer and describes the occurrence of DECREASED APPETITE (She is feeling like she is anorexic), ILLNESS (when she eats something, she becomes ill and feels sick), DYSPEPSIA (any food she is eating is not sitting well), EATING DISORDER (worried about developing an eating disorder from the vaccine) and VOMITING (she just started throwing) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, the patient experienced DECREASED APPETITE (She is feeling like she is anorexic), ILLNESS (when she eats something, she becomes ill and feels sick), DYSPEPSIA (any food she is eating is not sitting well), EATING DISORDER (worried about developing an eating disorder from the vaccine) and VOMITING (she just started throwing). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, DECREASED APPETITE (She is feeling like she is anorexic), ILLNESS (when she eats something, she becomes ill and feels sick), DYSPEPSIA (any food she is eating is not sitting well), EATING DISORDER (worried about developing an eating disorder from the vaccine) and VOMITING (she just started throwing) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication details were provided. This case was linked to US-MODERNATX, INC.-MOD-2021-137946 (E2B Linked Report). Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 31-Aug-2021: Follow up received contains no new information; Sender''s Comments: US-MODERNATX, INC.-MOD-2021-137946:Male patient


VAERS ID: 1696148 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait inability, Hypoaesthesia, Pain in extremity, Vascular test
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Pain in leg, couldn''t walk, numbness in leg (upper thigh). Numbness has continued for the last three weeks. Referred to a specialist.


VAERS ID: 1696294 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Eating disorder, Gastritis, Oesophagitis, Pharyngeal erythema, Sleep disorder
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topamax, Wellbutrin, Percocet, B2, magnesium, aspirin, Tylenol, Zyrtec
Current Illness: None
Preexisting Conditions: Pseudotumor cerebri (related to venous sinus stenosis), anxiety, depression, ADD, chronic hip and shoulder pain, membranous nephritis, pvd, gastric banding
Allergies: Lactose
Diagnostic Lab Data: No testing.
CDC Split Type:

Write-up: First 5 days esophagitis/gastritis, red inflamed throat, epigastric pain, difficulty eating, reflux pain so bad awakens during night, difficulty taking meds. Started 8-10 days of Prilosec 40mg BID, then liquid diet and taper to Prilosec 20mg BID last 3 days. Awaiting availability to have gastric band released.


VAERS ID: 1696342 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-07
Onset:2021-08-26
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Acute respiratory failure, Azotaemia, Barium swallow abnormal, Bladder hypertrophy, Blood potassium decreased, COVID-19, Chest X-ray abnormal, Computerised tomogram abdomen abnormal, Computerised tomogram head normal, Confusional state, Cystitis, Encephalopathy, Escherichia infection, Haematuria, Hypertension, Infection, Mental status changes, Metabolic encephalopathy, Oesophageal stenosis, Pain in extremity, Presbyoesophagus, Pulmonary congestion, Pulmonary oedema, SARS-CoV-2 test positive, Scan with contrast abnormal, Tachypnoea, Toxic encephalopathy, Ultrasound Doppler normal, Urinary tract infection, Urine analysis abnormal, Urine flow decreased
SMQs:, Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal obstruction (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Tubulointerstitial diseases (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (narrow), 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? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler CRANBERRY PO D-Mannose 500 MG CAPS Dextrose, Diabetic Use, (GLUCOSE PO) doxazosin (CARDURA) 4 MG tablet fiber supple
Current Illness: NA COVID-19 positive 8.26.21 / 9.7.21
Preexisting Conditions: DM (diabetes mellitus), type 2 with ophthalmic complications Generalized abdominal pain ESRD (end stage renal disease) on dialysis Chronic diarrhea HTN (hypertension) Arthritis Restless legs syndrome Multiple-type hyperlipidemia Unspecified severe protein-calorie malnutrition Multiple rib fractures Advanced care planning/counseling discussion Weakness Iron deficiency anemia, unspecified Chronic back pain Bipolar affective disorder Anemia of chronic disease Anemia in chronic kidney disease
Allergies: Percocet [Oxycodone-acetaminophen] Itching Tramadol Other
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized; COVID-19 positive (8.26.21 / 9.7.21); fully vaccinated Admission Date: 9/7/2021 Discharge Date: 09/13/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute cystitis with hematuria Acute encephalopathy Altered mental status, unspecified altered mental status type HOSPITAL COURSE: Patient is a 68-year-old female with past medical history significant for end-stage renal disease on dialysis, diabetes, hypertension and chronic debility, resides in a nursing home over the last 4 months, presents to the hospital from dialysis as she became confused and started yelling that her legs hurt, complain of abdominal pain and had only finished about 75% of her dialysis run. Patient was also tested positive for COVID-19 on 08/26 and was started on Decadron on 08/30. She was noted to be mildly tachypneic, hypertensive 199/73 and needed 4 L nasal cannula. Urinalysis also was indicative of infection. Chest x-ray showed moderate pulmonary vascular congestion. Patient was admitted for further workup. Patient was noted to have E coli urinary tract infection and upon further evaluation with a CT showed possible ascending urinary tract infection. Urology consultation was obtained however felt that changes noted on CT were noted previously and this is likely related to low flow state given her dialysis state. No further urological interventions were felt to be needed. 7 day antibiotic course was completed. COVID-19: Patient was diagnosed to have COVID-19 on 08/26 and was started on dexamethasone 8/30 which she completed 10 day course. Respiratory status improved to her baseline. Acute hypoxic respiratory failure: Likely related to a combination of COVID-19 and volume status given her dialysis. This returned back to her baseline with supportive treatment, negative fluid balance to dialysis and ongoing treatment of COVID-19 End-stage renal disease: Nephrology assisted in management of dialysis. Patient was noted to be on Lokelma 4 days per week but was also noted to have low normal to low potassium levels and hence ir Lokelma dose was reduced to just 2 days per week. Hypertension: Even though she was noted to be hypertensive at admit, patient actually needed of her home dosing both Lopressor and losartan and maintained normal blood pressures. Encephalopathy: Likely related to toxic/metabolic encephalopathy related urinary tract infection, uremia and COVID-19. Over the hospital stay her mental status slowly improved. Goals of care discussion: Spoke to multiple times with son but attempts to call husband were unsuccessful. Did speak further about code status but per my conversation with patient, wishes are consistent with full resuscitation Consultations: Nephrology Neurology Gastroenterology Procedures: CT of the head negative Lower extremity bilateral ultrasound negative for DVT Barium swallow esophagogram suspicious for esophageal stricture, presbyesophagus CT of the abdomen and pelvis with IV contrast--bilateral urothelial/bladder wall thickening and hyper enhancement concerning for ascending urinary tract infection. Similar to changes noted on previous CT in April. Patchy ground-glass attenuation interlobular septal thickening has peripheral solid nodularity related to pulmonary edema versus COVID-19 infection Bilateral upper extremity ultrasound negative for DVT


VAERS ID: 1696581 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Autoimmune disorder, Condition aggravated, Fatigue, Feeling abnormal, Headache, Hypersomnia, Inflammation, Lethargy, Malaise, Muscle spasms, Musculoskeletal pain, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Rubiola (1968 - fever, series not completed), flu vaccine (1990 - 13 days of high fever, flu)
Other Medications: Xalatan .1% qd/ou/pm; Synthroid 150mcg qd
Current Illness: NK
Preexisting Conditions: Hashimoto''s Disease, Grave''s Disease, CFS/ME, Glaucoma
Allergies: NK
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: High fever, aches, pains, headache, lethargy, hypersomnia, fatigue, malaise - lasting 6 days before becoming functional again, but with lessened symptoms. Chronic inflammation of underlying autoimmune disorders lasting in renewed and continuing musculoskeletal pain, brain fog, extreme fatigue, muscle spasms to date with no signs of ending to date. Could be permanent disability if it does not improve.


VAERS ID: 1696652 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram head, Hypoaesthesia, Pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: pt woke up at one am on Thursday Aug 26 with facial numbness on the left side, fever and body aches. Waited about an hour to ensure that my face was just not asleep from my sleeping position. Went to the ER where they did a head CT to rule out a stroke. Following up with primary care on Sept 1st but still numb as of 9/1/2021


VAERS ID: 1696680 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Atrial fibrillation, Chest X-ray, Echocardiogram, Electrocardiogram
SMQs:, Supraventricular tachyarrhythmias (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec, Singulair, Linzess, Pantoprozale
Current Illness: none
Preexisting Conditions: none
Allergies: seasonal allergies - mold, grass
Diagnostic Lab Data: 8/26 - EKG 8/26 - chest XRay 8/27 - echo
CDC Split Type:

Write-up: AFIB with RVR (with no history of Afib)


VAERS ID: 1696721 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-20
Onset:2021-08-26
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Dyspnoea, Electrocardiogram abnormal, Laboratory test normal
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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: Stelara injection every 2 months, Biktarvy 1x day, Lisinopril 1x day, Valtrex 1x day, Dutasteride 1x day, Zoloft 1x day.
Current Illness: No acute illnesses to report
Preexisting Conditions: Psoriatic Arthritis, Psoriasis, HIV+, High Blood Pressure
Allergies: Azithromycin - anaphylaxis
Diagnostic Lab Data: ecg, chest x-ray, lab work at hospital. all unremarkable except for ecg.
CDC Split Type:

Write-up: I had a heart episode (thurs 8/26) where I was playing with my dog, and a sharp, stabbing chest pain came on that knocked me to the ground and knocked the wind out of me, I couldn''t catch my breath. It then was episodic about every 5-15 minutes, coming on quickly. It was in the middle to middle/left side of the chest. Sitting up and leaning forward worked to ease the pain. I went to the ER thinking I was having a heart attack, and ECG/Chest X-ray and blood work were all conducted. I was told it was not life threatening and not a heart attack but they couldn''t tell me what exactly it was and I was discharged about 4 hours later. I was told it could be muscular/skeletal or acid related. Take tylenol and pepcid. It did not resolve with these treatments so I called my doctor the next day (fri), and got on advil and muscle relaxers. the following day (sat) I spoke to my doctor again, and we started a higher dose advil protocol. a week later the symptoms were fully resolved.


VAERS ID: 1696857 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-19
Onset:2021-08-26
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash, Pain in extremity, Varicose vein
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Exactly one week after my first dose, a red itchy rash appeared at the site injection on my left arm. The rash grew larger over the next 3 days and then eventually faded. Also had some pain in my right calf muscle near some varicose veins.


VAERS ID: 1696996 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-08-24
Onset:2021-08-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral, Laboratory test, Migraine with aura, Muscular weakness, Orthopnoea, Palpitations, Phonophobia, Photophobia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Respiratory failure (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: Aspirn, Ibuprofen, probiotics
Current Illness: Non-insulin dependent diabetes
Preexisting Conditions: Underweight
Allergies: None
Diagnostic Lab Data: Pending
CDC Split Type:

Write-up: Bilateral upper and lower lip, hand and foot numbness; bilateral leg weakness; recurrence of migraines with aura, photophobia and phonophobia; orthopnea and positional palpitations


VAERS ID: 1697403 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-22
Onset:2021-08-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Induration, Lymph node pain, Lymphadenopathy, Myalgia, Peripheral swelling, Skin exfoliation, Skin tightness, Skin warm, Swelling, Tenderness, Thermal burn
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I got the shot 8/22. On 8/25 I realized that the lymph nodes in my left armpit was tender, painful, hot to the touch, and swollen. The extreme tenderness went away however my left lymph node area (up to and including my chest and arm) are still enlarged and harder to the touch compared to the same area on the right side. Additionally, on 8/25 or 8/26 I awoke to find what looked like a burn (that developed internally) on my lympnode area, it was also tender to the touch. The burn later peeled and as of today it is fading but still visible. I also recently suffered from muscular pain in my left shoulder for 4-5 days. After taking an anti inflammatory (aleve) for 2 days, the shoulder pain subsided. The enlarged left area of my chest/lymph node still persists and feels tight/ hardened to the touch.


VAERS ID: 1697580 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-07
Onset:2021-08-26
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac stress test, Chest pain, Dyspnoea, Echocardiogram, Ejection fraction decreased, Left ventricular dysfunction, Oedema peripheral, Tachycardia, Viral infection
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allopurinol (ZYLOPRIM) 300 mg Tablet aspirin (BAYER CHILDRENS ASPIRIN) 81 mg Tablet, Chewable carvediLOL (COREG) 3.125 mg Tablet lisinopril (ZESTRIL, PRINIVIL) 5 mg tablet ferrous sulfate (FEOSOL) 325 mg (65 mg iron) Tablet
Current Illness: Untreated HTN
Preexisting Conditions: Cardiac Hypertensive emergency Acute clinical systolic heart failure (HCC) Systolic CHF (HCC) Cardiomyopathy (HCC)
Allergies: NKA
Diagnostic Lab Data: Heart Cath Patient is a 42 year old male who presents with left ventricular dysfunction and cardiomyopathy. PCI not performed during this cath lab visit. History and Risk Factors: Patient has a new diagnosis of Systolic Heart Failure. NYHA Class III within the last two weeks. Patient presents with atypical angina. Anginal Classification within the last two weeks is CCS II. Patient has never smoked. Patient''s CSHA Frailty Score = Well. Stress/Imaging Test Results: Stress Test not performed prior to procedure. CONCLUSIONS: 1. Left ventricular ejection fraction was 20 to 25%: non ischemic CMP 2. LM normal, LAD 30%, Lcx normal ,RCA normal EDP 30mmHg, no MR< no AV gradient TD CO 4.1, Fick 4.6L/MIN, Ao sat 96 RV 33/3, PA 33/27/30 RA 12 wedge 14
CDC Split Type:

Write-up: HISTORY OF PRESENT ILLNESS: Patient is a 41 year old male who is being admitted for chief complaint of shortness of breath and chest pain. Patient has been having ongoing symptoms for the past 2 weeks. Recently he developed peripheral edema, preceeded by a viral illness (unsure if COVID-19). Patient was seen in the clinic yesterday, EKG was done and noted tachycardia with heart rate of 107. Echocardiogram performed in the ED showed severe LV dysfunction with EF of 20-25%, concern for new onset cardiomyopathy. Patient has received both doses of the COVID-19 vaccine.


VAERS ID: 1697938 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia oral, Paraesthesia oral, Swelling, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 30 MG XR Addersll
Current Illness: N/a
Preexisting Conditions: Asthma, depression, anxiety, ADHD
Allergies: Cats and eggplants
Diagnostic Lab Data:
CDC Split Type:

Write-up: Neck on left side (where shot was administered) was at least 3x larger than right. Throat was closing slowly. Tongue tingling and numb similar to when I eat eggplant. Feeling of impending doom. Those are the most significant reactions; all on top of severe reactions to the shot itself. I had covid back in March 2019. The allergic reaction started at 7am and continued throughout the night. I spoke with a nurse on the phone and felt slightly better after taking Benadryl.


VAERS ID: 1700169 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-27
Onset:2021-08-26
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Dialysis, Endotracheal intubation, Haemofiltration, Haemoglobin decreased, Hypotension, Intensive care, Mechanical ventilation, Positive airway pressure therapy, Respiratory distress, SARS-CoV-2 test positive
SMQs:, Acute renal failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma, Chronic kidney disease (CKD) stage G4/A1, DM type 2, Dyslipidemia, Hypertension, Hypothyroidism, OSA (obstructive sleep apnea), Polymyalgia rheumatica (CMS/HCC)
Allergies:
Diagnostic Lab Data: CORONAVIRUS (COVID 19) RT PCR Collected: 08/26/21 2032 Lab Status: Final result Updated: 08/26/21 2224 Specimen: NASOPHARYNGEAL SWAB CORONAVIRUS SARS COV 2 PCR (RESP) POSITIVE
CDC Split Type:

Write-up: Hospital Course: on 8/26/21 Patient was admitted to the ICU. Her pulmonary status worsened and she eventually required BiPAP. Started on IV antibiotics and steroids. She required Levophed for hypotension. Started on remdesivir and baracitinib. 8/28: Ivermectin started. Started budesonide and zinc. On 8/30: Worsened respiratory distress, despite initiation of dialysis, thus was intubated. Proned. On 8/31: Started CRRT per nephrology, tocilizumab per ID, and given 1 unit of PRBC to improve perfusion due to low hemoglobin. Patient was not proned due to labile BPs. On 9/1: Bilevel to conventional vent. 9/3: Extubated.


VAERS ID: 1700210 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-09
Onset:2021-08-26
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Decreased appetite, Dyspnoea, Fluid retention, SARS-CoV-2 antibody test negative, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Atrial fibrillation, CHF, HTN
Allergies: NKDA
Diagnostic Lab Data: Covid rapid test = positive Covid IgG antibody test = negative
CDC Split Type:

Write-up: Patient is a 89 y.o. female with a PMHx of HTN, CHF, Afib, who presented to the emergency department for evaluation of cough that started approximately 2-3 weeks ago. She currently does not have complaints except for coughing, decreased appetite. Per ED documentation, she had also complained of shortness of breath. Of note, patient was seen in this ED on 8/18/2021 due to fluid retention after being noncompliant with her furosemide. She was restarted on her diuretic and was discharged. Daughter noticed that patient has since developed a wet cough and decided to bring the patient to the ED on 8/26/2021. Rapid COVID test positive, oxygen saturation was 90% on room air so patient was started on 2L of oxygen. She was also started on remdesivir and dexamethasone. Patient''s oxygen saturation rapidly improved and she was discharged from hospital the next day with an Rx for dexamethasone x 8 days. Patient reported she has been vaccinated. She received her second shot in late February.


VAERS ID: 1700238 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)

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

Write-up: I tasted strong medal taste for about 10 days after receiving the Covid-19 vaccine


VAERS ID: 1700323 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-31
Onset:2021-08-26
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Nausea, Pain, Pyrexia, 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)

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: Tylenol/ASA/Caffeine (Excedrin Ex. Str)
Current Illness: Unknown
Preexisting Conditions: Osteoporosis
Allergies: Codeine, Amoxicillin, Onions
Diagnostic Lab Data: "Pt reports she started feeling symptoms last week on Thursday and tested positive the next day." unknown testing site
CDC Split Type:

Write-up: The patient presents with fever, cough, chills x 1 week. Pt reports she started feeling symptoms last week on Thursday and tested positive the next day. She reports she has n/v from the coughing.. The onset was 1 weeks ago. The course/duration of symptoms is constant. Location: generalized. The character of symptoms is pain. The degree at onset was moderate. The degree at present is moderate. Risk factors consist of none. Therapy today: none. Associated symptoms: nausea, vomiting, cough, fever and chills.


VAERS ID: 1700394 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-26
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Dyspnoea, Lymphadenopathy, Pericarditis, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Arthritis (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: synthroid crestor fish oil tumeric
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: woke up and arm was swollen and hard(size of a baseball), chest pains and trouble breathing, went to cardiologist and was diagnosed with pericarditis, swollen lymph nods, joint pain, went to er after cardiologist and her level of inflammation on body was 35%


VAERS ID: 1700439 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Fatigue, Headache, Hypoaesthesia, Nausea, Pain, Pain in extremity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: 12 hour after vaccine employee developed bilateral leg numbness and pain along with bodyaches, fatigue, headache ,N/v and fever. 5 days later above resolved except for fatigue and leg pains. she states both remaining symptom became worse and bruising develpoed to both legs. by 9-6 2021l eft leg symptom resolved and fatuge improved but still persist along with bruising to lower legs.


VAERS ID: 1700521 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norvasc 5mg daily Lisinopril 10mg daily Protonix 40mg daily Glucophage 100mg 1.5 tablets BID Lantus inject 26 units QHS Aspirin 81mg daily Pravastatin 80mg daily Zoloft 100mg daily Flomax 0.4mg daily
Current Illness: shortness of breath
Preexisting Conditions: MEDICAL HISTORY: HTN IRREGULAR HEART BEAT CAD SYNCOPE STENOSIS RIGHT ARTERY PAROSYMAL ATRIAL FIBRILLATION GERD ENLARGED PROSTATE KIDNEY DISEASE TYPE 2 DIABETES
Allergies: SULFAMETHOXAZOLE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT WAS ADMINISTERED 0.8 ML OF THE PFIZER COVID VACINE INSTEAD OF 0.3ML NO ADVERSE EVENT NOTED PATIENT WAS MONITORED FOR OVER AN HOUR. HE WAS ADVISED TO HYDRATE . FOLLOWED UP ON PATIENT OVER THE NEXT FEW DAYS - NO ADVERSE REACTIONS REPORTED


VAERS ID: 1700762 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol HFA Inhaler as needed Flovent HFA 220mcg twice daily inhaler Pepcid 40mg Daily as needed
Current Illness:
Preexisting Conditions: Asthma GERD
Allergies: not known drug allergies
Diagnostic Lab Data: No medical test needed. Patient visited PCP on routine visit and did not reported any adverse reactions of vaccine.
CDC Split Type:

Write-up: Administration Error: Patient had Moderna vaccine first dose in 3/24/2021 and Pfizer vaccine 8/26/2021 Reason for error: Patient came to the Health Center indicating she wants to have the first Covid vaccine. The patient never provided information of having a prior Moderna dose in march 2021. We came to know about the error when entering the data in the vaccine reporting system of the Health Department. We are filing the report as recommended by local Health Department. There was no side effects of vaccine no adverse reaction of medication. She did not have to look for medical Help after the vaccine.


VAERS ID: 1700763 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-01
Onset:2021-08-26
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Lymphadenopathy, Neuralgia, Pain
SMQs:, Peripheral neuropathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Nerve pain the first day( random stinging / burning sensation, 2nd day swollen lymph nodes in the under arm on the left side/ same as the injection


VAERS ID: 1700815 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blepharospasm
SMQs:, Dystonia (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

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

Write-up: Shortly after receiving my second does, my right eye is consistently twitching


VAERS ID: 1700843 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial flutter, Bradycardia, Cardiac failure congestive, Dyspnoea exertional, Extra dose administered, Heart rate decreased, Hypoxia, Oedema, Oedema peripheral, Pulmonary oedema, Troponin increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Medication errors (narrow), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: sotalol 80mg aspirin 81mg DR atorvastatin 80mg dronabinol 5mg ezetimibe 10mg levothyroxine 125mcg lisinopril 5mg loratadine 10mg tamsulosin 0.4mg warfarin 5mg
Current Illness:
Preexisting Conditions: Right renal artery stenosis Atrial flutter Hyperlipidemia Hypertension Hypothyroidism Chronic anticoagulation Atherosclerotic hear disease Chronic kidney disease stage 3 Anemia
Allergies: NKDA
Diagnostic Lab Data: Working dx for acute symptomology is CHF on the basis of bradycardic rate. Will get CXR for heart size (effusion?) and pulmonary edema, CMP, CBC, BNP, troponin, CK, CKMB, INR today stat (Could he have gotten myocarditis or pericarditis from dose #3 given timing?) Critical lab value from hospital same day 9/15/21: elevated serum troponin level 240 (normal below 45), patient advised to go to closest emergency room by physician.
CDC Split Type:

Write-up: 76 y/o man with a history of CAD s/p 3 way CABG in 1998 and hx of "heart murmur" and hx of PAF with new onset of associated with new atrial flutter with rate in the 40s. Interestingly strongly associates the timing with 3rd dose of COVID vaccine (felt perfectly fine, quite active before dose #3, this started abruptly after dose #3) In clinic with bradycardia, self reports hypoxia on RA with exertion, pitting 2+ edema BLE,


VAERS ID: 1701332 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cognitive disorder, Cough, Dyspnoea, Ear pain, Fatigue, Headache, Malaise, Pain in extremity, Productive cough, Sleep disorder, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Crestor, vitamins C, D, Zinc, B,
Current Illness: Absolutely none. I have not had a flu in over 20 years or cold in over 10 years.
Preexisting Conditions: Heart stent
Allergies: Sulfa drugs, reaction to bee stings, lobster thermidor
Diagnostic Lab Data: Sept. 7th Blood tests, ultrasound of right leg. Attempt to do a CATScan on Sept 10th however they were unable to get a needle in a vein and after 4 tries they sent me home.
CDC Split Type:

Write-up: Extreme headaches-came in waves-started one or two hours after injection. Woke me up in the middle of the night. Also developed right ear pain, almost that it was closed. Over the next few days had shortness of breath, got a cough that tiny bits of flim came up, fatigue, malaise, continued to feel worse, developed more chest pain, by Friday night September 3rd and unbearable right leg pain, in tears, icing multiple areas in my body. Also felt as though I could not think straight. Called the doctor for an appointment. It was holiday weekend he saw me the following Tuesday.


VAERS ID: 1703722 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-24
Onset:2021-08-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac discomfort, Dyspnoea, Headache
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 - i have not been to the doctor note - vaccine was taken under duress as a condition of my employment
CDC Split Type:

Write-up: to date heart feels like it is being compressed all the time, shortness of breath and headaches


VAERS ID: 1704113 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-20
Onset:2021-08-26
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Myelitis transverse
SMQs:, Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: Transverse myelitis


VAERS ID: 1704220 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-08-26
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Vaccine breakthrough infection
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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: breakthrough case, hospitalized


VAERS ID: 1704222 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-26
Onset:2021-08-26
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: a month after shot, I broke out in a case of Shingles


VAERS ID: 1704314 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hot flush, Injection site pruritus
SMQs:

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

Write-up: Pt described Itching around injection site and "Hot Flashes" similar to Menopause for 1 week slowly waning


VAERS ID: 1704447 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-08-26
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Full blood count normal, Headache, Laboratory test normal, Malaise, Nausea, Pain, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: POTS with low blood pressure
Allergies: None
Diagnostic Lab Data: CBC, Chem Panel and COVID test on 08/27/2021 all ok.
CDC Split Type:

Write-up: Felt ill for 1st few days after vaccine with body aches, headache, and nausea. Improved about day 5 but ongoing fatigue unclear if related to vaccine. Beginning on 08/26/2021 extreme persistent nausea and increased fatigue. Nausea improving off and on as of this report today 9/16/2021.


VAERS ID: 1704483 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: sore shoulder, muscle, fatigue x 2 days


VAERS ID: 1704578 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Injected limb mobility decreased, Injection site pain, Tinnitus
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hearing impairment (narrow), Arthritis (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: Flu vaccine, egg allergy
Other Medications: Synthroid .125mg; Levocetirzine 5mg; Estradiol 2 mg; multivitamin; potassium; elderberry; zinc; vitamin c; vitamin d; biotin; b12
Current Illness: none
Preexisting Conditions: thyroidectomy; allergies; asthma; psoriatic arthritis; osteo arthritis
Allergies: eggs; onions; bee stings; sulfa drugs; doxycycline; tape/adhesive
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Tinnitus within 90 minutes of receiving vaccine. Lasted 3 days. Soreness at injection site. Lasted 4 days. Pain and decreased range of motion in left shoulder joint. Ongoing.


VAERS ID: 1704654 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       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: Vaccination of underage individual. Mom indicated a false birthdate which was confirmed with the doctors office.


VAERS ID: 1704771 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Decreased appetite, Exposure during pregnancy, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I was 9 weeks pregnant at the time of the 1st dose Pfizer COVID-19 vaccine. My symptoms began approx 12 hours after the shot. I had fever of 101 and felt generalized weakness and debility throughout the following 12 hours. Symptoms also accompanied by headache and body aches and loss of appetite. Sequential headaches x1 week following the vaccine.


VAERS ID: 1704821 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-26
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dermatitis, Lymph node pain, Lymphadenopathy, Oral herpes, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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: Metformin 500mg ER tab
Current Illness: none
Preexisting Conditions: Pre-diabetes
Allergies: Septra - rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/26/21: Bilateral sandpaper rash around knees at night. 8/27: Rash on entire legs, below buttocks; 8/28 Rash included buttocks and swollen, painful lymph nodes in inguinal area. Skin felt inflamed, but not itchy. Started Zyrtec 10mg daily. That night rash started on hands. 8/29 AM, rash was on arms up to the shoulder. 8/29 Rash started on lower trunk area, itching started. Singulair 10 mg nightly started. 8/30 Rash covered trunk area from below the chest in front and below the shoulder blades in back. 8/31 Top of breasts. 9/2, rash started to wane, inguinal pain started to diminish. By 9/5 pain in the inguinal area was gone. 9/10 small patchy areas behind the knee and at elbows. 9/13 rash completely resolved.


VAERS ID: 1706730 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Montana  
Vaccinated:2020-12-29
Onset:2021-08-26
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site pain, Off label use, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: her husband had his booster dose yesterday; Temperature of 104.4 degrees Farenheight; Sore left arm injection site; This spontaneous case was reported by a consumer and describes the occurrence of OFF LABEL USE (her husband had his booster dose yesterday), PYREXIA (Temperature of 104.4 degrees Farenheight) and INJECTION SITE PAIN (Sore left arm injection site) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 042B21A, 042L20A and 037K20A) for COVID-19 vaccination. No Medical History information was reported. On 29-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 26-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, the patient experienced OFF LABEL USE (her husband had his booster dose yesterday), PYREXIA (Temperature of 104.4 degrees Farenheight) and INJECTION SITE PAIN (Sore left arm injection site). At the time of the report, OFF LABEL USE (her husband had his booster dose yesterday), PYREXIA (Temperature of 104.4 degrees Farenheight) and INJECTION SITE PAIN (Sore left arm injection site) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment product information was not provided. Concomitant product use was not provided. This case was linked to MOD-2021-297362, MOD-2021-297493 (Patient Link).


VAERS ID: 1706735 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / UNK LA / OT

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

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

Write-up: Administered to a patient more than 24 hours after puncture; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administered to a patient more than 24 hours after puncture) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Aug-2021 at 10:30 AM, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021 at 10:30 AM, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administered to a patient more than 24 hours after puncture). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Administered to a patient more than 24 hours after puncture) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. Treatment information was not provided.


VAERS ID: 1706756 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / OT

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Feeling jittery, Headache, Heart rate irregular, Hypoaesthesia, Injection site pain, Joint swelling, Nausea, Oropharyngeal pain, Pain in jaw, Palpitations, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: GABAPENTIN
Current Illness: Shortness of breath
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: left sided jaw pain; lightheaded, dizziness; jitteriness; throat was sore; right side of their body was numb,when they touched their right arm the patient couldn''t feel their arm; their right knee became swollen and painful, swelling travelled to patient''s right hip; heart rhythm was out of rhythm, when i cough it gets back to normal rhythm; right frontal headache; nausea; Right knee became swollen and painful; injection site pain; right side of my body went numb; howlong joints should be swelled for; heart pounding; throat swelled, little bit of throat swelling; This spontaneous case was reported by a consumer and describes the occurrence of PHARYNGEAL SWELLING (throat swelled, little bit of throat swelling), HYPOAESTHESIA (right side of my body went numb), JOINT SWELLING (howlong joints should be swelled for), PALPITATIONS (heart pounding) and PAIN IN JAW (left sided jaw pain) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Shortness of breath. Concomitant products included GABAPENTIN for an unknown indication. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, the patient experienced PHARYNGEAL SWELLING (throat swelled, little bit of throat swelling) and PALPITATIONS (heart pounding). On an unknown date, the patient experienced HYPOAESTHESIA (right side of my body went numb), JOINT SWELLING (howlong joints should be swelled for), PAIN IN JAW (left sided jaw pain), DIZZINESS (lightheaded, dizziness), FEELING JITTERY (jitteriness), OROPHARYNGEAL PAIN (throat was sore), HYPOAESTHESIA (right side of their body was numb,when they touched their right arm the patient couldn''t feel their arm), JOINT SWELLING (their right knee became swollen and painful, swelling travelled to patient''s right hip), HEART RATE IRREGULAR (heart rhythm was out of rhythm, when i cough it gets back to normal rhythm), HEADACHE (right frontal headache), NAUSEA (nausea), ARTHRALGIA (Right knee became swollen and painful) and INJECTION SITE PAIN (injection site pain). On 26-Aug-2021, PHARYNGEAL SWELLING (throat swelled, little bit of throat swelling) and PALPITATIONS (heart pounding) had resolved. At the time of the report, HYPOAESTHESIA (right side of my body went numb), PAIN IN JAW (left sided jaw pain), DIZZINESS (lightheaded, dizziness), FEELING JITTERY (jitteriness), OROPHARYNGEAL PAIN (throat was sore), HYPOAESTHESIA (right side of their body was numb,when they touched their right arm the patient couldn''t feel their arm), HEART RATE IRREGULAR (heart rhythm was out of rhythm, when i cough it gets back to normal rhythm), HEADACHE (right frontal headache), NAUSEA (nausea) and INJECTION SITE PAIN (injection site pain) had resolved, JOINT SWELLING (howlong joints should be swelled for) and JOINT SWELLING (their right knee became swollen and painful, swelling travelled to patient''s right hip) outcome was unknown and ARTHRALGIA (Right knee became swollen and painful) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication includes muscle relaxant , Hormones , Vitamins. Most recent FOLLOW-UP information incorporated above includes: On 31-Aug-2021: Signficant followup appended. Updated reported information. Updated patient details. Added events heart pounding, right frontal headache, left sided jaw pain, nausea, injection site pain, lightheaded, dizziness, jitteriness, throat was sore, when they touched their right arm the patient couldn''t feel their arm, their right knee became swollen and painful, swelling traveled up to the patients right hip, swelling from right knee to mid thigh, heart rhythm was out of rhythm. Added batch number for dose 1. Added concomitant medication muscle relaxant, gabapentin, hormones, and vitamins.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information is expected


VAERS ID: 1706789 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-04
Onset:2021-08-26
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Feeling cold, Illness, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (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: TYLENOL; ASPIRIN [ACETYLSALICYLIC ACID]; PREDNISONE; PROTONIX [OMEPRAZOLE]; FLOMAX [TAMSULOSIN HYDROCHLORIDE]; ATORVASTATIN; BUMETANIDE; CHOLECALCIFEROL; PLAVIX; PEPCID [FAMOTIDINE]; PROSCAR; TOPROL XL; METFORMIN; PROZAC
Current Illness: Immunocompromised; Prostate cancer
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: He slept a lot/ bed sleeping for those two days; Sick; Left hip pain/ his left hip was hurting/ pain got worse and worse; Exhausted; Throwing up; He could not get warm; This spontaneous case was reported by a consumer and describes the occurrence of FEELING COLD (He could not get warm), SOMNOLENCE (He slept a lot/ bed sleeping for those two days), ILLNESS (Sick), ARTHRALGIA (Left hip pain/ his left hip was hurting/ pain got worse and worse), FATIGUE (Exhausted) and VOMITING (Throwing up) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 042L20A, 044A21A and 008B21A) for COVID-19 vaccination. The patient''s past medical history included COVID-19 in December 2020. Concurrent medical conditions included Prostate cancer and Immunocompromised. Concomitant products included PARACETAMOL (TYLENOL), ASPIRIN [ACETYLSALICYLIC ACID], PREDNISONE, OMEPRAZOLE (PROTONIX [OMEPRAZOLE]), TAMSULOSIN HYDROCHLORIDE (FLOMAX [TAMSULOSIN HYDROCHLORIDE]), ATORVASTATIN, BUMETANIDE, CHOLECALCIFEROL, CLOPIDOGREL BISULFATE (PLAVIX), FAMOTIDINE (PEPCID [FAMOTIDINE]), FINASTERIDE (PROSCAR), METOPROLOL SUCCINATE (TOPROL XL), METFORMIN and FLUOXETINE HYDROCHLORIDE (PROZAC) for an unknown indication. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Aug-2021, the patient experienced FEELING COLD (He could not get warm) (seriousness criterion medically significant), ILLNESS (Sick) (seriousness criterion medically significant), ARTHRALGIA (Left hip pain/ his left hip was hurting/ pain got worse and worse) (seriousness criterion medically significant), FATIGUE (Exhausted) (seriousness criterion medically significant) and VOMITING (Throwing up) (seriousness criterion medically significant). On 27-Aug-2021, the patient experienced SOMNOLENCE (He slept a lot/ bed sleeping for those two days) (seriousness criterion medically significant). On 28-Aug-2021, SOMNOLENCE (He slept a lot/ bed sleeping for those two days) outcome was unknown. At the time of the report, FEELING COLD (He could not get warm), ILLNESS (Sick), ARTHRALGIA (Left hip pain/ his left hip was hurting/ pain got worse and worse), FATIGUE (Exhausted) and VOMITING (Throwing up) outcome was unknown. Patient received the shots on in his left non dominant deltoid. He did not have symptoms with the second shot. The third shot felt like the first shot. Per reporter, she thought that patient was having a heart attack, however he was fine. Patient''s left hip pain, his left hip got worse. Treatment information was not provided. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. This case was linked to MOD-2021-303240 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 31-Aug-2021: Follow Up received- Snapshot attached. Reporter information added.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1706952 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Oregon  
Vaccinated:0000-00-00
Onset:2021-08-26
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PHENOBARBITAL [PHENOBARBITAL SODIUM]; TOPAMAX; CRESTOR OD; ATENOLOL
Current Illness: Asthma; Blood pressure high; Cholesterol; Epilepsy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Arm red raised; Arm itchy raised; Faint outline; Injection site red, like a bullseye, Red mark; It itches a lot/itchy,raised/itched for two days; Raised mark/faint outline; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (Injection site red, like a bullseye, Red mark), PRURITUS (It itches a lot/itchy,raised/itched for two days), SCAR (Raised mark/faint outline), ERYTHEMA (Arm red raised) and PRURITUS (Arm itchy raised) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Asthma since 01-Mar-1970, Epilepsy since 25-Jun-1968, Cholesterol and Blood pressure high. Concomitant products included ATENOLOL from 16-May-2000 to an unknown date for Blood pressure high, ROSUVASTATIN CALCIUM (CRESTOR OD) from 18-Apr-2001 to an unknown date for Cholesterol, PHENOBARBITAL SODIUM (PHENOBARBITAL [PHENOBARBITAL SODIUM]) from 15-Sep-1999 to an unknown date and TOPIRAMATE (TOPAMAX) from 12-Feb-2001 to an unknown date for Epilepsy. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, the patient experienced VACCINATION SITE ERYTHEMA (Injection site red, like a bullseye, Red mark), PRURITUS (It itches a lot/itchy,raised/itched for two days) and SCAR (Raised mark/faint outline). On 02-Sep-2021, the patient experienced ERYTHEMA (Arm red raised), PRURITUS (Arm itchy raised) and SCAR (Faint outline). On 28-Aug-2021, VACCINATION SITE ERYTHEMA (Injection site red, like a bullseye, Red mark) and PRURITUS (It itches a lot/itchy,raised/itched for two days) had resolved with sequelae. On 03-Sep-2021, ERYTHEMA (Arm red raised) and PRURITUS (Arm itchy raised) had resolved with sequelae, SCAR (Faint outline) had resolved. At the time of the report, SCAR (Raised mark/faint outline) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The consumer stated that one week after getting the shot, she woke up with the injection site red, like a bullseye. It itched for two days and cleared except there was a faint outline. The consumer stated that one week later it happened again, but only lasted for a day and the faint outline for a day. The consumer stated that her events resolved with Residual effects- Circle visible. No treatment medications were provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 06-Sep-2021: The follow up document was added and had significant information. Added events- Vaccination site erythema, Erythema, Pruritus, scar, concomitant medications. Updated Vaccine facility information, Events outcome, events start date and stop date, relevant history,Patient''s demographic. On 07-Sep-2021: The follow up document was received and had no new information


VAERS ID: 1706975 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Unknown  
Location: New Mexico  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Body temperature, Brain oedema, Confusional state, Cough, Encephalitis, Fatigue, Headache, Injection site reaction, Injection site warmth, Joint swelling, Musculoskeletal stiffness, Myalgia, Pain, Photophobia, Pulmonary pain, Pyrexia, Sneezing, Swelling, Tremor, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? No
Previous Vaccinations:
Other Medications: VALTREX; KLONOPIN; Multivitamins; GINGKO BILOBA.
Current Illness: Asthma; Drug allergy (allergic to most mediations); Memory impaired; Migraine (When they get a migraine, they also get an upset stomach.); Shingles; Sleep disorder.
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Transplant.
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Body temperature; Result Unstructured Data: Fever of 102, fever on and off- 100.8, 101.8
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: lung pain; They said they were in bed for 3 days and had severe adverse reaction.; Sneezed; They are just tired, like being run over by a truck/just still feeling slight tired,; Headache/head hurt so bad/swollen pain inside the head; Inflammation caused the brain to swell; sensitivity to light; stiff neck; encephalitis; mental confusion; It felt swollen inside the skull; light cough; hot spot at injection site; boday aches; joint pain; Fever of 102/fever on and off; Joints started to hurt; muscle pain; site was hot to the touch; rt shldr joint was swollen and painfull; shaking continued; hand began uncontrolled shaking; Joints are swollen; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (shaking continued), TREMOR (hand began uncontrolled shaking), CONFUSIONAL STATE (mental confusion), PULMONARY PAIN (lung pain) and VACCINATION COMPLICATION (They said they were in bed for 3 days and had severe adverse reaction.) in a 56-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 034C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 from April 2020 to May 2020 and Transplant on 18-Aug-2005. Concurrent medical conditions included Shingles, Sleep disorder, Memory impaired, Asthma since 05-May-2020, Drug allergy (allergic to most mediations) and Migraine (When they get a migraine, they also get an upset stomach.). Concomitant products included Multivitamins and GINKGO BILOBA (GINGKO BILOBA) for Memory impaired, VALACICLOVIR HYDROCHLORIDE (VALTREX) for Shingles, CLONAZEPAM (KLONOPIN) for Sleep disorder. On 26-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Aug-2021, the patient experienced TREMOR (shaking continued), TREMOR (hand began uncontrolled shaking), JOINT SWELLING (Joints are swollen), INJECTION SITE WARMTH (site was hot to the touch), JOINT SWELLING (rt shldr joint was swollen and painfull), ARTHRALGIA (Joints started to hurt) and MYALGIA (muscle pain). On 27-Aug-2021, the patient experienced COUGH (light cough), INJECTION SITE REACTION (hot spot at injection site), PAIN (boday aches), PYREXIA (Fever of 102/fever on and off) and ARTHRALGIA (joint pain). On 28-Aug-2021, the patient experienced CONFUSIONAL STATE (mental confusion), ENCEPHALITIS (encephalitis), SWELLING (It felt swollen inside the skull), BRAIN OEDEMA (Inflammation caused the brain to swell), PHOTOPHOBIA (sensitivity to light), MUSCULOSKELETAL STIFFNESS (stiff neck) and HEADACHE (Headache/head hurt so bad/swollen pain inside the head). On an unknown date, the patient experienced PULMONARY PAIN (lung pain), VACCINATION COMPLICATION (They said they were in bed for 3 days and had severe adverse reaction.), SNEEZING (Sneezed) and FATIGUE (They are just tired, like being run over by a truck/just still feeling slight tired,). The patient was treated with PARACETAMOL (TYLENOL A) at an unspecified dose and frequency and IBUPROFEN 29-Aug-2021 for Inflammation and Fever, at a dose of 400mg/4-6hrs. On 30-Aug-2021, JOINT SWELLING (Joints are swollen), PHOTOPHOBIA (sensitivity to light), MUSCULOSKELETAL STIFFNESS (stiff neck), COUGH (light cough), INJECTION SITE REACTION (hot spot at injection site), INJECTION SITE WARMTH (site was hot to the touch), JOINT SWELLING (rt shldr joint was swollen and painfull), PAIN (boday aches), PYREXIA (Fever of 102/fever on and off), ARTHRALGIA (Joints started to hurt) and ARTHRALGIA (joint pain) had resolved. At the time of the report, TREMOR (shaking continued), TREMOR (hand began uncontrolled shaking), CONFUSIONAL STATE (mental confusion) and MYALGIA (muscle pain) had not resolved, PULMONARY PAIN (lung pain), VACCINATION COMPLICATION (They said they were in bed for 3 days and had severe adverse reaction.), ENCEPHALITIS (encephalitis), SWELLING (It felt swollen inside the skull), SNEEZING (Sneezed), BRAIN OEDEMA (Inflammation caused the brain to swell) and FATIGUE (They are just tired, like being run over by a truck/just still feeling slight tired,) outcome was unknown and HEADACHE (Headache/head hurt so bad/swollen pain inside the head) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In August 2021, Body temperature: 102 (High) Fever of 102, fever on and off- 100.8, 101.8. He had organ transplant and is immunocompromised. Events little sore and extreme pain in the great longitudinal fissure were also included 9/7/2021 mild headache, no fever, uncontrolled muscle movements mild, no medications, still tired, lung issues Had COVID 3 week course, Fever, muscle aches, joint pain, lung pain, internal organ cramping. This case was linked to MOD-2021-306193, MOD-2021-306223, MOD-2021-306193 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 08-Sep-2021: Follow up received on 08-SEP-2021 and had significant information. Added patient demographics, events( hot to touch, uncontrolled shaking, mental confusion, stiff neck, sensitivity to light, extreme pain in the great longitudinal fissure, muscle weakness, lung issues. Outcome of the events also updated.


VAERS ID: 1707128 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Skin reaction, Vaccination site pain, Vaccination site pruritus, Vaccination site reaction, Vaccination site swelling
SMQs:, 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: USMODERNATX, INC.MOD20213

Write-up: She was told it is covid arm,a delayed reaction in the skin; A delayed reaction in the skin; Severe pain in her arm; Itches like crazy; a small nut since at the injection site, which on 02Sep2021 it got bigger; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (She was told it is covid arm,a delayed reaction in the skin), SKIN REACTION (A delayed reaction in the skin), VACCINATION SITE SWELLING (a small nut since at the injection site, which on 02Sep2021 it got bigger), VACCINATION SITE PAIN (Severe pain in her arm) and VACCINATION SITE PRURITUS (Itches like crazy) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, the patient experienced VACCINATION SITE SWELLING (a small nut since at the injection site, which on 02Sep2021 it got bigger). On 02-Sep-2021, the patient experienced VACCINATION SITE REACTION (She was told it is covid arm,a delayed reaction in the skin), SKIN REACTION (A delayed reaction in the skin), VACCINATION SITE PAIN (Severe pain in her arm) and VACCINATION SITE PRURITUS (Itches like crazy). At the time of the report, VACCINATION SITE REACTION (She was told it is covid arm,a delayed reaction in the skin), SKIN REACTION (A delayed reaction in the skin), VACCINATION SITE SWELLING (a small nut since at the injection site, which on 02Sep2021 it got bigger), VACCINATION SITE PAIN (Severe pain in her arm) and VACCINATION SITE PRURITUS (Itches like crazy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided.


VAERS ID: 1707563 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Broke out with a case of shingles 3 days after vaccine; This spontaneous case was reported by a consumer and describes the occurrence of HERPES ZOSTER (Broke out with a case of shingles 3 days after vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 23-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced HERPES ZOSTER (Broke out with a case of shingles 3 days after vaccine) (seriousness criterion medically significant). At the time of the report, HERPES ZOSTER (Broke out with a case of shingles 3 days after vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. Company Comment - Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1707624 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-23
Onset:2021-08-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain
SMQs:, Anaphylactic reaction (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Chest Tightness / Heaviness / Pain-Medium


VAERS ID: 1707998 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-26
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: Systemic: miscarriage-Severe


VAERS ID: 1708039 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       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: UNKNOWN
Current Illness: uNKNOWN
Preexisting Conditions: uNKNOWN
Allergies: nka
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vaccine had expired on 08/24/2021


VAERS ID: 1708040 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       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: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vaccine had expired on 08/24/2021.


VAERS ID: 1708041 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       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: UNKNOWN
Current Illness: uNKNOWN
Preexisting Conditions: uNKNOWN
Allergies: nka
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vaccine had expired on 08/24/2021


VAERS ID: 1708043 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       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: UNKNOWN.
Current Illness: UNKNOWN.
Preexisting Conditions: UNKNOWN
Allergies: NKA.
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vaccine had expired on 08/24/2021


VAERS ID: 1708337 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180B982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Migraine, Pain, 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: A Zithromax
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of J&J 08/26/2021, started experiencing symptoms that evening of severe Migraine lasting 17days. Migraine symptoms fever, chills, and body aches. Primary recommendation treated with Steroid. Symptoms have subsided.


VAERS ID: 1709187 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac stress test, Chest pain, Echocardiogram, Fatigue, Muscular weakness, Tachycardia
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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium, Turmeric, Biotin, Vitamin C, Multi-vitamin, Magnesium.
Current Illness: None.
Preexisting Conditions: None.
Allergies: Aquaphor.
Diagnostic Lab Data: ER Visit on 9/15/21. Cardiologist/on 9/16/21. Echo scheduled for 9/23/21 and Nuclear Stress test scheduled for 10/6/21. Return visit to doctor on 10/11/21.
CDC Split Type:

Write-up: Sharp chest pain in one location. Persistent dull/ache in another chest location. Tachycardia. Fatigue. Weak sensations in both arms. Sharp chest pain from 8/26/21-9/16/21. Dull/ache in chest from 9/15/21 - current. Tachycardia is inconsistent but is still present currently. Fatigue from 8/26/21-current. Weak sensations in both arms has not happened since 9/16/21.


VAERS ID: 1710192 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone disorder, Chills, Decreased appetite, Dyspnoea, Fatigue, Feeling cold, Hot flush, Hypopnoea, Joint noise, Musculoskeletal discomfort, Pain, Pain in extremity, Sleep disorder, Temperature intolerance
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Arthritis (broad), Respiratory failure (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: Men''s one a day vitamin, zinc supplement and turmeric with black pepper supplement
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Around 8PM I started having chills. Within an hour I was achy and the chills were terrible. I wore freezing winter weather clothing under 4 blankets and was still freezing. I experienced shortness of breath and started using my CPAP even when awake about half the time. I walked with a hunch very slowly and my knees and feet crunched. I couldn''t sleep for more than about 30 minutes at a time and it took a lot of energy to roll over or get up. By 6AM, I couldn''t even try to sleep anymore and started drinking constant hot black tea with a splash of milk. I had lost my appetite and only ate small amounts until Tuesday, July 31. The extreme chills started alternating between bad chills and burning up for about 12 hours but most of the time I was chilly and wore layers. My joints and bones felt loose and I still walked with a hunch and around 4PM on Aug 27 I was walking on a hardwood floor when I felt a crunch in the instep of my right foot and it started hurting bad. To this day (Sept 17) it still hurts although not as bad but occasionally I''ll be walking normally and I''ll feel a pop and it hurts like crazy for a few seconds. The chills started to die down slowly and the hot flashes became less often for the next two days and by dinner time on Sunday, Aug 29 I was only slightly chilly and no longer walked with a hunch but did walk slightly slower than normal. Normally I feel fine in temperatures between about 60 and 80 degrees Fahrenheit but by this point I wasn''t comfortable outside of about 70-75. Over the past 3 weeks my comfortable temperature range has widened a bit and as I write this my house is 68 degrees and I''m slightly cold when I normally wouldn''t be. My appetite restored by Tuesday and the only night I had a hard time sleeping thru was the first night. As of Wednesday, Sept 15 I''d say I felt close enough to my pre-vaccination self to say I''ve fully recovered. I''m not achy anymore but my energy level is only about 85%-90% of what it was pre-vaccination and my right foot still hurts sometimes when I walk. I''ve noticed that I still get winded quicker than I did pre-vaccination and fatigue quicker when walking but I''m no longer shallow breathing and haven''t since the day after my vaccination. I think that''s about as thorough as I can be.


VAERS ID: 1710799 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-08-26
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210931844

Write-up: EXPIRED VACCINE ADMINISTERED ON 26-AUG-2021 (VACCINE WAS EXPIRED ON 24-AUG-2021); This spontaneous report received from a health care professional concerned a 25 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1805031 expiry: 24-AUG-2021) dose was not reported, administered on 26-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 26-AUG-2021, the patient experienced expired vaccine administered on 26-AUG-2021 (vaccine was expired on 24-AUG-2021). The action taken with covid-19 vaccine was not applicable. The outcome of expired vaccine administered on 26-AUG-2021 (vaccine was expired on 24-AUG-2021) was not reported. This report was non-serious. This case, from the same reporter is linked to 20210931951, 20210931982, 20210932036, 20210931810, 20210932240, 20210932593, 20210932567, 20210932874, 20210933076 and 20210933129.


VAERS ID: 1710815 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-08-26
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210932593

Write-up: RECEIVED AN EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a 41 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1805031, and expiry: 24-AUG-2021) dose was not reported, administered on 26-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 26-AUG-2021, the patient experienced received an expired vaccine. The action taken with covid-19 vaccine was not applicable. The outcome of received an expired vaccine was not reported. This report was non-serious. This case, from the same reporter is linked to 20210931982, 20210932036, 20210932240, 20210931810, 20210932567, 20210931844, 20210931951, 20210932874, 20210933129 and 20210933076.


VAERS ID: 1710823 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-08-26
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210933129

Write-up: RECEIVED AN EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a 29 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1805031, and expiry: 24-AUG-2021) dose was not reported, administered on 26-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 26-AUG-2021, the patient experienced received an expired vaccine. The action taken with covid-19 vaccine was not applicable. The outcome of received an expired vaccine was not reported. This report was non-serious. This case, from the same reporter is linked to 20210931844, 20210932593, 20210932567, 20210932036, 20210932874, 20210933076, 20210931810, 20210931982, 20210931951 and 20210932240.


VAERS ID: 1710912 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / UNK - / OT

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

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

Write-up: Patient was administered expired dose at 17 hours and 10 minutes; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient was administered expired dose at 17 hours and 10 minutes) in an 18-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939901) for COVID-19 vaccination. No Medical History information was reported. On 26-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient was administered expired dose at 17 hours and 10 minutes). On 26-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Patient was administered expired dose at 17 hours and 10 minutes) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication were provided by reporter. No treatment medication were provided by reporter.


VAERS ID: 1710993 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-08-26
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 78C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site pruritus, Vaccination site rash, Vaccination site swelling
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: rash in her left arm; red bumps and itching over the area of size similar to a base ball; red bumps and itching over the area of size similar to a base ball; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (rash in her left arm), VACCINATION SITE SWELLING (red bumps and itching over the area of size similar to a base ball) and VACCINATION SITE PRURITUS (red bumps and itching over the area of size similar to a base ball) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 062E21A and 78C21A) for COVID-19 vaccination. No Medical History information was reported. On 28-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Aug-2021, the patient experienced VACCINATION SITE RASH (rash in her left arm), VACCINATION SITE SWELLING (red bumps and itching over the area of size similar to a base ball) and VACCINATION SITE PRURITUS (red bumps and itching over the area of size similar to a base ball). At the time of the report, VACCINATION SITE RASH (rash in her left arm) was resolving and VACCINATION SITE SWELLING (red bumps and itching over the area of size similar to a base ball) and VACCINATION SITE PRURITUS (red bumps and itching over the area of size similar to a base ball) outcome was unknown. Reportedly, Consent for safety follow up by the patient was granted. Patient had used Ice to treat the symptoms Concomitant product use was not provided. Treatment product information was not provided. This case was linked to MOD-2021-310822 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 13-Sep-2021: Non-Significant F/U Case.


VAERS ID: 1711206 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Feeling cold, Feeling of despair, Motor dysfunction, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Patient was feeling faint, fainted in chair; Despondent, cold to touch, weak and pale; Cold to touch; Weak; Pale; Difficulty in muscle control; This spontaneous case was reported by a pharmacist and describes the occurrence of SYNCOPE (Patient was feeling faint, fainted in chair), FEELING OF DESPAIR (Despondent, cold to touch, weak and pale), FEELING COLD (Cold to touch), ASTHENIA (Weak) and PALLOR (Pale) in a 22-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Aug-2021, the patient experienced SYNCOPE (Patient was feeling faint, fainted in chair), FEELING OF DESPAIR (Despondent, cold to touch, weak and pale), FEELING COLD (Cold to touch), ASTHENIA (Weak), PALLOR (Pale) and MOTOR DYSFUNCTION (Difficulty in muscle control). At the time of the report, SYNCOPE (Patient was feeling faint, fainted in chair), FEELING OF DESPAIR (Despondent, cold to touch, weak and pale), FEELING COLD (Cold to touch), ASTHENIA (Weak), PALLOR (Pale) and MOTOR DYSFUNCTION (Difficulty in muscle control) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Treatment information was not provided. Company comment: This concerns a case of a 22 year old Male with no relevant medical history who experienced unexpected events of syncope, feeling of despair, feeling cold, asthenia, pallor, and motor dysfunction. The events happened 1 day after receiving the first dose of the vaccine. The event syncope was upgraded to serious , however it is downgraded to non serious due to the lack of evidence of seriousness from a regulatory or clinical standpoint. The benefit-risk relationship of Moderna Covid-19 vaccine is not affected by this report. This case was linked to US-MODERNATX, INC.-MOD-2021-315343, US-MODERNATX, INC.-MOD-2021-141984, US-MODERNATX, INC.-MOD-2021-141984, US-MODERNATX, INC.-MOD-2021-141758, US-MODERNATX, INC.-MOD-2021-142081, US-MODERNATX, INC.-MOD-2021-142219 (E2B Linked Report).; Sender''s Comments: This concerns a case of a 22 year old Male with no relevant medical history who experienced unexpected events of syncope, feeling of despair, feeling cold, asthenia, pallor, and motor dysfunction. The events happened 1 day after receiving the first dose of the vaccine. The event syncope was upgraded to serious , however it is downgraded to non serious due to the lack of evidence of seriousness from a regulatory or clinical standpoint. The benefit-risk relationship of Moderna Covid-19 vaccine is not affected by this report. US-MODERNATX, INC.-MOD-2021-315343:Same report US-MODERNATX, INC.-MOD-2021-141984: US-MODERNATX, INC.-MOD-2021-141984: US-MODERNATX, INC.-MOD-2021-141758: US-MODERNATX, INC.-MOD-2021-142081: US-MODERNATX, INC.-MOD-2021-142219:


VAERS ID: 1711369 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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 INC202101109782

Write-up: Fingers were tingling; This is a spontaneous report from a contactable pharmacist via Regulatory Authority. A 60-year-old female patient received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- UNKNOWN) via an unspecified route of administration on 26Aug2021 as dose 1, single (at the age of 60-years-old) for COVID-19 immunization. Patient medical history and concomitant medications were not reported. Patient experienced events after receiving the Pfizer-BioNTech Covid19 vaccine, today. After administration, a couple minutes later she said her fingers were tingling on 26Aug2021. He reported that she did leave the pharmacy and he intended to follow-up with her later today. He also noted he did not observe anything out of the ordinary with administration. The outcome of the event was unknown. The lot number for [BNT162B2], was not provided and will be requested during follow up. This follow-up is being submitted to notify that the lot/batch number is not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected.


VAERS ID: 1711388 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Breast swelling, Burning sensation, Dyspnoea, Pain, Pain in extremity, Peripheral swelling, Tachycardia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy; Cholesterol
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101117367

Write-up: two bumps in her armpit/and they are really swollen; her breast and they are really swollen; burning sensations there; has a really strong pain if she breathes really deep; has a little pain in her arm; She states that she feels like she cannot breath; she feels like she has tachycardia; This is a spontaneous report from a contactable consumer (Patient). A 44-years-old female patient received bnt162b2 (COMIRNATY, Formulation:Solution for injection, Batch/Lot Number: FD8448) dose 2 via an unspecified route of administration on 26Aug2021 10:00 as dose 2, single (At the age of 44-years) for covid-19 immunisation. Medical history included blood cholesterol and hypersensitivity from an unknown date and unknown if ongoing. The patient concomitant medications was not reported. The patient previously took bnt162b2 (COMIRNATY, solution for injection, Batch/Lot Number: EC3100) dose 1 via an unspecified route of administration on 05Aug2021 (At the age of 44-years) for covid-19 immunisation. Patient has not taking any medications and has a lot of allergy but all of that she has and maybe some or a bit of cholesterol and triglycerides but that was already under control and states she had no other diseases; states the allergy, cholesterol and triglycerides began prior to the Pfizer Covid vaccine. On 26Aug2021 16:00 the patient experienced two bumps in her armpit/and they are really swollen, her breast and they are really swollen, burning sensations there, has a really strong pain if she breathes really deep, has a little pain in her arm, she states that she feels like she cannot breath, she feels like she has tachycardia. After 2nd dose Symptoms started at 4:00 pm and her symptoms are worse. Therapeutic measures were taken as a result of two bumps in her armpit/and they are really swollen, her breast and they are really swollen, burning sensations there, has a little pain in her arm, she states that she feels like she cannot breath. She states that someone told her to take 800 mg of Tylenol after getting the shot, but the Tylenol didn''t even take away 5 percent of the pain. Lot number F200557 and expiration date Feb2022. Symptoms started at 4:00 pm and her symptoms are worse. Caller was given the following information. In general, local side effects; the ones you get on the arm where you got the shot (such as injection site redness and injection site swelling) were mostly mild-to-moderate in severity and resolved within 1 to 2 days. Side effects that you may experience throughout the rest of your body; (systemic side effects) including fever and chills were observed with the first 1 to 2 days after vaccination and resolved shortly thereafter. Swollen lymph nodes (lymphadenopathy), which generally resolved within 10 days, is likely to have resulted from a robust vaccine-elicited immune response. The outcome of the events was not recovered. Follow up(27Aug2021): This is a spontaneous report included. Event onset dates and some clinically relevant information provided.


VAERS ID: 1711423 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Dysgeusia, Electrocardiogram, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Migraine; Scoliosis
Allergies:
Diagnostic Lab Data: Test Date: 20210829; Test Name: testing; Result Unstructured Data: Test Result:Arrhythmia; Comments: ER visit on 29Aug2021 confirmed arrhythmia.
CDC Split Type: USPFIZER INC202101127662

Write-up: ER visit on 29Aug21 confirmed arrhythmia; Metallic taste in mouth within minutes of vaccine; followed by tachycardia on and off since then; This is a spontaneous report from a contactable other healthcare professional (HCP, patient) reported for herself. A 42-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 26Aug2021 (Batch/Lot Number: FD8448) as dose 2, single for covid-19 immunisation in Pharmacy or Drug Store. Medical history included migraines and scoliosis. Patient is not pregnant. No Known allergies. There were no concomitant medications. No other vaccine in four weeks. No other medications in two weeks. Patient previously took the first dose of BNT162B2 (Lot number=EW0183) on left arm on 05Aug2021 at 42-year-old for COVID-19 immunisation. Patient experienced metallic taste in mouth within minutes of vaccine followed by tachycardia on and off since then. ER visit on 29Aug21 confirmed arrhythmia. Referred to cardiologist for follow up. events start date was 26Aug2021 and resulted in Emergency room/department or urgent care. No COVID prior vaccination, No COVID tested post vaccination. Treatment received for the event included IV Fluids and testing. Patient was not recovered from the events.; Sender''s Comments: Based on plausible temporal relationship, a possible causal association between the event Arrhythmia and the suspect drug BNT162B2 cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1711444 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Feeling abnormal, Gait disturbance
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101128328

Write-up: I am terrible, I feel horrible; I can hardly walk; Do not feel good; I am as weak as I can be, I have no strength; This is a spontaneous report from a contactable consumer or other non hcp. A patient of unspecified age and gender received bnt162b2 (BNT162B2), dose 3 via an unspecified route of administration on 26Aug2021 (Batch/Lot number was not reported) as DOSE 3, SINGLE for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced do not feel good (feeling abnormal) (non-serious) on 26Aug2021 with outcome of not recovered , i am as weak as i can be, i have no strength (asthenia) (non-serious) on 26Aug2021 with outcome of not recovered , i am terrible, i feel horrible (feeling abnormal) (non-serious) on 27Aug2021 with outcome of not recovered , i can hardly walk (gait disturbance) (non-serious) on 27Aug2021 with outcome of not recovered. The action taken in response to the event(s) for bnt162b2 was not applicable. Therapeutic measures were taken as a result of do not feel good (feeling abnormal), i am as weak as i can be, i have no strength (asthenia).


VAERS ID: 1711464 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Neck pain, Overdose, Pain in extremity, Vaccination site pain, Weight
SMQs:, Drug abuse and dependence (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), 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: Asthma (had since he was a kid)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Weight; Result Unstructured Data: Test Result:205 -210 lbs
CDC Split Type: USPFIZER INC202101132573

Write-up: pain in the legs; They received 2.1mLs instead of the 0.3mL recommended dose; fatigue; arm pain at the injection site; neck pain; This is a spontaneous report from a contactable consumer. (patient''s wife). A 53-years-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Left on 26Aug2021 13:30 (Batch/Lot Number: EW0172) as a single dose at 2.1 ML SINGLE for covid-19 immunisation. Medical history included ongoing asthma had since he was a kid. There were no concomitant medications. On 26Aug2021, the patient went to his employer for the first dose and received 2.1mLs instead of the 0.3mL recommended dose. The patient also complained of neck pain and fatigue that day. On 29Aug2021, he had arm pain at the injection site and pain in the legs.The lab that performed the vaccination recommended he receive the second dose. There was no physician office visit nor emergency room visit. The patient had not received any vaccinations within 4 weeks prior to receiving the vaccine. He was taking ibuprofen. The outcome of the arm pain, pain in the legs and fatigue was not recovered, the neck pain was recovering No follow-up attempts are possible. No further information is expected.


VAERS ID: 1711524 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:2021-04-01
Onset:2021-08-26
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, COVID-19, Drug ineffective, Myalgia, Nasal congestion, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic 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), 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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210829; Test Name: Covid Test Rapid Test; Test Result: Positive.
CDC Split Type: USPFIZER INC202101137524

Write-up: Break through infection in which he tested positive with covid 19, this past Sunday; Break through infection in which he tested positive with covid 19, this past Sunday; Loss of taste; Low grade fever; Myalgia; congestion; This is a spontaneous report received from a contactable consumer (patient). A 46-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), administered in left arm on Mar2021 (reported as 3rd or 4th week of Mar2021) as dose 1, single and on Apr2021 (reported as 2nd week of Apr2021) as dose 2, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were reported as none. It was reported that there was a breakthrough infection in which patient was tested positive with COVID-19, this past Sunday before the present report (29Aug2021). He did not know specific dates of when he got his COVID-19 vaccines, but he stated that his first dose was in the 3rd or 4th week of Mar2021 and the second dose was in the 2nd week of Apr2021. They did a rapid COVID test, for which he tested positive on Sunday 29Aug2021. On Thursday 26Aug2021 he started feeling sick, his twin 3rd years old school tested positive, and so it was 4 classes that were quarantined. He started feeling symptoms on this past Thursday 26Aug2021 and therefore provides his awareness date as 26Aug2021. Caller (patient) elaborated on the symptoms he experienced on Thursday 26Aug2021, he had congestion nasally, then on Friday 27Aug2021 a low grade fever. He had myalgia from 26Aug2021 having his body be sore. The congestion was done by Sunday and his nose started clearing. Caller confirmed that on Monday (30Aug2021) it was gone. Fever lasted a day and a half (28Aug2021). Regarding myalgia it was reported that he was sore and tired, just still a little sore. He added that another symptom he had was loss of taste, which started on Saturday (28Aug2021) and it was still ongoing and the same. He had no product details since he was quarantined at the moment, he didn''t take his COVID card with him and it was at home, he was not going home yet for the moment. The outcome of the events was resolved on 30Aug2021 for congestion, resolved on 28Aug2021 for low grade fever, resolving for myalgia, not resolved for loss of taste and unknown for the other events. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow-up.


VAERS ID: 1711574 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Fear, Feeling abnormal, Feeling cold, Frustration tolerance decreased, Hallucination, Illness, Malaise, Nausea, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Immune system disorder (diagnosed 12 years ago)
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101141436

Write-up: hallucinating; frustrated; doesn''t feel good, she''s mainly staying in bed; was so tired, extreme fatigue is awful; got very sick, nauseous; got very sick, nauseous; has made her feel crazy/doesn''t feel good; afraid; when she''s in bed, she''s always so cold; She also still had the arm pain, they said her arm would probably be tender for a little bit after the injection; difficulty with breathing, felt like the wind had been knocked out of her; This is a spontaneous report from a contactable consumer (patient self). A 6-decade-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration, administered in Arm Left on 26Aug2021 12:35 as dose 1, single for COVID-19 immunization. Medical history included ongoing compromised immune system diagnosed 12 years ago, covid-19 from 2020. There were no concomitant medications. The patient previously took zofran [ondansetron] and experienced nausea. No prior Vaccinations (within 4 weeks). No AE(s) following prior vaccinations. She called her healthcare provider and she talked to a social worker telling them her concerns. She stated she did not feel good, she was mainly staying in the bed on 27Aug2021. She called her manager, she had a video appointment with another doctor of hers and she told the doctor, she could see how bad the caller was looking in this video appointment. Hallucinating: she has been hallucinating, she was so frustrated, she did not hallucinate. It was the very next day after the shot, the next morning when she got up, she went outside. Confirmed began 27Aug2021, ongoing and persisting. Difficulty with breathing: when she got up she felt off, weird. She went to get some air and she was going to wash her car and she remembered her breathing, she had to stop because of her breathing. The only time she ever had difficulty with breathing was when she did have COVID, which was last year, she did not have any breathing problems since then other than that day. She stopped washing her car and she immediately felt like the wind had been knocked out of her. Confirmed began 26Aug2021 and also ended 26Aug2021. Confirmed she has recovered completely by 95%. She was so tired, extreme fatigue was awful: confirmed began 27Aug2021, ongoing, persisting. She did what she needs to do and has to do and stays in bed the rest of the time, she just wants to sleep. She had to make herself do things, which she usually doesn''t do that. She got very sick, nauseous on 27Aug2021: She has been taking Zofran. She has taken Zofran in the past and it always helped, but it was not helping other than the nausea would subside but it came back. Zofran: 4 mg, tablets- once a day as needed, sometimes twice, just depends. Expiry Date: Jun2024. She stated before this shot, she maybe had to take it once every three weeks or so but definitely not daily. Made her feel crazy on 27Aug2021: one day three different things happened. She went to withheld to get some Pepto-Bismol or water and put her debit card in and two times the transaction was denied, when the third transaction went through she realized she wasn''t putting her pin in she was putting her telephone number in. The next day after that she went out and came back in had her key out to open the door like she always does, and instead of putting her door key in she switched it to the mailbox key instead to open the door. She stated the third thing that happened, this really shook her, was the maintenance man had stopped her in the parking lot to talk to her so she put her car in park like she always does, and as he was talking to her, she felt her car drifting very slow going forward, she felt herself going past him, she kept looking at the gear, she was in park, she had her foot on the break, she put her foot on the break so hard she felt the muscle, she had to keep in her mind she was stopped, she didn''t want to say anything to the maintenance man, but she could see her car still rolling and she knows she was hallucinating, that just made her so afraid on 27Aug2021. She stated one other time she was hallucinating was last night, she was looking out the door, and there was a chair bedside the door, and she saw something in the chair sliding across the chair and out of the chair. She stated she has not hallucinated like that before. When she was in bed, she was always so cold on 27Aug2021: it was so weird, it was only like that when she was in the bed. Arm pain: She also still had the arm pain, they said her arm would probably be tender for a little bit after the injection. Stated began same day as injection on 26Aug2021, was ongoing, and improved, it was not as bad as it was. The AEs did not require a visit to Emergency Room. The patient visited Physician Office. Relevant Tests: None. Outcome of the arm pain was resolving, outcome of difficulty with breathing was resolved on 26Aug2021 while outcome of the other events was not resolved. The lot number for the vaccine [BNT162B2] was not provided and will be requested during follow up.


VAERS ID: 1711765 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Pyrexia, Suspected COVID-19, Throat irritation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101154775

Write-up: Weakness; Low grade fever; Itch throat; trying to find out so that he doesn''t know infect anybody else the COVID; got symptoms of COVID; This is a spontaneous report received from a contactable consumer (patient''s wife) reported that a male patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/lot number and Expiry Date: Unknown), via an unspecified route of administration on 26Aug2021 as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient was calling on behalf of her husband who got the first dose of the Pfizer COVID-19 Vaccine last 26Aug2021 and after getting it, the husband got symptoms of COVID which was weakness, low grade fever and itch throat actually he was asking if, was it possible that these are the side effects of vaccine. The patient''s wife did not know, he was not in here with me, she was trying to find out so that he doesn''t know infect anybody else the COVID (Further clarification unknown). Reporter seriousness for all events were unspecified. The outcome of the events was unknown. This follow-up is being submitted to notify that the lot/batch number is not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected.


VAERS ID: 1712107 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Hypersensitivity
SMQs:, Angioedema (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101206373

Write-up: had an allergic reaction; This is a spontaneous report from a contactable consumer (patient). A 56-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number and Expiration date were not reported) via an unspecified route of administration on 26Aug2021 (age at vaccination: 56-years-old) as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. After first vaccination on 26Aug2021, immediately the patient had experienced an allergic reaction due to which she was admitted to emergency room. The outcome of the event was unknown. The Lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1712159 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Vaccination site mass, Vaccination site pain, Vaccination site warmth
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: PRISTIQ; KLONOPIN; TOPAMAX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Common variable immunodeficiency; COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes); Idiopathic intracranial hypertension; Sulfonamide allergy (Known allergies: Sulfa antibiotics)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101216533

Write-up: Severe swelling and lump at injection sight/ the lumpwas extremely tight feeling; Severe swelling and lump at injection sight, hot to the touch; The lump was extremely painful to touch; Soreness of arm went all the way down to elbow; This is a spontaneous report from a contactable consumer, the patient. A 26-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3184) via an unspecified route of administration in right arm on 25Aug2021 (at the age of 26-years-old) as a single dose for COVID-19 immunisation. The patient''s medical history included COVID-19, idiopathic intracranial hypertension (reported as idiopathic intercranial hypertension), common variable immunodeficiency and allergy to sulfa antibiotics. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. Concomitant medications included desvenlafaxine succinate monohydrate (PRISTIQ), clonazepam (KLONOPIN) and topiramate (TOPAMAX); all for unknown indications from unknown dates and unknown if ongoing. On 26Aug2021, the patient developed severe swelling and lump at injection site which was hot to the touch. Lump was about the size of a golf ball. The patient felt the lump to be extremely tight and extremely painful to touch. The events lasted for almost two weeks. It was reported that soreness of arm went all the way down to the elbow. No therapeutic measures were taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events severe swelling and lump at injection site, hot to the touch and the lump was extremely tight feeling and extremely painful to touch was resolved on an unknown date in Sep2021. The clinical outcome of the event soreness of arm went all the way down to elbow was resolved on an unknown date in 2021.


VAERS ID: 1713277 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Zoloft
Current Illness: None
Preexisting Conditions:
Allergies: Sulfa, late
Diagnostic Lab Data: Nothing done yet, just taking Motrin
CDC Split Type:

Write-up: Horribly painful muscle and joint aches and pains.


VAERS ID: 1713335 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-04
Onset:2021-08-26
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Nodule, Pain, Pain in extremity, Pulmonary mass
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, Vitamin D3 and Zinc
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Shellfish
Diagnostic Lab Data: Multiple nodules in lungs and clavicle(s).
CDC Split Type:

Write-up: Pain in chest, soreness in arm. Pain when moving right arm across the chest.


VAERS ID: 1713536 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-25
Onset:2021-08-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Guillain-Barre syndrome, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Cardiomyopathy (broad), Demyelination (narrow), Tendinopathies and ligament disorders (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient described pain in extremities, difficulty breathing consistent with GBS. Patient was advised to wait to get 2nd dose until seen by his PCP. Patient stated he just started feeling back to normal after 3 weeks


VAERS ID: 1713588 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F25088 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Pain in extremity, Pollakiuria, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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 10 mg, met Forman 1000 mg, Bayer 81 mg
Current Illness: Nothing
Preexisting Conditions: Nothing
Allergies: Penicillin
Diagnostic Lab Data: Tachycardia
CDC Split Type:

Write-up: Tachycardia, unstable blood pressure,Frequent urination, pain in left arm,Chest pain


VAERS ID: 1713641 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: no side effects reported, only pt got a first pfizer dose when shouldn''t have. Pt came in on 8/26/21 requesting first pfizer dose and noting on consent form haven''t had any covid-19 vaccines before. Pfizer was administered. FOund pt had prior J&J dose at a health department a few months prior.


VAERS ID: 1714323 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-17
Onset:2021-08-26
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Asymptomatic COVID-19, Chest X-ray abnormal, Condition aggravated, Cough, Culture, Haemodialysis, Hypoxia, Lung infiltration, Pleural effusion, Pneumonia, Procalcitonin increased, SARS-CoV-2 test positive, Ultrasound scan normal
SMQs:, Acute renal failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (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? Yes
Hospitalized? Yes, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pramipexole, allopurinol, amiodarone, apixaban, esomeprazole, duonebs, atorvastatin, mag-ox, synthroid, tums, vitamin D3, lantus, rena-vite, tamsulosin
Current Illness:
Preexisting Conditions: 1. End-stage renal disease on hemodialysis. 2. Hypertension. 3. Hyperlipidemia 4. Restless leg syndrome 5. Carotid artery disease 6. Diabetes mellitus 7. Obstructive sleep apnea does not use CPAP. 8. Hearing loss 9. Paroxysmal atrial fibrillation with chronic anticoagulation on Eliquis. 10. Dilated nonischemic cardiomyopathy with ejection fraction around 35%. 11. Anemia of chronic disease 12. Chronic hypoxic respiratory failure 13. Neuropathy 14 Hyperuricemia 15. Hypomagnesemia 16. hypothyroidism
Allergies: Ace inhibitors, doxycycline
Diagnostic Lab Data: 9/9/21 COVID19: Positive 9/12/21 chest xray: Left lower lobe infiltrate and small left effusion. Slight worsening of the left lower lobe infiltrate and effusion since prior study. Patchy right midlung infiltrate. 9/13/21 US: Neg
CDC Split Type:

Write-up: presented to the emergency department secondary to weakness. Was found to have community-acquired pneumonia and was positive for COVID-19. Was he is fully vaccinated and his symptoms more consistent with community-acquired pneumonia and he had minimal COVID-19 issues. He was isolated placed on broad-spectrum antibiotics and pancultures obtained. O2 was titrated per his needs. Hemodialysis continued as facilitated by Nephrology. Hospital course was uncomplicated. He was briefly on remdesivir and dexamethasone but as was not hypoxic and asymptomatic in regards COVID-19 this was discontinued prior to finishing a full course. Was started with aggressive physical therapy. It was felt that he would need further rehabilitation in a skilled setting with goal to possibly be discharged to assisted living at some point. On 09/12/2021 was complaining of cough and was a little bit hypoxic. Procalcitonin was checked and was elevated and chest x-ray showed findings consistent with new infiltrate on the left consistent possibly with pneumonia. He was once again started on broad-spectrum antibiotics with cefepime and vancomycin. On 09/16/2021 his procalcitonin was trending down and he was not symptomatic. He was transition to p.o. Levaquin. Arrangements were made for discharge to hospital manner and he was discharged to that location in stable condition with plans to continue hemodialysis as directed on 09/17/2021.


VAERS ID: 1714437 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Angioedema, Arthralgia, Hypotonia, Infection, Lip swelling, Swelling of eyelid, Urticaria, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Periorbital and eyelid disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine
Other Medications: Multivitamin
Current Illness: No
Preexisting Conditions: No
Allergies: Penicillin
Diagnostic Lab Data: Basic metabolic panel performed at urgent care showed increased white blood cells / infection.
CDC Split Type:

Write-up: All side effects continue over 3 weeks after vaccine. Angioedema. Hives, initially on chest, then on joints, then throughout the body appearing asymmetrically. Severe joint pain. Lip and eye lid swelling. Limp arm on 9/19/21.


VAERS ID: 1714616 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-08-26
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210933076

Write-up: ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a 45 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805031, expiry: 24-AUG-2021) dose was not reported, administered on 26-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 26-AUG-2021, the patient experienced administration of expired vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administration of expired vaccine was not reported. This report was non-serious. This case, from the same reporter is linked to 20210931844, 20210931982, 20210932593, 20210932036, 20210932567, 20210931951, 20210932240 and 20210932874.


VAERS ID: 1715260 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-11
Onset:2021-08-26
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Asthenia, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough, Diarrhoea, Hypoxia, Lung opacity, Pneumonia klebsiella, Productive cough, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Sputum culture positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-COV-2 RAPID: Detected (8/26/2021)
CDC Split Type:

Write-up: 77 yo male pt s/p Pfizer COVID vaccination: dose 1 on 2/18 and dose 2 on 3/11. Past medical history of CLL on acalabrutinib, atrial fibrillation, type 2 diabetes, and hypothyroidism who presented to the ED on 8/26. His presenting symptoms were cough, weakness, rhinorrhea, clear sputum, and diarrhea. While in the ED he was found to be positive for COVID-19 with fevers of 101.1 He was started on Remdesivir on the evening of 8/26. Sputum cultures were collected and Initial chest X ray was negative for any acute processes. He had new hypoxia on 8/28 requiring supplemental oxygen. Given his new hypoxia and positive COVID test, he was started on a 10 day course of dexamethasone. Repeat Chest Xray on 8/28 showed multifocal hazy airspace opacities consistent with covid pneumonia. He was empirically started on ceftriaxone 8/28. On 8/29 his sputum cultures were positive for Klebsiella Pneumonia that was susceptible to ceftriaxone. His supplemental oxygen was titrated to a maximum of 6L on 9/2 and eventually weaned off until he was back to his baseline of room air on 9/8. Patient completed a total of two courses of Remdesivir on 8/26-8/31 and 9/2-9/5. His Ceftriaxone was completed on 9/4 for a total duration of 8 days. At his time of discharge, patient was maintaining his saturations on room air. Additionally he was started on 2.5mg Eliquis BID for 30 days given his increased risk of hypercoagulability post-covid infection.


VAERS ID: 1715262 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-20
Onset:2021-08-26
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Computerised tomogram thorax abnormal, Cough, Diarrhoea, Fibrin D dimer increased, Nausea, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), 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, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-COV-2 RAPID: Detected (8/26/2021)
CDC Split Type:

Write-up: 74 yo male patient s/p Pfizer vaccination: dose 1 on 1/30/21, dose 2 on 2/20/21, and booster dose on 8/17/2021. Past medical history significant for living donor renal transplant on immunosuppression with rapamune and cyclosporine, T2DM, HTN, HLD, primary hypothyroidism, gout, anemia, and obesity who presented on 8/26 with 4 days of nausea, vomiting, diarrhea, and dry cough who was found to be positive for COVID-19, despite being fully vaccinated. On admission Infectious Disease was consulted and he received remdesivir for 7 days and dexamethasone for 10 days. He required up to 15L high flow nasal cannula this admission. He had elevated d-dimer measurements this admission and on 9/2/21 CTPE was ordered...


VAERS ID: 1715813 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-26
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Decreased appetite, Dizziness, Feeling hot, Loss of personal independence in daily activities, Migraine
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad)

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

Write-up: face was hot, dizziness, loss of appetite, light headed and having horrible migraines has been affecting everyday routine


VAERS ID: 1715897 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-20
Onset:2021-08-26
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ENB207 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, Full blood count, Metabolic function test, Muscular weakness, Myalgia, Myocardial necrosis marker
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Potassium Chloride, Magnesium, Medical Marijuana, Aspirin, Hydroxychloroquine, Furosemide, Topiramate, Cholestyramine, Lyrica,Lamotrigine, Vyvanse, Allpurinol, Rexulti, Vitamin D3, Vitamin B12, Multivitamin, Biotin, NYSTOP Powder PRN, Vento
Current Illness: none other than chronic health conditions
Preexisting Conditions: Diagnosed with Papillary Tall Cell Thyroid Cancer April 2021 - no symptoms, found on PET scan looking for something else, hypokalemia, orthostatic hypotension, aortic valve insufficiency, sleep apnea, MGUS, antiphospholipid syndrome, fibromyalgia, pseudotumor cerebri, headaches, pulsatile tinnitus, vitamin D deficiency, binge eating disorder, schizoaffective disorder bipolar type, chronic PTSD, panic disorder, peripheral neuropathy, cubital tunnel syndrome (left), bilateral carpal tunnel syndrome, lumbar spondylosis, osteoarthritis (SI Joint, lumbar, feet, hands, neck, left shoulder), NAFKD, IBS w/ chronic diarrhea, restless leg syndrome, hepatosplenogamy, mild cataracts, exposure keratitis, alopecia areata, spontaneous ecchymoses
Allergies: Propofol, Macrolides, "mycin" antibiotics, Prednisone, Dilaudid, Tramadol, Hydrocodone, Toradol, Zoloft
Diagnostic Lab Data: CBC, CMP, EKG, cardiac enzyme blood work
CDC Split Type:

Write-up: fatigue more than usual, muscle pain and muscle weakness


VAERS ID: 1716081 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Feeling hot, Headache, Lymphadenopathy, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: kidney disease stage 2
Allergies: sulfa, penicillium, 113 food allergies
Diagnostic Lab Data: no
CDC Split Type:

Write-up: Felt dizzy , headache at base of neck . Face was swelling lymph nods armpits . All joints were hurting , chest and heart pain. Body was hot but no fever. Have not recovered form theses symptoms .


VAERS ID: 1716927 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-04
Onset:2021-08-26
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Diarrhoea, Dyspnoea, Heart rate increased, Palpitations, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Urgent Care 08/30/2021 Emergency Room 09/01/2021 Emergency Room 09/03/2021 ENT 09/04/2021 Gastrologist 09/20/2021
CDC Split Type:

Write-up: Difficulty breathing, palpitations, chest pain, fast beating heart rate, diarrhea, vomit


VAERS ID: 1717363 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 AR / IM

Administered by: Military       Purchased by: ?
Symptoms: Syringe issue
SMQs:, Medication errors (broad)

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

Write-up: Patient receiving his J&J vaccination and the vaccine leaked out, so when the needle was inserted into the Patient arm there was no vaccine to push. Technician stated she was 100% sure there was no fluid that was pushed into the PT arm.


VAERS ID: 1717693 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-08-26
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 3 LA / OT
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Decreased appetite, Depression, Interchange of vaccine products, Sleep disorder
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), 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: Allergy (Severe allergy with anaphylaxis); Hypertension (High blood pressure)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Loss of appetite; mild stomach ache; disrupted sleep pattern sleep 10 hours a day (9/12/21) Severe depression (until 9/11; disrupted sleep pattern sleep 10 hours a day (9/12/21) Severe depression (until 9/11; Interchange of vaccine; This spontaneous case was reported by a consumer and describes the occurrence of DECREASED APPETITE (Loss of appetite), ABDOMINAL PAIN UPPER (mild stomach ache), DEPRESSION (disrupted sleep pattern sleep 10 hours a day (9/12/21) Severe depression (until 9/11), SLEEP DISORDER (disrupted sleep pattern sleep 10 hours a day (9/12/21) Severe depression (until 9/11) and INTERCHANGE OF VACCINE PRODUCTS (Interchange of vaccine) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. Co-suspect product included non-company product (PFIZER BIONTECH COVID-19 VACCINE) for COVID-19 vaccination. Concurrent medical conditions included Hypertension (High blood pressure) and Allergy (Severe allergy with anaphylaxis). On 06-Mar-2021, the patient started (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 27-Mar-2021, (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) dosage was changed to 1 dosage form. On 26-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Aug-2021, the patient experienced DECREASED APPETITE (Loss of appetite) and ABDOMINAL PAIN UPPER (mild stomach ache). 26-Aug-2021, the patient experienced DEPRESSION (disrupted sleep pattern sleep 10 hours a day (9/12/21) Severe depression (until 9/11), SLEEP DISORDER (disrupted sleep pattern sleep 10 hours a day (9/12/21) Severe depression (until 9/11) and INTERCHANGE OF VACCINE PRODUCTS (Interchange of vaccine). On 26-Aug-2021, INTERCHANGE OF VACCINE PRODUCTS (Interchange of vaccine) had resolved. On 12-Sep-2021, DECREASED APPETITE (Loss of appetite) and ABDOMINAL PAIN UPPER (mild stomach ache) had not resolved and DEPRESSION (disrupted sleep pattern sleep 10 hours a day (9/12/21) Severe depression (until 9/11) and SLEEP DISORDER (disrupted sleep pattern sleep 10 hours a day (9/12/21) Severe depression (until 9/11) was resolving. No concomitant medications were reported. No treatment medications were mentioned


VAERS ID: 1717905 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 LA / OT

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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Dose administered to patient after improper storage and handling; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT STORAGE ERROR (Dose administered to patient after improper storage and handling) in a 31-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002C21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Aug-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Aug-2021, the patient experienced PRODUCT STORAGE ERROR (Dose administered to patient after improper storage and handling). On 26-Aug-2021, PRODUCT STORAGE ERROR (Dose administered to patient after improper storage and handling) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medications were provided. No Treatment medication was reported. This case was linked to MOD-2021-299914 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 01-Sep-2021: Follow up contains changed patient initials, gender, route of administration and dose details.


VAERS ID: 1717992 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 - / OT

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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: administered past the 30 day refrigeration time; This spontaneous case was reported by an other health care professional and describes the occurrence of PRODUCT STORAGE ERROR (administered past the 30 day refrigeration time) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Aug-2021, the patient experienced PRODUCT STORAGE ERROR (administered past the 30 day refrigeration time). On 26-Aug-2021, PRODUCT STORAGE ERROR (administered past the 30 day refrigeration time) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Vaccine refrigerated on 20 Apr 2021 and temperature changes 42 F were noted. No concomitant medication was provided by the reporter. No treatment information was provided by the reporter.


VAERS ID: 1718251 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH C3184 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Dizziness, Dyspnoea, Headache, Hyperhidrosis, Muscle spasms, SARS-CoV-2 test, Swelling face, Toothache, Vision blurred, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: MONTELUKAST; FLUTICASONE; TYLENOL; VITAMINS NOS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Contrast media allergy (known allergies: CT contrast); Drug allergy (known allergies: Eye Drops); Ehlers-Danlos syndrome; Fruit allergy (known allergies: Bananas); Latex allergy (known allergies: Latex); Migraine
Allergies:
Diagnostic Lab Data: Test Date: 20210826; Test Name: Nasal Swab; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101117542

Write-up: Leg cramps; abdominal pain; shortness of breath; weak; vomiting; teeth pain; facial swelling; sweating uncontrollably; blurred vision; dizzy/lightheaded; Headache; This is a spontaneous report from a contactable consumer (patient). A 27-year-old non-pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: C3184, Expiration date: Not reported) via an unspecified route of administration in left arm on 26Aug2021 at 13:00 (at the age of 27-year-old) as single dose for COVID-19 immunization. Medical history of the patient included asthma, migraine, Hypermobile Ehlers Danlos Syndrome, allergy to latex, bananas, CT contrast, eye drops. Concomitant/other medications in two weeks: Montelukast, Fluticasone, Tylenol, Vitamins all taken for unspecified indication. Patient did not receive any other vaccine on the same date of suspect product or in four weeks of COVID vaccine. Patient did not have Covid prior vaccination. Patient previously took diphenhydramine hydrochloride (BENADRYL), NSAIDS, dextromethorphan hydrobromide doxylamine succinate ephedrine sulfate ethanol paracetamol (NYQUIL) on an unspecified dates and experienced allergy. On 26Aug2021, at 13:30, patient began feeling dizzy and had a sudden headache. By 17:00, patient was sweating uncontrollably and experiencing blurred vision. At 19:00 she felt lightheaded, leg cramps, severe abdominal pain, shortness of breath, weak, vomiting, teeth pain, and facial swelling. She tried taking Claritin, Tylenol, warm bath, ice packs, drinking lots of water, and resting with no relief. Adverse event resulted in: Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care]. Patient was tested for COVID post vaccination via nasal swab, covid test name post vaccination: PCR, covid test date: 26Aug2021, covid test result: Negative. Treatment included IV, Pepcid, Antihistamine, and Steroids. Outcome of the events were recovering. Follow-up attempts are completed. No further information is expected.; Sender''s Comments: Based on available information and the close drug event temporal association, a possible contributory role of suspect product BNT162B2 to the development of events dizziness, headache, hyperhidrosis, vision blurred, muscle spasms, abdominal pain, dyspnoea, asthenia, vomiting, toothache and swelling face cannot be totally excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1718314 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthropathy, Pain
SMQs:, Arthritis (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 INC202101191227

Write-up: I am experiencing aches and pains throughout my body; My joints are clicking; This is a spontaneous report from a contactable consumer or other non hcp (patient himself). A 45-years-old male patient received bnt162b2 (BNT162B2, Formulation: Solution for injection, Lot number: FE3181, Expiry date: Unknown, Age at vaccination: 45 years) via an unspecified route of administration, administered in Arm Left on 26Aug2021 as dose 1, singe for COVID-19 immunisation. The patient''s medical history and concomitant medications were none. The patient had no known allergies. The patient was not tested positive for COVID-19 prior to vaccination and had not been tested post vaccination. Patient did not receive any other vaccines within 4 weeks prior and other medications 2 weeks prior to the COVID vaccine. On 26Aug2021, the patinet stated that, immediately after receiving the vaccine and through today, I am experiencing aches and pains throughout my body. My joints are clicking. I never had this before. It is interfering with my routine and life. I did not want to take the vaccine. I did so because of a workplace mandate. I got a call from human resources. Tylenol and Aleve don''t help. I am concerned that the vaccine triggered an autoimmune reaction. No treatment taken for the events. The outcome of the events was unknown.


VAERS ID: 1718574 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-03-18
Onset:2021-08-26
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Echocardiogram, Electrocardiogram ambulatory, Heart rate increased, Heart rate irregular, Hypertension, Laboratory test, Palpitations, Urine analysis normal
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin 3mg-0.03 mg oral tablet, Fluticasone 50mcg, Multivitamin, Zyrtec, CBD sleep gummies (when needed)
Current Illness: None
Preexisting Conditions: NA
Allergies: Levofloxacin
Diagnostic Lab Data: Blood Panel, nothing of concern 26 Aug Urine Panel, nothing of concern 26 Aug Chest X-ray, nothing of concern 26 Aug Holter Monitor, no results, 05-15 Sep Echocardiogram, no results 16 Sep
CDC Split Type:

Write-up: I was working out months after my second dose and my heart rate spiked above 210 beats per minute and it felt as though my heart was incorrectly beating (palpitations), it took 30 minutes to somewhat stabilize, by the time I got to the hospital my blood pressure was high but all the other tests were inconclusive, so I was referred to a cardiologist for follow-up.


VAERS ID: 1718741 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-08-24
Onset:2021-08-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / IM

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

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

Write-up: Irregular heavy bleeding, clotting, and cramping for 19 days straight


VAERS ID: 1718775 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-03-16
Onset:2021-08-26
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Fatigue, SARS-CoV-2 test positive, Sinusitis
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: Treated for sinus infection on 8/13/2021. Fatigue, loss of taste and smell on 08/26/2021. Tested positive for Covid on 08/30/2021. Tested negative for Covid on 09/08/2021. Taste and smell had gradually returned. Fatigue continued for 10 days.


VAERS ID: 1718893 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-26
Onset:2021-08-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose increased, Pruritus, SARS-CoV-2 test negative, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl Jardiance 25mg (once daily) Novolog (3-6 injections daily)
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: Dilaudid
Diagnostic Lab Data: COVID test (negative0
CDC Split Type:

Write-up: Itching internally, vomiting for 3 days, blood sugar ran up between 48-400.


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