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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 395 out of 8,010

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VAERS ID: 1673457 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-01
Onset:2021-08-25
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: PCR; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101126884

Write-up: Fully vaccinated in Mar2021 and contracted COVID-19 in Aug2021. Acquired two PCR to rule out a false positive from PCR test #1.; Fully vaccinated in Mar2021 and contracted COVID-19 in Aug2021. Acquired two PCR to rule out a false positive from PCR test #1.; This is a spontaneous report from a contactable consumer (patient). A 60-year-old male patient received the second dose and first dose of BNT162B2, second dose via an unspecified route of administration in Mar2021, first dose via intramuscular on the left arm on 09Mar2021 at 10:00 AM (Lot Number: EL3247), both at the age of 60-year-old as single dose for COVID-19 immunization. Medical history was none. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had been tested for COVID-19. The patient didn''t received other vaccines within 4 weeks prior to the COVID vaccine. known allergies was none. Concomitant medication was not reported. On 25Aug2021 at 02:15 PM, the patient fully vaccinated in Mar2021 and contracted COVID-19 in Aug2021. Acquired two PCR to rule out a false positive from PCR test #1. COVID test (PCR, Nasal Swab) post vaccination on 25Aug2021 and result was positive. The events resulted in doctor or other healthcare professional office/clinic visit. No treatment was received. The outcome of events was recovering. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1674419 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Myalgia, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood cholesterol abnormal; Hypertension; Osteoarthritis (throughout her body)
Preexisting Conditions: Medical History/Concurrent Conditions: Migraine headache (She normally has headaches everyday, too); Muscle disorder (normally has muscle issues, just not in the arm, always in the back, legs, and knees and went to a pain management doctor for epidurals and treatments for the issue.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021893580

Write-up: maybe more tired than usual; muscle pain in the injection site area/ injection site is very sore; muscle pain in the injection site area/injection site is very sore/ injection site is very sore; The initial case was missing the following minimum criteria: no adverse event. Upon receipt of follow-up information on [26Aug2021], this case now contains all required information to be considered valid. This is a spontaneous report from a contactable consumer (patient) via medical information team. This consumer reported for two patients. This is the one of two reports. A 70-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; solution for injection, lot number, expiration date was not reported), via intramuscular route, in left arm, on 25Aug2021 (at the age of 70-years-old), at dose 2, single for covid-19 immunization. Medical history included normally had muscle issues like osteoarthritis throughout her body which is ongoing; she normally has muscle issues, just not in the arm, always in the back, legs, and knees and went to a pain management doctor for epidurals and treatments for the issue, ongoing hypertension, ongoing cholesterol issues and had headaches every day; she is a migraine sufferer but didn''t get any headaches at the day of report. The patient''s concomitant medications were not reported. Historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; solution for injection, lot number, expiration date was not reported), via an unspecified route, in left arm, on an unspecified date in 2021 (at the age of 70-years-old), at dose 1, single for covid-19 immunization. The patient experienced muscle pain in the injection site area/ injection site is very sore on 25Aug2021 and she maybe more tired than usual on 26Aug2021. The outcome of muscle pain in the injection site area was not recovered and outcome of the other event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101110251 same reporter/drug/events with different patient


VAERS ID: 1674583 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood potassium, Blood test normal, Computerised tomogram, Diarrhoea, Hypertension, Hypoaesthesia, Malaise, Muscle twitching, Paraesthesia, Peripheral swelling, Weight decreased
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), 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), Hypertension (narrow), Noninfectious diarrhoea (narrow), Sexual dysfunction (broad)

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

Write-up: I had tingling after two hours of the vaccination and it stayed up late for two days and then I took Claritin. a couple of days later I had muscle numbness and tingling again and twitchiness in my muscle and lost complete sensation from my arm to my finger. I went to the emergency room and they said i had a reaction to the shot. Few days later I contacted my doctor and they said it will do away because of the vaccination but I had diarrhea and continued for 7 days. My blood pressure was really high and for my blood work everything was normal except the potassium. The doctors sent me to neurologist and they said everything was clear. I am physically ill. I have lost a lot of weight. Sometimes my left hand is suddenly swollen.


VAERS ID: 1674759 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-01
Onset:2021-08-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dysstasia, Eye movement disorder, Gait disturbance, Impaired work ability, Loss of consciousness, Musculoskeletal disorder, Sleep disorder, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril hctz 20-12.5mg Aleve pm
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vomited next morning. I?m the afternoon - eyes rolled back in head & blacked out. Very weak and could not walk or stand for about 30 min. No movement in legs, legs would not work. Had to have help getting home and could not sleep. Was very weak for 3 days and missed one day of work and did not get paid. Extremely lightheaded and dizzy the next day


VAERS ID: 1674767 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-19
Onset:2021-08-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ultrasound scan, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultra sound, prescribed oral contraception to stop the bleeding
CDC Split Type:

Write-up: Extreme vaginal hemorrhaging


VAERS ID: 1674815 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Irritable bowel syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious diarrhoea (broad), Sexual dysfunction (broad)

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

Write-up: Had GBS in my 20?s since receiving the shot have had numbness and tingling in bilateral lower and upper extremities. Also had digestive irritation and head aches


VAERS ID: 1674820 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-09
Onset:2021-08-25
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Human chorionic gonadotropin, Progesterone decreased, Respiratory syncytial virus infection, Ultrasound antenatal screen abnormal
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow), Opportunistic infections (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal vitamins; progesterone suppository
Current Illness: food poisoning/stomach bug Aug 1-2, 2021; RSV (speculative) Aug 16-19, 2021
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: initial HCG and progesterone low 08/13/2021; miscarriage confirmed at ultrasound 08/27/2021
CDC Split Type:

Write-up: Miscarriage at 8 weeks pregnant (est. due date April 5, 2022)


VAERS ID: 1675025 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-01
Onset:2021-08-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial pain, Fatigue, Head discomfort, Headache, Neck pain
SMQs:, Glaucoma (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Debilitating, relentless full head pain. My head feels like it is in a vice and is being constantly and continuously sqeezed. My entire head hurts to include my face and neck. The pressure reminds me of a headache associated with a CFS leak. It hurts terribly. I have been taking Sudafed sinus, Tylenol, Ibuprofen and saline nasal spray. I am also putting heat pads on my neck, face and head for relief. I am reporting this because I am still in a great deal of discomfort. I typically do an hour of yoga a day, ride my bike for an hour and exercise 4-5 times a week. I eat a healthy plant based diet. I would say I am in the best shape of my life. I have not been able to exercise since the vaccine. I have also been very tired.


VAERS ID: 1675324 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram normal
SMQs:, Anaphylactic reaction (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: Lipitor, Amlodipine Besylate,Lisinopril, Advil, multivitamin, Fish oil
Current Illness: None
Preexisting Conditions: High blood pressure, severe spinal issues, herniated disc some severe,Arthritis
Allergies: Penicillin
Diagnostic Lab Data: On September 1, 2021 I was able to get into my primary doctors office Dr. after examining me he had a EKG performed on me and said that it came out normal and referred me to the cardiology department to try to have a stress test done before the second injection scheduled for September 15
CDC Split Type:

Write-up: About five hours after having the injection my chest felt very tight so I took my blood pressure at home my first reading was 187/98 heart rate 69 I continue to drink as much water as I could try to flush the stuff out of me as instructed my blood pressure readings stayed relatively high for the next three hours settling down to 161/78 heart rate 62 bpm during this period I took another dose of my blood pressure medicine two pills one of me that is listed in my medication


VAERS ID: 1675364 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Chest discomfort, Pain
SMQs:, Anaphylactic reaction (broad), Lipodystrophy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosuvastatin, Synthroid., Multivitamin
Current Illness: none
Preexisting Conditions: none
Allergies: Macrodantin
Diagnostic Lab Data: Echocardiogram and stress test ordered
CDC Split Type:

Write-up: left axilla pain radiating to left breast and into right breast, chest heaviness


VAERS ID: 1675659 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-08-21
Onset:2021-08-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Contusion, Pain, Pain in extremity, Sciatica
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Accidents and injuries (narrow), 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: Setraline, Armour Thyroid, Magnesium, B-12, lisinolpril, metformin, Atorvastatin
Current Illness: N/A
Preexisting Conditions: Polycystic Ovarian Syndrome (PCOS), hypothyroidism, depression, high blood pressure, high cholesterol, diverticulitus
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bruising from normal everyday activities. Left side sciatic pain radiating from lower back to lower leg. Sore joints in left hand, left knee pain.


VAERS ID: 1675718 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose increased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood glucose 511 on 8/25/2021
CDC Split Type:

Write-up: Extremely high blood glucose, prescribed Metformin to hopefully get BG under control


VAERS ID: 1675832 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-08-17
Onset:2021-08-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Computerised tomogram abdomen, Hypoaesthesia, Magnetic resonance imaging, Magnetic resonance imaging head, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Cough for 6 weeks prior. Nasal congestion for 2 weeks prior.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: MRIs from brain to lower back. CT of torso
CDC Split Type:

Write-up: Numbness and parathesias in extreme tues. Extreme pain in lower back.


VAERS ID: 1675844 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mouth swelling, Rash, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Rash, hives, and swelling of both tongue and mouth started approximately 3 days after receiving vaccine. Patient admitted at the hospital and now doing better


VAERS ID: 1675858 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Feeling abnormal, Headache, Rhinovirus infection, SARS-CoV-2 test negative, Vision blurred
SMQs:, Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Multi-vitamin & buspirone
Current Illness: rhino virus 3+ days after vaccination
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: tested negative for covid day 3 after vaccine
CDC Split Type:

Write-up: - loss of taste and smell *days 3-15 following vaccine - blurred vision in right eye & difficulty focusing - headache - out of body / spacey sensation


VAERS ID: 1676262 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-09
Onset:2021-08-25
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #EW0187 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Metabolic function test, Red blood cell sedimentation rate normal
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi Vitamin, Vitamin D, Iodine, Co Q10, Omega 3 oil, Melatonin.
Current Illness: None
Preexisting Conditions: Active Epstein-Barr Virus, Chronic Fatigue, Asthma.
Allergies: Penicillin, Codeine
Diagnostic Lab Data: Blood tests: Basis Metabolic Panel and Sedimentation Rate (ESR) - All normal results. Ordered MRI and MRA scheduled for 9/29/2021
CDC Split Type:

Write-up: Intense pain beginning 9/25 on Right side of head above ear, lasting 10 seconds. Then again beginning at 5:00 am on 9/27 repeating every 30 to 60 seconds, continuing for 50 hrs., stopped on 9/28 at 10:00 pm. Stopped for 9 days, then began again on 9/6/21 at 3:00pm.


VAERS ID: 1677260 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / UNK RA / 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 received a dose of the vaccine from an expired vial; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (patient received a dose of the vaccine from an expired vial) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (patient received a dose of the vaccine from an expired vial). On 25-Aug-2021, EXPIRED PRODUCT ADMINISTERED (patient received a dose of the vaccine from an expired vial) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment medications were provided. Date the vial was initially stored in the refrigerator: 3 days ago. The vial was initially stored in the refrigerator 3 days ago and it did not undergo any temperature excursion. The vial was removed from the refrigerator and carried to the facility in refrigerated cooler where the patients are home bound.


VAERS ID: 1677527 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary mass
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101110087

Write-up: lump under my armpit; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: Unknown), via an unspecified route of administration on 23Aug2021 as dose 2, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. Historical vaccine included first dose of BNT162B2, lot number unknown, via an unspecified route of administration on an unspecified date, as single dose for COVID-19 immunization. It was reported that patient received the second shot, and 2 days after, on 25Aug2021, morning, patient woke up with lump under the armpit and patient was unsure if that was the possible side effect. No treatment was given in response to the event. The outcome of the event was unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1677531 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-08-25
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Covid test; Result Unstructured Data: Test Result: Positive.
CDC Split Type: USPFIZER INC202101116581

Write-up: Patient tested positive following full COVID-19 vaccination.; Patient tested positive following full COVID-19 vaccination.; This is a spontaneous report from a non-contactable other HCP. A 52-year-old female patient received bnt162b2 (BNT162B2, Formulation; Solution for Injection), dose 1 via an unspecified route of administration on 11Mar2021 (Batch/Lot Number: EL3248) as DOSE 1, SINGLE, dose 2 via an unspecified route of administration on 30Mar2021 (Batch/Lot Number: EL3248) as DOSE 2, SINGLE (at the age of 52-year-old) for COVID-19 immunisation. It was unknown if patient was pregnant at time of vaccination. The patient medical history and concomitant medications were not reported. It was unknown if patient had COVID prior vaccination. It was unknown if the patient receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. The patient tested positive following full COVID-19 vaccination on 25Aug2021 (COVID test positive). It was unknown if patient received treatment or not. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1677561 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3282 / 1 - / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait inability, Pain in extremity, Thrombosis
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TESTOSTERONE CYPIONATE
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None, Comment: Other medical history: No
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101128065

Write-up: He was unable to walk; Blood clot in his leg; His calf hurt; This is a spontaneous report from a contactable other health care professional. A 60-year-old male patient received BNT162B2(PFIZER-BIONTECH COVID-19 MRNA VACCINE, Lot Number: FC3282), via intramuscular route, administered in Arm Left on 25Aug2021 (at the age of 60-years-old) as dose 1, single for covid-19 immunization. Patient had no medical history. Concomitant medication included testosterone cipionate (TESTOSTERONE CYPIONATE). Prior to vaccination, not diagnosed with COVID-19, did not receive any other vaccines within 4 weeks. Since the vaccination, has the patient has not been tested for COVID-19. Patient had received other medication (testosterone cipionate) within 2 weeks of vaccination. Patients calf was hurt after the COVID-19 vaccine on 25Aug2021, the pain got worse and on 31Aug2021 morning and he was unable to walk. Since patient was unable to reach the pharmacist through phone, he had ended up going to the Urgent Care and was prescribed Eliquis for a blood clot in his leg. The outcome of the events was recovering. No follow-up attempts are needed. No further information is expected.; Sender''s Comments: Based on known drug safety profile, there is reasonable possibility of causal association between the event Thrombosis and BNT162B2. 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: 1677603 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Extra dose administered, Odynophagia, Off label use, Pharyngeal swelling, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210830; Test Name: RT PCR; Test Result: Negative ; Comments: SARS-COV-2 RNA, QL Nasal Swab test type
CDC Split Type: USPFIZER INC202101144634

Write-up: The left side of throat became so swollen that it became extremely difficult and painful to swallow; The left side of throat became so swollen that it became extremely difficult and painful to swallow; Dose number 3; Dose number 3; Left side of throat began to swell; This is a spontaneous report from a contactable consumer, the patient. A 74-year-old non-pregnant female patient received the third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Lot Number: FC3180) via an unspecified route of administration in the right arm on 24Aug2021 at 10:00 (at the age of 74-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported. Concomitant medications included ibuprofen (MANUFACTURER UNKNOWN); taken for an unknown indication on an unknown date and unknown if ongoing. The patient previously took acetylsalicylic acid (ASPIRIN) and experienced drug allergy. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 25Aug2021 at 21:00 the patient experienced left side of throat began to swell. On the morning of 26Aug2021, left side of throat was so swollen that it became extremely difficult and painful to swallow. The event resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of events and included treatment with Amoxicillin. Since the vaccination, the patient had been tested for COVID-19. On 30Aug2021, the patient underwent lab test and procedures which included RT PCR (SARS-COV-2 RNA, QL) test and the result was negative. The clinical outcome of the event left side of throat began to swell and left side of throat was so swollen that it became extremely difficult and painful to swallow were recovered on unspecified date in 2021. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1678151 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Missouri  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 - / OT

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

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

Write-up: Missed second dose, 6 months after first dose; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Missed second dose, 6 months after first dose) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. In 2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Missed second dose, 6 months after first dose). On 25-Aug-2021, PRODUCT DOSE OMISSION ISSUE (Missed second dose, 6 months after first dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The patient received the first dose of Moderna COVID-19 vaccine 6 months ago. Relevant concomitant medications were not provided by the reporter. Treatment medication was not reported.


VAERS ID: 1678160 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-13
Onset:2021-08-25
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: has diffuse pruritus on both arms and one leg; local itching pruritus at the injection site; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 26-Aug-2021 and was forwarded to Moderna on 26-Aug-2021. This spontaneous case was reported by a physician and describes the occurrence of PRURITUS (has diffuse pruritus on both arms and one leg) and VACCINATION SITE PRURITUS (local itching pruritus at the injection site) in a 93-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Hypertension and Hypercholesteraemia. On 13-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 22-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced VACCINATION SITE PRURITUS (local itching pruritus at the injection site). On 26-Aug-2021, the patient experienced PRURITUS (has diffuse pruritus on both arms and one leg). At the time of the report, PRURITUS (has diffuse pruritus on both arms and one leg) and VACCINATION SITE PRURITUS (local itching pruritus at the injection site) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient reported anti-hypertensive medications as concomitant medication. other treatment medication Claritin 10 mg orally for unknown indication.


VAERS ID: 1678264 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 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: Vaccine administered from a vial that has possibly been punctured for 48 hours.; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Vaccine administered from a vial that has possibly been punctured for 48 hours.) in a 50-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017E21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021 at 9:40 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Vaccine administered from a vial that has possibly been punctured for 48 hours.). On 25-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Vaccine administered from a vial that has possibly been punctured for 48 hours.) 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 medication information was reported. No treatment medications were reported. The patient given dose was punctured before 96 hours of administration. Most recent FOLLOW-UP information incorporated above includes: On 29-Aug-2021: Follow-up received added Patient demographics, updated event outcome.


VAERS ID: 1678269 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-15
Onset:2021-08-25
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetic; Hepatitis B
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Viral load Hep B; Result Unstructured Data: High Viral load Hep B
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Missed second shot more than 42 days after first shot; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Missed second shot more than 42 days after first shot) in a 5-week-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Diabetic and Hepatitis B. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Missed second shot more than 42 days after first shot). On 25-Aug-2021, PRODUCT DOSE OMISSION ISSUE (Missed second shot more than 42 days after first shot) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Viral load: high (High) High Viral load Hep B. Concomitant drug was not reported. Patient had no side effects. She did not have a ride and she missed the second dose appointment. She was thinking about getting the second shot now. Treatment medication was not reported.


VAERS ID: 1678270 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / OT

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

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

Write-up: red rash going into his armpit; red patch; This spontaneous case was reported by a consumer and describes the occurrence of RASH ERYTHEMATOUS (red rash going into his armpit) and RASH MACULAR (red patch) in a 32-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036C21A) 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) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced RASH ERYTHEMATOUS (red rash going into his armpit) and RASH MACULAR (red patch). At the time of the report, RASH ERYTHEMATOUS (red rash going into his armpit) and RASH MACULAR (red patch) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported No treatment medications were reported. Symptoms: It was reported that the patient had experienced a red line which was going into his armpit.


VAERS ID: 1678273 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: feels nauseous; has a headache; is fatigued; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (feels nauseous), HEADACHE (has a headache) and FATIGUE (is fatigued) in a 20-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Seizures. On 23-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced NAUSEA (feels nauseous), HEADACHE (has a headache) and FATIGUE (is fatigued). At the time of the report, NAUSEA (feels nauseous), HEADACHE (has a headache) and FATIGUE (is fatigued) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported by the reporter. No treatment was reported by the reporter.


VAERS ID: 1678282 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, SARS-CoV-1 test, Vaccination site pain
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: COVID test; Test Result: Negative ; Result Unstructured Data: Negative
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (experiencing shortness of breath, somewhat manageable,shortness of breath got worse, it was really tough at work,feels like she has to take really deep breaths.) and VACCINATION SITE PAIN (pain in the arm where she received injection, but that pain has subsided) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination.No Medical History information was reported. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced DYSPNOEA (experiencing shortness of breath, somewhat manageable,shortness of breath got worse, it was really tough at work,feels like she has to take really deep breaths.). On an unknown date, the patient experienced VACCINATION SITE PAIN (pain in the arm where she received injection, but that pain has subsided). At the time of the report, DYSPNOEA (experiencing shortness of breath, somewhat manageable,shortness of breath got worse, it was really tough at work,feels like she has to take really deep breaths.) had not resolved and VACCINATION SITE PAIN (pain in the arm where she received injection, but that pain has subsided) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available):On an unknown date, SARS-CoV-1 test: negative (Negative) Negative.The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concurrent and treatment medication was reported by patient.Patient reported that shortness of breath got worse on 26 Aug 2021. Patient also mentioned that her kids have asthma and she wants to go home and use their asthma nebulizer.


VAERS ID: 1678305 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

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

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

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


VAERS ID: 1678656 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site swelling, Rash, Rash erythematous, Rash pruritic, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I developed an itchy rash which felt hot and was swollen to the touch. The rash persisted for two weeks. At times it seemed the rash was receding, but about a week after receiving the vaccine, the injection site became swollen and raised again, and began spreading on my arm. It was very noticeably red, extremely itchy. Now, about a full two weeks after receiving the vaccination, it seems to have subsided.


VAERS ID: 1678687 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-08-25
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: C-reactive protein increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chills, Dyspnoea, Lung opacity, Malaise, Oxygen saturation decreased, SARS-CoV-2 test positive, Serum ferritin increased, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 51 yr old male with a PMHx significant for HTN, HLD, and bilateral uveitis who presented to ED after testing positive for COVID19 with worsening symptoms of chills, malaise, and shortness of breath. Patient states he tested positive for COVID 14 days ago. He continue to experience worsening symptoms so he called his PCP on 08/19 and was prescribed methylprednisone and a zpack. Pt states he took it for 2 days however his symptoms persisted so pt presented to the ED at another hospital system/ on 08/22 where a chest xray showed COVID19 pneumonia. Pt was prescribed Pulmicort and scheduled for convalescent plasma on 02/25. He was not admitted as he was noted to have a sat of 99% and was tolerating room air at the time. He presented to receive his convalescent plasma today. Patient states during his treatment he continued to be short of breath and his O2 sats dropped to the 90s. Patient was brought to the ED via EMS. On admission he was found to an elevated CRP and ferritin. His white count was stable and he was afebrile. His chest x-ray showed bibasilar patchy airspace opacities favoring infectious etiology. Patient states he was vaccinated with Johnson & Johnson on 03/2121. Patient is currently being admitted for further care.


VAERS ID: 1678699 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-03-04
Onset:2021-08-25
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / N/A RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Dyspnoea, Gait disturbance, Malaise, Oxygen saturation decreased, Pain, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin; omeprazole; rosuvastatin; Ramipril; farxiga; Trulicity; Toujeo; over counter allergy pill
Current Illness:
Preexisting Conditions: Type 2 diabetes
Allergies:
Diagnostic Lab Data: Covid test positive
CDC Split Type: vsafe

Write-up: On July 20th about lunch time I started with a fever chills, aches and I had her take me to urgent care I took a rapid test it was negative. I continued to have a fever that move 101-103. I took medication to lower my fever it never went away. On Sunday 25th I didn''t have a fever I still didn''t feel well. On Monday the 26th I was going to go to work, I started vomiting uncontrollably and I rode in ambulance. I could not breathe or walk, I was so weak. They tested me again test came back positive for Covid. I did the monoclonal infusion. I was in low 80s for my oxygen and they gave me supplemental oxygen which brought it up to high 80s and low 90s. They did not have a bed said someone would have to die or go home they called near by hospital. No beds available so they sent me home with supplemental oxygen and monitored my oxygen that was set up to my smart home. I''m still really weak and fatigued, exhausted and shortness of breath. I''m getting better just really slow.


VAERS ID: 1678703 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: Parasthesia to right foot and left hand. Also sharp Intermittent pain in right side of temple.


VAERS ID: 1678756 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

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

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

Write-up: Pt. states that after receiving the 1st dose of J&J 08/25/2021, started experiencing symptoms immediately of arm swelling, itching, and pain with welps. Primary Contact TeleHealth (08/25/2021) prescribed Hydrochlorothiazide. Primary visit scheduled @ 02:45pm. Continuing to experience symptoms.


VAERS ID: 1678893 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-20
Onset:2021-08-25
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK - / IM

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

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

Write-up: Hospitalized for COVID illness


VAERS ID: 1678926 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Lymph node pain, Lymphadenopathy, Musculoskeletal stiffness, Neck pain, Pain in extremity
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: local injection site pain, temporary, annual flu vaccine and periodic boosters (tetanus)
Other Medications: Birth control pills Zolpidem 12.5 mg Venlafaxine 75 mg
Current Illness: Pneumonia/lower respiratory infection (2 negative and 1 positive Covid test within one week of diagnosis)
Preexisting Conditions: Insomnia, irritable bowel syndrome
Allergies: Codeine
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Swollen lymph nodes and tenderness on left side, starting within 24 hours and persisting for 14 days (and counting) after vaccination. Not resolved Pain and stiffness in left arm, shoulder and neck starting after vaccination and persisting for 14 days after vaccination. Not resolved Headaches, temporarily resolved by OTC treatment (Advil, Tylenol) but recurring.


VAERS ID: 1678933 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Condition aggravated, Diarrhoea, Lymph node pain, Nausea, Pain in extremity, Paraesthesia, Paraesthesia oral, Pharyngeal paraesthesia, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer vaccine on 05/05/2021 - I developed pneumonia. I had swelling, discoloration, and pain in my left leg. I also developed a
Other Medications: Pepcid AC
Current Illness: N/A
Preexisting Conditions: I''ve been anemic since May 2021 after taking the first Pfizer vaccine. I developed pneumonia on May 2021.
Allergies: Sulfa drugs; Penicillin; Cipro; Macrobid; PEG; Miralax
Diagnostic Lab Data: N/A
CDC Split Type: vsafe

Write-up: Tingling in my throat and tongue, Nausea, Diarrhea, Hives, My whole body was tingling and itchy, Pain in my left leg Lymph nodes under both armpits.


VAERS ID: 1679017 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-25
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A216A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anion gap, Ataxia, Blood bilirubin increased, Blood calcium normal, Blood chloride normal, Blood creatine phosphokinase normal, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium decreased, Blood urea normal, C-reactive protein decreased, CSF glucose increased, CSF monocyte count increased, CSF protein increased, CSF white blood cell count increased, Carbon dioxide decreased, Carbon dioxide normal, Computerised tomogram spine, Differential white blood cell count, Electromyogram abnormal, Facet joint syndrome, Full blood count, Gait disturbance, Glomerular filtration rate decreased, Glycosylated haemoglobin increased, Guillain-Barre syndrome, Haematocrit normal, Haemoglobin normal, Hypoaesthesia, Hypoaesthesia oral, Immunoglobulin therapy, Impaired work ability, International normalised ratio normal, Intervertebral disc compression, Intervertebral disc protrusion, Malaise, Mean cell haemoglobin concentration normal, Mean cell haemoglobin decreased, Mean cell haemoglobin increased, Mean cell volume normal, Metabolic function test, Nerve conduction studies abnormal, Neutrophil count normal, Pain in extremity, Peroneal nerve palsy, Platelet count normal, Poor quality sleep, Prothrombin time prolonged, Red blood cell count decreased, Red blood cell sedimentation rate normal, Sleep disorder, Ultrasound Doppler normal, Vertebral foraminal stenosis, Walking aid user, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Acute pancreatitis (broad), Haematopoietic erythropenia (narrow), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Biliary system related investigations, signs and symptoms (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Hyponatraemia/SIADH (narrow), Demyelination (narrow), Depression (excl suicide and self injury) (broad), Chronic kidney disease (broad), Arthritis (narrow), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin C, D, and zinc Amlodipine 10 mg daily Aspirin 81 mg daily Atorvastatin 40 mg daily
Current Illness: None
Preexisting Conditions: High blood cholesterol High blood pressure Benign prostatic hyperplasia
Allergies: Demerol - reaction is hiccups
Diagnostic Lab Data: August 28th - POC Basic Metabolic Panel - glomerular filtration rate $g60, calcium 9.6, chloride 105, creatinine 0.8, blood glucose 84, potassium 4.1, sodium 143, total carbon dioxide 28, BUN 18 POC Complete Blood Count - white blood cell count 7.1, red blood cell 4.66, hemoglobin 14.9, hematocrit 42, MCV 90.1, MCH 8.7, MCHC 35.5, platelet 233, neutrophil 56.1 Bilateral US doppler venous lower extremities - No ultrasound evidence for DVT in either lower extremity August 30th - C-reactive protein - <0.3 Complete blood count (CBC) with differential - WBC 7.7, RBC 4.85, hemoglobin 15.1, hematocrit 44, MCV 90.7, MCH 31.1, MCHC 34.3, platelet count 237, Comprehensive metabolic panel (CMP) - Glucose 147, sodium 135, potassium 3.5, chloride 105, carbon dioxide 23, anion gap 7, BUN 13, creatinine 0.95, calcium 9.3, total bilirubin 1.1 Creatinine kinase - 155 Sedimentation rate (ESR) - 5 CT lumbar spine without contrast - 5 mm left subarticular disc protrusion L5-S1 with left lateral recess compression, bilateral facet arthropathy with severe bilateral foraminal stenosis L5-S1, facet arthropathy with severe right recess and moderately severe right foraminal stenosis L4-5 September 3rd - EMG/ NCS of RUE and BLE consistent with Gullain-Barre syndrome September 5th - Immune globulin (human) IGG first dose at 11 pm CBC - WBC 12.87, HGB 16, HCT 46.6, platelet 235 INR - 1.05, PT 13.5 CMP - sodium 138, potassium 4.3, chloride 102, CO2 19.4, Agap 17, glucose 164, BUN 18, creatinine 0.92, calcium 9.8, A1C 6.6 September 6th - Immune globulin (human) IGG second dose at 2137 Cerebrospinal fluid - CSF WBC 10, CSF monocyte 46, CSF protein 289.9, CSF glucose 106
CDC Split Type:

Write-up: August 11th - J&J covid vaccine August 25th - not feeling well late evening better next morning, bilateral legs hurt, slight numbness in arms, legs and lips August 26th - not feeling well again late evening, bilateral legs hurt more than on the 25th, numbness in arms, legs and lips. Took 3 Tylenol for pain to sleep August 27th - continue symptoms from the prior day August 28th - bilateral leg pain sufficient not to be able to sleep. Went to Emergency room. Doctor ran blood test and ultrasound of bilateral legs. Doctor stated no acute reason for bilateral leg pain August 29th - felt fair, still have pain and numbness in bilateral legs and arms August 30th - Called in sick at work. Went to another ER and took Emergency room blood test records. ER doctor performed lower back CT scan, prescribed steroid pills, tramadol, and steroid injection August 31st - Went to spine doctor, discussed treatments including physical therapy and steroid injection, felt fair, unable to sleep due to continue bilateral leg numbness and pain September 1st - Went to another ER - ER doctor reviewed medical records, prescribed muscle relaxant Flexeril - medication did not help and did not sleep well September 2nd - went to Medical Center and discussed treatment, had minor back adjustment, started taking steroid pills September 3rd - Went to Neurologist - saw Dr. and was diagnosed with Guillain-Barre and treatment to follow with findings of impaired walking and left foot drop and ataxia September 4th - could walk with difficulty September 5th - went to assigned hospital per Dr. since not able to walk by myself - received first dose of IVIG at 11 pm - plan for IVIG treatment for total of 5 days September 6th - walking with walker and second round of IVIG at 2137


VAERS ID: 1679063 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Neuralgia, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lyrica 75mg Lunesta3 mg Metformin 500 mg
Current Illness: None
Preexisting Conditions: Degenerative spine issues
Allergies: Nuts,bees,morphine ,some penicillin strains
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Tingling nerve pain in cranium,face,neck,and left arm every day since third dose


VAERS ID: 1679176 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-07
Onset:2021-08-25
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Atrioventricular block
SMQs:, Conduction defects (narrow)

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

Write-up: Patient was admitted to the hospital for atrioventricular block


VAERS ID: 1679235 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test abnormal, Chills, Condition aggravated, Decreased appetite, Extra dose administered, Headache, Influenza like illness, Nausea, Oropharyngeal pain, Pain, Platelet count decreased, Tremor
SMQs:, Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Local reaction to my arm Flu shot; Shingles shot; COVID shots; Pneumonia
Other Medications: Allegra; Amlodipine; Asmanex; Azelastine HCI nasal solution; Baclofen; Bystolic; Dexilant; Diclofenac Sodium (Voltaren); Diflunisal; Domperidone; Doxazosin; Elmiron; Estradiol; Fenofibrate; Linzess; Losartan; Triamterene; Rizatriptan; Ondan
Current Illness: Had had a little bit lower platelets. Other than that I hadn''t been sick.
Preexisting Conditions: Hypertension; Occipital Neuritis; CLL Leukemia; ITP for the last couple of years (under a hematologist''s care); Chronic back pains; IC; Gastro Paresis; (back surgery but not with rods); Tonsillitis - as teenager.
Allergies: Penicillin; Terramycin; Sulfa; Diflucan; Monistat; Terazol 7; Benzalkonium; Levaquin; and then about 10 other drugs I have had reactions to: Verapamil; Demerol; Heparin; Amitriptyline; Tedanizide; Minoxidil; Diovan; Clonidine; Zestril; Hydralazine; Carvedilol; Metoprolol
Diagnostic Lab Data: bloodwork - Oncologist ordered it - laboratory
CDC Split Type: vsafe

Write-up: I started with the chills at about 11 that night. I shook forever trying to pile covers on. Probably about 3 or 4 hours later, I felt better. I think I had taken Tylenol and that did stop the shakes. I took my temp later and it got to 100 later. I started like I had the flu: body aches; I had almost all the symptoms - sore throat and I still have sore throat really. It sorts of got better and then it came back. I got a COVID test. I had a lot of headaches. Terrible headaches - the Tylenol reduced the fever and in between I took the Rizatriptan and the Ondansetron for nausea. I didn''t eat anything but broths and liquids. By Friday, I felt a little better. I took Tylenol in the morning and at 12:00, I got my weekly bloodwork done for Leukemia - (two days after the shot - 12:00 PM on 8/27/2021). My platelets had dropped to 17 - they kept re-testing it to confirm that. I saw the doctor the next day. Last Wednesday, is when my sore throat came back. This was very similar to how I reacted after the 2nd Moderna vaccine. I also got a painful shoulder for a few days - very sore. In three days, that shoulder pain was gone. It was added pain to where I do have shoulder pain at times. I was put on mega Prednisone for the low platelets. It started with 80 mg - was give that on the 29th and then I went to 60 mg (the next day) - (by this day the platelets jumped up to 70) and then the next day went to 40 mg for a week. And then my platelets were good - (tested last Thursday - they were 229) so now I am on 20 mg for a week. I will continue to taper the Prednisone. I don''t know why I have the sore throat. I don''t go anywhere except for a walk very early in the morning.


VAERS ID: 1679317 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache
SMQs:

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

Write-up: Reports headaches in the daily in the afternoon. Reports oral pain relief medication helps the headache, but it comes back again the next day. Has had the headaches since he received the vaccine all except for "maybe 1 day". Reports headache pain 8/10 on a 0-10 scale. Notified PCP.


VAERS ID: 1679968 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Shellfish
Diagnostic Lab Data: No tests. First suspected to be shingles then it appeared on both sides of body the next day and encompassed upper body in addition to the right calf were it originated.
CDC Split Type:

Write-up: Rash on legs and trunk approximately 4 days after second dose


VAERS ID: 1681447 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Balance disorder, Loss of consciousness, Somnolence, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: USJNJFOC20210905676

Write-up: PASSED OUT AT HIS DESK; UNRESPONSIVE WHEN CONSUMER SPOKE TO HIM; EXTREMELY DROWSY; UNSTEADY FOR COUPLE MORE HOURS; This spontaneous report received from a consumer via social media via a company representative concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: not reported) dose was not reported, 1 total, administered on 25-AUG-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 25-AUG-2021, the patient was passed out at his desk and was unresponsive when consumer spoke to him. Consumer was trying to shook patient awake but patient was extremely drowsy and unsteady for a couple more hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the passed out at his desk, unresponsive when consumer spoke to him, extremely drowsy and unsteady for couple more hours was not reported. This report was serious (Other Medically Important Condition). This case, involving the same patient is linked to 20210855820.; Sender''s Comments: V0: 20210905676-COVID-19 VACCINE AD26.COV2.S-passed out at his desk, unresponsive when consumer spoke to him. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1681616 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dyspnoea, Heart rate
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: No medical history reported
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Heart beat; Result Unstructured Data: Fast
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Dizziness; Weakness; Trouble breathing; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), ASTHENIA (Weakness) and DYSPNOEA (Trouble breathing) in a 57-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history reported. On 24-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced DIZZINESS (Dizziness), ASTHENIA (Weakness) and DYSPNOEA (Trouble breathing). At the time of the report, DIZZINESS (Dizziness), ASTHENIA (Weakness) and DYSPNOEA (Trouble breathing) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 25-Aug-2021, Heart rate: fast (High) Fast. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient takes psychiatric medication. No treatment drug details was reported.


VAERS ID: 1681618 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 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? 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: patient received a dose of the vaccine from an expired vial; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (patient received a dose of the vaccine from an expired vial) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (patient received a dose of the vaccine from an expired vial). At the time of the report, EXPIRED PRODUCT ADMINISTERED (patient received a dose of the vaccine from an expired vial) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication was not provided. Treatment information was not provided.


VAERS ID: 1681630 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Overdose
SMQs:, Drug abuse and dependence (broad), Medication errors (broad)

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

Write-up: second dose they administered a 1mL dose and not the recommended 0.5mL dose; This spontaneous case was reported by a pharmacist and describes the occurrence of OVERDOSE (second dose they administered a 1mL dose and not the recommended 0.5mL dose) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 milliliter. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced OVERDOSE (second dose they administered a 1mL dose and not the recommended 0.5mL dose). At the time of the report, OVERDOSE (second dose they administered a 1mL dose and not the recommended 0.5mL dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication was not provided. Treatment information was not provided.


VAERS ID: 1681641 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-02-26
Onset:2021-08-25
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001A21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Incorrect route of product administration
SMQs:, Drug abuse and dependence (broad), 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: LAMICTAL; OXCARBAZEPINE; GABAPENTIN; QUETIAPINE; HYDROCHLOROTHIAZIDE; OMEPRAZOLE; NALTREXONE [NALTREXONE HYDROCHLORIDE]; PROBIOTICS [BIFIDOBACTERIUM LONGUM;LACTOBACILLUS ACIDOPHILUS;LACTOBACILLUS RHAMNOSUS]; LYSINE; D3; MELATONIN; NATTOKINA
Current Illness: Immunodeficiency
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: 3rd dose subcutaneous; Inappropriate scheduled of vaccine administered; This spontaneous case was reported by a consumer and describes the occurrence of INCORRECT ROUTE OF PRODUCT ADMINISTRATION (3rd dose subcutaneous) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate scheduled of vaccine administered) in a 44-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 052E21A, 001A21A and 201B21A) for COVID-19 vaccination. Concurrent medical conditions included Immunodeficiency. Concomitant products included LAMOTRIGINE (LAMICTAL), OXCARBAZEPINE, GABAPENTIN, QUETIAPINE, HYDROCHLOROTHIAZIDE, OMEPRAZOLE, NALTREXONE HYDROCHLORIDE (NALTREXONE [NALTREXONE HYDROCHLORIDE]), BIFIDOBACTERIUM LONGUM, LACTOBACILLUS ACIDOPHILUS, LACTOBACILLUS RHAMNOSUS (PROBIOTICS [BIFIDOBACTERIUM LONGUM;LACTOBACILLUS ACIDOPHILUS;LACTOBACILLUS RHAMNOSUS]), LYSINE, COLECALCIFEROL (D3), MELATONIN, NATTOKINASE, RESVERATROL, GLYCERINE MONOLAURATE, INOSINE (MONOLAURIN [GLYCERINE MONOLAURATE;INOSINE]), FISH OIL, ASCORBIC ACID (VIT C), LEVETIRACETAM (LEVRA) and IMMUNOGLOBULIN G HUMAN (IGG) for an unknown indication. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 25-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Subcutaneous) dosage was changed to 1 dosage form. On 25-Aug-2021, the patient experienced INCORRECT ROUTE OF PRODUCT ADMINISTRATION (3rd dose subcutaneous). 25-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate scheduled of vaccine administered). On 25-Aug-2021, INCORRECT ROUTE OF PRODUCT ADMINISTRATION (3rd dose subcutaneous) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate scheduled of vaccine administered) had resolved. Caller states that Patient is immunodeficient. She also stated that she got a sore arm with the1st dose and with the 2nd she got fever. Concomitant medications also included Sertiamen along with above mentioned medications. No treatment details were reported. This case was linked to MOD-2021-296521, MOD-2021-296516 (Patient Link).


VAERS ID: 1681645 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-28
Onset:2021-08-25
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 RA / OT
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products, Vaccination site pain
SMQs:, Medication errors (broad)

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

Write-up: Sore arm; 1st dose Pfizer- 2nd dose Moderna; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Sore arm) and INTERCHANGE OF VACCINE PRODUCTS (1st dose Pfizer- 2nd dose Moderna) in a 23-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 005C21A) for COVID-19 vaccination. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) injection for COVID-19 vaccination. Concurrent medical conditions included Autism. On 28-Jul-2021, the patient started TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 25-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced INTERCHANGE OF VACCINE PRODUCTS (1st dose Pfizer- 2nd dose Moderna). On 26-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced VACCINATION SITE PAIN (Sore arm). On 25-Aug-2021, INTERCHANGE OF VACCINE PRODUCTS (1st dose Pfizer- 2nd dose Moderna) had resolved. At the time of the report, VACCINATION SITE PAIN (Sore arm) outcome was unknown. No concomitant medications reported. No treatment information was provided.


VAERS ID: 1681672 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-26
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SPIRONOLACTONE; ALPRAZOLAM; CARVEDILOL; AMLODIPINE; ROSUVASTATIN
Current Illness: Anxiety; Blood pressure; Hypercholesteremia; Insomnia; Osteoarthritis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Dose administered greater than 12 hours after initial vial puncture; Vial was not stored in refrigerator and administered to patient; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose administered greater than 12 hours after initial vial puncture) and PRODUCT STORAGE ERROR (Vial was not stored in refrigerator and administered to patient) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036B21A) for COVID-19 vaccination. Concurrent medical conditions included Hypercholesteremia, Osteoarthritis, Anxiety, Blood pressure and Insomnia. Concomitant products included SPIRONOLACTONE, CARVEDILOL and AMLODIPINE for Blood pressure, ROSUVASTATIN for Cholesterol high, ALPRAZOLAM for Insomnia. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced PRODUCT STORAGE ERROR (Vial was not stored in refrigerator and administered to patient). On 26-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose administered greater than 12 hours after initial vial puncture). On 26-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Dose administered greater than 12 hours after initial vial puncture) and PRODUCT STORAGE ERROR (Vial was not stored in refrigerator and administered to patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment information was reported. Most recent FOLLOW-UP information incorporated above includes: On 30-Aug-2021: Updated reporter information, patient demographics, Added past relevant history, and updated vaccine dose details, and added concomitant medications.


VAERS ID: 1681679 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Intoxication; Rash in all over her Body; This spontaneous case was reported by a consumer and describes the occurrence of POISONING (Intoxication) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by reporter. Concomitant products included DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for an unknown indication. On 25-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced RASH (Rash in all over her Body). On an unknown date, the patient experienced POISONING (Intoxication) (seriousness criterion medically significant). At the time of the report, POISONING (Intoxication) and RASH (Rash in all over her Body) outcome was unknown. The patient used unidentified medicament to alleviate rash. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Follow up information received 29 August 2021 does not change company causality, however a new event of "intoxication" was reported and added to the case. Most recent FOLLOW-UP information incorporated above includes: On 29-Aug-2021: Route of administration suspected product and event 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. Follow up information received 29 August 2021 does not change company causality, however a new event of "intoxication" was reported and added to the case.


VAERS ID: 1681979 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Eye haemorrhage, Eye swelling, Facial pain, Pain in extremity, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Glaucoma (broad), Retinal disorders (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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None, Comment: Patient history: No
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101110258

Write-up: My arm hasn''t hurt, only if I lift it a lot; under my eye it''s so swollen that it is oozing water / it was a build of water from a sore from her face and not water coming from her eye; Today I woke up with a swollen face/very evident; hives; under my eye it''s so swollen that it is oozing water; small blood vessels in my left eyes that burst/some blood vessels in her right eye burst; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 48-years-old female patient received BNT162B2 PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported, Expiry date, NDC number: unknown), via an unspecified route of administration, administered in left arm on 25Aug2021 (age at vaccination was 48 years) as DOSE 1, SINGLE for covid-19 immunisation. No medical history reported. Concomitant medication was not reported, but patient stated that she was only taking her menopause pill. It was a vitamin that patient has been taking for years. Does not wish to add at this time. Does not think that it is related to this. On an unspecified date the patient was experienced my arm hasn''t hurt, only if I lift it a lot and under my eye it''s so swollen that it is oozing water / it was a build of water from a sore from her face and not water coming from her eye; On 25Aug2021, experienced some blood vessels in her right eye burst; On 26Aug2021, experienced face is swollen, hives, under my eye it''s so swollen that it is oozing water. The report received as, yesterday, the patient received the Pfizer Covid 19 vaccine and today patient has a reaction to it. Today, patient woke up with a swollen face and small blood vessels in eyes that burst. What worries patient most are the hives and the swollen face, it was very evident. The patient was little worried, this hadn''t happened to patient before. The patient arm hasn''t hurt, only if patient lift it a lot, but patient face was swollen and under patient eye it''s so swollen that it was oozing water. The patient washing the face normally and patient going to put on sunscreen. Later confirmation got that it was a build of water from a sore from her face and not water coming from her eye. Clarified that beneath both eyes are swollen. Treatment was reported as none. No investigation assessment was done. Outcome of the events pain in arm and facial pain was unknown and remaining events were not resolved. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1681984 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-05
Onset:2021-08-25
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Arthritis, Joint stiffness, Movement disorder, Urinary tract infection
SMQs:, Systemic lupus erythematosus (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? 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:
CDC Split Type: USPFIZER INC202101110840

Write-up: UTI; Joint Stiffness and Pain; Joint Stiffness and Pain; couldn''t get out of the chair; reactive inflammatory arthritis from the vaccine; This is a spontaneous report from a contactable consumer. An 80-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was Unknown) via an unspecified route of administration on 05Mar2021 (at the age of 80-year-old) as dose 2, single for COVID Prophylaxis. Patient had no medical history and no concomitant medications. The patient was not received any other vaccines within 4 weeks prior to the COVID vaccine. Historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on 12Feb2021 (at the age of 80-year-old) as dose 1, single for COVID Prophylaxis. It was reported that the patient come to the ER with really bad joint stiffness and pain, reactive inflammatory arthritis that started a little after her first vaccine. It was stated that in 2021, the joint stiffness and pain, reactive inflammatory arthritis got a lot worsened after her second dose. Caller stated her doctor tried her going on a Prednisone burst and taper which helped but when she stopped the Prednisone it got worse and she had to call an ambulance because she couldn''t get out of the chair in 2021. On 25Aug2021, the patient had UTI (urinary tract infection) and the patient was on Solumedrol IV, Antibiotic Levofloxacin for a UTI that they started treating. On the same date (25Aug2021), the patient was hospitalized which was ongoing (at the time of reporting, the patient was in the hospital) for the events of UTI, joint stiffness and pain, reactive inflammatory arthritis and couldn''t get out of the chair. Caller stated that the physician put down the disease, reactive inflammatory arthritis from the vaccine in 2021. The patient was visited Physician Office for all events except UTI. On 25Aug2021, the patient visited Emergency Room for all reported events. Relevant tests were none. Outcome of the event UTI was unknown and the other events was not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1682005 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celecoxib; Hydroxychloroquine; APAP Codeine; Trazo
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism (No); Lupus syndrome.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101118041

Write-up: I''m getting headaches that come on strongly; This is a spontaneous report received from a contactable consumer(patient). A 46-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection; lot number: Fc3181 and expiry date not reported) via an unspecified route of administration, at the age of 46-year-old, on 24Aug2021, at the left arm, at dose 1, single for covid-19 immunisation in a Pharmacy/drug store. Relevant medical history included Lupus and Hypothyroidism. The patient had no known allergies. Concomitant medications in two weeks included hydroxychloroquine, celecoxib, codeine phosphate, paracetamol (APA CODEINE) and trazadone hydrochloride (TRAZO). The patient is not pregnant at the time of vaccination. The patient did not have other vaccine in four weeks. The patient did not have prior COVID vaccination and was not tested post vaccination. On 25Aug2021, the patient experienced headaches that come on strongly in the same place. It comes and goes but when it comes it''s on top of her head and it was a strong headache. The patient did not receive treatment in response to the events. The outcome of the events was not recovered at the time of report.


VAERS ID: 1682133 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Chills, Headache, Renal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine; Cabergoline
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism; Pituitary adenoma.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101151836

Write-up: Severe persistent stomach pain; Persistent kidney pain; Persistent lower back pain; Persistent headache; Persistent chills; This is a spontaneous report from a contactable consumer, the patient. A 52-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3182) via an unspecified route of administration in the left arm on 24Aug2021 at 13:00 (at the age of 52-years-old) as a single dose for COVID-19 immunisation. Medical history included hypothyroidism and pituitary adenoma. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included levothyroxine sodium (LEVOTHYROXIN) and cabergoline (MANUFACTURER UNKNOWN); both for unknown indication from unknown date and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA7485) via an unspecified route of administration in the left arm on 03Aug2021 at 13:00 (at the age of 52-years-old) as a single dose for COVID-19 immunisation. On 25Aug2021 at 12:00, the patient experienced severe persistent stomach pain, persistent kidney pain, persistent lower back pain, persistent headache and persistent chills. The adverse events did not result in a visit to the doctors or other healthcare professional office/clinic visit and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the reported events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events severe persistent stomach pain, persistent kidney pain, persistent lower back pain, persistent headache and persistent chills were not resolved at the time of this report.


VAERS ID: 1682542 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Blood potassium decreased, Blood test, Borrelia test negative, C-reactive protein increased, Chills, Decreased appetite, Diarrhoea, Dizziness, Fatigue, Feeling abnormal, Headache, Loss of consciousness, Mononucleosis heterophile test negative, Nausea, Rash, Sleep disorder, Vestibular disorder, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Tic Disorder, anxiety, seasonal allergies
Allergies: mild seasonal allergies
Diagnostic Lab Data: Had bloodwork completed on 8/30/2021 showing high c-reactive protein, low potassium, negative lymes, negative mono
CDC Split Type:

Write-up: Tuesday (day of vaccine) restless night of sleep Wednesday- chills, fatigue, restless sleep Thursday - passed out in school, fatigue, chills, nausea, restless sleep, dizzy/lightheaded, unbalanced, loss of appetite Friday - extreme fatigue, nausea, chills, dizzy/lightheaded, unbalanced, loss of appetite, restless sleep, felt like eyes were bouncing Saturday - fatigue, lightheaded/dizzy, restless sleep Sunday - fatigue, lightheaded/dizzy, diarrhea, rash on upper chest and upper back Monday - lightheaded/dizzy, diarrhea, rash on entire torso, vestibular deficits: Rhomberg EC = severe sway, headache at night Tuesday - + R hypofunction of vestibular system, dizzy/lightheaded, foggy, Diarrhea, headache in the morning, difficulty focusing to read school work Wednesday - fatigue when reading, continued balance deficits Thursday - able to return to school in person; dizzy/lightheaded, mild fatigue, continued balance/vestibular deficits Friday - feels 90% better but still unable to perform higher level athletic activities without dizziness. has to perform at slower pace.


VAERS ID: 1682700 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)

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

Write-up: Patient states that about one week after vaccination she noticed tingling / weakness in her pinky and ring finger which radiates to her arm. Today is three week out and patient state it still is bothersome. Recommended patient not take 2nd dose until reviewed with a healthcare provider.


VAERS ID: 1682706 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Headache, Limb discomfort, Musculoskeletal stiffness, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), 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: Sickle Cell carrier
Allergies: Mushroom
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that after getting vaccination she had a light headache. The next day the headache got worse. She also noticed that her left foot is swollen. If she lifts anything she get light headed. Walking up stairs she is out of breath. She has a pin in the left arm like a stiff heaviness.


VAERS ID: 1682741 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head normal, Confusional state, Extra dose administered, Eye pain, Feeling abnormal, Flushing, Immediate post-injection reaction, Memory impairment, Muscular weakness, Ocular discomfort, Vision blurred, Visual impairment, Vitreous floaters
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valium, Zofran, Vyvanse, Norco, Albuterol, zoloft, welbutrin , hctz
Current Illness: Breast CA
Preexisting Conditions: Depression, migraines, ADHD
Allergies: NKDA
Diagnostic Lab Data: Ct Head wnl
CDC Split Type:

Write-up: reaction after 3rd dose covid vaccine, complains of immediately felt flush, seeing spots, 45 mins later, complains of floaters and left leg weakness, confusion, had some arm weakness, had negative CT head, developed blurred vision left eye, Still with complains of cloudy vision left eye, complains of feeling foggy, does not feel sharp, forgetful, no numbness, no tingling, complains of pressure some pain around eye


VAERS ID: 1682865 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Immediate post-injection reaction, Loss of consciousness, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clonazepam, Quetapine, Sertraline
Current Illness: None
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: Glucose: 77
CDC Split Type:

Write-up: Patient receieved the vaccine at 3:39PM. Immediately stated he felt he may pass out. Provider and LPN responded at 3:40PM. Patient had loss of consciousness for about 15 seconds. Vital signs taken: BP: 105/65, Pulse: 100; Temp: 98.2F, Glucose 77. Repeated after 5 mins with BP 109/66. Pulse 71. Patient reported nausea and left in laying position until 1600 with frequent vital checks. At 4:00PM vitals were 112/76 for BP. Patient cleared to leave.


VAERS ID: 1682886 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site rash, Injection site warmth, Pain in extremity
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? 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 RETURNED TO THE PHARMACY TODAY TO INFORM US OF AN ADVERSE REACTION TO THE MODERNA COVID SHOT. SHE SAID AFTER GETTING THE SHOT HER ARM WAS VERY SORE. ON THE 4TH DAY AFTER THE SHOT SHE DISCOVERED A RASH HAD DEVELOPED AROUND THE INJECTION SITE. IT HAS BEEN WARM AND PAINFUL AND NOW 2 WEEKS LATER IT IS GROWING. PATIENT WAS INSTRUCTED TO GO SEE THEIR PRIMARY DOCTOR TO OBTAIN TREATMENT AND MANAGEMENT OF THEIR REACTION.


VAERS ID: 1682912 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-03-04
Onset:2021-08-25
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Feeling abnormal, Headache, Pain, Respiratory tract congestion, SARS-CoV-2 test negative, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Arthritis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alopurinol; Aspirin - 81 mg; Pepcid - for GERD; Laxative - Senna; Miralax
Current Illness: no
Preexisting Conditions: pacemaker Diagnosed with Parkinson''s
Allergies: Lisinopril - allergic to
Diagnostic Lab Data: COVID test - August 25 - Rapid test - came back negative. But my wife had been sick three days before me. So then they did the other test - PCR test and that came back positive after about 7 hours. No other testing that day - Emergent Center.
CDC Split Type: vsafe

Write-up: I never got a fever but I did have body and joint aches. That started the first day. I went to Emergent Center August 25th. I had headache and congestion and just felt punky. No treatment - I just treated it like a flu bug - I drank a lot of liquids and rested. On 9/2/2021 - I had a monoclonal infusion and that was day # 9 and that really turned me around. By day 11, Saturday, I was feeling much better.


VAERS ID: 1683116 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 LA / IM

Administered by: Unknown       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: No adverse reaction noted. Pt given Moderna vaccine and is currently only approved for pts 18 and older.


VAERS ID: 1683300 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysgeusia, Influenza like illness, Paraesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (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: Norco ,
Current Illness: no
Preexisting Conditions: COPD
Allergies: highly allergic to many medicine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Flu Like symptoms , felt like throat was closing, metalic and salty taste. lips tingly.


VAERS ID: 1683315 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-06
Onset:2021-08-25
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood gases abnormal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Impaired work ability, Malaise, Oxygen saturation decreased, PO2 decreased, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Lactic acidosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), 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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Coronavirus Testing: 8/24/2021 - positive
CDC Split Type:

Write-up: Pt admitted on 8/25/2021: A 41-year-old female with no primary care physician, is followed by Doctor P of Gastroenterology for Crohn disease, and is also followed by Doctor L at Oncology for anemia. She recently moved to and has not set up with a primary care provider there. She was vaccinated for COVID back in March 2021. However, she is on chronic Remicade for Crohn disease. She gets it every 6 weeks and was due to have it this coming weekend. One week ago, she began having malaise, generally feeling poorly, body aches, and a cough. The following day, she began having fever and worsened symptoms and tested positive for COVID initially on August 20th. She took it easy at home and tried to go back to work today. However, at work, she became very fatigued, dizzy, short of breath, and had to leave work and went back to an urgent care clinic. They prescribed her prednisone, cefdinir, Symbicort, but she never got these filled. She thinks her oxygen saturation was in the upper 80s in the urgent care clinic, but does not know this for certain period. Because she was feeling worse, she came to the emergency room. Her oxygen saturation here has gone down into the upper 80s. Of note, the patient was also prescribed albuterol, azithromycin, and Breo Ellipta on August 20th. Pt discharged 8/29/2021: 41 y/o F with PMHx including Crohn disease, DM2, HTN, obesity, etc., presented to the ER c/o worsening shortness of breath, cough, fatigue, etc. Her symptoms began 1 week prior to admission. ABG with pO2 56 and CXR consistent with SARS pneumonia. With concern for severe COVID-19, she was admitted to the inpatient service (SDU) for continued workup & management.


VAERS ID: 1683332 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-15
Onset:2021-08-25
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Ciprofloxacyn
Diagnostic Lab Data: Positive pcr on 08/29
CDC Split Type:

Write-up: Got covid


VAERS ID: 1683375 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Heart rate increased, Palpitations, Rash, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol ER 50 mg, ASA 81 mg, omeprazole
Current Illness: Type 2 diabetes, RA, Ehlers-Danlos syndrome,
Preexisting Conditions: Type 2 diabetes, RA, Ehlers-Danlos syndrome,
Allergies: Penicillin, Prednisone, Cortisone, Demerol, Zoloft, Ampicillin, Sulfa, all metals, iron
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1-hour post vaccination, heart rate increased to an unknown rate, feelings of throat closing, feeling of pounding in chest and headache, after 24 hours pt got rash that has lasted 2 weeks and is still present


VAERS ID: 1683616 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 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: Used a vial that was expired yesterday to administer 7 employees, today; 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 EXPIRED PRODUCT ADMINISTERED (Used a vial that was expired yesterday to administer 7 employees, today) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Used a vial that was expired yesterday to administer 7 employees, today). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Used a vial that was expired yesterday to administer 7 employees, today) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was reported. No treatment medication was reported.


VAERS ID: 1683619 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-27
Onset:2021-08-25
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 - / OT

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

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

Write-up: Dose administered more than 24 hours after the vial was first punctured; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose administered more than 24 hours after the vial was first punctured) in a 29-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 052E21A and 040C21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021 at 4:28 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose administered more than 24 hours after the vial was first punctured). On 25-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Dose administered more than 24 hours after the vial was first punctured) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant product use was provided by the reporter. No treatment medication was provided. The syringe was pre-drawn from a previously unopened vial at 12:27 pm on 24-Aug-2021 and was administered at 4:28 pm all on 25 Aug 2021


VAERS ID: 1683621 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 - / OT

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

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

Write-up: dose given more than 24 hours after the vial was first punctured; This spontaneous case was reported by a medical assistant and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (dose given more than 24 hours after the vial was first punctured) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (dose given more than 24 hours after the vial was first punctured). On 25-Aug-2021, EXPIRED PRODUCT ADMINISTERED (dose given more than 24 hours after the vial was first punctured) 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 and treatment information provided.


VAERS ID: 1683628 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-04
Onset:2021-08-25
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Feeling abnormal, Feeling hot, Headache, Muscular weakness, Pain, Pain in extremity, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Pericarditis (Patient''s father had pericarditis when he was younger)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Anxiety; Bad nasty headaches; Pain in arm/ Bizarre pain in his arms; His weakened arm on fire; His weakened arm on fire; Severe pain on the injection site; Hang over effects/ Feeling awful, crappy/ Noise upsetting him; His body hurting; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Hang over effects/ Feeling awful, crappy/ Noise upsetting him), FEELING HOT (His weakened arm on fire), ANXIETY (Anxiety), PAIN IN EXTREMITY (Pain in arm/ Bizarre pain in his arms) and PAIN (His body hurting) in a 45-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 059e21a) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Family history included Pericarditis (Patient''s father had pericarditis when he was younger). On 04-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced FEELING HOT (His weakened arm on fire), MUSCULAR WEAKNESS (His weakened arm on fire) and VACCINATION SITE PAIN (Severe pain on the injection site). On 26-Aug-2021, the patient experienced PAIN IN EXTREMITY (Pain in arm/ Bizarre pain in his arms). On an unknown date, the patient experienced FEELING ABNORMAL (Hang over effects/ Feeling awful, crappy/ Noise upsetting him), ANXIETY (Anxiety), PAIN (His body hurting) and HEADACHE (Bad nasty headaches). The patient was treated with IBUPROFEN for Adverse event, at an unspecified dose and frequency. At the time of the report, FEELING ABNORMAL (Hang over effects/ Feeling awful, crappy/ Noise upsetting him), FEELING HOT (His weakened arm on fire), PAIN (His body hurting), MUSCULAR WEAKNESS (His weakened arm on fire), VACCINATION SITE PAIN (Severe pain on the injection site) and HEADACHE (Bad nasty headaches) had resolved, ANXIETY (Anxiety) outcome was unknown and PAIN IN EXTREMITY (Pain in arm/ Bizarre pain in his arms) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not provided. The patient experienced events following vaccination for a week. The patient experienced pain in arm which then it disappeared and now it comes and goes in the same spot on the injection site. The patient took ibuprofen but it did not helped.


VAERS ID: 1683634 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 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: A vial that has been opened for 9 days was administered; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (A vial that has been opened for 9 days was administered) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (A vial that has been opened for 9 days was administered). On 25-Aug-2021, EXPIRED PRODUCT ADMINISTERED (A vial that has been opened for 9 days was administered) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medication were reported No Treatment information was reported


VAERS ID: 1683650 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea, Fatigue, Feeling of body temperature change, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: I feel short of breath; feel tired; headaches; body ache; I''ve been hot and cold; Dry cough; This spontaneous case was reported by a consumer and describes the occurrence of FEELING OF BODY TEMPERATURE CHANGE (I''ve been hot and cold), COUGH (Dry cough), DYSPNOEA (I feel short of breath), MYALGIA (body ache) and FATIGUE (feel tired) in a 44-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Anxiety, Depression, Migraine and Sleep disorder. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced FEELING OF BODY TEMPERATURE CHANGE (I''ve been hot and cold), COUGH (Dry cough), MYALGIA (body ache) and HEADACHE (headaches). On 26-Aug-2021, the patient experienced DYSPNOEA (I feel short of breath) and FATIGUE (feel tired). At the time of the report, FEELING OF BODY TEMPERATURE CHANGE (I''ve been hot and cold), COUGH (Dry cough), DYSPNOEA (I feel short of breath), MYALGIA (body ache), FATIGUE (feel tired) and HEADACHE (headaches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medication was reported by patient. Patient reported concomitant medication for anxiety, depression, migraines and sleep. Patient reported no history of COVID-19 infection nor history of myocarditis and pericarditis.


VAERS ID: 1683716 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
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: received 2nd shot too early


VAERS ID: 1683743 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101152514

Write-up: muscle sore on upper right part of her back; This is a spontaneous report from contactable consumer (patient). A 71-years-old female patient received bnt162b2 (Pfizer BioNTech COVID-19 Vaccine), dose 1 via an unspecified route of administration, administered in Arm Left on 17Aug2021 (Batch/Lot number was not reported) as dose 1, single for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. Patient has been experienced muscle sore on upper right part of her back since 25Aug2021. She received the 1st dose of the vaccine on 17Aug2021 and had it on her left arm-It usually occurs some time in a day but not 24/7. Patient took Ibuprofen once a day that started 2 days ago but skipped today as she will have her 2nd dose on 07Sep2021- Asking if this is a general reaction from the vaccine. Therapeutic measures were taken as a result of muscle sore on upper right part of her back. The outcome of the event was unknown. The lot number for the vaccine, was not provided and will be requested during follow up.


VAERS ID: 1684259 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-16
Onset:2021-08-25
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Had not menstruated for one year. About a week after the shot, I began bleeding and have bled intermittently since then.


VAERS ID: 1684486 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Ear pain, Fatigue, Flushing, Headache, Hyperhidrosis, Lethargy, Nausea, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Medium, Systemic: Nausea-Medium, Systemic: Weakness-Medium, Additional Details: ear ache both sides


VAERS ID: 1684883 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-03
Onset:2021-08-25
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Atelectasis, COVID-19 pneumonia, Chest X-ray abnormal, Condition aggravated, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), 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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: osteoarthritis, asthma
Allergies: penicillins
Diagnostic Lab Data: 9/1/21: chest xray: ubtle changes may indicate airspace disease or atelectasis. Recommend PA and lateral views when feasible. 9/1/21: covid 19 positive
CDC Split Type:

Write-up: hospitalized for covid 19 pna, respiratory failure, asthma exacerbation on the background of COVID-19


VAERS ID: 1684900 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

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

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

Write-up: Vaccine was given without diluent. To date no adverse symptoms reported.


VAERS ID: 1684954 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Vaccine administered undiluted.


VAERS ID: 1684962 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product preparation 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Vaccine administered with no diluent


VAERS ID: 1685010 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-27
Onset:2021-08-25
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

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

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

Write-up: Vaccinated and then got COVID


VAERS ID: 1685098 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-07
Onset:2021-08-25
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Influenza A virus test negative, Influenza B virus test, Respiratory syncytial virus test negative, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No Known allergies
Diagnostic Lab Data: Aug 25, 2021@16:43:18 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA*
CDC Split Type:

Write-up: 8.25.21 Covid 19 Screening


VAERS ID: 1685280 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-04-07
Onset:2021-08-25
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Influenza A virus test negative, Influenza B virus test, Respiratory syncytial virus test negative, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Apixaban, Atorvastatin, Calcipotriene, Clobetasol, Lisinopril, Metoprolol, Pioglitazone, tamsulosin, Vitain D3, Zinc
Current Illness: none
Preexisting Conditions: Meridional amblyopia OD, Hx of colonic polyps, HTn, Obesity, asymmetrical hearing loss, DM type 2, Paroxysmal Atrial fibrillation, chronic systolic heart failure, benign prostatic hyperplasia, chronic ischemic hearty disease, angina pectoria, hyperlipidemia,
Allergies: no known allergies
Diagnostic Lab Data: Aug 25, 2021@17:05:24 FLU A NEGATIVE, FLU B NEGATIVE, RSV NEGATIVE _COVID-19 POSITIVEA*
CDC Split Type:

Write-up: 8.25.2021 Routine covid 19 screening


VAERS ID: 1685321 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-05
Onset:2021-08-25
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / IM

Administered by: Private       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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: insulin, albuterol, atorvastin, asprin,omeprazole
Current Illness:
Preexisting Conditions: obesity, DM2, tubular adenoma colon, hypercholesterolemia, barrette esophagus
Allergies: ibuprofen, doxycycline, metformin
Diagnostic Lab Data:
CDC Split Type:

Write-up: hospitalized twice for covid. Break thru covid case


VAERS ID: 1685344 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-01-29
Onset:2021-08-25
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Influenza A virus test negative, Influenza B virus test, Pain, Respiratory syncytial virus test negative, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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: Acetaminophen, Aspirin, Ciclopirox topical sol, Fexofenadine, Fulticasone, lisinopril, probiotic
Current Illness: None
Preexisting Conditions: HTN, Recurrent lt. leg cellulitis, Onycohomycosis, Bilateral Knee pain, Lymphedema lt. leg.
Allergies: Benadryl, Ibuprofen, Bactrium DS
Diagnostic Lab Data: Aug 25, 2021@13:38:07 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA*
CDC Split Type:

Write-up: patient is having mild cough and minor aches and pains


VAERS ID: 1685405 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-01-07
Onset:2021-08-25
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Respiratory syncytial virus test negative, SARS-CoV-2 test negative
SMQs:, COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, Glipizide, Sildenafil, Vitamin E, Metformin, Multivitamin
Current Illness: None
Preexisting Conditions: DM type 2, HTN, hyperlipidemia, GERD,
Allergies: Omeprazole, Lisinopril
Diagnostic Lab Data: Aug 25, 2021@13:33 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA
CDC Split Type:

Write-up: Covid 19 exposure asymptomatic


VAERS ID: 1685628 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute pulmonary oedema, Cardiomyopathy, Computerised tomogram thorax abnormal, Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Hypoxia, Myocarditis, Troponin increased, White blood cell count increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient had sudden shortness of breath. Ambulance documented severe hypoxia. ER did CT scan of chest which showed flash pulmonary edema. Admitted for two days in hospital. Echo showed EF 39%. Troponin mildly elevated. WBC elevated to 23,000. Diagnosis is myocarditis and cardiomyopathy due to COVID vaccine.


VAERS ID: 1685996 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-11
Onset:2021-08-25
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Laboratory test normal, Premature labour
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: Labetalol
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pre term labor. Due date 10-21-21. All labs came back normal. No explanation for sudden onset.


VAERS ID: 1686211 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNREADABLE / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Asmanex, Trental, and allergy immunotherapy
Current Illness: Asthma, allergies, nasal polyps
Preexisting Conditions: Asthma, , allergies, Necrobiosis lipoidica, and prior Guillain-Barre Syndrome (2017)
Allergies: Dust mites, pollen, certain grasses, and aspirin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pfizer vaccine administered 8/25/2021 at pharmacy at approximately 5:00 p.m. At approximately 5:30 p.m. on 8/25/2021, while still sitting inside pharmacy, I noticed redness on the inside of both arms, then the redness turned into small, red, raised bumps on both arms, top of each hand, and each finger. I notified the pharmacist who adminstered the vaccine. Her response was simply "do you need to go to urgent care?" I did not go to urgent care, but instead went home. Within a hour the raised, red bumps began to itch. The itching became intense an hour later. The bumps, redness and itching, continued from 8/25/21 to 9/06/2021. On 9/8/2021, areas around both wrists, and between each finger started to itch, with a few red bumps appearing. On 9/7/2021, I contacted doctor''s office to inform him of my reaction to the vaccine. I was informed by the on-call nurse, that the doctor would not be in the office until 9/15/2021. I contacted doctor''s office to add my immediate reaction to the Pfizer vaccine to my medical records. As of the date I am completing this form (9/9/21 @ 7:30 p.m.) I am experiencing only minor itching on both hands.


VAERS ID: 1686218 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit D, Cod liver oil, Multi-Vitamin
Current Illness: n/a
Preexisting Conditions: Seborrhea
Allergies: Vicodin
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Reoccurring numbness in the right arm throughout the day. At night both hands may experience numbness. Right foot occasionally goes numb while walking. Numbness is relived by flexing hands, arms, and feet. No treatment sought. This is still an ongoing issue.


VAERS ID: 1686435 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Ringing in ears


VAERS ID: 1686603 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenopia, Discomfort, Dyspnoea, Gait disturbance, Hypoaesthesia, Paraesthesia, Sensory disturbance, Skin warm, Tinnitus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Corneal disorders (broad), Hearing impairment (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Anemia Eczema Endometriosis
Allergies: Ciprofloxen, epinephrine, prednisone, pineapple, plum, cobalt dichloride, iodopropynyl butylcarbamate, linalool
Diagnostic Lab Data: None taken- doctor isn?t sure what to recommend but said I can wait for shot if afraid
CDC Split Type:

Write-up: Entire right side of body has tingling and numbness, a general heavy feeling. Have been stubbing toes of right foot and knocking things down when I forget to overcompensate for slight numbness/weakness. Ringing in the right ear on and off tinnitus Right cheek warm and tingly, right eye heavy and droopy feeling, right side of mouth feels as if Novacaine is about to wear off. Entire right side of body is affected from the midline out including my ear, throat, even notice in ribs when out of breath-that side feels weaker like I?m not getting a full breath. Symptoms remain after 2 weeks Fear second shot may cause permanent and greater symptoms/damage to nervous system and hearing


VAERS ID: 1686721 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea
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: Venclexta 400mg Lexapro 10 mg Omeprozole. 20 mg
Current Illness: CLL CANCER
Preexisting Conditions: CLL SINCE 2011 Ascending aortic aneurysm 08/2020
Allergies: Percocet Dilutoid
Diagnostic Lab Data: 09/06/2021. ER.
CDC Split Type:

Write-up: Difficulty breathing


VAERS ID: 1686736 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

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

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

Write-up: About a week after 1st dose, I broke out in HIVES and was very itchy all over my arms, feet, and lower legs


VAERS ID: 1688514 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 RA / OT

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

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

Write-up: Nausea and vomiting; Nausea and vomiting; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (Nausea and vomiting) and VOMITING (Nausea and vomiting) in a 55-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced NAUSEA (Nausea and vomiting) and VOMITING (Nausea and vomiting). At the time of the report, NAUSEA (Nausea and vomiting) and VOMITING (Nausea and vomiting) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. It was unknown if the patient was treated for the reported events.


VAERS ID: 1688856 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pain, Pain in jaw
SMQs:, Glaucoma (broad), Osteonecrosis (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: Valsartan omeprazole triamterene-hydrochlorothiazide
Current Illness: No, but had Covid-19 on March 17, 2021
Preexisting Conditions: no
Allergies: Mango, Tomato, Percocet, adhesive
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pain began in right jaw beginning around noon on August 25th. Pain then radiated up towards right eye. It lasted about 5 days until it was fully gone. I treated it with ice, heat and tylonel. I did call my doctor''s office to let them know and put it in my medical chart.


VAERS ID: 1688993 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Pain in extremity
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: diarrhea: ~13 times on 8/25, ~6 times on 8/26, 3-4 times on 8/27, once on 8/28 Arm soreness 8/25-8/27


VAERS ID: 1688999 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-09
Onset:2021-08-25
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Cardiac disorder, Chest X-ray abnormal, Cough, Dyspnoea, Fatigue, Lung infiltration, Pulmonary embolism, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol, apixaban, Ascorbic Acid, atorvastatin,benzonatate
Current Illness: N/A
Preexisting Conditions: Malignant neoplasm, CAD, colectomy, anemia, acute kidney injury, pacemaker, Sick Sinus Syndrome, Heart Black, Obese,
Allergies: N/A
Diagnostic Lab Data: Chest x-ray taken, which showed pulmonary infiltrate. PE protocol done shows small acute embolus in proximal right lower lobe, suggesting some degree of right heart strain with...
CDC Split Type:

Write-up: Pt tested + for COVID on 8/25/2021. Came to ER and admitted 9/1/2021. Experiencing dyspnea and fatigue. O2 saturation dipping down to 84%. Acute hypoxic respiratory failure. COVID-19 Pneumonia. Discharged 9/6/2021, rehospitalized 9/8/2021 with worsening shortness of breath, oxygen saturation 74-80%, nonproductive cough. Remains hospitalized at present time.


VAERS ID: 1689091 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dysstasia, Fatigue, Gait disturbance, Migraine, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Extreme muscle and joint pain lasting over 7 days, including but not limited to difficulty walking and standing, extreme fatigue lasting over 5 days, migraine headaches,


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