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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 397 out of 8,010

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VAERS ID: 1711486 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Immunocompromised; Leukemia (moderately immunocompromised with a history of leukemia)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101133862

Write-up: headaches; nausea; He received the third dose of the vaccine; This is a spontaneous report from a contactable other hcp (Nurse). A 74-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection) via an unspecified route of administration on an unspecified date (batch/lot number was not reported) as dose 3, single for covid-19 immunization (at the age of 74-years-old). Medical history included leukaemia (moderately immunocompromised with a history of leukemia) and moderately immunocompromised from unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The patient previously received first and second doses of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) on an unspecified date, as single dose for COVID-19 immunization. It was reported that to the patient who was moderately immunocompromised with a history of leukemia, his haematologist recommended he receive the third dose of the Pfizer Covid-19 vaccine and he received the third dose last Wednesday on 25Aug2021 and on 26Aug2021 he started experiencing side effects of headaches and nausea and been having them ever since. Caller reports treating the patient with Tylenol. Caller asked were there any other treatment recommendations. Caller states "he was basically asking me if I had any medical advice, so I''ll have him call his doctor and keep treating with Tylenol." The outcome of the events was unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1711504 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-12
Onset:2021-08-25
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / -

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

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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101134588

Write-up: Appendicitis; This is a spontaneous report from a contactable consumer (patient). A 70-year-old female patient received the 1st dose of bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), via an unspecified route of administration in arm left on 12Aug2021 (Lot Number: FA7484) as DOSE 1, SINGLE for COVID-19 immunisation. Medical history and concomitant medications were none. The patient did not receive any other vaccinations within 4 weeks prior to the administration of the suspect vaccine. The patient experienced appendicitis (caused hospitalization, medically significant) on 25Aug2021 with outcome of recovering. The event required emergency room visit. The patient was hospitalized for appendicitis from 25Aug2021 to 28Aug2021. Therapeutic measures were taken as a result of the event and included appendectomy on 25Aug 2021. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1711610 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Headache, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101145614

Write-up: My body aches completely my whole body aches; my body hurts; my head hurts; I get up when I am gonna get up after the bed or when I am sitting down I feel dizzy; I felt bad; I have been running a fever; This is a spontaneous report from a contactable consumer (patient). A patient of an unspecified age and gender received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot/batch number: unknown), via an unspecified route of administration on 20Aug2021, as dose 1, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced body aches completely whole body aches; body hurts, head hurts, I get up when I am gonna get up after the bed or when I am sitting down I feel dizzy, running a fever and I felt bad. The patient visited emergency room. The outcome of events was unknown. Information on the lot/ batch number has been requested. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1711625 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Rhode Island  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Crohn''s disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101145994

Write-up: I got a blood clot in my left leg; This is a spontaneous report from a contactable other health professional reporting for herself. A 41-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 25Aug2021 09:00 (Lot number: EW0185) at the age of 41 years old at left arm as single dose for COVID-19 immunization. Medical history included Crohns. Concomitant medications were not reported. The patient got a blood clot in my left leg on 25Aug2021 17:00. The event resulted in Doctor or other health care professional office/clinic visit, Life threatening illness (immediate risk of death from the event). Treatment received for the event included putting on Eliquis for 6 months. The outcome of the event was not resolved.; Sender''s Comments: Based on the information in the case report and a plausible temporal relationship, a possible causal relationship between the event Thrombosis cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1711763 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Unknown  
Location: Alabama  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Limb discomfort, Neuropathy peripheral, Off label use, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Paraplegic; Wheelchair user
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101154754

Write-up: nerves are just all over the place in legs; legs have been throbbing and aching; legs are feeling really heavy; dose 1 was given in Jun2021; dose 2 was given on 25Aug2021; dose 1 was given in Jun2021; dose 2 was given on 25Aug2021; This is a spontaneous report from a contactable consumer (patient). A 60-year-old patient of an unspecified gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the left arm, on 25Aug2021 (Batch/lot number: FC3184, Expiration date unknown), at age 60 years old, as dose 2, single, for COVID-19 immunisation. Relevant medical history includes being paraplegic on a wheelchair from an unknown date and ongoing. Concomitant medications were not reported. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the left arm, in Jun2021 (Bath/lot number: EW0150), at age 60 years old, as dose 1, single, for COVID-19 immunization and had some really bad side effects. The patient did not receive any other vaccines within 2 weeks prior to the first BNT162B2 shot. It was reported that the patient received dose 1 in Jun2021. The patient was supposed to receive dose 2 on 21Jul2021 but did not receive it. The patient received dose 2 on 25Aug2021. On 26Aug2021, 1 day after dose 2, the patient''s legs have been throbbing and aching, nerves are just all over the place in legs are feeling really heavy. So, the patient went to the ER on 26Aug2021 and they gave the patient an unspecified shot to calm the nerves down. The patient reported that it has been over a week and the patient was still having problems. The patient does not understand why the hurting does not stop. The patient states that it has gotten better but still hurts, the physician said it would last 4-5 days, but it has been past 7 days already. The outcome of the events was not resolved. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1711859 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-16
Onset:2021-08-25
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: COVID-19; Result Unstructured Data: Test Result:experienced COVID-19
CDC Split Type: USPFIZER INC202101169615

Write-up: COVID-19; COVID-19; This is a solicited report based on the information received by Pfizer (Mfr. Control No.: 21K-163-4062321-00) via a contactable consumer (patient). A 43-years-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot number was not reported, expiry date was not reported) via intramuscular route of administration on 16Mar2021 (at the age of 43-years-old) as DOSE 1, SINGLE, second dose (Batch/Lot number was not reported, expiry date was not reported) via intramuscular route of administration on 08Apr2021 as DOSE 2, SINGLE for covid-19 immunisation and adalimumab (HUMIRA, formulation: solution for injection in pre-filled pen) via subcutaneous route from Apr2021 and ongoing, at unspecified dose for an unspecified indication. The patient''s medical history and the concomitant medications were not reported. On 25Aug2021, the patient experienced covid-19. The patient underwent lab tests and procedures which included sars-cov-2 test: experienced covid-19 on 25Aug2021. The outcome for the events was not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up. The reporter''s assessment of the causal relationship of the events (vaccination failure & COVID-19) with the suspect product was not provided at the time of this report. Since no determination has been received, the case is managed based on the company causality assessment.; Sender''s Comments: As there is limited information in the case provided, the causal association between the events vaccination failure, COVID-19 and the suspect drug BNT162B2 cannot be excluded. The case will be reassessed once new information is available. The impact of this report on the benefit-risk profile of the Pfizer product and on the conduct of the study is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1713630 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: not known
Preexisting Conditions: unknown
Allergies: none
Diagnostic Lab Data: none needed
CDC Split Type:

Write-up: This patient came in for his second pfizer covid-19 vaccine, however after pt was administered the vaccine it was later discovered that the diluent used to dilute the vaccine was sterile water for injection instead of Normal Saline 0.9%. No adverse event was expected and patient contacted and confirmed only had bit or sore arm which resolved within couple days. We are completing this only to report vaccine admin error. Sterile Water for injection has not been studied thus unsure if vaccine on 8/25 would be effective. It was thus recommended that Patient be revaccinated and pt came in on 9-17-21 and was revaccinated. Again no Adverse event occurred with patient!


VAERS ID: 1713635 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Florida  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pain in extremity, Product preparation issue
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (broad)

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

Write-up: This patient was administered a Pfizer Covid-19 vaccine but it was latter discovered that the incorrect diluent was used upon mixing the vaccine. 1.8 ml of Sterile Water for injection was accidently used to reconstitute the vaccine instead of 0.9% Normal Saline. The correct amount was used and pt was administered 0.3ml. Pharmacy clinical team, Pfizer and CDC were contacted and it was determined that Sterile water for injection was not studied and thus they could not comment whether or not this vaccine would be effective. However no expected harm would have resulted and it was recommended to revaccinate. Was finally able to reach Patient on 9-10-21, who was advised of error and patient stated he was doing fine only had temporary headache and sore arm but both completely resolved without incident. Patient stated he would think about revaccination. Again no adverse event occurred this is being reported as vaccine administration error.


VAERS ID: 1713645 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Florida  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: This is not an adverse event report to patient but rather an vaccine administration error report. This patient came into obtain his second dose of Pfizer COvid-19 vaccine and it was administered without incident. However it was later discovered that the diluent used to reconstitute this vaccine was Sterile Water for injection (NDC: 00409-4887-17) instead of the recommended 0.9% normal saline. No expected adverse event expected from this vaccine admin error, Clinical team, Pfizer and CDC were contacted. We were advised that a diluent of Sterile Water for injection was not studied and therefore it could not be determined if vaccine from 8-25-21 would be efficascious. Was finally able to contact patient on 9/10/21 who spoke another language and with assistance of interpreter. was advised of the error. Patient stated he was doing fine had no problem with vaccine. Patient was advised it was recommended that he be revaccinated. Patient indicated his wife was at hospital and would consider coming in next week or two.


VAERS ID: 1713888 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-03
Onset:2021-08-25
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Muscle spasms, Pain in extremity, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: n/a
Current Illness: n/a
Preexisting Conditions: right shoulder chronic pain
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: later in the evening, i started to have spasms below the injection site on my left arm. In formed this also to the pharmacist where I received my shot. She stated she would document in my file as and asked my if I was still having the symptoms. I informed her, my last spasm occurred 08/21/2021. I received my second shot on 08/25/21. Within two hours, my arm started hurting extremely, which I knew it possibly would, however, it also raised quite a bit and was warm to touch as well. The raised bump lasted for three weeks. Also, since receiving the second shot, my left pinky has gone numb. I reported this to the pharmacist as my two family members waited to receiver their second shot. He stated he did not hear anything like this and appeared puzzled. Like it had nothing to do with the shot. after a further conversation with him, he finally stated he would document in my record on file.


VAERS ID: 1714048 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Fibrin D dimer normal
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: chest pain after covid vaccine


VAERS ID: 1714529 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-21
Onset:2021-08-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ethosuximide, Topirimate, Ferrous Sulfate, Clonidine ER and short acting, Lexapro, Multivitamin, D3, Vitamin C, Claritin
Current Illness: Absence seizure disorder
Preexisting Conditions: Absence seizure disorder
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Has been seizure free for 4-6 months (longest she?s been seizure free). The week of the 1st dose she had pretty significant seizures.


VAERS ID: 1714660 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-03
Onset:2021-08-25
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Product dose omission issue, SARS-CoV-2 test
SMQs:, Medication errors (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: sars-Cov-2 test; Test Result: Positive ; Result Unstructured Data: positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Missed second dose (37 days); COVID-19; This spontaneous case was reported by a nurse and describes the occurrence of COVID-19 (COVID-19) and PRODUCT DOSE OMISSION ISSUE (Missed second dose (37 days)) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 03-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 COVID-19 (COVID-19). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Missed second dose (37 days)). At the time of the report, COVID-19 (COVID-19) outcome was unknown and PRODUCT DOSE OMISSION ISSUE (Missed second dose (37 days)) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 25-Aug-2021, SARS-CoV-2 test: positive (Positive) positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was provided by reporter. No treatment drug was provided by reporter. This case was linked to MOD-2021-314265 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 09-Sep-2021: Follow up Received, included updated Reporter details. Patient details were added and start date of the event was added.


VAERS ID: 1714917 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Insomnia, Joint range of motion decreased, Loss of personal independence in daily activities, Pain in extremity
SMQs:, Dementia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: serovital
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Nothing except Advil Povides little relief
CDC Split Type:

Write-up: Within in 48 hours sharp pain in left shoulder with limited range of motion. the pin has not subsided byt has seemed to shift location moving down my arm No swelling but sharp pain and soreness Dailey activities are difficult and extreme trouble sleeping


VAERS ID: 1715183 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1021 / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alopecia, Aphasia, Computerised tomogram, Decreased appetite, Dizziness, Fatigue, Feeling abnormal, Full blood count, Headache, Injection site pain, Injection site swelling, Magnetic resonance imaging, Migraine, Nausea, Pyrexia, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: after flu vax in 1997-2003 chronic migraines would last for 7 to 10 days and would end in ER or PCP. Stopped injection and went
Other Medications: Hydroxychloroquine, sereteline
Current Illness: None
Preexisting Conditions: Lupus, Chronic Migraines, meningitis
Allergies: environmental allergies, flu vaccine
Diagnostic Lab Data: CT scan, CT with Contrast - which showed aneurism, waited 2.5hrs for MRI and MRA of neck to find out it was NOT aneurism. CBC, a ton of other blood work. MRA of Brain ordered Dates - see above
CDC Split Type:

Write-up: *Dizziness *Nausea *vomitting Chronic Migraine - 12 hours later at 0300 *headache *Fever (100.2 to 101.8) *EXTREME fatigue *Blurred vision *loss of appetite *Injection site felt like it was hit by sledge hammer *Injection site swollen aphasia brain fog Hair loss ER Visit on 8/31 after I Maxed out all triptans and other chronic migraine meds and all of the other symptoms Migraine PCP 9/7 wrote exemption and advised to follow with neuro and rest Neuro 9/8 who started infusions and ordered an MRA 9/9 1st infusion 9/15 2nd infusion 9/16 3rd infusion 9/21 eye dr to check pressure in eyes for the blurred vision


VAERS ID: 1715217 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Injection site pain, Muscle twitching, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 1ST Shot, I hade muscle twitching in the L arm (vaccinated arm). 2ND Shot, I have extreme arm pain in R arm ( injected arm) Not only at injection site from radiating pain down arm. I had muscle twitching in injected arm again. Headache, Fever 102.7 with chills and diaphoresis and body aches.


VAERS ID: 1715345 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dyspepsia, Fatigue, Feeling abnormal, Hypoaesthesia, Impaired work ability, Influenza like illness, Myalgia, Oropharyngeal pain, Paraesthesia, Skin test, Sneezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin; Lamotrigine; Clonazepam; Robaxin; OTC Vitamins: Emer-gen C powder drink; Vitamin D3; CoQ10; Albuterol inhaler
Current Illness: No
Preexisting Conditions: Recovering from lung cancer 2020 - did not have chemo; I had part of my lung removed last August - caught it early. Migraines; Bipolar Disorder
Allergies: Tramadol; Codeine; onion and garlic - give me migraines; MSG - give me migraines; Dairy intolerance
Diagnostic Lab Data: Doctor - tested to see if I was totally numb and I could feel it.
CDC Split Type: vsafe

Write-up: I did have an influenza vaccine at the same right arm and I had it right after the 1st COVID vaccine. Lot#P100348416. Afluria Quad 2021 - 2Q. Seqirus - Manufacturer. After the shots, probably about an hour afterwards, I started having a sore throat and sneezing. And feeling really fatigue. I continued through the night to feel bad/malaise and flu-like symptoms with muscles aches, sore throat and I went to bed. The next morning, I felt the same. I stayed home from work. I took OTC cold medicine and Dayquil. The night before I took Benadryl. I went to back to work the day after that day - but felt rundown and had a lot of fatigue. I have been feeling very exhausted - don''t have any energy. Starting the 1st of September, I started having numb-like tingling sensations in my feet and in my calves and my lower legs - aching super bad. It''s really odd. Aching has subsided but the tingling in my fingertips - not arms - having tingling in numbness that hasn''t stopped. At night, it has been waking me up with my feet and lower legs (the tingling and numbness). I went to the doctor on the 15th because it hadn''t stopped. I do have restless leg syndrome - one of my medications causes it - but it''s not bad as it used to be. Doctor said it could be related. I am having really bad, slow digestion problems. I didn''t think much of at time of doctor because I have had a history of it before. But I am feeling it again and whatever I take (like mag citrate) - it isn''t working and x-lax isn''t working either. Doctor said to continue to let her know. I did email her over the weekend - the tingling and numbness was so bad it was waking me up. I am concerned of Guillain-Barre syndrome and concerned with getting my 2nd shot. I recovered from the cold-like symptoms.


VAERS ID: 1715499 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Cardiac discomfort, Cardiac flutter, Cardiac monitoring, Chest X-ray normal, Chest pain, Chills, Echocardiogram, Electrocardiogram normal, Hypoaesthesia, Muscle spasms, Pain, Palpitations, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/8 - Blood work, EKG, X-Ray of heart, full blood panel- results came back normal, told to follow up with cardiologist 9/9: Follow up with primary doctor, EKG performed (normal) 9/17: Met with Dr. EKG taken and prescribed a 14 day heart monitor as well as scheduled an MRI (no date provided yet). Follow up Echo Stress test to be done on October 12. 9/17: Echo cardiogram performed at request from primary doctor (before he was aware I could get into the cardiologist as soon as I did). They also drew bloodwork- no results as of yet.
CDC Split Type:

Write-up: 8/25 felt symptoms similar to a heart attack and then palpitations and flutters consistently after with chills. Symptoms of heart attack went away but flutters and smaller chest pains persisted through the week. 9/8 the severe chest pain returned and I checked into the ER at Hospital as left arm was knumb and tingly with severe chest pain. Pain and a cramping feeling persists as well as abnormal feeling in heart and at random times of the day/night.


VAERS ID: 1715519 (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: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 RA / -

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

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

Write-up: brain fog, empty feeling in body/feels dead


VAERS ID: 1716887 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Hypoaesthesia, Paraesthesia, Pyrexia, Sensory loss
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Patient experienced joint pain, back pain, mild fever and chills for the first few days. Seven days post vaccination he experienced pain on right elbow. Fourteen days post vaccination the elbow pain subsided but he began to lose sensation on his right arm from his pinky up to his elbow/upper arm area. He described it as if his arm fell asleep and was numb and tingly.


VAERS ID: 1718307 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Heart rate increased, Investigation, Thirst, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none, Comment: none; very healthy
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Heart beat; Result Unstructured Data: Test Result:fast
CDC Split Type: USPFIZER INC202101182948

Write-up: abnormal, unexplained weight loss without change in behavior, up to 5 pounds (out of 117 pounds); fast beating heart; fatigue for several weeks when performing light tasks; felt like I was weak and thirsty; felt like I was weak and thirsty; This is a spontaneous report from a contactable consumer (patient). A 34-years-old non-pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot number was not reported, patient was 34-year-old and not pregnant at the time of vaccination), via an unspecified route of administration, administered in Arm Right on 20Aug2021 at 02:30 PM as DOSE 1, SINGLE for covid-19 immunisation. Medical history reported as none; very healthy. The patient''s concomitant medications were not reported. No seriousness criteria were reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine, no other medications were received within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19; since the vaccination, the patient was not tested for COVID-19. No known allergies were reported. On 25Aug2021, the patient experienced abnormal, unexplained weight loss without change in behavior, up to 5 pounds (out of 117 pounds), fast beating heart, fatigue for several weeks when performing light tasks, felt like i was weak and thirsty, felt like i was weak and thirsty. Reported that not just a fluctuation because I weighed myself at consistent times of the day. The patient underwent lab tests and procedures which included Heartbeat: fast on 25Aug2021. No treatment was received for events. The outcomes of events were not recovered. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1718764 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Cardiac stress test, Echocardiogram, Electrocardiogram abnormal, Hypertension, Tachycardia, Troponin normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

Life Threatening? Yes
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: Taltz
Current Illness: No
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Electrocardiogram, echocardiogram, blood tests for troponin (negative), stress test (exercise).
CDC Split Type:

Write-up: Tachycardia, arrhythimia, elevated blood pressure, abnormal EKG readings


VAERS ID: 1718864 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arrhythmia, Chest discomfort, Dizziness, Dyspnoea, Heart rate increased, Immediate post-injection reaction, Insomnia, Limb discomfort, Nausea, Palpitations, Somnolence
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Armour Thyroid 90mg/day Vitamin D3 NAC
Current Illness: Asthma Thyroid Cancer [cancer free for 11 years]
Preexisting Conditions: Asthma
Allergies: Ceftin Qvar inhaler
Diagnostic Lab Data: I am programmed to see my cardiologist next week. I have a full blood test taken prior to the vaccination if needed for comparison.
CDC Split Type:

Write-up: Heart palpitation and nausea immediately after vaccination. When reported, I was advised to drink water. Later - resting heart increased the beats per minute from 65 to 77. Palpitations with arrhythmia, difficulty breathing and difficulty sleeping [falling asleep]. constant chest "buzzing". Muscles in arms and legs delayed responsiveness - lead like feeling Fainting and dizziness especially in the mornings.


VAERS ID: 1718955 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-21
Onset:2021-08-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3180 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood test, Chest pain, Dizziness, Dyspnoea, Electrocardiogram, Fatigue, Heart rate irregular, Palpitations, Pyrexia
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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Chest pain, shortness of breath, heart palpitations, fever, joint pain, lightheadedness, fatigue, joint pain, irregular heartbeat


VAERS ID: 1718966 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Heart rate increased, Hyperpyrexia, Injection site erythema, Injection site pain, Injection site pruritus, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Allegra but stopped few days before each vaccine dose
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin, cephalosporin, Anesthetics like Lydocain, Novocain Many food allergies: Honey, eggplant seeds, parmesan cheese + some aged cheeses, intolerance to cow milk (but not yogurt or cheese) Large swelling from mosquito & bee bites Skin allergies when exposed to the sun (small itchy skin blisters start to develop after 15-30 minutes of sun exposure)
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Symptoms 8/25 - 8/27 Extreme chills Very high fever 104.6 (with 2 Tylenols) Headache Irregular rapid heart palpitations Pulse reached 148+ beats/minute at sedentary status Sore injection site and arm on 8/27 injection site was red all around it (elongated circle to almost the elbow) and very itchy Did not call doctor. No treatment from doctor but took 2 Tylenols when fever started to increase.


VAERS ID: 1719490 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: Drospirenone Womens multi-vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore arm at injection site through the night. Arm was significantly better the next day, and tenderness completely gone after 2 days.


VAERS ID: 1719531 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT SURE / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Panic attack
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: None
Current Illness:
Preexisting Conditions: Central Sensitization Syndrome
Allergies: Valium, cats
Diagnostic Lab Data: None
CDC Split Type:

Write-up: First panic attack in my life. I?ve never had anxiety or come close to a panic attack. I don?t know that it?s related to the vaccine, but I hope this information is helpful. Since that full on anxiety attack, I?ve felt sort of an onset maybe 6 or 7 separate times, but was aware of what was happening and was able to lay down and breathe my way out of it!


VAERS ID: 1720060 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-17
Onset:2021-08-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Injection site rash, Pain, Pain in extremity, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Graves Disease, uterine issues, pins and needles sensation throughout limbs and back, back pain
Allergies: Codene
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme pain, swelling, redness and itching in left arm for several weeks after injection, large heart shaped rash at injection area was noticed on August 25th 2021 around 10:00 am. Sometimes I still feel a dull achy sensation. (I took a picture of my arm)


VAERS ID: 1720077 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / ID

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest pain, Condition aggravated, Dyspnoea, Pertussis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Shortness of breath , fever, and gastric issues with past flu shots
Other Medications: Coreg, Zetia, Alsace, Gabapentin, Lexapro, Vitamin D, Enbrel
Current Illness: N/A
Preexisting Conditions: rheumatoid arthritis, CAD, IBS, sub-total colonectomy, sjogrens
Allergies: Multiple food allergies X 47 , gluten, ampicillin, naproxen, neomycin, Voltaire?s, MSG, BLUE 2, potassium nitrate, sodium sulfite, aspartame, benzocaine acid, BHT, saccharine, polysorbate 80, goldenseal, agave, barley grass, glucosamine, rooibos tea, goji berry, black walnut bilberry, rhodiola
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Quickly deteriorating energy, rise in fever, trouble breathing, shortness of breath, severe ?whooping? type cough, chest pain


VAERS ID: 1720697 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Erythema, Joint swelling
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient had severe swelling and redness to joint of left knee the following day after vaccine. It then worsened to include swelling to both knees and ankles although the left knee remained the most swollen, red and painful.


VAERS ID: 1721352 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Alabama  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: Swollen lymph nodes and a hard knot close to breast; Swollen lymph nodes and a hard knot close to breast; This spontaneous case was reported by a consumer and describes the occurrence of BREAST MASS (Swollen lymph nodes and a hard knot close to breast) and LYMPHADENOPATHY (Swollen lymph nodes and a hard knot close to breast) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy (Allergic to morphine). On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced BREAST MASS (Swollen lymph nodes and a hard knot close to breast) and LYMPHADENOPATHY (Swollen lymph nodes and a hard knot close to breast). At the time of the report, BREAST MASS (Swollen lymph nodes and a hard knot close to breast) and LYMPHADENOPATHY (Swollen lymph nodes and a hard knot close to breast) had not resolved. Not Provided 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 reported. No treatment medications were reported.


VAERS ID: 1722211 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-02-26
Onset:2021-08-25
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Gait disturbance, Head injury, Impaired driving ability, Limb injury, Mobility decreased, Off label use, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: I can''t even move/ States it is absolutely ridiculous she cannot move around of having this vertigo, and got this vertigo since she got the booster shot; she has to be driven because she can''t drive; she went off balance from the vertigo and fell backwards, and hit her head and shoulders because of the vertigo.; Received the Moderna booster shot and she is not immunocompromised.; she went off balance from the vertigo and fell backwards; she went off balance from the vertigo and fell backwards, and hit her head; she went off balance from the vertigo and fell backwards, and hit her head and shoulders because of the vertigo.; had complete vertigo/if she lays down and close her eyes, or if she lays down too fast, it will put her into the vertigo; I couldn''t walk without falling down/I cannot get up and walk around without having vertigo/She just lays back on her sofa and gets the vertigo; This spontaneous case was reported by a consumer and describes the occurrence of VERTIGO (had complete vertigo/if she lays down and close her eyes, or if she lays down too fast, it will put her into the vertigo), GAIT DISTURBANCE (I couldn''t walk without falling down/I cannot get up and walk around without having vertigo/She just lays back on her sofa and gets the vertigo), MOBILITY DECREASED (I can''t even move/ States it is absolutely ridiculous she cannot move around of having this vertigo, and got this vertigo since she got the booster shot), IMPAIRED DRIVING ABILITY (she has to be driven because she can''t drive) and BALANCE DISORDER (she went off balance from the vertigo and fell backwards, and hit her head and shoulders because of the vertigo.) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Encephalitis. Concurrent medical conditions included Disability and Asthma chronic. On 26-Feb-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 VERTIGO (had complete vertigo/if she lays down and close her eyes, or if she lays down too fast, it will put her into the vertigo) and GAIT DISTURBANCE (I couldn''t walk without falling down/I cannot get up and walk around without having vertigo/She just lays back on her sofa and gets the vertigo). On an unknown date, the patient experienced MOBILITY DECREASED (I can''t even move/ States it is absolutely ridiculous she cannot move around of having this vertigo, and got this vertigo since she got the booster shot), IMPAIRED DRIVING ABILITY (she has to be driven because she can''t drive), BALANCE DISORDER (she went off balance from the vertigo and fell backwards, and hit her head and shoulders because of the vertigo.), OFF LABEL USE (Received the Moderna booster shot and she is not immunocompromised.), BALANCE DISORDER (she went off balance from the vertigo and fell backwards), HEAD INJURY (she went off balance from the vertigo and fell backwards, and hit her head) and LIMB INJURY (she went off balance from the vertigo and fell backwards, and hit her head and shoulders because of the vertigo.). At the time of the report, VERTIGO (had complete vertigo/if she lays down and close her eyes, or if she lays down too fast, it will put her into the vertigo), GAIT DISTURBANCE (I couldn''t walk without falling down/I cannot get up and walk around without having vertigo/She just lays back on her sofa and gets the vertigo), MOBILITY DECREASED (I can''t even move/ States it is absolutely ridiculous she cannot move around of having this vertigo, and got this vertigo since she got the booster shot), IMPAIRED DRIVING ABILITY (she has to be driven because she can''t drive), BALANCE DISORDER (she went off balance from the vertigo and fell backwards, and hit her head and shoulders because of the vertigo.), BALANCE DISORDER (she went off balance from the vertigo and fell backwards), HEAD INJURY (she went off balance from the vertigo and fell backwards, and hit her head) and LIMB INJURY (she went off balance from the vertigo and fell backwards, and hit her head and shoulders because of the vertigo.) had not resolved and OFF LABEL USE (Received the Moderna booster shot and she is not immunocompromised.) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication information provided by the reporter. No treatment information provided.


VAERS ID: 1722717 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Migraine
SMQs:, Anaphylactic reaction (broad)

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

Write-up: migraines and chest tightness


VAERS ID: 1722755 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Palpitations, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: syncope--memory loss- heart palpitations


VAERS ID: 1722913 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-19
Onset:2021-08-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / UNK 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: Flonase, zyrtec
Current Illness:
Preexisting Conditions: HSV2
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on around collar bone both sides of chest, expanded toward neck


VAERS ID: 1722959 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Rash
SMQs:, Anaphylactic reaction (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? 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: rash and shortness of breath


VAERS ID: 1723334 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-20
Onset:2021-08-25
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 2 LA / SYR

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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bictarvy
Current Illness: N/a
Preexisting Conditions: Hiv
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed Bell?s palsy around 8/25


VAERS ID: 1723364 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-15
Onset:2021-08-25
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Incassia 0.35 mg
Current Illness: none
Preexisting Conditions: Hashimoto''s
Allergies: Diflucan
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heavy irregular menstrual bleeding. I had been extremely regular prior to this. Injection was administered on cycle day 5, during my period. I continued my period for another day, which was normal. Heavy bleeding started again on cycle day 15, lasted for 6 days. Started again 3 days later, lasted for 6 more days. I have never had irregular bleeding like this before. My cycle has not returned to normal.


VAERS ID: 1723590 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, 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: horse serum/ rattle snake bite
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme fatigue, big increase in tinnitus in my ears


VAERS ID: 1723625 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chest discomfort, Headache, Loss of consciousness, Malaise
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not none
Current Illness: Not known
Preexisting Conditions: Not known
Allergies: Aspirin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt came to office to bring her children for their second Pfizer vaccine. She stated that the day after her vaccine she had a headache and did not feel well. She described that her chest felt like a "brick" was on it and it was "caving" in. She passed out and her family called 911. The paramedics took her temperature and it was "over 103 degrees". She stated that she did not know she had a temp and did not have a way to check it. They gave her Tylenol, an inhaler and observed her. They did not take her to the ER.


VAERS ID: 1724305 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-25
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec Prozac Methimazole
Current Illness: Graves Disease
Preexisting Conditions: Migraines
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Migraine every day for two weeks after the first dose and one week after the second dose. I have not had a period since before the first dose.


VAERS ID: 1725641 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cough, Decreased appetite, Depression, Headache, Nausea, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (Known allergies: Penicillin)
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: Nasal Swab; Test Result: Negative ; Test Date: 20210827; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101236980

Write-up: Headache; Low grade fever; Nausea; Depression; Weak; No appetite; Cough; This is a spontaneous report from a non-contactable consumer, the patient. A 56-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3183) via an unspecified route of administration in the left arm on 24Aug2021 at 09:30 (at the age of 56-years-old) as a single dose for COVID-19 immunisation. Medical history included penicillin allergy. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any concomitant medications. The patient previously took ranitidine hydrochloride (ZANTAC) and morphine sulfate (MORPHINE) and experienced drug allergy. On 25Aug2021 at 07:00, the patient experienced headache, low grade fever, nausea, depression, weak, no appetite and cough. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were not taken as a result of the events. On 27Aug2021, the patient underwent nasal swab test for COVID-19 and the result was positive. On 10Sep2021, the patient underwent nasal swab test for COVID-19 and the result was negative. The clinical outcome of the events headache, low grade fever, nausea, depression, weak, no appetite and cough was resolved with sequelae (reported as patient recovered with lasting effects) on an unknown date in 2021. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1726364 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-21
Onset:2021-08-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Burning sensation, Dizziness
SMQs:, Peripheral neuropathy (broad), 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: No
Current Illness: No
Preexisting Conditions: Multiple Chromes
Allergies: No
Diagnostic Lab Data: Blood Work
CDC Split Type: vsafe

Write-up: Burned feeling on my forehead. I felt dizziness.


VAERS ID: 1726516 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-19
Onset:2021-08-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bacterial vaginosis, Blood test, Genital discomfort, Genital swelling, Laboratory test, Urinary tract infection
SMQs:, Angioedema (broad), Hypersensitivity (broad), Sexual dysfunction (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: Ibuprofen, Clonidine, Synthroid
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfates
Diagnostic Lab Data: Lab Test 08/28/2021 Blood Test 08/28/2021
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of Phizer 08/19/2021, started experiencing symptoms 08/25/2021 of a raised bump in the genital area and irritation. Urgent Care (08/28/2021) visit diagnosed with Bacterial Vaginosis, 2nd Urgent Care visit diagnosed with UTI. Treated with (2 rounds) Antibiotics and Anti-Viral. Still continuing to experience symptoms.


VAERS ID: 1726642 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methotrexate, Leucovorin, Methocarbamol, gabapentin, plaquenyl, omeprazole, Montelukast, famotidine, Xyzal, Tylenol, advair , restasis , calcium,
Current Illness: None
Preexisting Conditions: Sjogren?s, Raynaud?s, cervical disc herniation, lumbar bulging disc, asthma
Allergies: Imuran, Keflex, Mupirocin, Darvocet, Ambien, Phenazopyridine,Mupirocin
Diagnostic Lab Data: Labs were done by rheumatologist. He said it was normal.
CDC Split Type:

Write-up: Low grade fever for more than a month , ranging from 99.2 to 101.6. Fatigue


VAERS ID: 1727383 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-08-25
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 29 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 16888

Write-up: COVID pneumonia. Treated with dexamethasone and Remdesivir.


VAERS ID: 1728712 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abdominal discomfort, Blood pressure increased, Chest discomfort, Diarrhoea, Dysgeusia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Noninfectious diarrhoea (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: metoprolol metformin1000, glipizide 10 mg
Current Illness: no
Preexisting Conditions: diabetic type 2 heart problems high blood pressure
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood pressure immediately went up to 200/116 chest pressure and metallic taste . Pressure was elevated until the next day . Diarrhea and upset stomach.


VAERS ID: 1728793 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Deep vein thrombosis, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Chest pain, shortness of breath, chest pressure, deep vein blood clot.


VAERS ID: 1730365 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-08-25
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site pain
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: some soreness in his left arm at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (some soreness in his left arm at injection site) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) 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, the patient experienced VACCINATION SITE PAIN (some soreness in his left arm at injection site). At the time of the report, VACCINATION SITE PAIN (some soreness in his left arm at injection site) had not resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant medication were reported. No treatment information was reported. This case was linked to MOD-2021-320997 (Patient Link).


VAERS ID: 1730395 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TYNELOL
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Covid test; Test Result: Negative
CDC Split Type: USPFIZER INC202101102396

Write-up: hives approximately 15 hours later-at first on abdomen and back then chest then tops of legs and inside of arms; Itching badly; This is a spontaneous report from a contactable consumer (Patient). A 22-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; solution for injection, Lot Number: Unknown), via unspecified route of administration, in left arm on 24Aug2021 11:15 AM (at the age of 22-year-old) as a dose 2, single for COVID-19 immunization. The patient medical history was not reported. The concomitant medication of the patient included paracetamol (TYNELOL). The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: Unknown) via unspecified route of administration on 03Aug2021 as a dose 1, single for COVID-19 immunization. The patient had no known allergies and no other medical history. Patient had no COVID prior to vaccination. The patient was tested for COVID post vaccination (negative). On 25Aug2021 02:00 AM the patient experienced hives approximately 15 hours later-at first on abdomen and back then chest then tops of legs and inside of arms. Itching badly. Patient reported that hives were worse on arm that didn''t receive the injection. Patient received the treatment of Benadryl and Benadryl topical cream for the reported events. Outcome of the reported events was recovering. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1730396 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Dyspnoea, Euphoric mood, Hypoaesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular 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: AMLODIPINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (Known allergies: yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101103056

Write-up: 2nd dose - after approx hour of administration - face tingling and numbness, light-headed/ floaty feeling, difficulty swallowing and breathing; 2nd dose - after approx hour of administration - face tingling and numbness, light-headed/ floaty feeling, difficulty swallowing and breathing; 2nd dose - after approx hour of administration - face tingling and numbness, light-headed/ floaty feeling, difficulty swallowing and breathing; 2nd dose - after approx hour of administration - face tingling and numbness, light-headed/ floaty feeling, difficulty swallowing and breathing; 2nd dose - after approx hour of administration - face tingling and numbness, light-headed/ floaty feeling, difficulty swallowing and breathing; 2nd dose - after approx hour of administration - face tingling and numbness, light-headed/ floaty feeling, difficulty swallowing and breathing; This is a spontaneous report from a contactable consumer (patient). A 53-years-old female patient (not pregnant at the time of vaccination) received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection and batch no: not reported/lot number: EW0181) via an unspecified route of administration, in left arm on 25Aug2021 11:00 AM (at the age of 53-years-old) as single dose of for COVID-19 immunization at Pharmacy or Drug store. Medical history included as allergy. Concomitant medications included the patient received medications within 2 weeks of vaccination included amlodipine at 2.5 mg for an unspecified indication. Historical vaccine included as patient received her first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection and batch no: not reported/lot number: EW0181) via an unspecified route of administration, in left arm on 04Aug2021 11:00 AM (at the age of 53-years-old) as single dose for COVID-19 immunization and experienced tingling cold in left arm and leg within 15min of administration. The patient had not received any other vaccines within 4 weeks prior to the covid vaccine. Prior to vaccination, the patient was not diagnosed with covid-19 and since the vaccination, the patient has not been tested for covid-19. On 25Aug2021 at 12:15PM after approx. hour of administration, patient experienced face tingling and numbness, light-headed/ floaty feeling, difficulty swallowing and breathing. The outcome of the events was not recovered. Follow-Up (02Sep2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1731242 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-02-26
Onset:2021-08-25
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Adenocarcinoma, Condition aggravated, Non-small cell lung cancer, Positron emission tomogram abnormal
SMQs:, Non-haematological malignant tumours (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: Alecensa (alectinib), Lexapro, multi vitamin and Glucosamin/Chondrotin tablet
Current Illness: NSCLC adenocarcinoma
Preexisting Conditions: NSCLC adenocarcinoma
Allergies: None Known
Diagnostic Lab Data: PET scan 08/25/2021 showed progression of disease NSCLC adenocarcinoma up until that time the disease had been stable
CDC Split Type:

Write-up: I am in active treatment for NSCLC adenocarcinoma with an oral targeted therapy drug Alecensa (alectinib). After 4 years of being stable I had progression within months of receiving the second dose of the COVID vaccine. I do not know if the two are in any way connected but felt it important enough to report


VAERS ID: 1731796 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Condition aggravated, Deafness unilateral, Pain in jaw, Tinnitus
SMQs:, Hearing impairment (narrow), Osteonecrosis (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: 1980 - Guillian-Barre from flu vaccine
Other Medications:
Current Illness: None
Preexisting Conditions: Obesity, HTN, DM II, ADHD, Anxiety, Depression, PTSD, Strabismus, tinnitus, hearing loss, TA, osteoarthritis , pseudogout, TAH/BSO estrogen replacement, GERD, TMJ, carpal tunnel, Guillain-Barre
Allergies: Opium, Sulfa, Doxycycline, nitrofurantoin, benzoin, mold, grass, tobacco, marijuanna, cat hair
Diagnostic Lab Data: Hearing test with 10dB loss left ear
CDC Split Type:

Write-up: Immediate increase tinnitus and additional hearing loss left ear, jaw pain,


VAERS ID: 1732038 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Nausea, Pyrexia
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)

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: Losartan, Atorvastatin, Vitamin D, Zinc
Current Illness: None
Preexisting Conditions: Blood pressure
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever 102F; headache; extreme fatigue; nausea; loss of appetite.


VAERS ID: 1732063 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-03
Onset:2021-08-25
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood gases, Bronchitis, Chest X-ray abnormal, Chest discomfort, Cough, Dyspnoea, Oxygen saturation decreased, Pneumonia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Adderall; levothyroxine; venlafaxine XR; alprazolam; albuterol nebulizer; montelukast; EpiPen; Symbicort; Diovan; sitagliptin; amitriptyline; escitalopram; bupropion SR; gabapentin
Current Illness: None.
Preexisting Conditions: Asthma; High blood pressure; Fibromyalgia; Diabetes.
Allergies: Penicillin; bees; oranges.
Diagnostic Lab Data: Lung X-ray, Blood Oxygen Test, Covid.
CDC Split Type: vsafe

Write-up: About 3 AM I woke up and couldn''t breathe. It was very difficult to breathe and I thought I was having an asthma attack so I took my rescue inhaler and it didn''t work so I waited about 10 minutes and tried again and it still didn''t work. I called my husband and he took me to the ER and they put me on 12 liters of oxygen because oxygen was down so low, and then they tested me for covid (negative) and they did an X-ray of lungs and said it was pneumonia, and they put me in a room and I stayed there for 5 days so my oxygen gradually came down and I was able to get off oxygen by the fifth day. During that time I had multiple breathing treatments (2x a day in hospital) and then I also got antibiotics and my regular medicine as well and then I was able to go completely off of the oxygen the 4th afternoon. They kept me for the 24 hours to evaluate and make sure everything was clear and I was able to get out the next day and then I was given instructions to follow up with my PCP which I did the next week and he diagnosed me with Bronchitis. He gave me Levaquin and put me on a steroid pack (meprednisone pack 4 mg) and codeine for the deep cough, and levofloxacin 500 mg (antibiotics) and so I finished that up and it took me awhile. I notice sometimes my chest is tighter than normal but that''s it.


VAERS ID: 1732390 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-25
Onset:2021-08-25
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Cardiac disorder, Chest pain, Colonoscopy, Dyspepsia, Endoscopy gastrointestinal, Helicobacter infection
SMQs:, Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Opportunistic infections (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: Simvastatin; SYNTHROID; Indomethacin; hydrologien; amlodipine; potassium chloride; allopurinol; RESTASIS; ANORO ELLIPTA
Current Illness: No
Preexisting Conditions: Hypertension; Arthritis; Gout Degenerative joint disease; CAD Coronary Artery Disease
Allergies: Contact Cold medication; PYRIDIUM
Diagnostic Lab Data: GI endoscopy and cholenoscopy 2 cm polyp. 08/19/2021 Flu vaccination at pharmacy.
CDC Split Type: vsafe

Write-up: Joint pain with history of arthritis and degenerative back issue; new health problems with interjection and chest pain with GI. H Pylori infection which Clarithromycin 500mg twice a day/Amoxicillin 500mg twice daily. Cholenoscopy 2 cm polyp/ stain results was rare organism. GI issue was negative issue intergestion and chest pain located on the left side radiant her cardiac enzymes levels with heart test and cardio blockage. 08/19/2021 Flu vaccination at pharmacy.


VAERS ID: 1733911 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-13
Onset:2021-08-25
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fall, Feeling cold, Hyperhidrosis, Mobility decreased, Paralysis
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament 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:
Current Illness: Anaemia; Autoimmune disorder.
Preexisting Conditions: Medical History/Concurrent Conditions: Pacemaker insertion (cardiac) (Pacemaker).
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: He has not had any symptoms since this episode of paralysis; Started to sweat; Couldn''t move at all for 30 minutes; He tried to scoot off the bed and go to bathroom but ended up on the floor; Felt cold; This spontaneous case was reported by a consumer and describes the occurrence of PARALYSIS (He has not had any symptoms since this episode of paralysis) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 033C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Pacemaker insertion (cardiac) (Pacemaker). Concurrent medical conditions included Anaemia and Autoimmune disorder. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-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 PARALYSIS (He has not had any symptoms since this episode of paralysis) (seriousness criterion medically significant), HYPERHIDROSIS (Started to sweat), MOBILITY DECREASED (Couldn''t move at all for 30 minutes), FALL (He tried to scoot off the bed and go to bathroom but ended up on the floor) and FEELING COLD (Felt cold). On 25-Aug-2021, PARALYSIS (He has not had any symptoms since this episode of paralysis), HYPERHIDROSIS (Started to sweat), MOBILITY DECREASED (Couldn''t move at all for 30 minutes), FALL (He tried to scoot off the bed and go to bathroom but ended up on the floor) and FEELING COLD (Felt cold) had resolved. No concomitant medication was given. No treatment medication was given. Company Comment: A 75-year-old male, with pacemaker, presented with serious unexpected paralysis, and non-serious hyperhidrosis, mobility decreased, fall and feeling cold. Latency 224 days after first dose, 197 days after second dose, and 1 day after third dose. Events resolved. Rechallenge not applicable. Reporter causality not provided. Causality possible based on temporal association. Events consistent with known profile of mRNA-1273. The benefit-risk relationship of mRNA-1273 is not affected by this report.; Sender''s Comments: A 75-year-old male, with pacemaker, presented with serious unexpected paralysis, and non-serious hyperhidrosis, mobility decreased, fall and feeling cold. Latency 224 days after first dose, 197 days after second dose, and 1 day after third dose. Events resolved. Rechallenge not applicable. Reporter causality not provided. Causality possible based on temporal association. Events consistent with known profile of mRNA-1273. The benefit-risk relationship of mRNA-1273 is not affected by this report.


VAERS ID: 1734125 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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: ESTRADIOL
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101102960

Write-up: swelling in underarm area on right arm; This is a spontaneous report from a contactable consumer (Patient). A 57-years-old non-Pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection; Lot number: EW0168), via an unspecified route of administration on 23Aug2021 at 13:00(at the age of 57-years-old) administered in Arm Right as a single dose for COVID-19 immunisation at Public Health Clinic/Military Facility. The patient had received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection; Lot number: EW0168), via an unspecified route of administration on 28Jul2021 at 09:00 am administered in Arm Right as a single dose for COVID-19 immunisation at Public Health Clinic/Military Facility. The patient medical history was not reported. Concomitant medication(s) included estradiol taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. The patient had no allergies. On 25Aug2021 at 05:00 AM, the patient experienced swelling in underarm area on right arm. No treatment was given for the event. The outcome of the event was not recovered. Follow-Up (02Sep2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1734590 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Hallucination, olfactory, Headache, Human chorionic gonadotropin negative, Menstruation delayed
SMQs:, Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), 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: amour thyroid, fish oil, probiotics, NAC, Vitamin D3, Magnesium Threonate
Current Illness: none
Preexisting Conditions: hashimotos
Allergies: fluconazole, amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: headaches 3 weeks, phantom smells since vaccination, and now I have not had my period (2 weeks late) - verified not pregnant through serum HCG.


VAERS ID: 1734689 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-13
Onset:2021-08-25
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Capillary disorder, Joint swelling, Peripheral swelling, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Triamterene-Hydrocholrorthiazide; Amlodipine-Benazepril; KCl; Metoprolol Tartarate; Docusate-Na; (small) Aspirin; Chlortrimeton; Metamucil capsule; multivitamin; Vitamin C; Glucosamine Chondroitin w/Vit D3;
Current Illness: none (except chronic, next block)
Preexisting Conditions: high blood pressure; hepatic cysts
Allergies: none to "products", allergic to some pollen, and to cat dander.
Diagnostic Lab Data: none
CDC Split Type:

Write-up: On left foot and ankle, slight swelling accompanied by a rash, apparently caused by inflammation of capillaries under the skin. Treated with low dose of Prednisone for 3 days. Much improved at end of that time; prednisone ceased; resolved (gone) within a few more days.


VAERS ID: 1735423 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-08-25
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Adverse reaction, Anticoagulant therapy, Computerised tomogram pelvis, Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Magnetic resonance imaging, Pain in extremity, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: benicar, norvasc, metoprolol
Current Illness: n/a
Preexisting Conditions: high blood pressure
Allergies: n/a
Diagnostic Lab Data: Ct scan of lungs and pelvis RLE ultrasound MRI of right leg
CDC Split Type:

Write-up: adverse reaction-Right leg DVT and bilateral pulmonary emboli. Symptoms- right leg pain and shortness of breath Time- over 3 weeks Treatment- anticoagulant Outcome- dischrged from hospital. Still on medications for 6 months to a year


VAERS ID: 1736665 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bronchitis, Cough, Imaging procedure
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest radiograph: 9/24/2021.
CDC Split Type:

Write-up: Chronic cough onset first-day post-vaccination. Confirmed serious bronchitis. Potentially unseen atypical pneumonia.


VAERS ID: 1737016 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-20
Onset:2021-08-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram peripheral abnormal, Anticoagulant therapy, Antiphospholipid antibodies negative, Asthenia, Atrial thrombosis, Beta-2 glycoprotein antibody negative, Blood electrolytes normal, Blood fibrinogen, Blood homocysteine, Cardiolipin antibody negative, Catheterisation cardiac, Echocardiogram abnormal, Full blood count, Haematocrit normal, Haemoglobin normal, Heart valve replacement, Hypoaesthesia, International normalised ratio increased, Mitral valve incompetence, Mitral valve stenosis, Myxoma, Pain in extremity, Peripheral artery occlusion, Peripheral artery thrombosis, Platelet count normal, Prothrombin time prolonged, Pulse absent, Right ventricular enlargement, SARS-CoV-2 RNA undetectable, Thrombectomy, Thromboembolectomy, Ultrasound Doppler abnormal, White blood cell count increased
SMQs:, Cardiac failure (broad), Liver-related coagulation and bleeding disturbances (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None reported
Preexisting Conditions: asthma
Allergies: None reported
Diagnostic Lab Data: Labs: SARS-CoV-2: RNA: negative Electrolytes: within normal ranges Initial PT/INR on arrival from outside facility: 16.5 seconds/1.4 CBC: hemoglobin: 11.7 gm/dL, hematocrit: 34.5%, WBC: 14.2 10*9/L, platelets: 393 10*9/L Fibrinogen: 316 mg/dL Lupus anticoagulant, Beta-glycoprotein antibodies, Anti-Cardiolipin antibodies: within normal ranges Homocysteine: 4.1 umol/L Imaging: CTA: occlusive thrombus in left distal common femoral artery into proximal profunda; occlusive thrombus in right distal popliteal artery; non occlusive thrmbus extending into tibial peroneal trunk ECHO: echogenic structure in left atrium (myxoma), enlarged right ventricle, mitral valve stenosis and regurgitation
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: patient presented to another hospital with sudden onset left leg pain, numbness, and weakness during athletic activity. No Doppler pedal pulse detected and transferred to this facility. Found to have occlusions on left CFA, right profunda, and right popliteal as well as a left atrial mass (myxoma), left atrial thrombus, and mitral insufficiency. Admitted, anticoagulated, and underwent balloon embolectomies, mechanical valve replacement, right heart catheterizations, and thrombectomies. Discharged to home stable on anticoagulation with cardiology follow-up in place.


VAERS ID: 1737294 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-08-25
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose decreased, COVID-19, Dyspnoea, Exposure to SARS-CoV-2, Patient isolation
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypoglycaemia (narrow), 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes mellitus Cardiovascular disease Chronic renal condition
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient thinks she contracted Covid during a trip prior to the onset of symptoms. She developed symptoms on 08/19/2021 and they lasted about 3 weeks. She isolated with her husband (also positive) and resumed normal activities after about 4 weeks. She was admitted to the hospital 2x due to shortness of breath and 1x due to low blood sugar.


VAERS ID: 1737352 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Numbness and tingling in face and extremities


VAERS ID: 1737411 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-02-25
Onset:2021-08-25
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Cachexia, Diarrhoea, Dysstasia, Fatigue, Feeling cold, Hyperhidrosis, Lymphadenopathy, Muscular weakness, Nausea, Pain, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After a second pneumonia vaccine
Other Medications: Vitamin D3 Centrum for women 50 and over Fish Oil capsule Zinc Garlic supplements
Current Illness: None
Preexisting Conditions: Scoliosis Stacis Dermititis Mild spurring of the knees detected through xrays
Allergies: Highly sensitive to medications when taken so I rarely take medications
Diagnostic Lab Data: Since I had to crawl to the bathroom throughout the night, on March 13 two weeks later I experienced momentary extreme right knee pain and again could not put weight on that knee for about 36 hours. Xrays showed spurring in both knees. Spent 3 subsequent months in physical therapy.
CDC Split Type:

Write-up: After the second vaccine:Severe total body pain for 4 hours beginning 8 hours after the second vaccine, weakness in the legs so severe that I could not stand, vomiting, nausea, diarrhea , chills, profuse sweating, heartache, total fatigue. After the first vaccine: extreme fatigue and two days after the first vaccine swollen glands for a two days. After about a week a felt back to normal after the second vaccine.


VAERS ID: 1737476 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203AZIA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Colitis, Colonoscopy, Computerised tomogram, Condition aggravated, Haematochezia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamins
Current Illness: No illnesses
Preexisting Conditions: Ulcerative Colitis
Allergies: Amoxicillin
Diagnostic Lab Data: CT Scan 9/20/2021 and Colonoscopy 9/24/2021
CDC Split Type:

Write-up: One week later, I started experiencing abdominal cramping. The next week I started seeing blood in my stools. My colon is now inflammated.


VAERS ID: 1737592 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Headache, Laboratory test, Sleep disorder, X-ray
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: Albuterol Inhaler, Adderall
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Lab and X-ray just recently ordered (results pending)
CDC Split Type:

Write-up: Very soon after vaccine dose, patient began having unrelenting headaches. Causes awakening in early AM. Work-Up in progress; Note: Patient has strong family history of clotting disorder


VAERS ID: 1741056 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pain, 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
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt is under age at 14 yrs old. He complained of generalized body aches for the first two days


VAERS ID: 1741187 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-01
Onset:2021-08-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Burning sensation, Diarrhoea, Disturbance in attention, Dizziness, Dyspepsia, Dyspnoea, Ear discomfort, Eye irritation, Fatigue, Feeling abnormal, Hyperventilation, Hypoaesthesia, Hypoaesthesia oral, Immediate post-injection reaction, Myalgia, Nausea, Oral discomfort, Pain in extremity, Panic attack, Photophobia, Vertigo, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamin
Current Illness: None
Preexisting Conditions: Fibromyalgia, muscle aches, migraine
Allergies: Codeine, Demorol, Citrus fruits, pinapple
Diagnostic Lab Data: Neurology assessment. experiencing severe dizziness, ear fullness, numbness tongue and hands, numb tongue, light headed, exhausted, fatigue, muscle aches, burning feet, pain in feet when walking, hands ache,hands burn, burning around lips, difficulty concentrating, blurriness eyes, mild sensitivity to light and burning. I have some digestive issues with intermittent diarhea and nausea due to the dizziness and vertigo. The vertigo especially when driving and any continuous motion.
CDC Split Type:

Write-up: Right arm injection. Immediately my hands. feet, and tongue completely numb. I could not feel my hands, feet, tongue. I felt dizzy and woozy and all of sudden I was sharing I was not feeling right. I shared I could not breathe. I was hyperventilating and kept sharing I did not feel right. I was treated as if i was having a panic attack. I kept saying I cannot breath and utilized my inhaler because I have asthma and took 2 puffs. This did not make a difference. I was given 2 doses of ativan and the 2nd dose I do not remember leaving and being taken home.


VAERS ID: 1741966 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-08-25
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Hypoxia
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), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol, Colestid, Cardizem CD, Breo Ellipta, Lasix, insulin degludec, insulin lispro, Spiriva, Eliquis, Lipitor, Xopenex, Myrbetriq, Flomax
Current Illness:
Preexisting Conditions: Arrhythmia, arthritis, A fib, chronic bronchitis, COPD, diabetes mellitus, hyperlipidemia, hypertension, hypotension, malignant neoplasm (right kidney), pancreatitis, sleep apnea
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 74y.o. male who came to the ER with shortness of breath. He had been diagnosed with COVID-19 earlier in the week. He was treated with monoclonal antibody therapy. He continued to have dyspnea and developed hypoxia so he came into the ER. Patient was treated with Decadron and Remdesivir.


VAERS ID: 1741975 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adiposis dolorosa, Condition aggravated, Injection site reaction, Mobility decreased, Pain, Pyrexia, Rash, Rash erythematous, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, effexor, klonopin, robaxin, etodolac, synthroid, nurontin
Current Illness: None
Preexisting Conditions: Dercums disease.
Allergies:
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Arm became warm then hot and a red rash and new dercum''s lump appeared where shot was given. The rash lasted for over a week along with 102.8 temp for three days then 99 degree for 5 days. I also now cannot bend over or squat down as the shot attacked my dercum''s lumps only on the right side. The pain is excrutiating and I refuse to take pain meds. My dercum''s lumps on my left side remained the same.


VAERS ID: 1743013 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 3 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Dyspnoea, Electrocardiogram, Extra dose administered, Fatigue, Immediate post-injection reaction, Malaise, Peripheral swelling, Somnolence, X-ray
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: JRA Lung Scarring Obesity
Preexisting Conditions: Yes
Allergies: No Known Allergies
Diagnostic Lab Data: He was in the ER on 8/31/21 and they did blood tests, xrays and an ekg
CDC Split Type:

Write-up: Moderna nor the FDA have approved a 3rd Booster/Dose vaccine. So why then was my brother given a 3rd dose of Moderna? He was immediately not feeling well and had abnormal unusual exhaustion and sleepiness. He started developing trouble breathing and his legs swell so bad. He went to the Emergency room on the 31st of August and they told him the vaccine had nothing to do with how he was feeling. Yes, my brother has health issues. But why was he given a booster for Moderna that had NOT YET BEEN AUTHORIZED? Not only that but we immediately reported the symptoms to his doctors who assured us it was normal for a few days. My questions are, what is going to happen to my brother since he was given this accidental dose?


VAERS ID: 1744686 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Headache, Hypersensitivity, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: epipen
Current Illness:
Preexisting Conditions:
Allergies: many, patient did not specify but does carry an epipen and said she has many allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports delayed allergic reaction involving shortness of breath, headaches, hives starting about a week after her shot and having 2 or 3 episodes over the several weeks since receiving the vaccine. The patient reports having used her epipen during at least one episode.


VAERS ID: 1745644 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-27
Onset:2021-08-25
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arrhythmia, Cardiac disorder, Condition aggravated, Echocardiogram, Electrocardiogram abnormal, Palpitations, Thrombosis, Ultrasound scan abnormal
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: Baby Aspirin; CoQ10 - stopped taking the CoQ10 around the 1st of September
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Ultrasound, EKG, Echogram of heart - See above
CDC Split Type: vsafe

Write-up: Follow up report: I had a second Ultrasound on August 24th in legs - things were still not right. I was feeling the same still as the first time as I went to Ultrasound in June. I was told to get it checked out. It was exactly the same - that doctor told me - Dr. (urgent care doctor) - said the blood clots were still there and still the same size as the previous Ultrasound had shown. I also had an EKG at that time and he said that it was basically the same as the previous. Dr. had said that it hadn''t been normal (my EKG readings) and saw I saw a NP (8/16/2021) for the cardiologist and took the EKG and they said there was a little abnormality - the top part was beating faster than the lower part of my heart. The best thing to do would be to get an Echogram on my heart. That was done 8th of Sept. I saw a hematologist on the 16th and he didn''t really look at or do anything - he said that everything seems okay - when I get to the end of Pradaxa I can stop taking it. I am about 2 weeks away from that. He said everything should be okay. Dr. said to schedule with a real cardiologist - and I saw her (Dr.) on 23rd (last Thursday) and in the meantime, I had had the echogram (8th) and she ordered a CT scan (from neck down to pelvis) (I have a family history of having aortic aneurisms - have had it checked in the past and none of been detected prior) and Echocardiogram at the same time - because my left atrium is a bit enlarged and the bulk of the main veins coming off my heart are enlarged (moderately). And she said that they are at the Aortic Root area. Doing the two tests at the same time would give her a better picture of what was going on with my heart. I will get that this coming Friday and I will see her again on October 28th. I was having palpitations - that was why they were looking at my heart - and they said that is typical to have if I have blood clots. She can find out better what''s going on with both of these tests at the same time (October 1st). Palpitations have seemed to mostly have gone away - before they were multiple times a day but now they are mostly gone. Just every now and then I have it - I walk a mile and 1/2 or two miles every morning now. I do worry about the blood clots but the Hematologist isn''t too worried about it, it seems. Note: I got the flu shot of 16th of September, 2021; haven''t yet had the second shingles shot - wanted to wait until all of this other stuff.


VAERS ID: 1745976 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site hypoaesthesia, Injection site pain, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

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

Write-up: PATIENT HAS EXPERIENCED NUMBNESS ON THE LEFT ARM THAT PROCEEDS FROM HIS HANDS TO HIS NECK AS WELL AS PAIN SINCE THE VACCINATION. HIS NECK IS ALSO HURTS TO TURN.


VAERS ID: 1747936 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Immunisation, Lung disorder, Off label use, Polymerase chain reaction, SARS-CoV-2 test
SMQs:, 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 Name: Blood test; Result Unstructured Data: Test Result:Unknown results; Test Name: PCR test; Result Unstructured Data: Test Result:Unknown results; Test Name: Antigen; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC202101110822

Write-up: I had my 3rd covid shot yesterday; I had my 3rd covid shot yesterday; I have a problem with my left lung; This is a spontaneous report from a contactable consumer or other non-hcp (Patient). A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: solution for injection; Batch/Lot Number: Unknown, Expiration date: Unknown) via an unspecified route of administration on 25Aug2021 at 14:30 as dose 3 (booster), single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Historical vaccine included first and second dose of BNT162B2 administered on an unspecified date for COVID-19 immunization. On an unspecified date in 2021 the patient experienced he had a problem with his left lung. The patient underwent lab tests and procedures on an unspecified date which included blood test: unknown results, polymerase chain reaction: unknown results, SARS-CoV-2 test: unknown results. It was reported that "the patient had his 3rd COVID shot yesterday. Question asked "if there is antibody testing available to check his immunity (regarding his 3rd dose). he had a blood test done previously an antigen and PCR test they were designed that he had powerful response to the virus. They said his immune system reacted and he had good protection; had enough protection as a result of the pfizer vaccine." "He asked if the 3rd shot the same dose." Caller stated, "he had a problem with his left lung. He had his 3rd COVID shot yesterday at 2:30 in the afternoon and today at 4pm he took 1 Celebrex pill. He took a pain killer 26 hours after his shot will that negate the covid shot he got. He asked if it would negate the antiviral in terms of protection. He also asked if he need to take another shot." Therapeutic measures were taken as a result of he had a problem with his left lung. The clinical outcome of the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1747951 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / OT

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Lymphocytic leukemia (Verbatim: Large granular Lymphocytic leukemia); Ulcerative colitis (Verbatim: Ulcerative colitis)
Preexisting Conditions: Medical History/Concurrent Conditions: Basal cell carcinoma (Verbatim: Basal cell carcinoma); Nausea (Verbatim: Nausea); Small bowel obstruction (Verbatim: Small bowel obstruction); Thyroid cancer (Verbatim: Thyroid cancer)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101138645

Write-up: This is a spontaneous report from a contactable other HCP. This other HCP reported for a 74-year-old male patient that. A 74-year-old male patient received a dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: FC3183, Expiration date: 31Oct2021), via intramuscular, administered in deltoid left on 25Aug2021 (at the age of 74-year-old) as dose 3, 0.3ml, single for COVID-19 immunization. Patient received a dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: EL3247, Expiration date: 30May2021), via intramuscular, administered on 14Jan2021 (at the age of 74-year-old) as dose 1, single for COVID-19 immunization. Patient received a dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: EL9262, Expiration date: 31May2021), via intramuscular, on 04Feb2021 (at the age of 74-year-old) as dose 2, single for COVID-19 immunization. The patient medical history includes Nausea, Ulcerative colitis, small bowel obstruction, Lymphocytic leukaemia, Thyroid cancer, Basal cell carcinoma all from an unspecified onset and unknown ongoing and concomitant medications were not reported. On 26Aug2021, after the vaccination, the patient experienced headaches and nausea for 5 days. reported that patients are moderately immunocompromised and has a history of leukaemia and received his 3rd dose of the vaccine at the request of the patient''s haematologist. The outcome of the events was not recovered. No follow-up attempts possible. No further information expected. Follow-up (PRD/SRD (10Sep2021): This follow-up is being submitted to notify that the lot/batch number is not available despite the follow-up attempts made. Follow-up at-tempts have been completed and no further information is expected.


VAERS ID: 1749400 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Rash, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: shingles vaccine
Other Medications: Nexium
Current Illness: no
Preexisting Conditions: Pleva, Gerd
Allergies: Latex
Diagnostic Lab Data: took ceterizine and diphenhydramine
CDC Split Type:

Write-up: 1.5 hours after receiving injection - throat tightened, itching everywhere, significant itching of head and scalp, some rash on chest and abdomen


VAERS ID: 1749630 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-24
Onset:2021-08-25
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030M20A / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Computerised tomogram thorax abnormal, Endotracheal intubation, Extubation, General physical health deterioration, Hypoxia, Influenza virus test, Lung opacity, Metastatic neoplasm, Osteolysis, Oxygen saturation decreased, Pericardial effusion, Pyrexia, Respiratory syncytial virus test, SARS-CoV-2 test positive
SMQs:, Angioedema (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (narrow), 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, 19 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Head trauma, right pulmonary contusion, seizures, history of multiple myeloma, chronic progressive leukopenia
Allergies: Codeine, Neo-synephrine (phenylephrine)
Diagnostic Lab Data: Covid-19, Flu, RSV by NAA: SARS CoV 2 DETECTED (8/26/2021)
CDC Split Type:

Write-up: Patient was one of 8 patients sent from a local nursing facility secondary to COVID-19 outbreak. No reported complaints initially, but was found to be hypoxic on arrival. Improved to 95% on 3L nasal cannula. Febrile on admission at 100.1 degrees F. CT scan of chest showed no evidence for pulmonary embolus, but there was bilateral ground glass opacities, small pericardial effusion, and lytic lesions throughout the bones consistent with metastatic disease. Patient declined, satting at 80%, which led to intubation and PICC line placement. Patient was stabilized and eventually extubated. Discharged in stable condition.


VAERS ID: 1750118 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Muscle spasms, Night sweats
SMQs:, Dystonia (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: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Night sweats and cramping. felt much like menstrual cramps


VAERS ID: 1751832 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dry skin, Pruritus, Swelling, Vaccination site pain, Vaccination site pruritus, Vaccination site urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (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? 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: skin is very scabby; it''s spreading on entire left side of the body/leg is itching/back is itching/itching is on the inside of flesh; bad hives; swelling; little itchy/super duper itchy/scratched my arm to the point of bleeding; the day of injection my arm was really sore; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING (swelling), DRY SKIN (skin is very scabby), PRURITUS (it''s spreading on entire left side of the body/leg is itching/back is itching/itching is on the inside of flesh), VACCINATION SITE PRURITUS (little itchy/super duper itchy/scratched my arm to the point of bleeding) and VACCINATION SITE PAIN (the day of injection my arm was really sore) in a 27-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. 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 SWELLING (swelling), VACCINATION SITE PRURITUS (little itchy/super duper itchy/scratched my arm to the point of bleeding) and VACCINATION SITE PAIN (the day of injection my arm was really sore). On 28-Aug-2021, the patient experienced DRY SKIN (skin is very scabby), PRURITUS (it''s spreading on entire left side of the body/leg is itching/back is itching/itching is on the inside of flesh) and VACCINATION SITE URTICARIA (bad hives). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. On 28-Aug-2021, VACCINATION SITE PAIN (the day of injection my arm was really sore) had resolved. At the time of the report, SWELLING (swelling) was resolving, DRY SKIN (skin is very scabby), PRURITUS (it''s spreading on entire left side of the body/leg is itching/back is itching/itching is on the inside of flesh) and VACCINATION SITE URTICARIA (bad hives) outcome was unknown and VACCINATION SITE PRURITUS (little itchy/super duper itchy/scratched my arm to the point of bleeding) 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. No concomitant drug details were reported.


VAERS ID: 1752174 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-09
Onset:2021-08-25
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Blood pressure decreased, Blood pressure measurement, COVID-19, Dry throat, Dysphonia, Heart rate, Heart rate increased, SARS-CoV-2 test, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Blood pressure has dropped; Result Unstructured Data: Test Result:Decreased; Test Date: 20210825; Test Name: heart rate of 120-130 beats per minute; Result Unstructured Data: Test Result:120-130; Comments: resting heart rate of 120-130 beats per minute; Test Date: 20210825; Test Name: Covid test; Test Result: Positive
CDC Split Type: USPFIZER INC202101258619

Write-up: He tested positive for COVID-19 infection; He tested positive for COVID-19 infection; developed Atrial Fibrillation; his heart rate had increased quite a substantial amount; His blood pressure has dropped so low; feeling hoarse; his throat was dry; This is a spontaneous report from a contactable consumer or other non hcp. A 69-year-old male patient received bnt162b2 (COMIRNATY, Formulation: solution for injection, Batch/Lot number: EN6206, Expiration date was not reported), dose 2 via an unspecified route of administration, administered in Arm Left on 09Mar2021 (age at vaccination 69-years) as dose 2, single for covid-19 immunization and first dose of bnt162b2 (Comirnaty) for covid-19 immunization (batch number: EN6201) on 16Feb2021. The patient medical history and concomitant medications were not reported. On 25Aug2021 the patient experienced tested positive for COVID-19 infection. On an unspecified date in 2021 patient developed atrial Fibrillation, his heart rate had increased quite a substantial amount, his blood pressure has dropped so low, feeling hoarse, his throat was dry, he did lose his smell and taste. Clinical course: He tested positive for COVID-19 infection in Aug2021. He then developed Atrial Fibrillation. He read online that people who had the vaccine and who developed the infection after within days of isolation, had a higher heart rate which is associated with atrial fibrillation. This is report 1 of 2. Consumer received both doses of the Pfizer BioNTech COVID-19 vaccines in March. In August, specifically on 25Aug2021, he was tested positive for COVID-19. He quarantined himself for 2 weeks. The third week he went to the gym and noticed his heart rate had increased quite a substantial amount. He was at resting heart rate of 120-130 beats per minute. He had discovered he developed A-fib, so he was looking to make sure that gets documented. He doesn''t think the vaccine had anything to do with his diagnosis of A-fib. He is just wanting to know if Pfizer had information on the breakthrough COVID infections. He read some information and he knows Pfizer is really on top of this, but he is not thinking his A-fib has anything to do with the vaccine. His blood pressure has dropped so low and his heart rate is so high, and the caller wants to know does Pfizer have more information, maybe through other studies. The caller confirms his second dose was 09Mar2021. He verifies there is no other information including NDC, expiration date or dosing information on his vaccine record card. He clarifies he did a leg workout on 25Aug2021 and that is when he came down with symptoms and had the problem, clarified as A-fib. He was working out his legs again for the second time and noticed the A-fib. He is guessing he didn''t write it down but he believed he was diagnosed with A-fib on 08Sep2021.The callers states he believes he came down with symptoms of COVID on 25Aug2021, but he didn''t really think he had COVID at that point. He slept with a fan and he woke up feeling hoarse and his throat was dry, but he assumed that was just because of the fan blowing. He states it wasn''t until 27Aug2021 that he was tested and tested positive. He mentioned he did lose his smell and taste so he knew it was COVID. Description of Product Complaint: Description of complaint: Consumer received both doses of the Pfizer BioNTech COVID-19 vaccines in March. In August, specifically on 25Aug2021, he was tested positive for COVID-19. The callers clarifies he believes he came down with symptoms on 25Aug2021, but he didn''t really think he had COVID at that point. He slept with a fan and he woke up feeling hoarse and his throat was dry, but he assumed that was just because of the fan blowing. He states it wasn''t until 27Aug2021 that he was tested and tested positive. He mentions he did lose his smell and taste so he knew it was Covid. The patient underwent lab tests and procedures which included blood pressure measurement: decreased on 25Aug2021, heart rate: 120-130 on 25Aug2021 and resting heart rate of 120-130 beats per minute, sars-cov-2 test: positive on 25Aug2021. Outcome of all the events was unknown.


VAERS ID: 1753010 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-25
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arrhythmia, Blood test, C-reactive protein, Echocardiogram, Electrocardiogram, Full blood count, Inflammation, Influenza like illness, Lymphadenopathy, Metabolic function test
SMQs:, Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: METOPROLOL
Current Illness: Abstains from alcohol; Accelerated idioventricular rhythm; Non-smoker; Penicillin allergy; Shellfish allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Cardiac ablation; Comments: The patient did not have any history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210922; Test Name: Electrocardiogram; Result Unstructured Data: Result not reported; Test Date: 20210923; Test Name: Echocardiogram; Result Unstructured Data: Normal; Comments: Normal; Test Date: 20210923; Test Name: Complete blood count; Result Unstructured Data: Normal; Test Date: 20210923; Test Name: Basic metabolic panel; Result Unstructured Data: Normal; Test Date: 20210923; Test Name: Blood test; Result Unstructured Data: Normal; Test Date: 20210923; Test Name: C-reactive protein; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210956440

Write-up: INFLAMMATORY RESPONSE TO THE VACCINE; VACCINE PROVOKED ARRHYTHMIA; SWOLLEN LYMPH NODES UNDER ARMS; FLU-LIKE SYMPTOMS; This spontaneous report received from a patient (who is a Nurse) concerned a 59 year old female. Initial information received on 25-Aug-2021 was processed with additional information received on 14-Sep-2021. This case was reassessed as serious based upon new information received from patient (nurse) on 14-Sep-2021. The patient''s weight was 139 pounds, and height was 62 inches. The patient''s past medical history included: two cardiac ablations, and concurrent conditions included: accelerated idioventricular rhythm, shellfish allergy, penicillin allergy, non alcohol user, and non smoker, and other pre-existing medical conditions included: The patient did not have any history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A expiry: 21-SEP-2021) dose was not reported,1 total, administered on 25-AUG-2021 to left arm for prophylactic vaccination. Concomitant medications included metoprolol for vaccine provoked arrhythmia, accelerated idioventricular rhythm, and inflammatory response to the vaccine. On 25-AUG-2021, twelve hours after the vaccination, the patient experienced flu-like symptoms that were not severe, and resolved in 24-48 hours. On 11-SEP-2021, the patient experienced swollen lymph nodes under arms that went away in a day or two, and this happened multiple times where one swollen lymph node would resolve, and another would become swollen. On 14-SEP-2021, the patient noticed that had some skipped beats and this became more frequent. On 22-SEP-2021, the patient visited cardiologist because symptoms were not going away and the cardiologist suspected that the patient is experiencing an inflammatory response to the vaccine and had Electrocardiogram (NR: not provided) Result not reported and done and metoprolol was increased from 25mg twice a day to 100 mg/day. On 23-SEP-2021,the patient visited to family doctor. On 23-SEP-2021 had blood work done (NR: not provided) including a, basic metabolic panel (NR: not provided), C-reactive protein (NR: not provided), Complete blood count (NR: not provided), and Echocardiogram (NR: not provided), which resulted all normal and was prescribed an anti-inflammatory. The patient stated that symptoms are not getting any better, despite the increased dosage of metoprolol for 1 week. The patient will be following-up with a physician at the end of the week and stated that the vaccine seems to have provoked arrhythmia. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu-like symptoms on AUG-2021, and swollen lymph nodes under arms on SEP-2021, and had not recovered from inflammatory response to the vaccine, and vaccine provoked arrhythmia. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0 20210956440-COVID-19 VACCINE AD26.COV2.S-vaccine provoked arrhythmia. 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: MEDICAL HISTORY.


VAERS ID: 1753718 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 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: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Rash.


VAERS ID: 1755870 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-28
Onset:2021-08-25
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210826; Test Name: COVID-19 test; Test Result: Positive; Result Unstructured Data: POSITIVE
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Got positive COVID-19 test on 26Aug2021, Pyrexia; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Got positive COVID-19 test on 26Aug2021, Pyrexia) in a 52-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) 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, the patient experienced COVID-19 (Got positive COVID-19 test on 26Aug2021, Pyrexia). At the time of the report, COVID-19 (Got positive COVID-19 test on 26Aug2021, Pyrexia) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 26-Aug-2021, SARS-CoV-2 test: positive (Positive) POSITIVE. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was reported. The patient got positive COVID-19 test on 26Aug2021. Had fever and got tested had COVID results. Patient received the vaccination in the right (unclear) This case concerns a 52-year-old, male patient with no relevant medical history, who experienced the unexpected event of COVID 19. The event occurred approximately 30 days after the second dose of Moderna COVID-19 Vaccine. The rechallenge was unknown since events occurred after first dose and no information about the second dose was disclosed as not yet administered. Based on the current available information, the mRNA-1273 does not contain a virus capable of causing COVID-19 infection after vaccination. The benefit-risk relationship of Moderna COVID-19 Vaccine is not affected by this report.


VAERS ID: 1755994 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Vaccination site swelling, Vaccination site warmth
SMQs:

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

Write-up: injection felt hot and swollen for 2 weeks; injection felt hot and swollen for 2 weeks; fatigue; chills/chills; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (injection felt hot and swollen for 2 weeks), VACCINATION SITE SWELLING (injection felt hot and swollen for 2 weeks), FATIGUE (fatigue) and CHILLS (chills/chills) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026C21A) for COVID-19 vaccination. Concomitant products included METFORMIN HYDROCHLORIDE (METFORMIN [METFORMIN HYDROCHLORIDE]), INSULIN ASPART (NOVOLOG) and LISINOPRIL 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 VACCINATION SITE WARMTH (injection felt hot and swollen for 2 weeks), VACCINATION SITE SWELLING (injection felt hot and swollen for 2 weeks), FATIGUE (fatigue) and CHILLS (chills/chills). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 800 milligram. On 26-Aug-2021, FATIGUE (fatigue) and CHILLS (chills/chills) had resolved. In September 2021, VACCINATION SITE WARMTH (injection felt hot and swollen for 2 weeks) and VACCINATION SITE SWELLING (injection felt hot and swollen for 2 weeks) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.


VAERS ID: 1756038 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-10-01
Onset:2021-08-25
   Days after vaccination:328
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthritis, Erythema, Illness, Immunisation, Pain, Skin warm
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Hypersensitivity (broad), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101140439

Write-up: received coronavirus booster vaccine; sick; symptoms of arthritis flare in right arm; skin hot/ red around shoulder; skin hot/ red around shoulder; soreness; This is a spontaneous report from a contactable other hcp. A 56-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection, Lot number and expiration date was not reported) via an unspecified route of administration on 25Aug2021 as dose 3, (BOOSTER) single for COVID-19 immunization (at the age of 56-year-old); tofacitinib citrate (XELJANZ XR), oral from 01Oct2020 (Batch/Lot number was not reported) and ongoing, at 11 mg, daily for rheumatoid arthritis. The patient''s medical history and concomitant medications were not reported. The patient historical vaccine included dose 1 and dose 2 of BNT162B2 (Lot number and expiration date was not reported) via an unspecified route of administration on an unspecified dates for COVID-19 immunization. The patient received coronavirus booster vaccine on 25Aug2021 and experienced sick, symptoms of arthritis flare in right arm, skin hot/ red around shoulder, soreness on an unspecified date in 2021. It was reported that, after start of therapy "rarely" missed a dose of xeljanz, took later than normal schedule (morning) over the last few weeks. Unknown if change in symptoms and received coronavirus booster vaccine on 25Aug2021 and was sick for 1 day/no fever, symptoms of arthritis flare in right arm/skin hot/red around shoulder, soreness for several days, better today. MD was unaware and encouraged to notify MD. No additional information/details provided. The outcome of the event sick and soreness was recovered on an unspecified date in 2021, and for symptoms of arthritis flare in right arm, skin hot/ red around shoulder, received coronavirus booster vaccine it was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1757191 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E211A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Heart rate irregular, Injection site pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: Finasteride
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe pain in chest. Heavy/hard heartbeat. Severe pain down left arm. It started on the evening of the second day and persisted throughout the night into morning. I went to work the next day and a tightness remained in my chest until the evening. I did not go to a doctor although I felt I needed to. I chewed two 80 mg aspirins approximately at 2 AM the night the pain started. I also chewed 2 more 80 mg aspirins approximately at 8 AM when I arrived at work. They seemed to help the pounding in my chest but not the pain really. I did this as I read it might be beneficial to chew aspirin when you have heart attack symptoms, which I thought I was having as I never had pain in my chest like that. I am reporting this now as I recently learned of VAERS.


VAERS ID: 1757759 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 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: vaccine administered 15 days after first puncture; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (vaccine administered 15 days after first puncture) in a 56-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006C21A) 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 (vaccine administered 15 days after first puncture). On 25-Aug-2021, EXPIRED PRODUCT ADMINISTERED (vaccine administered 15 days after first puncture) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication reported. No treatment information was provided.


VAERS ID: 1758825 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-19
Onset:2021-08-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Incorrect route of product administration, Injection site pain, Joint range of motion decreased, Loss of personal independence in daily activities
SMQs:, Dementia (broad), Drug abuse and dependence (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (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: COVID-19 End of July.
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type: vsafe

Write-up: After receiving the vaccine his arm is sore and he can''t lift his arm or his hand. He is not able to participant in sports at this time. He went to the doctor and he was advised the shot was not administered correctly, it was given to deep and it damaged the muscle underneath.


VAERS ID: 1759246 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-03
Onset:2021-08-25
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anger, Herpes zoster
SMQs:, Hostility/aggression (narrow), 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: Viibryd Toprimax
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I had Covid in Feb/March 2021 Lost taste smell Still cannot taste or smell Had antibodies test. Still have them Needed COVID-19 vaccine for work Furious ABOUT getting shingles not once but TWICE!!!
CDC Split Type:

Write-up: Shingles diagnosis after second shot. Back of right leg. Took medication. Shingles gone for 3 weeks Shingles came back same area of leg on 10/2. Got prescription immediately


VAERS ID: 1759450 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alopecia, Aneurysm, Arthralgia, Back pain, Blood test abnormal, Cardiac flutter, Chills, Computerised tomogram abnormal, Condition aggravated, Diarrhoea, Dyspnoea, Fatigue, Feeling abnormal, Magnetic resonance imaging head, Magnetic resonance imaging neck, Mobility decreased, Nausea, Pain in extremity, Pyrexia, Respiratory tract congestion, Systemic lupus erythematosus, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Tachyarrhythmia terms, nonspecific (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine, I had chronic migraines that lasted for 7-10 days and I end up in the emergency room.
Other Medications: Hydroxychloroquine; sertraline
Current Illness: None
Preexisting Conditions: Lupus; Chronic Migraines; Meningitis
Allergies: Environmental allergies; flu vaccine
Diagnostic Lab Data: MRI of brain and neck, MRA of brain and neck, CT showed I had an aneurism, but it was a false positive. Blood work, Lupus was active
CDC Split Type: vsafe

Write-up: I started having symptoms 5 minutes after getting the vaccine. I had fever, heart fluttering, shortness of breath, fatigue, brain fog, chills, congested, nausea, diarrhea, joints aches and pain, hand feet and back pain, hair loss, blurred vision, it caused my lupus to flare up when it was inactive for over a year and a half. I had blood work done 5 days prior to the vaccine and it was inactive. 3 days later after the vaccine it showed my lupus was active. My PCP wants to do additional blood work and spinal tap but I had a steroid injection so they want to see if that resolves it. I have had 5 infusions total. I did not have a choice in getting the vaccine. I had to take the vaccine or I would not be able to see my kids. I have not been able to participate with my daughter''s senior year at all or my son''s daily activities because I have been in bed. MRI of brain and neck, MRA of brain and neck, CT showed I had an aneurism, but it was a false positive. I have been to multiple doctors and emergency visits and no one seems to know how to treat this. I still have these symptoms.


VAERS ID: 1759754 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Lip swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril 20 mg PO daily (confirmed by prescription bottle) and client verbalized he also takes metoprolol 20 mg PO daily.
Current Illness: None
Preexisting Conditions: Hypertension, Chronic Hepatitis C
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Client received first dose of the COVID-19 vaccine Moderna on 08/24/2021. Client returned on 08/25/2021 (the following morning) with facial and lip swelling and arrived cursing at the security staff of building at 10:45 AM. Lead Nurse spoke to client at 10:53 AM outside on 08/25/2021 and recommended for client to seek medical attention due to bilateral lip swelling. Lead Nurse offered to call 911 for client numerous times but client declined. Lead Nurse remembers client was scared about his facial and lip swelling. Client left the premises on his own free will at 10:59 AM. Client returned on 9/23/21 and Nurse Co Lead spoke to client for second dose medical consult. Client stated he experienced generalized facial swelling and bilateral lip swelling that began the next morning after receiving first Moderna vaccine dose. Exact time of symptom onset was determined to be unknown. Client verbally stated, "My entire face felt numb like when you go to the dentist, I just woke up like that." Client denied swallowing and breathing difficulties. Swelling duration lasted 1 day and self resolved.


VAERS ID: 1759765 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-26
Onset:2021-08-25
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Penicillin; citrus
Diagnostic Lab Data: Urgent Care visit - 2 COVID testing - two tests - one rapid and one normal - negative results.
CDC Split Type: vsafe

Write-up: I had a fever - it came and went. The highest was 103. I had congestion, runny nose, body aches and it was two days of fever on/off. The rest of the symptoms lingered for a few days. The cough came on the 3rd day and that lingered for a week longer than the other symptoms. I took a rapid test and a normal test at the same time and they both came back negative - those tests were 3 or 4 days after I noticed symptoms. They gave me something for a cough - it numbed my throat. I was only able to take one of them. It was a capsule - gelled with pearls in them. It totally numbed my throat.


VAERS ID: 1760027 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-18
Onset:2021-08-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Brachial plexopathy, Chest X-ray, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (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: Vitamin B and D
Current Illness: None
Preexisting Conditions: Chronic cough
Allergies: None
Diagnostic Lab Data: 9/16/21 visit to clinic resulted in diagnosis. Xray taken to rule out lung problems.
CDC Split Type:

Write-up: Diagnosed with Brachial Plexopathy. Severe pain from right shoulder down right arm to wrist.


VAERS ID: 1760281 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Back pain, Biopsy lymph gland abnormal, Hypoaesthesia oral, Lymphadenopathy, Malaise, Mass, Pain in extremity, Pyrexia, Ultrasound scan abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Malignant lymphomas (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: -saw ENT about collarbone lump 9/10/21 -neck ultrasound 9/10/21 -results delivered 9/15 show multiple lymph nodes visualized all report as morphologically benign -report states collarbone lump is possible side effect of vaccine says ?known phenomenon? -follow up with ENT 9/20/21 as no change in collarbone lump. -dr ordered follow up ultrasound and FNAC biopsy of collarbone lump -biopsy completed 9/30/21 -results on 10/4/21 show reactive node -collarbone lump still no change 10/4/21
CDC Split Type:

Write-up: Night of 1st vaccine had numbness in mouth & tongue Day after vaccine fever, malaise, back pain, hand pain 2 days after vaccine painful lump on collarbone on shot side 3 days after vaccine soreness in armpit on shot side All events subsided by day 4 except lump on collarbone which was then painless Lump on collarbone still there as of today 10/4/21


VAERS ID: 1761625 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Bell's palsy, Bone pain, Headache, Hypoaesthesia, Limb discomfort, Lymphadenopathy, Nausea, Neck pain, Pain in extremity, Pain in jaw, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: 2nd Pfizer vaccine in left deltoid at clinic. About 30 mins later she developed tingling in left face, jaw and neck. This went away but 6 hours later she had bad pain in left axilla, clavicle, neck and jaw. Area became swollen. Lymph nodes also became swollen. She called clinic and told to monitor. EE was also getting nausea and HA that lasted 2 weeks. Arm continued to be heavy and painful. Swelling started to go away after about 2.5 weeks. Last week face and neck numb, and she was dx with bells palsy.


VAERS ID: 1762093 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-25
Onset:2021-08-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

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

Write-up: Patient was given the incorrect vaccine. She received her first dose of Moderna on June 19 and her second dose of Pfizer on August 25.


VAERS ID: 1762110 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-24
Onset:2021-08-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Chills, Computerised tomogram, Dizziness, Fatigue, Headache, Hypoaesthesia, Hypoaesthesia oral, Laboratory test, Magnetic resonance imaging, Mobility decreased, Nausea, Pain, Pain in extremity, Peripheral coldness, Pharyngeal hypoaesthesia, Pyrexia, Sensory loss, Tenderness
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Azathioprine 100mg, Lexapro 10mg, Daily Vitamins, electrolyte powder, Tylenol (several hours after vaccine)
Current Illness: None
Preexisting Conditions: Lupus and Autoimmune Hepatitis
Allergies: Adhesive, environmental, percoset
Diagnostic Lab Data: CAT scan, MRI, Chest Xray, labs, on August 25 at Hospital
CDC Split Type:

Write-up: About 1 hour after the shot, I started to have a bad headache. Around hour 5, fatigue and body aches set in. Around hour 12, chills, severe pain in my left arm and body aches and low grade fever. Could not move or touch my arm the pain was SO severe. This lasted for about 24 hours. About 2 hours after those symptoms subsided (hour 26 post vaccine), I was lying down on the floor and had fallen asleep putting my son to bed. I woke up and noticed my left arm was limp when I went to move it after waking up. I tried moving it and opening and closing my fist, but could not. I lost strength, mobility, and sensation. I then felt extremely nauseated and like I was going to pass out. I sat on the bathroom floor and put a cold compress on my head and neck, and noticed the same numb, loss of strength & sensation feeling spread to the entire left side of my body including my leg, mouth, throat and face. At this point, only about 20 minutes had passed since I noticed it. When the EMT arrived and tried to get me to stand up, I collapsed on my left side. They took me to the ER where they admitted me overnight for a full stroke workup. The continued to evaluate me but my symptoms started to subside about 2 hours after my arrival, and were gone by the next morning. The next day, my arm started to lose strength and sensation again for a few hours, then it subsided. Since then, I''ve had intermittent loss of sensation, mobility, and strength and my arm goes ice cold-- this is noticed whenever I am driving for longer than a few minutes. When I went to get the flu shot (in my RIGHT ARM) Sept 29, this triggered the same response in my LEFT arm where I was numb, could not make my hand do what I wanted it to do, could not grip, loss strength. This lasted a couple of hours and then subsided after about 5 hours.


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