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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 396 out of 8,010

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VAERS ID: 1689301 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood magnesium normal, Blood thyroid stimulating hormone normal, Electrocardiogram, Full blood count, Hyperhidrosis, Metabolic function test, Paraesthesia, Vaccine positive rechallenge
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none listed
Current Illness: none
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: CBC, ECG, CMP, Mag (normal), TSH (normal)
CDC Split Type:

Write-up: Adverse reaction to covid vaccine sent o ED First immunization 12/30/2020 Pfizer Second immunization 8/25/2021 Pfizer (admit to ED 8/25 0948, discharged from ED 1416) Pt came in for 2nd Pfizer vaccine where she reported her first dose (back in December 2020) caused "a hot tingly feeling going from the injection site, which happened 3 different times and then started sweating and threw up twice." Pt was sent to the ER after 1st dose and continued to have episodes of tingling and vomiting on and off for 5 days. Pt reported extremely dry mouth each time. Pt reports seeing cardiologist and allergist, both of which found no issues with pt health or vaccine. Both providers gave pt okay to get 2nd dose. Pt received 2nd dose at 8:56AM on 8/25/21 and within 5 minutes reported the tingling sensation again. Pt was given 25 mg liquid diphenhydramine in case of allergy, but reported no other symptoms. Pt sat in waiting area for around 45 minutes and had 3 episodes of tingling that were getting longer with each episode. Pts blood pressure was taken twice (~162/88 and ~152/80), but patient reports she was nervous and anxious which was playing a role in high BP. Pt was sent to ER for further monitoring. Patient is a 58 y.o. female presents to ED for a possible allergic reaction to the Pfizer COVID vaccine. Pt explains that she received the second dose of the vaccine around 0900 today. Afterwards, pt began having whole body tingling and sweating. Pt reports a similar reaction during her first dose of the vaccine in December 2020. Pt was told to come to ED for further evaluation. Pt has already taken an antihistamine before coming to ED. Patient denies F/C, N/V, CP, dyspnea. Date/Time: 8/25/2021/9:53 AM Attending Attestation: The documentation was recorded by acting as scribe in my presence at the time of the encounter and accurately reflects the service I personally performed. Vaccine reaction, initial encounter Diagnosis management comments: Patient seen and evaluated by Doctor and care followed by PAC. Patient with past medical history of MI reports for evaluation neuropathy following 2nd dose of COVID vaccine. Patient states she had her initial vaccine in December 2020. Following that dose she experienced intermittent burning/whole-body tingling described as being of her head radiating to her toes. She was seen at multiple ERs and was told she was having vasovagal response. Symptoms resolved after several days. She was told prior to 2nd dose to self medicate with antihistamines and complied. She reported for her 2nd dose this am at 9. She reports similar burning sensation that began almost immediately after injection; she was told to report to ED for further evaluation. Patient states the sensation begins at her head and radiates door her feet and is described as a burning/tingling sensation. She also reports associated dry mouth that was similar to previous injection and body aches beginning in her lower back. Denies any previous illness, fever, chills, chest pressure, palpitations, shortness of breath, difficulty swallowing, headache, vision changes, injection site reaction, rashes, or any other associated weakness. Physical exam reveals no focal neurological deficits. Will further evaluate with EKG, CBC, TSH, magnesium, CMP. Laboratory evaluation unremarkable. EKG with normal sinus rhythm. After initial episode, Patient continues to have no complaints while in the ED for observation upon re-evaluation. Discussed side effects and return precautions at length with patient. She will continue Benadryl for the next 24-48 hours and may take Tylenol/ibuprofen for any body aches that may arise. Patient will follow-up with primary care provider or return to local ED for any new concerns as discussed including chest pain, shortness of breath, difficulty swallowing.


VAERS ID: 1689420 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Laboratory test, Pericardial drainage, Pericardial effusion
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: hydrochlorthiazide
Current Illness: none
Preexisting Conditions: hypertension
Allergies: no known allergies
Diagnostic Lab Data: Pericardiocentesis and sent the pericardial fluid sample for further tests
CDC Split Type:

Write-up: Shortness of breath, fatigue, chest pain was found to have large pericardial effusion after a week of vaccination, the second shot


VAERS ID: 1689437 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-12
Onset:2021-08-25
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nasal congestion, Nausea, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Vaccine breakthrough infection, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cardiovascular disease. Immunosuppressive condition
Allergies:
Diagnostic Lab Data: 08/26/2021 PCR+ COVID-19 test at facility, 08/30/2021 PCR+ COVID-19 test at Hospital, 09/03/2021 PCR+ COVID-19 test at Hospital
CDC Split Type:

Write-up: Breakthrough COVID-19 case with Subjective fever (felt feverish), Muscle or body aches, New loss of taste or smell, Runny nose/Congestion, Sore throat, Cough (new onset or worsening of chronic cough), Shortness of breath or difficulty breathing, Fatigue or tiredness, Nausea or vomiting, Headache, Diarrhea ($g/=3 loose/looser stools in 24 hr period). Hospitalized 8/27/2021


VAERS ID: 1689802 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
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 026C21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Headache, Neuropathy peripheral, Pain, Paraesthesia, Vertigo
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine D3 Vitamin C
Current Illness: None known
Preexisting Conditions: Autoimmune disease
Allergies: None known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe Body aches -one day Neurapathy - burning in arms, legs, cheeks at night 3 days Followed by tingling in hands 2 additional days Cloudy headed headache / vertigo 5 days


VAERS ID: 1689990 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Tennessee  
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 (MODERNA)) / MODERNA 006D21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site swelling, Injection site warmth, Pyrexia, Rash, Rash erythematous, Rash maculo-papular, Rash papular, Superficial vein thrombosis, Thrombophlebitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna Covid 19 on 2/5/2021 - fever, localized reaction and later development of superficial thrombophlebitis
Other Medications: Methotrexate (halted for 2 weeks for vaccine administration), prednisone, folic acid, multivitamin
Current Illness:
Preexisting Conditions: Rheumatoid arthritis
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site was hot, sore and swollen within 8 hours. I had fever between 101-102 until taking tylenol the next day. Most concerning was a maculopapular rash that appeared suddenly on my neck, upper chest, abdomen and back - it was red, raised and not pruritic. I took benadryl and it did not advance, but it took about 3 days to resolve. This was my third Moderna vaccine. Please note my second shot on 2/5/2021 resulted in fever up to 101 and sore, hot, swollen arm. I developed thrombophlebitis in my left great saphenous vein - symptoms began a few days after shot and persisted for weeks and later confirmed by ultrasound. No previous history of thrombophlebitis.


VAERS ID: 1690141 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Virginia  
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 (MODERNA)) / MODERNA 052E21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Cardiac monitoring, Chest pain, Dyskinesia, Electrocardiogram abnormal, Fear, Heart rate irregular, Hyperhidrosis, Pallor, Paraesthesia, Sensory disturbance, Ventricular extrasystoles
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Hypokalaemia (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 known
Current Illness: none known
Preexisting Conditions: none known
Allergies: shell fish -severe anaphylastic reaction
Diagnostic Lab Data: went to primary care 8/26 (EKG had pvc''s) , cardio 9/6 (being wear vest) returns 9/15
CDC Split Type:

Write-up: stated involuntary movements in shoulders, neck, face, perspire profusely on skin, arms, shirt cold and wet, bp 180/100pulse 84, irregular pulse, look of fright on face, felt being pulled toward ceiling, skin was ashen, no apparent sob, no nausea or pain radiation, pain localized in chest and abdomnial area, tingling all over, took cetirizine 10mg (due to allergy and had received 2nd dose) within 15 mins got up then reclined bp was still 148/90 pulse still irregular but no distress, did not go to er, went through night with no further episodes,


VAERS ID: 1691045 (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: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 - / OT

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: USMODERNATX, INC.MOD20213

Write-up: Headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache) 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) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced HEADACHE (Headache). At the time of the report, HEADACHE (Headache) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment information was provided.


VAERS ID: 1691341 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLEGRA M
Current Illness: Abstains from alcohol; Cholesterol; Diabetes; Hepatitis C (Non transferable); Non-smoker
Preexisting Conditions: Comments: Patient had allergies for which patient took allergy m and patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: SARS-CoV-2 IgG antibody test; Result Unstructured Data: 0 %, No antibodies present (Negative); Test Date: 20210825; Test Name: SARS-CoV-2 IgM antibody test; Result Unstructured Data: 0 %, No antibodies present (Negative)
CDC Split Type: USJNJFOC20210915503

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 61 year old male of unknown ethnicity. The patient''s height, and weight were not reported. The patient''s concurrent conditions included diabetes, cholesterol, hepatitis c ( non transferable), non smoker, non alcohol user. Patient had allergies had no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, expiry: unknown) 1 total, dose was not reported, administered on 02-APR-2021 to left arm for prophylactic vaccination. Concomitant medications included Allegra M (fexofenadine hydrochloride/montelukast sodium) for allergy. On 25-AUG-2021, patient had antibody testing. The antibody tests he received were SARS COVID 2 antibody immunoglobulin M (IgM) and SARS COVID 2 antibody immunoglobulin G (IgG). His results came back 0 percent showing no antibodies present (Negative) (coded to confirmed immunological vaccine failure). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210915503 - JANSSEN COVID-19 VACCINE Ad26.COV2.S- Confirmed immunological vaccine failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS.


VAERS ID: 1691565 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
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 37-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. Concomitant product was not provided Treatment information was not provided CASE CROSSLINKED TO MOD21-135951, MOD21-135963


VAERS ID: 1691570 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-07-28
Onset:2021-08-25
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088021A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Contusion, Fatigue, Injection site warmth, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Bruised left arm; Swollen left arm; Burning feeling down left arm; Hot left arm; Very tired/ Fatigued; This spontaneous case was reported by a consumer and describes the occurrence of CONTUSION (Bruised left arm), PERIPHERAL SWELLING (Swollen left arm), BURNING SENSATION (Burning feeling down left arm), INJECTION SITE WARMTH (Hot left arm) and FATIGUE (Very tired/ Fatigued) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 004F21A and 088021A) for COVID-19 vaccination. No Medical History information was reported. On 28-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Aug-2021, the patient experienced CONTUSION (Bruised left arm), PERIPHERAL SWELLING (Swollen left arm), BURNING SENSATION (Burning feeling down left arm), INJECTION SITE WARMTH (Hot left arm) and FATIGUE (Very tired/ Fatigued). At the time of the report, CONTUSION (Bruised left arm), PERIPHERAL SWELLING (Swollen left arm), BURNING SENSATION (Burning feeling down left arm), INJECTION SITE WARMTH (Hot left arm) and FATIGUE (Very tired/ Fatigued) outcome was unknown. Relevant concomitant medications includes antibiotics for UTI and severe sinus infections with double ear infections and take calcium and vitamin D for my bones. Treatment product information was not provided. This case was linked to MOD-2021-297880 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 30-Aug-2021: Significant follow up received on 30-AUG-2021 and date of second dose of vaccine, concomitant medications and events has been updated.


VAERS ID: 1691588 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
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: 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 25-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) (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 medications were provided. No treatment medication was given. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was not applicable. It was reported that the vial was in the refrigerator between 34- and 36-degree Fahrenheit and the vial was not frozen.


VAERS ID: 1691592 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-25
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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: Stomach problems; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL DISCOMFORT (Stomach problems) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027B21A) for COVID-19 vaccination. No Medical History information was reported. On 14-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 ABDOMINAL DISCOMFORT (Stomach problems). At the time of the report, ABDOMINAL DISCOMFORT (Stomach problems) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment history was reported. Patient stated that she has exposed to people with active COVID-19 Disease. Patient also stated that the stomach problems which started has nothing to do with the vaccine.


VAERS ID: 1691606 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-08-25
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: It is swollen from the shoulder to her elbow; Arm is very red; Arm is hard; Arm is hot; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (It is swollen from the shoulder to her elbow), ERYTHEMA (Arm is very red), INDURATION (Arm is hard) and SKIN WARM (Arm is hot) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011D21A and 011D21A) for COVID-19 vaccination. No Medical History information was reported. On 28-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Aug-2021, the patient experienced PERIPHERAL SWELLING (It is swollen from the shoulder to her elbow), ERYTHEMA (Arm is very red), INDURATION (Arm is hard) and SKIN WARM (Arm is hot). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, PERIPHERAL SWELLING (It is swollen from the shoulder to her elbow), ERYTHEMA (Arm is very red), INDURATION (Arm is hard) and SKIN WARM (Arm is hot) outcome was unknown. No Concomitant medications were provided by the reporter. No medical history was provided by the reporter. Reporter did not allow further contact


VAERS ID: 1691629 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Lacrimation increased, Pain in extremity, SARS-CoV-2 test
SMQs:, Lacrimal disorders (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OXYGEN
Current Illness: Blood pressure abnormal; COPD
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: Patient tested positive for COVID-19.
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: More than 35 days between doses; Watery eyes; Pain in the arm; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between doses), LACRIMATION INCREASED (Watery eyes) and PAIN IN EXTREMITY (Pain in the arm) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006D21A) for COVID-19 vaccination. Concurrent medical conditions included COPD and Blood pressure abnormal. Concomitant products included OXYGEN 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 INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between doses), LACRIMATION INCREASED (Watery eyes) and PAIN IN EXTREMITY (Pain in the arm). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between doses), LACRIMATION INCREASED (Watery eyes) and PAIN IN EXTREMITY (Pain in the arm) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-May-2021, SARS-CoV-2 test: positive (Positive) Patient tested positive for COVID-19.. Concomitant medications included sugar pill, blood pressure and COPD medication. Treatment information was not provided. This case was linked to MOD-2021-299964 (Patient Link).


VAERS ID: 1691672 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-08
Onset:2021-08-25
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Illness, Myalgia, Nausea, Pain in extremity, Paraesthesia, Peripheral coldness, Peripheral swelling, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure abnormal; Heart disorder; Scleroderma
Preexisting Conditions: Medical History/Concurrent Conditions: Hemoglobin high
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Cold feet and toes after 3rd shot; Tingly feet and toes after 3rd shot; She still has a very swollen area on her arm but not as tender; Very sick/she was sick all day; A bad headache, the headache is not as bad; Chills / chills after 3rd shot; Fever / Fever 100.5 F On; Fatigue after 3rd shot; Muscle pain after 3rd shot; Joint pain after 3rd shot; Nausea after 3rd shot; Pain on her left arm; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (She still has a very swollen area on her arm but not as tender), PAIN IN EXTREMITY (Pain on her left arm), ILLNESS (Very sick/she was sick all day), PERIPHERAL COLDNESS (Cold feet and toes after 3rd shot) and PARAESTHESIA (Tingly feet and toes after 3rd shot) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 01TR17, 010M20A and 025L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Hemoglobin high. Concurrent medical conditions included Blood pressure abnormal, Heart disorder and Scleroderma. On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Aug-2021, received third 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 PAIN IN EXTREMITY (Pain on her left arm). On 26-Aug-2021, the patient experienced ILLNESS (Very sick/she was sick all day), HEADACHE (A bad headache, the headache is not as bad), CHILLS (Chills / chills after 3rd shot) and PYREXIA (Fever / Fever 100.5 F On). 26-Aug-2021, the patient experienced FATIGUE (Fatigue after 3rd shot), MYALGIA (Muscle pain after 3rd shot), ARTHRALGIA (Joint pain after 3rd shot) and NAUSEA (Nausea after 3rd shot). On 27-Aug-2021, the patient experienced PERIPHERAL SWELLING (She still has a very swollen area on her arm but not as tender). On 28-Aug-2021, the patient experienced PERIPHERAL COLDNESS (Cold feet and toes after 3rd shot) and PARAESTHESIA (Tingly feet and toes after 3rd shot). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 dosage form. At the time of the report, PERIPHERAL SWELLING (She still has a very swollen area on her arm but not as tender) had not resolved, PAIN IN EXTREMITY (Pain on her left arm), ILLNESS (Very sick/she was sick all day), HEADACHE (A bad headache, the headache is not as bad) and CHILLS (Chills / chills after 3rd shot) was resolving and PERIPHERAL COLDNESS (Cold feet and toes after 3rd shot), PARAESTHESIA (Tingly feet and toes after 3rd shot), PYREXIA (Fever / Fever 100.5 F On), FATIGUE (Fatigue after 3rd shot), MYALGIA (Muscle pain after 3rd shot), ARTHRALGIA (Joint pain after 3rd shot) and NAUSEA (Nausea after 3rd shot) outcome was unknown. Concomitant medications reported include heart medications, medicines for blood pressure, statins and prescription creams for scleroderma. She had open heart surgery 2007. This case was linked to MOD-2021-300142 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 30-Aug-2021: Significant follow-up appended: Added medical history, new events, inarrative supplement.


VAERS ID: 1691731 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea, Nasal congestion, Rhinorrhoea, 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: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Tightness in my chest; It is hard to breath/ Have an Asthma feeling; Congestion in chest; Left arm pain; Coughing; Runny nose; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (Coughing), RHINORRHOEA (Runny nose), CHEST DISCOMFORT (Tightness in my chest), DYSPNOEA (It is hard to breath/ Have an Asthma feeling) and NASAL CONGESTION (Congestion in chest) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 on 01-Jan-2021. On 25-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 COUGH (Coughing), RHINORRHOEA (Runny nose) and VACCINATION SITE PAIN (Left arm pain). On 27-Aug-2021, the patient experienced CHEST DISCOMFORT (Tightness in my chest), DYSPNOEA (It is hard to breath/ Have an Asthma feeling) and NASAL CONGESTION (Congestion in chest). At the time of the report, COUGH (Coughing), CHEST DISCOMFORT (Tightness in my chest), DYSPNOEA (It is hard to breath/ Have an Asthma feeling) and NASAL CONGESTION (Congestion in chest) had not resolved and RHINORRHOEA (Runny nose) and VACCINATION SITE PAIN (Left arm pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. No treatment medications were provided. The patient contacted vaccination provider and was told that if the symptoms got worse, than the patient should go to the emergency room.


VAERS ID: 1691853 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Limb discomfort
SMQs:, Arthritis (broad)

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

Write-up: Legs are tender to touch; Pain seems more severe behind knees/Experienced pain down both legs to ankle; This spontaneous case was reported by a consumer and describes the occurrence of LIMB DISCOMFORT (Legs are tender to touch) and ARTHRALGIA (Pain seems more severe behind knees/Experienced pain down both legs to ankle) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. Concurrent medical conditions included Leg pain (three times) since 22-Aug-2021. On 23-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced LIMB DISCOMFORT (Legs are tender to touch) and ARTHRALGIA (Pain seems more severe behind knees/Experienced pain down both legs to ankle). At the time of the report, LIMB DISCOMFORT (Legs are tender to touch) and ARTHRALGIA (Pain seems more severe behind knees/Experienced pain down both legs to ankle) outcome was unknown. No concomitant information was provided by the reporter. No treatment information was provided. The patient stated that the pain in the legs and knees started a day before the vaccination (22-AUG-2021). The patient stated that the pain in the legs lasts for 16 minutes for each episode and it goes away. The patient inquired if it was a blood clot. It was unknown if the patient was treated for the reported events. Most recent FOLLOW-UP information incorporated above includes: On 30-Aug-2021: Follow up information received: Added medical history. Updated inarrative supplement


VAERS ID: 1691959 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-05
Onset:2021-08-25
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective
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:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: diagnosed with COVID-19; Lack of drug effect; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (diagnosed with COVID-19) and DRUG INEFFECTIVE (Lack of drug effect) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 021B21A and 027A21A) for COVID-19 vaccination. No Medical History information was reported. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Aug-2021, the patient experienced COVID-19 (diagnosed with COVID-19). 25-Aug-2021, the patient experienced DRUG INEFFECTIVE (Lack of drug effect). At the time of the report, COVID-19 (diagnosed with COVID-19) and DRUG INEFFECTIVE (Lack of drug effect) outcome was unknown. Concomitant product included thyroid medications. Treatment information was not provided.; Sender''s Comments: Based on the mechanism of action of mRNA-1273 causal association between the event of COVID-19 infection and mRNA-1273 is assessed as not applicable. Causal association between the drug ineffective and mRNA-1273 is assessed as possible.


VAERS ID: 1692116 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Fever; Result Unstructured Data: Test Result:99.4
CDC Split Type: USPFIZER INC202101110283

Write-up: loss of appetite; Fever of 99.4,; body aches; headache with sharp stings in back of head; This is a spontaneous report from a non-contactable consumer. This 15-year-old female consumer reported that: A 15-year-old female patient received the second dose of BNT162b2 (PFIZER BIONTECH COVID-19 VACCINE, Lot number ew0165) via an unspecified route of administration in right arm on 24Aug2021 03:30PM (at the age of 15-year-old) for COVID-19 immunisation. The patient received first dose of BNT162b2 (PFIZER BIONTECH COVID-19 VACCINE, Lot number ew0179) via an unspecified route of administration in right arm on 03Aug2021 (at the age of 60-year-old) for COVID-19 immunisation. Relevant medical history and concomitant medications were not reported. The patient did not have COVID prior vaccination and was not tested post vaccination. On 25Aug2021 the patient had fever of 99.4, body aches, headache with sharp stings in back of head and loss of appetite. The patient was treated with pain relief pills. Events resolved on an unspecified date. No follow up attempts are possible. No further information is expected.


VAERS ID: 1692130 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-28
Onset:2021-08-25
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 LA / OT

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Cough, Drug ineffective, Fatigue, Feeling abnormal, Pain, Pyrexia, SARS-CoV-2 test, Sleep deficit
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Nasal Swab/covid test; Test Result: Positive
CDC Split Type: USPFIZER INC202101110841

Write-up: covid test result=Positive; Covid test date=25Aug2021,covid test result=Positive; body aches.; fever, HA/fever last night; Coughing; Feels like " hit by truck"; Felt like she was super tired; Went into work because she thought she just didn''t get enough sleep; This is a spontaneous report from a non-contactable nurse. A 62-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EL3248), dose 1 via an Intramuscular route of administration, on 28Jan2021 (age at vaccination: 61), in left arm as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 25Aug2021 the patient experienced covid test result as positive, body aches, fever, HA/fever last night, Coughing, feels like " hit by truck", felt like she was super tired, went into work because she thought she just didn''t get enough sleep. Covid prior vaccination reported as unknown and post vaccination reported as yes. On 25Aug2021 the patient underwent lab test and procedure included SARS-CoV-2 test: positive. Treatment received reported as unknown. The patient had a physician office visit. The outcome of all events was recovering. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on the information in the case report and a plausible temporal relationship, a possible causal relationship between the event COVID_19, Drug ineffective and suspect drug BNT162B2 cannot be excluded.


VAERS ID: 1692154 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Extra dose administered, Feeling abnormal, Herpes zoster, Hyperhidrosis, Hypersomnia, Malaise, Off label use, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOSARTAN POTASSIUM; AMLODIPINE BESILATE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure; Chronic lymphocytic leukemia; Immunocompromised (he is immunocompromised)
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: his temperature got up; Result Unstructured Data: Test Result:102.8
CDC Split Type: USPFIZER INC202101116690

Write-up: Off label use; shingles; feeling bad; wasn''t'' feeling well; Sweat, last night he had to change his pajamas 2 times because he was so wet from the sweat; Had broken out in some kind of bumps on his shoulder and his abdomen/bumps break out over night; Running a fever; Slight fever; Had a fever of 102; Had really bad chills; he is in the bed sleeping a lot; Extra dose administered; This is a spontaneous report from a contactable consumer or other non-health care professional. This consumer (patient''s wife) reported for a 72-year-old male patient (reporter''s husband). A 72-year-old male patient received third dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: So-lution for injection, Lot number: FC3181), via an unspecified route of administration (at the age of 72-years), administered in arm left on 25Aug2021 as dose 3, single for COVID-19 immunization. Medical history included , chronic lymphocytic leukaemia , blood pressure and he was immunocompromised from an unknown date and unknown if ongoing. The patient historical vaccine included first dose and second dose an unspecified date in Feb2021 (at the age of 72-years), on of BNT162B2 for COVID-19 immunization. Concomitant medications included losartan potassium (LOSARTAN POTASSIUM) taken as 100mg, once a day and amlodipine besilate (AMLODIPINE BESILATE) taken for blood pressure measurement as 5mg, 1 tablet a day , start and stop date were not reported. On 26Aug2021, the pa-tient experienced shingles. On 25Aug2021, experienced feeling bad, wasn''t'' feeling well, sweat, last night he had to change his pajamas 2 times because he was so wet from the sweat, had broken out in some kind of bumps on his shoulder and his abdomen/bumps break out over night, running a fever; slight fever; had a fever of 102, had really bad chills, he is in the bed sleeping a lot. On an unspecified date, experienced off label use. It was further stated that caller was a consumer, calling on behalf of her 72-year-old husband, asking what kind of side effect she should expect due to the circumstances of his vaccination. Caller reported that her husband had both Pfizer vac-cine doses in Feb, which he did not have any reaction to, and then the booster dose of the vaccine on Wednesday the 25th because he has the type of Leukemia, CLL. Caller reports that on Tuesday her husband noticed that he had a couple of spots or bumps on him that they suspected were mosquito bites. He decided to go and get his booster dose on Wednesday. Caller reports that about 30 minutes after getting the booster dose her husband started feeling bad reporting that he was fine during the 15 minutes he was supposed to wait after getting the dose but then we had to make another stop at the bank and were there for about 20 minutes and by the time we got out he said he was not feeling well. Now he feels really bad, he is in the bed sleeping a lot and had a temperature about an hour ago, his temperature got up to 102.8. Caller also reports that her husband had a lot of sweats during the night and had to change his pajamas a couple of times because he was so wet. She also reports that he also had some more bumps break out over night last night. Caller reports that her husband saw his PCP yesterday, who said that they Suspect its shingles but it was not acting normally like shingles her hus-band has never had the shingles vaccine. Also reports that they are still waiting for a call back from his Oncologist because he is a leukemia patient although he has not yet started to receive treatment. Caller asked, if you could tell me if because he was already possibly sick with the shingles virus and did not know it would that have caused his reaction. I do not know about an expiration date on the card. I do not see anything, they did not write that down. I only have the expiration date when he had the first 2 shots in Feb but go ahead. Well he started having these issues after the vaccine on the took on (25Aug2021). When confirmed if patient started experiencing the side effects on the same day of ad-ministration. Right, that when he started having, feeling bad, slight fever and chills. The treatment was received for the adverse events running a fever; slight fever; had a fever of 102 (pyrexia). He took 2 Ibuprofen yesterday because he had a fever of 102. Ibuprofen he took, he took 2 of them and they are 200mg each. It was further stated that he does take any treatment for his leukemia yet. He was waiting for a phone call from his, the cancer center today but so far he has not had to take any treat-ment. The adverse events, shingles feeling bad, was not feeling well, sweat, last night he had to change his pajamas 2 times because he was so wet from the sweat, had broken out in some kind of bumps on his shoulder and his abdomen/bumps break out over night, running a fever; slight fever; had a fever of 102, had really bad chills, he is in the bed sleeping a lot, resulted in physician office visit. The patient underwent lab tests and procedures which included body temperature: 102.8 on an unknown date in Aug2021. The clinical outcome for all the events was reported as unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1692178 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Feeling abnormal, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Hearing impairment (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: OMEPRAZOLE; NP THYROID
Current Illness: Bell''s palsy
Preexisting Conditions: Medical History/Concurrent Conditions: Broken foot (2010 Protein S diagnose after DVT Right calf from broken foot); DVT of calf (2010 Protein S diagnose after DVT Right calf from broken foot); Hypothyroidism; Laryngopharyngeal reflux; Protein S (Protein S diagnose after DVT Right calf from broken foot); Retinal artery occlusion
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101119119

Write-up: lower face felt funny especially right; tingling/numbness around lower face; tingling/numbness around lower face; ER agreed Bell''s Palsy mild case; This is a spontaneous report from a contactable consumer (patient). A 51-years-old Non pregnant female patient received bnt162b2 (PFIZER COVID-19 VACCINE, Solution for injection, Batch/Lot Number: FD8448), via an unspecified route of administration, administered in arm left on 25Aug2021 at 02:30 PM (age at vaccinattion was 51-years-old) as DOSE 1, SINGLE for covid-19 immunisation. No other vaccines were received within four weeks. The patient was not pregnant at the time of vaccination. Medical history included bell''s palsy from 2002 and ongoing, blood clot to eye from 1997 to an unknown date, protein s diagnose from 2010 to an unknown date (Protein S diagnose after DVT Right calf from broken foot), hypothyroidism from 2010 to an unknown date, LPR acid Reflex from 2021 to an unknown date, deep vein thrombosis (DVT) right calf from 2010 to an unknown date (2010 Protein S diagnose after DVT Right calf from broken foot), broken foot from 2010 to an unknown date (2010 Protein S diagnose after DVT Right calf from broken foot). No known allergies were reported. Concomitant medications included omeprazole 20 mg and levothyroxine, liothyronine 45 mg (NP THYROID); both taken for an unspecified indication, start and stop date were not reported. On 25Aug2021 at 02:50 PM, the patient experienced tingling/numbness around lower face which subsided at 03:30 PM. On 26Aug2021 at 05:00 AM, the patient''s lower face felt funny especially right. On the same day at 07:20 AM, the patient decided to go to urgent care and was sent to ER. ER agreed Bell''s Palsy mild case. Therapeutic measures were taken as a result of the events. Treatment included prescribed steroid (unspecified) but the patient did not take it. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient was not tested for COVID-19. The outcome of the events tingling/numbness around lower face was recovered and other events was unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1692186 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Myalgia, Myocarditis, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101119836

Write-up: MyocarditisHeart Pain, it is getting worse over time paired with chest pains, muscle pains throughout body, arm pains; MyocarditisHeart Pain, it is getting worse over time paired with chest pains, muscle pains throughout body, arm pains; MyocarditisHeart Pain, it is getting worse over time paired with chest pains, muscle pains throughout body, arm pains; MyocarditisHeart Pain, it is getting worse over time paired with chest pains, muscle pains throughout body, arm pains; MyocarditisHeart Pain, it is getting worse over time paired with chest pains, muscle pains throughout body, arm pains; This is a spontaneous report from a contactable consumer. A 28-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection; Lot Number: Unknown), via an unspecified route of administration on 25Aug2021 17:00 (age at the time of vaccination was 28 years old as dose number unknown, single for COVID-19 immunisation. The patient''s medical history was not reported. The patient''s concomitant medications were not reported. It was reported that no other vaccine in four weeks and no other medications in two weeks. It was reported that covid prior vaccination was no, covid tested post vaccination was no. It was reported that patient had no known allergies. The patient experienced myocarditis heart pain, it was getting worse over time paired with chest pains, muscle pains throughout body, arm pains on 25Aug2021.Therapeuitc measure were taken as no as a result of events. The outcome of events was not recovered. The lot number for the vaccine [BNT162B2] was not provided and will be requested during follow-up.


VAERS ID: 1692909 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dysgeusia, Fatigue, Hypoaesthesia, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (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: levothyroxine 50 mcg, vitamin D3 5000 IU, omeprazole 20 mg, docusate sodium 100 mg X2
Current Illness: none
Preexisting Conditions: low thyroid
Allergies: penicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Arm sore within 24 hours, facial numbness, tingling in various body areas, chest pain within 1 week, metallic taste in mouth in 2 weeks, numbness and tingling in face seems to be worsening. Soreness only lasted about 1 day. Extreme fatigue the following day but it subsided by the 2nd day.


VAERS ID: 1692970 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-02-01
Onset:2021-08-25
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Genital swelling
SMQs:, Angioedema (broad), Hypersensitivity (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: I measured it yesterday
CDC Split Type:

Write-up: Increased the size of my gentiles


VAERS ID: 1693158 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Coronary artery dissection, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Other ischaemic heart disease (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: Carvedilol Losartan Multi vitamin
Current Illness: None
Preexisting Conditions: SCAD - spontaneous coronary artery dissection
Allergies: Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Racing heart rate started 8/19/21 Anxiety 8/24/21


VAERS ID: 1693265 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram normal, Extra dose administered, Myalgia, Pyrexia, Troponin normal
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: mycophenolate mofetil 500 mg PO QAM and 1000 mg PO QPM,
Current Illness: Evan''s syndrome
Preexisting Conditions: Evan''s syndrome
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Briefly, patient is a 16 year old with Evans syndrome who presents to the ED with low-grade fever (Tm 100.4), muscle aches, and left-sided chest pain. Symptoms began yesterday and chest pain today. Patient received third dose of COVID vaccine yesterday. Pfizer vaccine. ROS: All other systems of a 10 system review are negative. Medical history: reviewed, and no relevant medical conditions Immunizations: up to date Surgical history: reviewed, and non-contributory Social history: lives at home with family Exam: My examination of the patient revealed the patient to be active, alert, and in no distress. The HEENT exam was clear, the neck was supple, the lungs clear to auscultation, no abnormal cardiac sounds, Briefly, patient is a 16 year old with Evans syndrome who presents to the ED with low-grade fever (Tm 100.4), muscle aches, and left-sided chest pain. Symptoms began yesterday and chest pain today. Patient received third dose of COVID vaccine yesterday. PFIZER vaccine. ROS: All other systems of a 10 system review are negative. Medical history: reviewed, and no relevant medical conditions. Immunizations: up to date. Surgical history: reviewed, and non-contributory. Social history: lives at home with family. Exam: My examination of the patient revealed the patient to be active, alert, and in no distress. The HEENT exam was clear, the neck was supple, the lungs clear to auscultation, no abnormal cardiac sounds, the abdomen was nontender throughout. Normal skin color and perfusion. No rashes. Neurologic examination is normal. ED course: Patient with fever, muscle aches, left-sided chest pain 1 day status post PFIZER Baxi #3. ECG obtained which was normal with no ST elevation. D/W hematology who follows patient for Evan''s syndrome. Troponin sent. Patient is well appearing, and well hydrated. No focus of infection on examination. I transferred care to colleague at change of shift at 23:36. I performed a history and physical exam was involved in the initial care and management of the patient. Signed out to me at 11 PM change of shift. In summary, this is a 16-year-old male past medical history of Evan syndrome who presents the emergency department low-grade fever and chest pain after his third COVID vaccine. EKG is reassuring. Troponin is 0.01. Discussed with cardiology feels that it is safe for him to go home. Will discharge home with outpatient follow-up as needed. Cardiac MRI pending as of 9/11/2021.


VAERS ID: 1693336 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-21
Onset:2021-08-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 6 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal
SMQs:, Dementia (broad)

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

Write-up: I have an emptiness inside of my body. It could be an infection


VAERS ID: 1693500 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-24
Onset:2021-08-25
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA C32B21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Electric shock sensation, Fatigue, Herpes zoster, Hypoaesthesia, Laboratory test, Myalgia, Peripheral swelling, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Freshman year college but no knowledge of vaccine given
Other Medications:
Current Illness: Zero
Preexisting Conditions:
Allergies: Glycols? Morphine Codeine Amoxicillin
Diagnostic Lab Data: Went to urgent care with pain and rash. Doctor took a sample but I was told it would probably come back negative because it wasn?t a good enough sample. Rash was not oozing or blistered.
CDC Split Type:

Write-up: Shingles: leg swelling, deep muscular pain in right leg, shock pains in upper leg, burning in leg, numbness in upper leg, shingles rash on right thigh and right arm. Now in week 3 of virus and I am exhausted and still enduring pain but less so than before.


VAERS ID: 1693518 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN J&J 207A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothroxine 75 mcg, collagen, omega -3 1000 mg (from fish oil)
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 vaccine EUA


VAERS ID: 1693524 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-10
Onset:2021-08-25
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests, Deafness, Ear discomfort, Excessive cerumen production, Magnetic resonance imaging, 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: Flu shot, back in the 90''s, had a reaction due to the preservatives and determined I was not allergic to the shot itself, I was
Other Medications: amlodipine besylate 10 mg od; atenolol 25 mcg bd; atorvastatin 10 mcg od evening; Allegra 180 mg od evening; fluticasone propionate nasal spray 50 mcg 1 spray in each nostril at bed time; losartan potassium 100/25 od; lansoprazole dr 30 mg
Current Illness: no
Preexisting Conditions: diabetes; hypertension; metabolic syndrome; thyroid issues, under active thyroid/ hypothyroidism; arthritis; obesity
Allergies: Boston advanced bausch & loms contact solution; codeine; Contrave; erythromycin; mycolog; morphine; triamcinolone acetonide .1 %; Vicodin; adhesive tape; some metal/ nickel; formaldehyde; OxyContin; Voltaren; chocolate but I can tolerate chocolate flavor aspartame; walnuts
Diagnostic Lab Data: MRI with and without Contrast will be on 09/24/2021; hearing test 09/15/2021 they will continue to do hearing test
CDC Split Type: vsafe

Write-up: On 08/25/2021 @ 1:00 PM the ear just appeared to clog over, all of a sudden there was no hearing. I had just gone up one floor on the elevator, one level up on the elevator. I had taken this elevator many times. I contacted my Doctor and saw her PA. She examined my ear and said there was wax on the Left ear and removed the wax. I thought I could hear a little bit. She thought there might be more wax in there. She suggested Debrox to soften any other wax that didn''t come out. There was no improvement. My hearing was no better. On Sunday , I went to the Clinic. I had ringing, buzzing , swishing sound in my ear, like tinnitus . They found that both ears were very clear, no wax. Treatments given: Claritin and Sudafed. The doctor thought it was a sinus type thing. The doctor diagnosed it as ETD. The following Tuesday I went to see the PA. because I was getting shooting pain in my ear. The doctor said the ears had changed from last week. they were showing signs of infection. She treated it with Amoxycillin 875 bd, for 10 days and a probiotics, Culturelle. After a couple of days the pain in the ear did subside. When I went the the ENT on the 09/08/2021, the ENT saw no sign of infection. So the antibiotic cleared up the infection, but I still have hearing loss. She put me on prednisone so I am on prednisone for 15 days. I have to monitor my sugars 4 times a day as opposed to once a day as I was. I have not recovered from my hearing loss. I have an appointment to see my ENT on 09/21/2021.


VAERS ID: 1693664 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Echocardiogram, Electroencephalogram, Hypoaesthesia, Laboratory test, Magnetic resonance imaging, Pruritus, Rash, Seizure like phenomena, Ultrasound Doppler, Urticaria, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Codeine, Penicillin, Cocamidopropyl Betaine, Thimerosal, Amidoamine and Fragrance.
Diagnostic Lab Data: Labs, MRI, CT, EEG, Ultrasounds of heart and carotid arteries.
CDC Split Type:

Write-up: Seizure activity, blurred vision, numb finger tips and toes, hives, itchy skin, bumps.


VAERS ID: 1693778 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-13
Onset:2021-08-25
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

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

Write-up: No period since last vaccine


VAERS ID: 1694052 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-19
Onset:2021-08-25
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 03/27/21 2nd dose04/19/21 Diagnosed covid positive:08/26/21 Symptom onset:08/25/21 Exposure: Symptoms:fever. cough,fatigue, loss of smell/taste, sore throat,chills, runny nose.


VAERS ID: 1694083 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-11
Onset:2021-08-25
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Gait disturbance, Heavy menstrual bleeding, Menstrual discomfort, Menstruation delayed
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Fertility disorders (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Period late, heavier and more painful when started: I normal have a very regular 26 day cycle. Period should have started 8/25. Period started on 9/7, with significantly more severe cramping and bleeding noted. I was unable to walk due to the cramping for the first 24 hours, despite large doses of anti-inflammatories. I bled through 3 or 4 super absorbency tampons in less than 3 hours for the next 24 hours. I also bled for 7 days, as opposed to the regular 5.


VAERS ID: 1694112 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / IM

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

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

Write-up: Chest Pain


VAERS ID: 1694211 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cardiac flutter, Heart rate increased, Hypoaesthesia oral, Mouth swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow), Dehydration (broad)

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

Write-up: Rapid heart beat, heart flutter, spent 5 hours in the emergency room treating the heart fluttering, swelling in mouth, between upper nose and lip, numbness on left side of upper lip


VAERS ID: 1694237 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: I am a practicing physician. I had my two doses of Covid Vaccine- (second dose was on June24th) and had no severe adverse reactions what so ever, except for the common pain at injection site and some myalgia. I moved in August and as per the School?s mandate to get vaccinated with an FDA approved Vaccine, I went for my first Jab of Pfizer at Pharmacy, where I was paying a visit to my sister?s family. I got my first shot on 24th of August at around 1:20 pm. I had a regular day with no immediate/anaphylactic reactions. But by the morning next day ie.25th of August, I had severe itching all over my body. I developed red blotchy hives which were severely itchy. Being a Doctor I just applied some topical Calamine and some cold sponges. I kept on doing this for two days after which I started taking Antihistamines (cetirizine and fexofenadine) based on symptoms and it gave me some relief and I started believing that this would subside. After a week of antihistamines, by 2nd of September the urticaria did subside a bit. But after two days, the welts started again with full force (4th of September) and I started taking medicine regularly. My urticaria has never really subsided completely, on top of it I noticed dermatographia as well. I am now using Cetrizine regularly. I had a belief that like every other adverse reactions of covid vaccine, this condition would as well get better by 2-3 weeks. Its been more than 3 weeks now and the calamine no longer works and I had to resort to use topical steroids (Desonide 5%) in extreme conditions, when the itching is very severe. Inspite of regular medicine, I keep getting these flareup every other day. I am really very concerned, now that my second dose is due in few days and I am afraid how to go about this situation. Please guide me in this regard.


VAERS ID: 1694341 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: Itchy throat and cough.


VAERS ID: 1694483 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-04
Onset:2021-08-25
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012A21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Dyspnoea, Fatigue, Feeling abnormal, Feeling hot, Headache, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Iron supplement
Current Illness:
Preexisting Conditions:
Allergies: Shrimp
Diagnostic Lab Data: Covid 19 positive
CDC Split Type: vsafe

Write-up: I started off with headache, congestion and sneezing. Then I had fatigue, fever loss of taste and smell. I felt like I was overheating, I had brain fog and shortness of breath. I went to ER, they gave me an infusion of antibodies.


VAERS ID: 1694616 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-11
Onset:2021-08-25
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac flutter, Heart rate increased, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 125mcg (one daily) Potassium Chloride 20mg (3 times daily) Valsarten HCT 160/25 mg (once daily) Metapropol 50mg (3 times daily)
Current Illness: High Blood Pressure Heart Conditions
Preexisting Conditions: High Blood Pressure Heart Conditions
Allergies: Codeine Erythromycin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Huge red rash down left arm, heart flutter with fast heart rate


VAERS ID: 1694650 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-10
Onset:2021-08-25
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Immunosuppression, Positive airway pressure therapy, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 08/25/2021, COVID-19 (NAA), Positive
CDC Split Type:

Write-up: Patient received his Pfizer COVID vaccines on 3/10/21 and 3/31/21 and was admitted to the hospital on 8/25/2021 with COVID-19. Due to MD note #COVID19 PNA #Acute hypoxic respiratory failure Continued on Dexamethasone (started 8/25 in ER), Ceftriaxone (started 8/30), Azithromycin (started 8/30). 5-day course of remdesivir was completed on 8/29. Now on BiPAP. Desaturating with any activity. Baricitinib was going to be started on 9/3 but just before giving Tocilizumab was delivered. He received 600 mg Tocilizumab. Baricitinib was not given. Duoneb q6h sch. I have concern of occult underlying infection such as fungal or other lung disease that is worsening with immunosuppression due to COVID treatment. It is odd to


VAERS ID: 1694835 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-01-04
Onset:2021-08-25
   Days after vaccination:233
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Diabetes
Preexisting Conditions: Spots on lung removed
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient went to the hospital for an infusion treatment after being diagnosed with COVID-19. Medical personnel admitted patient to the hospital on 08/30/2021.


VAERS ID: 1694885 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007D21A / 2 RA / IM

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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient stated that 2 days after he got covid shot he broke out in rash on legs and the rash is still there.


VAERS ID: 1694967 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Pantoprazole. Cyclobenzaprine, Levothyroxine, Vitamin D3, Sumatriptan, Nurtec
Current Illness: None
Preexisting Conditions: Obesity, Fibromyalgia, hypothyroidism, osteoarthritis, Headaches, traumatic brain injury, manic depression, anxiety
Allergies: Latex
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt reports Receiving shot on Monday, being extremely tired the day after receiving the shot on Tuesday, and then experiencing full body itching on Wednesday, which lasted for 3 to 4 days resolving some time on saturday. Pt reports self administering benadryl q 6 hours during that time to alleviate the itching. has had no additional itching since then,


VAERS ID: 1694973 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test normal, Brain natriuretic peptide normal, Chest X-ray normal, Chest discomfort, Chest pain, Differential white blood cell count, Dizziness, Electrocardiogram abnormal, Fibrin D dimer normal, Full blood count normal, Gait disturbance, Hyperhidrosis, Hypertension, International normalised ratio normal, Joint swelling, Metabolic function test, Metabolic function test normal, Muscular weakness, Pain, Pain in extremity, Palpitations, Peripheral swelling, Troponin I normal, Ultrasound scan normal
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: escitalopram, balance complex (probiotic), livery (supplement by innovita)
Current Illness:
Preexisting Conditions: mild mitral valve prolapse, asthma
Allergies: penicillin, avocado, mango, dust mites, grass, trees, etc
Diagnostic Lab Data: 8/30: multiple EKGs, D-Dimer blood test, protime-INR, Brain natriuretic peptide, troponin I, I-stat, comprehensive metabolic panel, CDC with differential, Chest X-ray, ultrasound of legs. All came out normal.
CDC Split Type:

Write-up: Woke up in the middle of the night after the first dose with swollen feet, ankles, legs and tightness in chest. Feet hurt to walk that morning, but that went away. Reported it to my doctor. She said to take some Tylenol and antihistamine. A week later still felt like my calves were swollen and tightness/weakness feeling in my chest (like my heart muscle was weakened), and then more frequent heart palpitations-- so I went to Urgent care 1pm on Monday 8/30. My EKG was showing abnormal (which it does often - due to Mitral valve prolapse), but they suggested I go to the Emergency room, so I went that afternoon. I noticed my blood pressure was higher than normal at ER (which it''s always the same), but the raised blood pressure coincided with chest pressure/pain. ER recommended referral to Cardiology. Since the first show, I''ve continued to have bouts of chest pressure/weakness feeling. Also not sure if it was related, but had one morning after I went for a walk, I felt like I got really weak, felt faint, sweating-- kind of like low blood sugar. Never really had that happen before.


VAERS ID: 1695350 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Pyrexia, SARS-CoV-2 test, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202011; Test Name: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: The patient had COVID.
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Vomiting; a 101 F fever; Cold chills; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (a 101 F fever), CHILLS (Cold chills) and VOMITING (Vomiting) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022C21A) 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) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced PYREXIA (a 101 F fever) and CHILLS (Cold chills). On 26-Aug-2021, the patient experienced VOMITING (Vomiting). At the time of the report, PYREXIA (a 101 F fever), CHILLS (Cold chills) and VOMITING (Vomiting) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In November 2020, SARS-CoV-2 test: positive (Positive) The patient had COVID.. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. Treatment information was not provided.


VAERS ID: 1695353 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026CZ1A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Somnolence, Tenderness, Vaccination site pain
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: ASPIRIN 81; SUPER B COMPLEX WITH C; GINGKO BILOBA; COQ10 + D3; VITAMIN D3; CENTRUM SILVER +50; GLUCOSAMINE; EMERGEN C; LUTEIN +; GRAPESEED; METOPROLOL; IRON; LOSARTAN
Current Illness: Bee sting (Bee stings); Drug allergy (Multiple allergies to medications (she don''t have a list))
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Tenderness; Feels sleepy all day; Pain at injection site; This spontaneous case was reported by a consumer and describes the occurrence of TENDERNESS (Tenderness), SOMNOLENCE (Feels sleepy all day) and VACCINATION SITE PAIN (Pain at injection site) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026CZ1A) for COVID-19 vaccination. Concurrent medical conditions included Bee sting (Bee stings) and Drug allergy (Multiple allergies to medications (she don''t have a list)). Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN 81), SUPER B COMPLEX WITH C, GINKGO BILOBA (GINGKO BILOBA), COLECALCIFEROL, UBIDECARENONE (COQ10 + D3), VITAMIN D3, CENTRUM SILVER +50, GLUCOSAMINE, EMERGEN C, ASCORBIC ACID, BETACAROTENE, COPPER, NICOTINAMIDE, SELENIUM, TOCOPHEROL, XANTOFYL, ZINC (LUTEIN +), VITIS VINIFERA EXTRACT (GRAPESEED), METOPROLOL, IRON and LOSARTAN for an unknown indication. On 25-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 TENDERNESS (Tenderness), SOMNOLENCE (Feels sleepy all day) and VACCINATION SITE PAIN (Pain at injection site). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 500 milligram once. At the time of the report, TENDERNESS (Tenderness), SOMNOLENCE (Feels sleepy all day) and VACCINATION SITE PAIN (Pain at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient also reported other concomitant medications that include Garlic capsule, Aller-tec 1 tab once daily.


VAERS ID: 1695404 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Dyskinesia, Headache, Illness, Influenza like illness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: soreness in joints; severely sick; could not move and it took 2 days to get out of her bed; very weird, different and severe than normal flu symptoms; Chills; Fever with 100.9F; soreness in whole body- including joints, muscle.; weird headache; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (severely sick), DYSKINESIA (could not move and it took 2 days to get out of her bed), INFLUENZA LIKE ILLNESS (very weird, different and severe than normal flu symptoms), CHILLS (Chills) and PYREXIA (Fever with 100.9F) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. 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 ILLNESS (severely sick), DYSKINESIA (could not move and it took 2 days to get out of her bed), INFLUENZA LIKE ILLNESS (very weird, different and severe than normal flu symptoms), CHILLS (Chills), PYREXIA (Fever with 100.9F), MYALGIA (soreness in whole body- including joints, muscle.) and HEADACHE (weird headache). On an unknown date, the patient experienced ARTHRALGIA (soreness in joints). At the time of the report, ILLNESS (severely sick), DYSKINESIA (could not move and it took 2 days to get out of her bed), INFLUENZA LIKE ILLNESS (very weird, different and severe than normal flu symptoms), CHILLS (Chills), PYREXIA (Fever with 100.9F), MYALGIA (soreness in whole body- including joints, muscle.), HEADACHE (weird headache) and ARTHRALGIA (soreness in joints) was resolving. The patient was feeling better on 29-Aug-2021. No Concomitant medications were provided. No treatment medications were provided. This case was linked to MOD-2021-302184 (Patient Link).


VAERS ID: 1695651 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-16
Onset:2021-08-25
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Lip swelling, Off label use, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: RESTYLANE
Current Illness:
Preexisting Conditions: Comments: No medical history was provided
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Swelling in her upper lip; Swelling above the upper lip; Not immunocompromised, got her third dose; This spontaneous case was reported by a consumer and describes the occurrence of LIP SWELLING (Swelling in her upper lip), SWELLING (Swelling above the upper lip) and OFF LABEL USE (Not immunocompromised, got her third dose) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 052E21A, 030M20A and 042L20A) for COVID-19 vaccination. No medical history was provided. Concomitant products included HYALURONIC ACID (RESTYLANE) for an unknown indication. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Aug-2021, the patient experienced OFF LABEL USE (Not immunocompromised, got her third dose). On 27-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced LIP SWELLING (Swelling in her upper lip) and SWELLING (Swelling above the upper lip). On 25-Aug-2021, OFF LABEL USE (Not immunocompromised, got her third dose) had resolved. On 31-Aug-2021, LIP SWELLING (Swelling in her upper lip) and SWELLING (Swelling above the upper lip) had resolved. Treatment information was not provided.


VAERS ID: 1696086 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-12
Onset:2021-08-25
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Covid 19 test
CDC Split Type: vsafe

Write-up: 8/25/2021, I tested positive for Covid-19 via home test via nasal swab. There have been 2 students with prior positive covid 19 case. I still have fatigue and loss of taste and smell.


VAERS ID: 1696169 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Musculoskeletal stiffness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 103 fever persisted $g12 hours, pain at injection site $g72 hours, whole bode stiffness ~24 hours after onset of fever upon waking day after injection


VAERS ID: 1696262 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-08-25
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 - / -

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

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

Write-up: COVID 19 positive


VAERS ID: 1696388 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ear pain, Headache, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Two days after vaccination developed a headache which is atypical for the client. Headache started at the crown of the headache and has been present for 3 weeks. It is mainly focused at the crown of the head and behind the L ear. Pain is worse at night when lying flat and better but not completely gone in the am. When taking Tylenol PRN it does help. Health department advised a clinic evaluation.


VAERS ID: 1696552 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Biopsy oesophagus, Chest discomfort, Choking, Dysphagia, Eosinophilic oesophagitis, Oesophageal dilation procedure, Oesophageal food impaction, Oesophagogastroduodenoscopy abnormal, Salivary hypersecretion
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Famotidine 10mg every night
Current Illness: Seasonal allergies
Preexisting Conditions: IBS Chronic indigestion, heartburn, and hiccups during/after eating
Allergies: Amoxicillin Bananas
Diagnostic Lab Data: EGD (Upper endoscopy) with esophagal dilation and biopsy on 09/08/2021 The gastroenterologist who did the procedure said I had signs of eosinophilic esophagitis. I''m awaiting the results of the biopsies he took.
CDC Split Type:

Write-up: Disclaimer: I have had issues with eating food for many years, so this is not a completely new condition in any way related to the vaccine. For at least 10 years, I have had severe heartburn, indigestion, and painful hiccups when I eat. Certain foods (e.g. red meat & bread) cause worse/more predictable reactions. I believe my possible adverse event is related to this preexisting condition, but the date in which it became debilitating correlate with my vaccination date. Around 08/25/2021, I was eating a sandwich that I often eat, and I noticed it was a lot harder to get it down my esophagus. I didn''t choke, as I was able to drink water and push it down, but I did notice it got a little stuck. On 08/30/2021, I was eating a steak slowly and in small bites as I''m used to doing to prevent my hiccups, when I felt a strange pressure in my chest. I tried taking a sip of water, but it felt like my body couldn''t drink. I told my husband, who saw this happening and became alarmed, not to worry, that I could breathe. After a few failed attempts to drink, I told him I thought I may be choking. My mouth and nose both started to pour saliva/snot and I realized the steak was stuck in my esophagus. I kept trying to sit up straight and swallow as much water as possible, and finally after about a minute it went down. A few days later, I was eating a cheeseburger, and the same thing happened. This time, however, I couldn''t get the food to go down. I kept trying to drink my Sprite, but every sip I took came immediately back up along with a tiny bit of food. It took me at least 20 minutes of doing this repeatedly for me to clear my esophagus and get relief from the choking sensation. I have had issues swallowing food since and have been limiting myself to soft & wet foods to avoid anything getting stuck. I have never experienced food getting stuck in my esophagus until that date 08/25/2021, though I did have preexisting related issues with eating. It was like a switch flipped and suddenly I couldn''t swallow normal food anymore. I received a phone call from the CDC today advising me to file this report in case it is related to the vaccine I received about a week prior to the start of this issue.


VAERS ID: 1696666 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Rash, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 30 minutes after 1st covid vaccine, developed rash. Was given benadryl at location of injection. Then came to ED for further assessment and treatment. In ED had normal respirations and clear lungs. Stated she also had throat tightness. Given solumedrol and benadryl in the ED. Observed and discharged home after 1.5 hours. Returned to ED the next day with shortness of breath. Observed and discharged home with steroid pack and benadryl after given IV fluids in ED.


VAERS ID: 1696692 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 3 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Extra dose administered, Fatigue, Neurological symptom, Vertigo
SMQs:, Vestibular disorders (narrow), Arthritis (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the Booster 3rd dose of Moderna 08/24/2021, started experiencing symptoms 08/25/2021 of vertigo, loss of function throughout the body, joints in the upper body pain, and mild fatigue. Primary recommendation for Neurologist follow-up 09/15/2021.


VAERS ID: 1696917 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site rash, Injection site warmth, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (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: losartan, topirimate, Benadryl, Zyrtec, combo birth control, Dulera, albuterol, valacyclovir, calcium carbonate.
Current Illness: none
Preexisting Conditions: Turner syndrome, hypertension, coartic aorta, bicuspid aortic valve, CKD stage 2, asthma, allergic rhinitis, ventral septal defect.
Allergies: sulfa, cephalosporins, trimethoprim, lisinopril, morphine
Diagnostic Lab Data: refer immunologist.
CDC Split Type:

Write-up: Patient presents today for evaluation of rash after receiving COVID vaccine. On 8/25/21 received Pfizer COVID vaccine at in left arm. Within 40min had a red, hot to touch rash around injection site and down most of left arm. The rash was not itchy or painful. No paresthesia. No swelling. Then last week, the rash has went to stomach, legs, right arm and face. Most spots have improved yet new areas develop. Again no itching or pain. Unsure if Zyrtec or Benadryl help which she already routinely takes for allergies. Has a history of multiple allergies but never to a vaccine. Prior to vaccine was feeling well and feels well besides rash. No fever. No lip, tongue, facial swelling, wheezing or SOB.


VAERS ID: 1696949 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Eyelid ptosis, Headache, Muscular weakness, Myasthenia gravis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Azathioprine, Montelukast, Pantoprazole, Prednisone, Pyridostigmine, Lisinopril, Vitamin D3, Magnesium Oxide, Vitamin B12, and Atorvastatin
Current Illness:
Preexisting Conditions: Patient has myasthenia gravis, which was under control.
Allergies: Flu vaccine (intolerance), penicillin (childhood reaction), metformin (intolerance)
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient started experiencing symptoms consistent with a myasthenia gravis exacerbation. These symptoms include headache, dizziness, muscle weakness, and ptosis. He started experiencing them the day after the vaccine.


VAERS ID: 1696962 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, Fludrocortisone, Hydrocortisone, Metformin, and Metoprolol
Current Illness:
Preexisting Conditions: Diabetes Mellitus 2, Hypertension, and Addison''s Disease
Allergies: Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, vomiting, and dizziness


VAERS ID: 1697180 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-04
Onset:2021-08-25
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Anxiety, Back pain, Blood test abnormal, Dizziness, Dyspnoea, Electrocardiogram normal, Mean cell volume decreased, Neck pain, X-ray normal
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Smallpox/military NA
Other Medications: Prilosec
Current Illness: None
Preexisting Conditions: Varicose veins headaches anxiety
Allergies: None.
Diagnostic Lab Data: SEP 13-14 I went to the ER and doctors multiple times. My EKG was fine, X-rays were fine Oxygen fine. They came up with nothing. Only one blood test my MCV count was low at 79. Anyways I just felt at a loss, I feel this could have been a reaction from the vaccine.
CDC Split Type:

Write-up: About 2 weeks after first shot I started to get a dull pain in what felt like my carotid artery. It was mild at first, then about a week later I started to get shortness of breath/anxiety back and neck pain. I felt like I was going to pass out. I was thinking I was having a heart attack, it was so bad I ended up going to the ER 3 times.


VAERS ID: 1697377 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

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

Write-up: Went to ER and diagnosed by ER doctor that she has Bell''s Palsy due to the Janssen Covid Vaccine


VAERS ID: 1697394 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, CoQ10, prenatal
Current Illness: none
Preexisting Conditions: Painful bladder syndrome, endometriosis
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have had tinnitus since about a week after my vaccination. This ringing in my left ear only is sometimes so loud it wakes me up at night. There are times when I do not hear it. It is always worse as the day goes on.


VAERS ID: 1699118 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-08-25
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Dyspnoea, N-terminal prohormone brain natriuretic peptide increased
SMQs:, Cardiac failure (broad), 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? 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: Blood test showed $g600 pg/mL nt-probnp levels
CDC Split Type:

Write-up: Difficulty breathing, persistent for three weeks


VAERS ID: 1700069 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 0489-9435-6263- / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Impaired work ability, Injected limb mobility decreased, Malaise, Palpitations, Pyrexia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 8/25/21 Pounding heart, dizziness headache. 8/26/21 Feeling unwell still pounding heartbeat could not lift and use left arm. 8/27/21 left work early 102 fever chills severe headache swollen face. 8/28/2021 Missed work swollen face severe headache chills fever still pounding heart. 8/29 pounding heart fatigue headache. 8/30 Same. 8/31 felt better but still pounding heart rate that lasted until 9/2/2021. Due to the side effect of my pounding heart rate I have cancelled 2nd dosage. The other side effects are manageable but not something as alarming as my heart pounding for 9 days


VAERS ID: 1700229 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Mobility decreased, Pain, Pain in extremity
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient indicates when urinating there was presence of blood. In addition, today she obtained the second dose, she had pain in her arm and in the mammary glands. She feels exhausted and have difficulty getting up.


VAERS ID: 1700255 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-06
Onset:2021-08-25
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Herpes zoster, Menstruation delayed, Neuralgia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Fertility disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: August 25th I noticed a rash on my lower mid back that itched. Monday nigh august 30th I started to experience neuropathy pain on my left hip . September 1st Dr. examined my rash and confirmed it was shingles. Also I have not had my ministration and was suppose to get on august 30th according to my period calendar.


VAERS ID: 1700346 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Psoriatic arthropathy, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prescriptions: Tremfya OTC Supplements: Vitamin A (10,000 IU); B-Complex; Vitamin D (10,000 IU); Integrative Similase Digestive Enzymes (2 capsules at meal time); Metagenics UltraFlora Acute Care Probiotic (1 capsule daily); Innate Respons
Current Illness: Lower GI inflammation (being treated with the above referenced supplements and strict dietary restrictions -FODMAP diet)
Preexisting Conditions: Managed - Psoriasis and Psoriatic Arthritis (currently taking Tremfya) Previously diagnosis with Lupus (not currently being treated or known to be active) History of epilepsy, but not seizure activity in the past 2 years and not currently taking medication
Allergies: Allergies: Benzodiazepines
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arthritic flair up in hands, specifically both left and right ring fingers, and in toes on left foot. Treatment recommendation is a round of steroids (have not started). Outcome pending. Additional symptoms included hives on hands and feel (all three doses). Not treatment sought.


VAERS ID: 1700407 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Muscle spasms
SMQs:, Dystonia (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Suntan Oil, plants, grass, trees, ragweed, animals, shellfish
Diagnostic Lab Data: None right now. Doctor said not to receive second shot of Pfizer vaccine. I had an appointment with Pharmacy on September 14, 2021 to receive second shot and after telling them the adverse effects from the first shot, they said I would need medical clearance from Doctor to receive second shot. On September 15, 2021, Dr said it was in my best interests not to receive second vaccine.
CDC Split Type:

Write-up: The following day I had pain in joints - especially fingers and cracking of the jaw when opening and closing my mouth. Also, about 1 week following the shot, severe cramps in legs and toes.


VAERS ID: 1700610 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abnormal sensation in eye, Headache, Musculoskeletal discomfort, Ocular discomfort, Spinal disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Corneal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: patient refers not taking anything
Current Illness: No conditions
Preexisting Conditions: No chronic illness
Allergies: No allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: 38 year old female patient reports after the administration of her first dose she felt a sensation of "latency" in the right eye, pressure in the eye, headache, neck and spinal area. Therefore, she visited her Dr. who indicated "it could have been the effect of the vaccine" so he prescribed anti-inflammatory for the patient. Patient reports the symptoms lasted approximately 4 days.


VAERS ID: 1700630 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-08-25
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain upper, Appendicitis, COVID-19, Dehydration, Gastritis, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Dehydration (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data: SARS CoV 2 PCR COVID-19 positive on 8/24/21
CDC Split Type:

Write-up: 8/24/21: Presents to the ED with epigastric pain for 2 days. Tested positive for COVID on admission via pre-procedure test. Diagnosed with: Abdominal pain, dehydration, gastritis, diffuse abdominal pain, appendicitis 8/26/21: Patient discharged.


VAERS ID: 1700734 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood creatine phosphokinase normal, C-reactive protein normal, Full blood count normal, Head discomfort, Metabolic function test, Muscle fatigue, Muscular weakness, Musculoskeletal discomfort, Nervousness, Neurological examination abnormal, Paraesthesia, Respiratory viral panel, Sensory loss, Thyroid function test normal, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NatureThyroid taken daily (60)
Current Illness: N/A
Preexisting Conditions: Hypothyroid
Allergies: Latex, onions, metroprolol
Diagnostic Lab Data: thyroid panel-normal, respiratory viral panel- all negative, CMP, CBC, C-reactive protein, Mg, sedimentation rate, creatinine kinase CK- all normal
CDC Split Type:

Write-up: 8/25-8/27 Pins & needles tingling that started in fingers & toes & progressed up all extremities and then started on the nose & cheeks. Extreme muscle fatigue in legs with some loss of strength & shaking with exertion head felt extremely heavy and neck was tierd just holding it up. On 27th, was immediately sent to ER to be evaluated for Gillian-barre during visit all blood work came back normal, negative stroke assessment, but was noted to have loss of "sharp" sensation when poked with a needle I could not feel it, tremor in hands & muscle weakness during my neurological exam. Was sent home to monitor my symptoms & told by the ER doctor it just seemed to be an adverse reaction to the


VAERS ID: 1700747 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mobility decreased, Pollakiuria
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: When I was giving patient her second Pfizer vaccine, she stated that on the first shot on 8/24/21, on the following day, she had side effects. She reported that she couldn''t get out of bed and had to use restroom 3 times.


VAERS ID: 1700862 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-20
Onset:2021-08-25
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9259 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6407 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal discomfort, Blood test normal, Fatigue, Magnetic resonance imaging normal, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone Atenolol Lipitor Fosamax Benadryl Calcium Vitamin D Multivitamins Tylenol Naproxen Zyrtec Flonase
Current Illness: Ususal chronic conditions listed below
Preexisting Conditions: Cardiac arrhythmia Vertigo Insomnia Osteopenia
Allergies: Sinus allergies
Diagnostic Lab Data: Blood work: normal results MRI: no lesions noted
CDC Split Type:

Write-up: 6 months after the last vaccine I experienced vertigo, nausea, fatigue, GI distress


VAERS ID: 1701096 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Rash macular, Rash pruritic
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Omeprazole
Current Illness: Unknown
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Client reported that he developed pain over the left side of his chest the night after receiving the vaccine. The client described the pain as "I feel like I got hit." The client also reported some shortness of breath. The client stated the symptoms lasted about 1 week. After one week the client stated his symptoms started to "go down." The client reported mild persistent chest pain. The client also reported that two weeks after the 1st COVID vaccine Pfizer, he developed a "red rash on my arms." The client described the rash as "big red spots that were itchy." The client stated that the rash resolved after one day. The client did not take any medication for the symptoms. The client did not follow up with PCP or allergist. The client denies any chronic conditions. The client takes Omeprazole daily for heartburn. The client has no known allergies.


VAERS ID: 1703053 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Unknown  
Location: Indiana  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Hot flush
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: USMODERNATX, INC.MOD20212

Write-up: chills with hot flashes; chills with hot flashes; This spontaneous case was reported by a consumer and describes the occurrence of HOT FLUSH (chills with hot flashes) and CHILLS (chills with hot flashes) in a 55-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) 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) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced HOT FLUSH (chills with hot flashes) and CHILLS (chills with hot flashes). At the time of the report, HOT FLUSH (chills with hot flashes) and CHILLS (chills with hot flashes) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information were not provided by the reporter. Concomitant medications were not reported by reporter.


VAERS ID: 1703675 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA P26C21A / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), 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: Medical History/Concurrent Conditions: Chronic kidney disease (Stage 3B); Coronary artery disease; Diabetes (Type 2 diabetes, controlled); Drug allergy (Allergic to Cimziai, Remicade, Methrotexate, Psudephrine); Hypertension; Hypothyroidism; Latex allergy; Psoriatic arthritis; Rheumatoid arthritis; Comments: Ty2 2 diabetic controlled, CAD, CKD stage 3b, psoriatic arthritis, rehumatoid arthritis, hypothyroidism, high blood pressure. Allergic to Cimziai, Remicade,Methrotexate, Psudephrine, latex
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Shortness of breath; Loss of taste; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Shortness of breath), AGEUSIA (Loss of taste) and FATIGUE (Fatigue) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. p26C21A) for COVID-19 vaccination. Ty2 2 diabetic controlled, CAD, CKD stage 3b, psoriatic arthritis, rehumatoid arthritis, hypothyroidism, high blood pressure. Allergic to Cimziai, Remicade,Methrotexate, Psudephrine, latex. Concurrent medical conditions included Diabetes (Type 2 diabetes, controlled), Coronary artery disease, Chronic kidney disease (Stage 3B), Psoriatic arthritis, Rheumatoid arthritis, Hypothyroidism, Hypertension, Drug allergy (Allergic to Cimziai, Remicade, Methrotexate, Psudephrine) and Latex allergy. On 25-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced DYSPNOEA (Shortness of breath), AGEUSIA (Loss of taste) and FATIGUE (Fatigue). On 07-Sep-2021, DYSPNOEA (Shortness of breath), AGEUSIA (Loss of taste) and FATIGUE (Fatigue) had not resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered DYSPNOEA (Shortness of breath), AGEUSIA (Loss of taste) and FATIGUE (Fatigue) to be possibly related. Sender''s (Case) Safety Report Unique Identifier- -2021-001245 No concomitant medication information provided by reporter. No treatment information provided by reporter. Most recent FOLLOW-UP information incorporated above includes: On 08-Sep-2021: Follow up received contains non significant information.


VAERS ID: 1704793 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit C, Vit D, Vitamin B complex, Prenatal, iron
Current Illness: none
Preexisting Conditions: post nasal drip, gerd
Allergies: benadryl
Diagnostic Lab Data: MRI and appt with neurologist
CDC Split Type:

Write-up: facial tingling and numbness on bottom half of face, numbness and tingling of left hand


VAERS ID: 1704994 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-25
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: patient experienced one swollen finger and back pain 2 weeks post vaccination. patient consulted with family physician who cannot rule out if these were covid-19 vaccination related.


VAERS ID: 1704997 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3180 / 3 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Hypersensitivity, Lymphadenopathy, Pruritus, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin
Current Illness: N/A
Preexisting Conditions: Borderline diabetes
Allergies: Penicillin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Got the Pfizer shot August 24th following day woke up at 6 a.m. 25th of August with severe allergic reaction to Pfizer lymph nodes extremely swollen hives all over my body and swells all over my body extremely itchy. Call my doctor to see what I could take through my insurance they advised me to go to the emergency room then I was prescribed Prednisone 20 mg tablet,Loratadine 10mg Claritin,Famotidine 20 mg Pepcid. Then send home and to schedule an appointment with my doctor that itching continue with swells for 8 days was seen by Dr. doctor sent me to get blood results at a lab and was prescribed omeprazole 40mg.


VAERS ID: 1705280 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-10
Onset:2021-08-25
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: STOMACH UPSET


VAERS ID: 1705472 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Blood test, Conjunctivitis viral, Eye pain, Fatigue, Iridocyclitis, Lacrimation increased, Lymphadenopathy, Ocular hyperaemia, Oedema peripheral, Photosensitivity reaction, Pruritus, Respiratory tract congestion, Sneezing, Vision blurred
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Lacrimal disorders (narrow), Ocular infections (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergic rhinitis
Allergies: Hay fever ( spring time) and dust mite allergy
Diagnostic Lab Data: Of note, blood work was unremarkable with ESR of 2; Lyme negative; CBC wnl; RF negative but ANA of 1:80 ( 1:80 is considered normal at laboratory). ANCA and ACE still pending at the time of this clinical description.
CDC Split Type:

Write-up: Patient: Arun Walcott- DOB 2/24/2006; CC: Red, painful eyes with blurred vision, right $g$gL; HPI: patient is a 15 year old AA male with no prior PMH except Allergic rhinitis who was in his USOH until; 8/25- onset of OD erythema, mild eye pain, photosensitivity, ? mildly pruritic, minimally blurred vision, watery but never purulent discharge. No other symptoms at that time. No intercurrent illness. He was treated with Artificial tears and erythromycin with a presumptive dx of atypical viral conjunctivitis. His sxs seemed to slowly self-resolve and by 8/31 most symptoms had resolved except minimal residual erythema. 9/4 Awoke with marked right $g left eye pain, erythema, photosensitivity, headache, blurred vision again without purulent discharge. This time associated symptoms - sneezing, congestion, swollen glands under right arm/ right side of neck and fatigue. He complained of a 30 second, chest pain more right-sided which was reproducible on palpation. No tachycardia, no dizziness, no palpitation, No fever, no SOB, no cough, no persistent chest pain. Restarted erythromycin ointment, started Tylenol 500 mg po q 6hrs, cool compresses; changed to Ibuprofen 400 mg po bid by 9/5; Changed to Vigamox 1 gtt tid on 9/6 until could contact family ophthalmologist on 9/7. Mother became very suspicious for uveitis on 9/5. Seen on 9/8 by local Ophthalmologist who confirmed diagnosis of anterior uveitis with mild vision loss in OD. Started on Prednisolone gtt on 9/9 ( needed to be ordered by the pharmacy so unavailable for application until 9/9). Patient was reassessed on 9/10 by ophthalmologist but the visual acuity in the right eye was slightly worsened although the erythema and eye pain was marked improved. Photosensitivity and blurred vision are the current symptoms. Current plan is to see a Uveitis specialist on 9/17. Pfizer Covid- 19 vaccination #1 received on 8/20. Pfizer Covid- 19 vaccination # 2received on 9/3. No FH of known autoimmune disorders but Aunt has a high nl ANA of 1:80 as well. Mom had a history of erythema nodosum after Hepatitis B vaccination as an adult. Patient has tolerated all his prior vaccinations without difficulty.


VAERS ID: 1706585 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Hypokinesia, Impaired quality of life, Laboratory test, Lymphadenopathy, Swelling, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (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:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had ruling out orthopedic issues.
Allergies:
Diagnostic Lab Data: Test Name: Lab test; Result Unstructured Data: not a blood clot
CDC Split Type: USJNJFOC20210926528

Write-up: SEVERE SWELLING; AFFECTING DAILY LIFE; LYMPH NODE SWOLLEN LEFT SIDE OF BODY; CAN NOT BEND LEGS; REACTION FROM VACCINE; This spontaneous report received from a patient concerned a 68 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient don''t have blood clots. The patient had ruling out orthopedic issues. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820095, and expiry: 22-FEB-2022) dose was not reported, administered on 25-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-AUG-2021, the patient experienced reaction from vaccine. On 25-AUG-2021, the patient experienced can not bend legs. On SEP-2021, the patient experienced lymph node swollen left side of body. On an unspecified date, the patient experienced severe swelling, and affecting daily life. Laboratory data (dates unspecified) included: Lab test (NR: not provided) not a blood clot. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from reaction from vaccine, can not bend legs, severe swelling, lymph node swollen left side of body, and affecting daily life. This report was non-serious.


VAERS ID: 1706757 (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: 2021-09-17
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.MOD20213

Write-up: Administered with an expired vaccine; 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 (Administered with an expired vaccine) 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 (Administered with an expired vaccine). On 25-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Administered with an expired vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications reported. No treatment information was reported by reporter.


VAERS ID: 1707143 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Bell's palsy, Erythema, Facial paralysis, Oropharyngeal pain, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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: ESTRADIOL
Current Illness: Hormone replacement therapy
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Sore throat; Bells palsy; Light thou painful paralysis of the face; Hand redness; Feet itchiness/Hand itchiness; Pain in the left armpit; Tingling sensation in hands/Tingling sensation in face; This spontaneous case was reported by a consumer and describes the occurrence of FACIAL PARALYSIS (Light thou painful paralysis of the face) and BELL''S PALSY (Bells palsy) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 054C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concurrent medical conditions included Hormone replacement therapy. Concomitant products included ESTRADIOL for Hormone replacement therapy. 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 PARAESTHESIA (Tingling sensation in hands/Tingling sensation in face) and AXILLARY PAIN (Pain in the left armpit). On 27-Aug-2021, the patient experienced FACIAL PARALYSIS (Light thou painful paralysis of the face) (seriousness criterion medically significant), ERYTHEMA (Hand redness) and PRURITUS (Feet itchiness/Hand itchiness). On an unknown date, the patient experienced BELL''S PALSY (Bells palsy) (seriousness criterion medically significant) and OROPHARYNGEAL PAIN (Sore throat). At the time of the report, FACIAL PARALYSIS (Light thou painful paralysis of the face), BELL''S PALSY (Bells palsy), PARAESTHESIA (Tingling sensation in hands/Tingling sensation in face), OROPHARYNGEAL PAIN (Sore throat), ERYTHEMA (Hand redness), PRURITUS (Feet itchiness/Hand itchiness) and AXILLARY PAIN (Pain in the left armpit) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Additional concomitant medication included Polycaprolactone 25mg twice a day for Hormone replacement therapy. Treatment included a Topical cream for itchiness. Patient reportedly did not used it. Patient was under hormone replacement treatment. Patient''s endocrinologist told her that the adverse events are not linked to the hormone replacement treatment, but to the vaccine. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1707234 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-28
Onset:2021-08-25
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0056021A / 1 - / OT

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

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

Write-up: Very painful that he cannot sleep comfortably; Fever; Chills; Headache; Pain on the left arm,After that, he will still have intermittent moderate to severe arm pain. the arm pain started to be severe; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain on the left arm,After that, he will still have intermittent moderate to severe arm pain. the arm pain started to be severe), INSOMNIA (Very painful that he cannot sleep comfortably), PYREXIA (Fever), CHILLS (Chills) and HEADACHE (Headache) in a 40-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0056021A) for COVID-19 vaccination. No Medical History information was reported. On 28-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 25-Aug-2021, the patient experienced PAIN IN EXTREMITY (Pain on the left arm,After that, he will still have intermittent moderate to severe arm pain. the arm pain started to be severe), PYREXIA (Fever), CHILLS (Chills) and HEADACHE (Headache). On 03-Sep-2021, the patient experienced INSOMNIA (Very painful that he cannot sleep comfortably). At the time of the report, PAIN IN EXTREMITY (Pain on the left arm,After that, he will still have intermittent moderate to severe arm pain. the arm pain started to be severe), INSOMNIA (Very painful that he cannot sleep comfortably), PYREXIA (Fever), CHILLS (Chills) and HEADACHE (Headache) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications reported. No treatment information was reported by reporter.


VAERS ID: 1707253 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088C21A / 3 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Arthritis, Asthenia, Intervertebral disc disorder, Magnetic resonance imaging, Nerve compression, Pain, Pain in extremity, Paraesthesia, Peripheral coldness, Stenosis
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Accidents and injuries (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID; LAMICTAL; CALCIUM; VITAMIN C [ASCORBIC ACID]; CENTRUM SILVER [ASCORBIC ACID;CALCIUM;MINERALS NOS;RETINOL;TOCOPHERYL ACETATE;VITAMIN B NOS;VITAMINS; BIOTIN
Current Illness: Arthritis; Hashimoto''s disease; Penicillin allergy (Penicillin or any other penicillin derivatives)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: MRI; Result Unstructured Data: inflammation between vertebrae (C1 to C7 and T2 to T3), stenosis
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Inflammation between her vertebrae; Stenosis; Arthritis; Flattening of the nerve; Weakness; Pain on fingers/Pain on arms; she had pain on her upper body (arms, shoulders, fingers); needle like feeling on her fingers,; ice coldness feeling on her fingers; Pain on shoulders; This spontaneous case was reported by a consumer and describes the occurrence of ARTHRALGIA (Pain on shoulders), INTERVERTEBRAL DISC DISORDER (Inflammation between her vertebrae), STENOSIS (Stenosis), ARTHRITIS (Arthritis) and NERVE COMPRESSION (Flattening of the nerve) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Hashimoto''s disease, Penicillin allergy (Penicillin or any other penicillin derivatives) and Arthritis. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID), LAMOTRIGINE (LAMICTAL), CALCIUM, VITAMIN C [ASCORBIC ACID], ASCORBIC ACID, CALCIUM, MINERALS NOS, RETINOL, TOCOPHERYL ACETATE, VITAMIN B NOS, VITAMINS NOS, ZINC (CENTRUM SILVER [ASCORBIC ACID;CALCIUM;MINERALS NOS;RETINOL;TOCOPHERYL ACETATE;VITAMIN B NOS;VITAMINS NOS;ZINC]) and BIOTIN for an unknown indication. On 24-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced ARTHRALGIA (Pain on shoulders), INTERVERTEBRAL DISC DISORDER (Inflammation between her vertebrae), STENOSIS (Stenosis), ARTHRITIS (Arthritis), NERVE COMPRESSION (Flattening of the nerve), ASTHENIA (Weakness), PAIN IN EXTREMITY (Pain on fingers/Pain on arms), PAIN (she had pain on her upper body (arms, shoulders, fingers)), PARAESTHESIA (needle like feeling on her fingers,) and PERIPHERAL COLDNESS (ice coldness feeling on her fingers). The patient was treated with IBUPROFEN (MOTRIN [IBUPROFEN]) at a dose of 6 Tab once a day and LORAZEPAM (ATIVAN) at a dose of 1 Tab once a day. At the time of the report, ARTHRALGIA (Pain on shoulders), INTERVERTEBRAL DISC DISORDER (Inflammation between her vertebrae), STENOSIS (Stenosis), ARTHRITIS (Arthritis), NERVE COMPRESSION (Flattening of the nerve), ASTHENIA (Weakness), PAIN IN EXTREMITY (Pain on fingers/Pain on arms), PAIN (she had pain on her upper body (arms, shoulders, fingers)), PARAESTHESIA (needle like feeling on her fingers,) and PERIPHERAL COLDNESS (ice coldness feeling on her fingers) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Magnetic resonance imaging: abnormal (abnormal) inflammation between vertebrae (C1 to C7 and T2 to T3), stenosis. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient is allergic to latex, fragrance, aromatic soaps, detergents, furr,. fruits like mangoes and kiwi. Also had high ANA levels and considered to be immunocompromised. This case was linked to MOD-2021-309590.


VAERS ID: 1707549 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling hot, Rash, Rash erythematous, Rash macular, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PHENTERMINE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: then they swell up, Some of them pop and look like sores, started having bumps on her left arm; it feels warm when it first starts; Patch on her side / a little red dot/spot,; new spots this morning, spreading in different places of her body. Front legs affected, back of legs affected, thighs affected, both arms affected, up to the shoulders are affected/ bumps on her left arm/ it''s all over; some rash on stomach/ bumps on her left arm/ a little red dot/spot, then it starts swelling up and turn into red bumps/ Some of them start swelling up and pop into a little sores front and back of her leg, front and back of her thighs. Its all over; This spontaneous case was reported by a consumer and describes the occurrence of RASH ERYTHEMATOUS (Patch on her side / a little red dot/spot,), RASH MACULAR (new spots this morning, spreading in different places of her body. Front legs affected, back of legs affected, thighs affected, both arms affected, up to the shoulders are affected/ bumps on her left arm/ it''s all over), SWELLING (then they swell up, Some of them pop and look like sores, started having bumps on her left arm), FEELING HOT (it feels warm when it first starts) and RASH (some rash on stomach/ bumps on her left arm/ a little red dot/spot, then it starts swelling up and turn into red bumps/ Some of them start swelling up and pop into a little sores front and back of her leg, front and back of her thighs. Its all over) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 059E21A) for COVID-19 vaccination. Concomitant products included PHENTERMINE from 18-Aug-2021 to an unknown date for Dietary control. On 18-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 MACULAR (new spots this morning, spreading in different places of her body. Front legs affected, back of legs affected, thighs affected, both arms affected, up to the shoulders are affected/ bumps on her left arm/ it''s all over) and RASH (some rash on stomach/ bumps on her left arm/ a little red dot/spot, then it starts swelling up and turn into red bumps/ Some of them start swelling up and pop into a little sores front and back of her leg, front and back of her thighs. Its all over). On 26-Aug-2021, the patient experienced RASH ERYTHEMATOUS (Patch on her side / a little red dot/spot,). On an unknown date, the patient experienced SWELLING (then they swell up, Some of them pop and look like sores, started having bumps on her left arm) and FEELING HOT (it feels warm when it first starts). The patient was treated with METHYLPREDNISOLONE ACETATE (DEPO MEDROL) for Adverse event, at a dose of 1 dosage form; PREDNISONE for Adverse event, at a dose of 1 dosage form and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. At the time of the report, RASH ERYTHEMATOUS (Patch on her side / a little red dot/spot,), RASH MACULAR (new spots this morning, spreading in different places of her body. Front legs affected, back of legs affected, thighs affected, both arms affected, up to the shoulders are affected/ bumps on her left arm/ it''s all over), SWELLING (then they swell up, Some of them pop and look like sores, started having bumps on her left arm), FEELING HOT (it feels warm when it first starts) and RASH (some rash on stomach/ bumps on her left arm/ a little red dot/spot, then it starts swelling up and turn into red bumps/ Some of them start swelling up and pop into a little sores front and back of her leg, front and back of her thighs. Its all over) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment medications included steroid and sinus drug. Most recent FOLLOW-UP information incorporated above includes: On 08-Sep-2021: Follow-up document received included events


VAERS ID: 1708457 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Patient is 17 years old and received the first dose of Moderna as an administration error due to her age.


VAERS ID: 1708675 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Pain in extremity
SMQs:, 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: None - she can''t take NSAIDS, she only has one kidney.
Current Illness: One kidney, "thyroid high"
Preexisting Conditions: One Kidney, donated it, other is healthy
Allergies: None
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Patient complained that her arm started hurting about 1 hour after receiving the vaccination. It got worse over time and often runs down her arm into her hand and her whole arm is EXTREMELY painful. She was very upset and wanted this reported, even though I mentioned that arm pain, joint pain was listed as a known side effect. She was concerned that the pain increase, leveled off and then has never gone away. It leveled off about 5 days after the shot, but has never gotten better. She can not take NSAIDS and doesn''t want to take any medications at all.


VAERS ID: 1708699 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-28
Onset:2021-08-25
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Dyspnoea, Electrocardiogram, Fibrin D dimer, Hypoxia, Oxygen saturation decreased
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad)

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: 1. Albuterol QID, prn 2. Anoro qd 3. Eliquis 5mg BID 4. Wellbutrin-XL 300mg qd 5. Strattera 40mg qd 6. Cialis 20mg qd, prn 7. Phentermine 37.5mg qd
Current Illness: No Acute Sx''s
Preexisting Conditions: 1. COPD--Controlled 2. Hypercoagulable State 3. h/o PE
Allergies: Spiriva--Unable to breathe
Diagnostic Lab Data: CXR=WNL and NAF; CT PE (-), but D-Dimer Elevated; EKG=Sinus Tach with occasional PAC; Leukocytosis with (L) Shift
CDC Split Type:

Write-up: 4 days after Vaccine #2, Pt with difficulty Breathing, SOB, and Hypoxia. Went to ED on 09/09/21 as SaO2 at home dropped to 88%. D/C''d with PO Omnicef, Steroids, and O2


VAERS ID: 1708713 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Joint swelling, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: HBP
Allergies: Ibuprofen, Some HBP medications (unknown)
Diagnostic Lab Data: Auto-Immune Test 09/17/2021
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of Phizer 08/25/2021, started experiencing symptoms immediately of swelling throughout the right arm starting at the wrist moving up. Currently experiencing swelling along the whole right side of body. Physician recommendation of Auto-Immune Test done and follow-up with Results and check in.


VAERS ID: 1708913 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dizziness, Dyspnoea, Electrocardiogram, Electrocardiogram ambulatory abnormal, Injection site pain, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lalita, Evening Primrose, Probiotic, Vitamin D3
Current Illness:
Preexisting Conditions: hyperthyroidism, grays disease, asthma, seizures, eczema, appendicitis
Allergies: Sulfa, Trileptal
Diagnostic Lab Data: Holter monitor, EKG
CDC Split Type: vsafe

Write-up: A few hours after receiving the vaccine I got a sore arm from the injection site. The next day late in the evening I developed episodes of tachycardia with shortness of breath, dizziness, chest pain, and chest discomfort to the point where I had to get put onto a Holter monitor. The monitor saw episodes of the tachycardia. My lowest heart rate was 46, which is normal for me when I sleep, and up to 156. I had to give up caffeine because of the episodes from the tachycardia that was getting. The Holter monitor also noticed a Wenckebach once.


VAERS ID: 1709102 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-06
Onset:2021-08-25
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Dizziness, Impaired driving ability
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Bloodwork done for low blood pressure and diabetes on 9/10/21 all came out okay
CDC Split Type:

Write-up: less than 3 weeks after my first covid shot i started to feel dizzy and faint.. Now, when i am over tired or stressed i start to feel faint and my equilibrium is off.. I was not like this prior to the Covid vaccine.. it usually happens when i am driving and i feel very unsafe when driving.


VAERS ID: 1709210 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO175 / 1 UN / IM

Administered by: School       Purchased by: ?
Symptoms: Dizziness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKA
Diagnostic Lab Data: BP-94/67, P80, 02-95% P88, 02-99%
CDC Split Type:

Write-up: After vaccine was administered, patient felt dizzy, vision was a little blurry. Patient sat on cot and ice pack was applied to back of neck. Vitals taken. Patient sat in EMS room approx 12 minutes until stated feeling better. Had patient stand to check balance and dizziness. Patient stated she felt good. Walked with patient and her mother to exit.


VAERS ID: 1710976 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Loss of personal independence in daily activities, Vaccination site pain
SMQs:, Dementia (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: Cerebral palsy (with an atrophied non-dominant arm)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Had difficutly using it for functional activities; Very sore arm in the injection arm after injection; This spontaneous case was reported by an other health care professional and describes the occurrence of VACCINATION SITE PAIN (Very sore arm in the injection arm after injection) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (Had difficutly using it for functional activities) in a 37-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 005C21A) for COVID-19 vaccination. Concurrent medical conditions included Cerebral palsy (with an atrophied non-dominant arm). On 25-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 VACCINATION SITE PAIN (Very sore arm in the injection arm after injection). On an unknown date, the patient experienced LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (Had difficutly using it for functional activities). At the time of the report, VACCINATION SITE PAIN (Very sore arm in the injection arm after injection) had resolved and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (Had difficutly using it for functional activities) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were provided by reporter. No treatment medications were provided by reporter. Most recent FOLLOW-UP information incorporated above includes: On 14-Sep-2021: Added Patient Ethnicity, Race information and outcome of event sore arm. Loss of personal independence in daily activities event added.


VAERS ID: 1711000 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 - / OT

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

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

Write-up: resting heart rate elevated; heart was pounding a little bit/ slight spluttering on the chest, a little bit, a mild case; This case was received via an unknown source, no reference has been entered for a health authority on 07-Sep-2021 and was forwarded to Moderna on 07-Sep-2021. This spontaneous case was reported by a consumer and describes the occurrence of resting heart rate elevated and PALPITATIONS in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024C21A) 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 resting heart rate elevated and PALPITATIONS. On 26-Aug-2021, resting heart rate elevated and PALPITATIONS had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) was unknown. No Concomitant medication was reported. No treatment Drug was reported.


VAERS ID: 1711370 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Fatigue, Off label use, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101110057

Write-up: off label use; Extra dose administered; very tired; she slept all day; This is a spontaneous report from a contactable consumer. This 63-year-old female consumer reported for herself that. A 63-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: FC3180), dose 3 via an unspecified route of administration on 24Aug2021 16:15 as (At the age of 63-years-old) dose 3, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. No Other Products, Patient History and no Investigation Assessment ware reported. The patient previously took first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: unknown) on 13May2021 and second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: unknown) on13May2021. It was reported that patient received extra dose administered (off label use) on an unspecified date. It was reported that Consumer calling regarding the Pfizer booster for COVID 19. Mentions she got the first and second dose and the booster. They wanted her to call in so Pfizer can keep up with what people are having. She is not at home and does not have her other vaccination card but does have information for the booster. When ask to report caller states if she had known it was this big a deal she would not have called. It was reported that patient first dose 13May2021; second dose 03Jun2021. Caller states she doesn''t have the card and cannot provide lot number. No NDC, expiration date or dose known to caller. Booster 24Aug2021 at 16:15PM in the left arm; lot FC3180. Caller states there is no other writing on the card for the booster; no NDC, expiration or dose. Administered at doctor''s office. Caller reports she was very tired on 25Aug2021; she slept all day. She didn''t have that with the first ones. The outcome of events was unknown. No follow up attempts are possible. No further information is expected.


VAERS ID: 1711381 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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 INC202101112050

Write-up: Sore arm; Have lot of discomfort in my chest and it''s getting really hard to breath; Have lot of discomfort in my chest and it''s getting really hard to breath; This is a spontaneous report from a contactable consumer (patient). A patient of an unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection), via an unspecified route of administration on 24Aug2021 (Batch/Lot number was not reported) as dose number unknown, single for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. Patient got the Pfizer vaccine on 24Aug2021 (yesterday, as reported) and on 25Aug2021 (today, as reported) patient had like you know the normal side effects like sore arm or whatever, but as the day go on patient had lot of discomfort in chest and it''s getting really hard to breath. So patient was wondering if patient could see a doctor or just wait and see. The outcome of the event(s) was unknown. Information on batch/lot number was requested.


VAERS ID: 1711469 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back disorder, Back pain, Chills, Gait inability, Headache, Illness, Joint injury, Movement disorder, Muscle spasms, Muscle swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
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 INC202101133028

Write-up: I''m so sick; my whole back ended up in emergency room the next day because I could not walk and move; all the muscles and the ''chi-chis'' around my back are swollen; knees hurt; couldn''t stand or walk; my whole back ended up in emergency room the next day because I could not walk and move; Headache; Feverish; body hurt, her joints didn''t feel right; Pain/I am in so much pain I literally can not stand it; so much in pain with my back; chills; my back seized up and took me to the floor; This is a spontaneous report from a contactable consumer (patient). A 53-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in left arm on 24Aug2021 (Lot Number: EW0217) at the age of 53-years-old as single dose for covid-19 immunisation. Medical history was none. Patient was a very healthy person. There were no concomitant medications. No other vaccine prior vaccination 4 weeks. Patient landed herself in emergency room and she was still suffering. Patient was so sick, she had been so sick. Patient had not done a second shot yet and she does not think she wants to. On 25Aug2021, starting early in the morning she had a horrible headache, feverish, her body hurt, her joints didn''t feel right and later that evening she was literally walking and her back seized up and took her to the floor. She couldn''t stand or walk or sit or anything and on 26Aug2021, she drove herself because she was a single mom but nobody helped her. She had to drive herself to the ER because she was in so much in pain with her back and it cost her a 100 dollars for the ER visit. Got shot up with Prednisone and Toradol and still have to see the back doctor which she had not yet. She was gonna to have an MRI and to figure out what''s wrong with back. They gave patient three pills of Prednisone and shot her up with Toradol and now she was gonna have to have an MRI because it was not fixed and then probably gonna have to go from there to figure out what else she needed to have done because she was in a lot of pain and now she was taking Hydrocodone for the pain and have been sick been literally sick for the 5 days. Patient received vaccine and believed was 25Aug2021 literally after 24 hours, she had to go home from work, had a headache, chills and basically turn back out she took a stab and her whole back ended up in emergency room the next day because she could not walk and move. Now she had an MRI to see what was wrong with back. Patient can tell a 100 percent this was due to having the Pfizer COVID shot. Now she had to take a high round of Pregnazon (Intent: Treatment for AE) and then she had to have another shot of Toradol (Intent: Treatment for AE) which was an anti inflammatory because all the muscles and the ''chi-chis'' around back are swollen, her knees hurt, knees normally pop but now they are popping all the time and they hurt, she was still struggling. Patient was waiting for the doctor to call her in the morning to see her either a back doctor but now she had to go in for them what she asked them to pick back but now she had to get on the plane in seven days and she was in so much pain, she literally cannot stand it. Outcome of the events was unknown. Follow-up attempts are completed. No further information is expected.


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