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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 410 out of 8,010

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VAERS ID: 1704196 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-23
Onset:2021-08-24
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: hospitalization


VAERS ID: 1704322 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-11
Onset:2021-08-24
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Atrial fibrillation, Chest X-ray, Electrocardiogram, Full blood count, Metabolic function test, Pelvic pain
SMQs:, Acute pancreatitis (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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, 23 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: humalog, levemir, metformin synjardy trulicity, amlodipine, pravastatin,trelegy, famotidine, tylenol, enoxaparin, pantoprazole
Current Illness:
Preexisting Conditions: Sleep Apnea, neuropathy, anxiety, GERD, osteoarthritis,, A fib, depression, COPD, herpes zoster, severe obesity, acute kidney injury, hyperlipidemia, UTI, DM2
Allergies: NKDA
Diagnostic Lab Data: CBC,CHEM8, CXR, EKG
CDC Split Type:

Write-up: abdominal/ pelvic pain


VAERS ID: 1704328 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3102 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Fatigue, Hyperhidrosis, Immediate post-injection reaction, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxcarbazepine, bupropion, testosterone Cypionate, Hydroxyzine, Tizanidine, DIM, multivitamin
Current Illness:
Preexisting Conditions: Lumbar/cervical spondylitis and neuritis, hydrocephalus with vp shunt, high cholesterol and triglycerides
Allergies: Zpack
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Red face immediately after taking vaccine, sweating, nausea for about 5 hours, extreme fatigue throughout the evening into the next day.


VAERS ID: 1704381 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-11
Onset:2021-08-24
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3181 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Oligomenorrhoea, Pregnancy test
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility 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: Stillbirth at 38 weeks of pregnancy following tdap 11/1/2014, I was 33 at the time.
Other Medications: Prenatal supplement
Current Illness: Postpartum anxiety
Preexisting Conditions: None
Allergies: Doxycycline, erythromycin, Keflex, tetracycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Loss/missed period, resumed about 3 weeks later with very heavy red bleeding. I am very regular and was concerned I was pregnant and that this causes miscarriage. I tested negative (over the counter) a few days after missed period date.


VAERS ID: 1704490 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Eye discharge, Fatigue, Headache, Muscle spasms, Rhinorrhoea, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Alive Vitamin, Supplements Garlic, D3, Calcium, Vitamin C, Probiotic, Aspirin 81mg, Claritin, Cincular, Sodium 20mg, Magnesium, Potassium, Salmon Oil
Current Illness: N/A
Preexisting Conditions: Fibromyalgia
Allergies: Latex, Clorox, Lipitor, Mildew
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of Phizer 08/24/2021, started experiencing symptoms that evening of pain in all joints, headaches, muscle spasms, swollen throughout the body, and fatigue. Drainage noticed from the left nostril and eye. Primary recommendation to not receive the 2nd dose of Phizer. Still experiencing symptoms.


VAERS ID: 1704501 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC8448 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Axillary pain, Breast pain, Breast swelling, Oedema peripheral, Weight increased
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: reaction to first covid vaccine
Other Medications: Lipitor 10mg
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin trintellix
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain and major swelling under right armpit, right breast, and right abdomen on day 2. Swelling resulted in 5 pounds of weight gain overnight. Swelling lasted 6 days and weight returned to normal.


VAERS ID: 1704532 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event, Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: NKDA
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pfizer vaccine was diluted with Normal Saline Bacteriostatic 0.9%, which is not recommended. Pfizer and CDC contacted. CDC recommended repeating dose where improper dilution occurred. No sighs or symptoms reported by patient. Pt has since received their repeat 1st dose.


VAERS ID: 1704567 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Improper dilution of the Pfizer vaccine with Normal Saline 0.9% Bacteriostatic. Notified CDC and Pfizer, recommendation from CDC was to repeat dose that was diluted improperly. No signs or symptoms reported. PT received repeat 1st dose.


VAERS ID: 1704584 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Electrocardiogram ambulatory, Impaired driving ability, Palpitations, Presyncope
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: I started having heart palpitations within 24 hours of getting the vaccine and I have had heart palpitations, been having off and on lightheaded and dizziness, as well as dull sporadic chest pain. Went on a holter monitor and waiting for results. Almost fainted the other day. Had to stop activities that could cause my heart to race and I''ve stopped driving because of the lightheaded and dizzy symptom


VAERS ID: 1704602 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event, Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Improper dilution of the Pfizer vaccine with Normal Saline 0.9% Bacteriostatic. Notified CDC and Pfizer, recommendation from CDC was to repeat dose that was diluted improperly. No signs or symptoms reported. PT received repeat 1st dose.


VAERS ID: 1704800 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Headache, Hypoaesthesia, Immediate post-injection reaction, Impaired driving ability
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Hypersensitivity (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? No
Hospitalized? No
Previous Vaccinations: childhood vaccines
Other Medications: colchicine
Current Illness:
Preexisting Conditions: immune disorder SMS
Allergies: nuts ,eggs , zinc magnums all elements
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood pressure immediately went up to almost 200 . was keep at the site until is came down . whole left side was numb had to have someone drive her home . Numbness lasted 2 weeks . headaches have not stopped and pressure is still elevated


VAERS ID: 1705910 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Flushed / Sweating-Severe, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Pt experienced profuse sweating and some lightheadednes. Also had some tingling in the fingers. After sitting for awhile with fan and ice pack on back of neck patient recovered and was able to leave on his on accord.


VAERS ID: 1705980 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac disorder, Ventricular extrasystoles
SMQs:, Ventricular tachyarrhythmias (narrow), Hypokalaemia (broad)

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

Write-up: Systemic: Cardiac Disorder (diagnosed by MD)-Medium, Additional Details: Went to Emergency department where he was diagnosed with premature ventricular contractions. He was discharged from ED (not admitted to hospital) and referred to cardiology for follow up.


VAERS ID: 1706580 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-24
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Human immunodeficiency virus syndrome
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210824; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210926160

Write-up: COVID-19 TEST POSITIVE; This spontaneous report received from a patient concerned a 36 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: human immunodeficiency virus. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A expiry: UNKNOWN) dose was not reported, administered on 07-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-AUG-2021, the patient experienced covid-19 test positive. Laboratory data included: COVID-19 virus test (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of covid-19 test positive was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1706727 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-15
Onset:2021-08-24
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029M20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Pruritus, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: started itching 4 days after receiving second dose; had redness on the neck/flat red patches; swollen, flat red patches; swollen, flat red patches/breaking out with rash on all over body; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (started itching 4 days after receiving second dose), ERYTHEMA (had redness on the neck/flat red patches), SWELLING (swollen, flat red patches) and RASH (swollen, flat red patches/breaking out with rash on all over body) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 059E21A and 029M20A) for COVID-19 vaccination. Concomitant products included PRAVASTATIN, BUSPIRONE and BUPROPION for an unknown indication. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Aug-2021, the patient experienced PRURITUS (started itching 4 days after receiving second dose) and ERYTHEMA (had redness on the neck/flat red patches). 24-Aug-2021, the patient experienced SWELLING (swollen, flat red patches) and RASH (swollen, flat red patches/breaking out with rash on all over body). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency and HYDROCORTISONE for Adverse event, at an unspecified dose and frequency. At the time of the report, PRURITUS (started itching 4 days after receiving second dose), ERYTHEMA (had redness on the neck/flat red patches), SWELLING (swollen, flat red patches) and RASH (swollen, flat red patches/breaking out with rash on all over body) outcome was unknown.


VAERS ID: 1706745 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Inflammation, Insomnia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad)

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

Write-up: not sleeping well; tingling in their feet/pins and needles on their forearm; Inflammation in hands and fingers / Inflammation in feet and toes; Pain behind knee; This spontaneous case was reported by a consumer and describes the occurrence of INFLAMMATION (Inflammation in hands and fingers / Inflammation in feet and toes), INSOMNIA (not sleeping well), PARAESTHESIA (tingling in their feet/pins and needles on their forearm) and ARTHRALGIA (Pain behind knee) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004F21A) for COVID-19 vaccination. No Medical History information was reported. On 23-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced ARTHRALGIA (Pain behind knee). On 25-Aug-2021, the patient experienced INFLAMMATION (Inflammation in hands and fingers / Inflammation in feet and toes) and PARAESTHESIA (tingling in their feet/pins and needles on their forearm). On 27-Aug-2021, the patient experienced INSOMNIA (not sleeping well). On 26-Aug-2021, ARTHRALGIA (Pain behind knee) had resolved. At the time of the report, INFLAMMATION (Inflammation in hands and fingers / Inflammation in feet and toes), INSOMNIA (not sleeping well) and PARAESTHESIA (tingling in their feet/pins and needles on their forearm) outcome was unknown. 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 provided. No treatment information provided.


VAERS ID: 1706754 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-01-22
Onset:2021-08-24
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Fall, Fatigue, Feeling abnormal, Hypokinesia, Laboratory test, Loss of consciousness, Myalgia
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: TORSEMIDE; ELIQUIS; METOPROLOL SUCCINATE; COSENTYX; POTASSIUM CHLORIDE
Current Illness: Diabetes mellitus (diet controlled); Drug allergy (Fentanyl); Penicillin allergy; Psoriasis (Dermal Psoriasis)
Preexisting Conditions: Medical History/Concurrent Conditions: Heart valve replacement (aortic and mitral valves); Open heart surgery
Allergies:
Diagnostic Lab Data: Test Name: Laboratory test; Result Unstructured Data: normal
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Passed out by bed; she was on the floor and could not move.; muscles pain; Fatigue; Fell on the floor; she was not feeling good and went to bed; chills; shoulder pain; This spontaneous case was reported by a physician and describes the occurrence of LOSS OF CONSCIOUSNESS (Passed out by bed), HYPOKINESIA (she was on the floor and could not move.) and FALL (Fell on the floor) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 053E21A, 006M20A and 032L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Open heart surgery in February 2021 and Heart valve replacement (aortic and mitral valves) on 23-Sep-2019. Concurrent medical conditions included Psoriasis (Dermal Psoriasis) since 2009, Diabetes mellitus (diet controlled) since 1990, Penicillin allergy and Drug allergy (Fentanyl). Concomitant products included TORSEMIDE for Edema, APIXABAN (ELIQUIS) from 01-Feb-2021 to an unknown date for Heart valve replacement, SECUKINUMAB (COSENTYX) for Psoriasis, METOPROLOL SUCCINATE from 23-Sep-2019 to an unknown date and POTASSIUM CHLORIDE from 23-Oct-2019 to an unknown date for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Subcutaneous) 1 dosage form. On 22-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Subcutaneous) 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 24-Aug-2021, the patient experienced CHILLS (chills) and ARTHRALGIA (shoulder pain). On 25-Aug-2021, the patient experienced LOSS OF CONSCIOUSNESS (Passed out by bed) (seriousness criteria hospitalization and medically significant), HYPOKINESIA (she was on the floor and could not move.) (seriousness criterion hospitalization), FALL (Fell on the floor) (seriousness criterion medically significant), FEELING ABNORMAL (she was not feeling good and went to bed) and FATIGUE (Fatigue). On 26-Aug-2021, the patient experienced MYALGIA (muscles pain). The patient was hospitalized from 25-Aug-2021 to 26-Aug-2021 due to HYPOKINESIA and LOSS OF CONSCIOUSNESS. On 26-Aug-2021, LOSS OF CONSCIOUSNESS (Passed out by bed) had resolved with sequelae. At the time of the report, HYPOKINESIA (she was on the floor and could not move.) and ARTHRALGIA (shoulder pain) had resolved, FALL (Fell on the floor), FEELING ABNORMAL (she was not feeling good and went to bed) and CHILLS (chills) outcome was unknown and MYALGIA (muscles pain) and FATIGUE (Fatigue) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Laboratory test: normal (normal) normal. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered LOSS OF CONSCIOUSNESS (Passed out by bed) to be related. No further causality assessments were provided for HYPOKINESIA (she was on the floor and could not move.), FALL (Fell on the floor), FEELING ABNORMAL (she was not feeling good and went to bed), CHILLS (chills), ARTHRALGIA (shoulder pain), MYALGIA (muscles pain) and FATIGUE (Fatigue). On 24-Aug-2021, Patient received 3rd shot of Moderna vaccine and had some shoulder pain on that night. On 25-Aug-2021, at 11 am patient felt tired and went to bed and at 11.30 get out of bed to go to bathroom and fell on the floor and could not get up or follow instruction. Ambulance was called to take to the hospital and patient could not remember anything until 8 pm. Patient had a treatment of physical therapy on 26-AUG-2021. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. However, the patient''s concomitant medication is a confounder. This case was linked to MOD-2021-300984, MOD-2021-301025 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 01-Sep-2021: Included medical history, allergies, concomitants medications and additional events, case upgraded to serious.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. However, the patient''s concomitant medication is a confounder.


VAERS ID: 1707063 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-27
Onset:2021-08-24
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Body temperature, Chills, Decreased appetite, Diarrhoea, Dizziness, Dizziness postural, Fatigue, Feeling abnormal, Headache, Illness, Mobility decreased, Nausea, Pain, Palpitations, Pyrexia, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (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? 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: 20210824; Test Name: Body temperature; Result Unstructured Data: 100.5; Test Date: 2021; Test Name: COVID-19 Virus test; Test Result: Negative; Result Unstructured Data: Negative
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of PAIN (severe aching), FEELING ABNORMAL (felt generally awful), MOBILITY DECREASED (strictly in bed all day), DIARRHEA (diarrea) and DECREASED APPETITE (no appetite) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 24-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 24-Aug-2021, the patient experienced PAIN (severe aching), FEELING ABNORMAL (felt generally awful), CHILLS (chills) and PYREXIA (woke up with a temperature of 100.5). On 25-Aug-2021, the patient experienced MOBILITY DECREASED (strictly in bed all day). 25-Aug-2021, the patient experienced DIARRHEA (diarrea), DECREASED APPETITE (no appetite), ILLNESS (the sickest I have ever been), FATIGUE (huge fatigue), HEADACHE (headache) and NAUSEA (nausea). On 31-Aug-2021, the patient experienced ASTHENIA (15 to 20 minutes of energy). On an unknown date, the patient experienced PALPITATIONS (heart racing), DIZZINESS (extremely light headed/dizzy) and DIZZINESS POSTURAL (worse with standing). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. On 25-Aug-2021, MOBILITY DECREASED (strictly in bed all day) had resolved. On 26-Aug-2021, PYREXIA (woke up with a temperature of 100.5) had resolved. On 29-Aug-2021, HEADACHE (headache) had resolved. At the time of the report, PAIN (severe aching), FEELING ABNORMAL (felt generally awful), DIARRHEA (diarrea), DECREASED APPETITE (no appetite), ILLNESS (the sickest I have ever been), PALPITATIONS (heart racing), DIZZINESS (extremely light headed/dizzy), DIZZINESS POSTURAL (worse with standing), ASTHENIA (15 to 20 minutes of energy), FATIGUE (huge fatigue), NAUSEA (nausea) and CHILLS (chills) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, SARS-CoV-2 test: negative (Negative) Negative. On 24-Aug-2021, Body temperature: 100.5 (High) 100.5. No relevant concomitant product were reported


VAERS ID: 1707626 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (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: Site: Pain at Injection Site-Severe, Additional Details: Pt said she have been experiencing a throbbing pain on her arm after receiving the vaccine that doesn''t go away. It''s has been more than 3 weeks and she is experiencing the pain and would like to be contacted.


VAERS ID: 1708251 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Muscle spasms, Paraesthesia, Visual impairment
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diabetes vitamins, turmeric, vitamin C, niacin
Current Illness: None
Preexisting Conditions: Pre Diabetic
Allergies: Allergic to sulpha medications
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left side of face numb tingling and spasms. Left eye hard to focus and spasm around the eye.


VAERS ID: 1708284 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Dysgeusia, Electrocardiogram, Feeling abnormal, Immediate post-injection reaction, Migraine, Pain, Pain in extremity, Palpitations
SMQs:, Taste and smell disorders (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Immediately after the injection I had a metal taste in my mouth however no other symptoms. I was told I may have a sore arm and have flu like symptoms the following day. I waited 15 minutes after the injection at the pharmacy to ensure I didn''t have any life threatening effects which I did not. On my ride home, I started having a shooting acute pain in my right leg with pressure. The pain persisted for 20 minutes or so then subsided. Later that evening, I started having more shooting acute pains all over my body like the one I had in my leg and they would subside as well like the first instance. The next day I felt ok except for the metal taste in my mouth and the pains but felt ok enough to engage in physical activity (swimming). By that afternoon the pains increased in frequency coupled with migraines. That evening, I was awoken by my heart racing in addition to pains all over my body. The next day 8/26/21 I had a telemedicine appointment with my doctor''s office. The pain and racing would subside so I did not feel it was appropriate for a ER visit. The office requested I have blood work done to confirm I did not have any blood clots. The results came back negative (everything was ok from the tests). The next few days the pain, racing heart and metal tastes continued but were slowly decreasing in frequency however I started feeling mentally foggy (difficulty recalling words/speaking). 8/31/21 I had a follow-up telemedicine appointment and was told I should have an in-office EKG done to confirm my heart was ok. 9/1/21 I went to my doctor''s office and had the EKG done. My results were normal. My doctor advised me to reduce my activity level and ease back into my prior routine (running, swimming, biking, walking - daily) and I should report what happened to the CDC as I had an adverse event. Over the next few days the pains were decreasing in frequency, the metal taste went away and my heart was not racing as often. My last episode of my heart racing with a concurrent migraine was 9/14/21 and occurred only once that day. As of today, 9/17/21 I feel ok and plan on trying to workout again (at a moderate pace, though).


VAERS ID: 1708304 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-30
Onset:2021-08-24
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Catheterisation cardiac, Chest discomfort, Chest pain, Cough, Decreased appetite, Dehydration, Dyspnoea, Electrocardiogram abnormal, Fatigue, Myalgia, Nausea, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Vaccine breakthrough infection, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Heart attack in 2015 and had heart blockages, Current smoker
Allergies:
Diagnostic Lab Data: 08/25/2021 PCR+ COVID-19 test; 09/02/2021 PCR+ COVID-19 test; 09/09/2021 PCR+ COVID-19 test
CDC Split Type:

Write-up: Breakthrough COVID-19 case with symptom onset 8/24/2021: Fever $g100.4, Muscle or body aches, New loss of taste or smell, Runny nose/Congestion, Sore throat, Cough (new onset or worsening of chronic cough), Shortness of breath or difficulty breathing, Chest pain, Fatigue or tiredness, Nausea or vomiting, Loss of appetite, extreme chest tightening. Hospitalization. Admitted for dehydration and lack of appetite. Went to hospital on 9/1 but not admitted until 9/2. They did a heart catherization because they thought he had blockages based on an EKG on 9/3.


VAERS ID: 1708315 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine was diluted with Bacteriostatic NS 0.9% which is not recommended for use with Pfizer. CDC recommendations are to repeat affected dose. Pt was notified, all questions answered. Pt repeated dose on 9/15/21. No s/s reported by pt.


VAERS ID: 1708329 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine was diluted with Bacteriostatic NS 0.9% which is not recommended for use with Pfizer. CDC recommendations are to repeat affected dose. Pt was notified, all questions answered. Pt repeated dose on 9/14/21. No s/s reported by pt.


VAERS ID: 1708338 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Influenza like illness
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: Tylenol
Current Illness:
Preexisting Conditions: Diabetes,thyroid disease, asthma, heart disease, high blood pressure
Allergies:
Diagnostic Lab Data: I didn?t have COVID nor did I have the flu
CDC Split Type:

Write-up: All COVID symptoms


VAERS ID: 1708353 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with Bacteriostatic NS 0.9% which is not recommended for use with Pfizer. CDC recommendations are to repeat affected dose. Pt was notified, all questions answered. Pt repeated dose on 9/14/21. No s/s reported by pt.


VAERS ID: 1708373 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with Bacteriostatic NS 0.9% which is not recommended for use with Pfizer. CDC recommendations are to repeat affected dose. Pt was notified, all questions answered. Pt repeated dose on 9/14/21. No s/s reported by pt.


VAERS ID: 1708381 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Pfizer vaccine was diluted with Bacteriostatic 0.9% which is not recommended for use with Pfizer. CDC recommendations are to repeat affected dose. Patient was notified, all questions answered. Patient repeated dose on 9/14/21. No s/s reported by patient.


VAERS ID: 1708395 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with Bacteriostatic NS 0.9% which is not recommended for use with Pfizer. CDC recommendations are to repeat affected dose. Pt was notified, all questions answered. Pt repeated dose on 9/14/21. No s/s reported by pt.


VAERS ID: 1708813 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Pfizer vaccine was diluted with Normal Saline 0.9% Bacterostatic, which is not recommended. Reported to CDC and Pfizer, recommendation was to repeat affected dose. Patient was notified and all questions answered. Patient has received their repeat dose on 9/15/21.


VAERS ID: 1708828 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine was diluted with Normal Saline 0.9% Bacterostatic, which is not recommended. Reported to CDC and Pfizer, recommendation was to repeat affected dose. Patient was notified and all questions answered. Patient has received their repeat dose on 9/15/21.


VAERS ID: 1708992 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye irritation, Eye pain, Ocular hyperaemia, Photophobia
SMQs:, Anaphylactic reaction (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)

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

Write-up: Patient states a few hours after vaccine her eyes began burning and really red and feeling like she had been crying for hours. Her eyes remained red, burning, extremely sensitive to light, and painful for about 18 hours.


VAERS ID: 1710782 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-24
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Human immunodeficiency virus syndrome
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210420; Test Name: COVID-19 PCR test; Result Unstructured Data: Negative; Comments: A negative result for this test means that SARS-CoV-2 RNA (the cause of COVID-19) was not detected in the collection sample.; Test Date: 20210824; Test Name: COVID-19 antigen test; Result Unstructured Data: Positive; Comments: Test Taken: 24-AUG-2021 at 12:43:05 PM -04:00 Lot Number: 21154001
CDC Split Type: USJNJFOC20210925932

Write-up: COVID-19 TEST POSITIVE; This spontaneous report received from a patient concerned a 36 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: human immunodeficiency virus. The patient received covid-19 vaccine (suspension for injection, intramuscular, batch number: 1820095, and expiry: UNKNOWN) .5 ml, administered on 07-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-APR-2021, Laboratory data included: COVID-19 PCR test (NR: not provided) Negative. On 24-AUG-2021, the patient experienced covid-19 test positive. Laboratory data included: COVID-19 antigen test (NR: not provided) Positive. The action taken with covid-19 vaccine was not applicable. The outcome of covid-19 test positive was not reported. This report was non-serious. The case is associated with Product quality complaint 90000193488.; Sender''s Comments: V0 : Medical assessment comment not required as per standard procedure as the case was assessed as non-serious.


VAERS ID: 1711133 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Diarrhoea, Fatigue, Malaise, Mobility decreased, Myalgia, Oxygen saturation, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: INSULIN
Current Illness: Diabetes; Hypertension
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Body temperature; Result Unstructured Data: High; Test Date: 202108; Test Name: O2 saturation; Result Unstructured Data: Low.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Just haven''t felt well; Very fatigued; Temperature of 101.9 F/ low-grade temperature in the 100s for two other days; Diarrhea; Could not move around at all; very painful; Aches; Very sore arm and it is sore right now; This spontaneous case was reported by a consumer and describes the occurrence of Diarrhea, malaise, Could not move around at all, pain, and aches in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in January 2021. Concurrent medical conditions included Diabetes and Hypertension. Concomitant products included INSULIN for Diabetes. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Aug-2021, the patient experienced MYALGIA. On 25-Aug-2021, the patient experienced Diarrhea, Could not move around at all, pain, Aches, and PYREXIA. On an unknown date, the patient experienced MALAISE and Fatigued. The patient was treated with TYLENOL at an unspecified dose and frequency. At the time of the report, Diarrhea, MALAISE, Very sore arm and it is sore right now, and Fatigued had not resolved and Could not move around at all, pain, Aches, and PYREXIA had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In August 2021, Oxygen saturation: 88 Low. On 25-Aug-2021, Body temperature: 101.9F High. 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. Patient had COVID-19 back in January for which she was put with life support, and survived. After 1st dose patient also had 88 of O2 saturation, and couldn''t make it go up for two weeks, so she was with oxygen machine. Concomitant medications included Hypertension medication and Fluid pill medication along with above mentioned medications. Patient''s doctor recommended her not to take the second dose when she visited doctor on 08Sep2021.


VAERS ID: 1711348 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101103027

Write-up: red bumps on his skin and it is itching; red bumps on his skin and it is itching; he does not feel comfort; This is a spontaneous report from a contactable consumer (patient). A 23-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 24Aug2021 as dose 1, single for Covid-19 immunisation. The patient medical history and concomitant medications were not reported. Caller reported that he got his first shot yesterday (24Aug2021) and explained he did not feel comfort. He experienced red bumps on his skin, and it was itching. Caller wanted to know if this was an allergy to the product. The outcome of events was unknown. Information about lot/batch number cannot be obtained. No further information expected.


VAERS ID: 1711357 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination site erythema
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101104373

Write-up: red at the injection site and it was about the size of finger nail; This is a spontaneous report from a contactable consumer or other non-health care professional. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; solution for injection), via an unspecified route of administration on 23Aug2021 (Batch/Lot number was not reported) as dose number unknown, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced red at the injection site and it was about the size of finger nail on 24Aug2021. The outcome of the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1711360 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Heart rate, Heart rate abnormal, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (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: 20210824; Test Name: Blood pressure; Result Unstructured Data: Test Result:High; Comments: Going high; Test Date: 20210824; Test Name: Heart rate; Result Unstructured Data: Test Result:90 and 91
CDC Split Type: USPFIZER INC202101105044

Write-up: My blood pressure is going high; my wrist and heart is 90 and 91; This is a spontaneous report from a contactable consumer or other non health care professional (patient). A patient of unspecified age and gender received bnt162b2 (BNT162B2, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 24Aug2021 14:30 as DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 24Aug2021 at 14:30, the patient''s blood pressure was going high and wrist and heart was 90 and 91. The patient got the Pfizer Vaccine like 14:30 today and now patient''s blood pressure was really high like patient''s wrist and heart was 90 and 91. The patient underwent lab tests and procedures which included blood pressure measurement: high on 24Aug2021 going high, heart rate: 90 and 91 on 24Aug2021. The outcome of the event "My blood pressure is going high" was not recovered and outcome of "my wrist and heart is 90 and 91" was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up. Follow-up attempts have been completed and no further information is expected.


VAERS ID: 1711361 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Extra dose administered, Limb discomfort, Myalgia, Off label use, Vaccination site bruising, Vaccination site haemorrhage, Vaccination site pain, Vaccination site swelling, Vaccination site warmth
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Eosinophilic pneumonia (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CUVITRU
Current Illness: Mycobacterium avium complex infection (She has been fighting it for 4 years.); Primary immunodeficiency syndrome (Diagnosed in Spring of 2017.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101105162

Write-up: The whole area feels warm and is more sore than the other areas; her arm is uncomfortable and a little scary; It was very swollen in the center of her injection site last night; It is sore all the way under her arm and around her shoulder; It is more sore at the sight of the injection though; she had the 3rd dose yesterday; she had the 3rd dose yesterday; it really hurt; wound had a considerable amount of blood; arm developed a bruise the size of a silver dollar; This is a spontaneous report from contactable consumer (patient) via a Pfizer sponsored program. A 68-year-old female patient received third dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number: FD8448), via an unspecified route of administration, administered in arm right on 24Aug2021 14:45 (at the age of 68-years-old) as dose 3, single for covid-19 immunisation at pharmacy or drug store. Medical history included mycobacterium avium complex infection and primary immune deficiency disease from 2017 to ongoing. She was immunocompromised and has a primary immune deficiency disease. Also diagnosed with something else that was related to her being immunocompromised. She said that she gets Subcutaneous IG every 2 weeks. The patient mom died of cancer. Investigation Assessment was no. Prior Vaccinations, patient did not receive any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient''s concomitant medication included immunoglobulin human normal (CUVITRU) from Jun2017 and subcutaneous IG every 2 weeks. Historical vaccines included Prevnar 13 and Pneumovax vaccine and had no problems with either of them. Additional vaccines administered on same date of the Pfizer suspect was none. The patient previously second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9262), via an unspecified route of administration, administered in arm left on 26Feb2021 as dose 2, single and first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EB5313), via an unspecified route of administration, administered in right arm on 05Feb2021 (at the age of 68-years-old) as dose 1, single for covid-19 immunisation. She did not feel the first injection and the second injection did sting a little. List of any other vaccinations within four weeks prior to the first administration date of the suspect vaccine was none and no prior vaccinations within 4 weeks. Patient reported that on 24Aug2021, she had the 3rd dose and had an unusual reaction. While being vaccinated the dose it really hurt and it was like the vaccine was thick, unlike the previous doses. The wound had a considerable amount of blood. The arm developed a bruise the size of a silver dollar. Caller reported that her arm was uncomfortable and a little scary. It was very swollen in the center of her injection site last night, it had kind of spread out now, it was sore and kind of swollen, but not lumped up then. It was sore all the way under her arm and around her shoulder. It was more sore at the sight of the injection though. The whole area felt warm and was more sore than the other areas. It definitely hurt. She did not feel the lump anymore, it was just a bulging all over then like swelling. She said that there was almost a hard feeling in the centre of its last night. She said that she kept rubbing the front of her chest, was massaging the shoulder and back, and gently rubbing the injection site area. Caller said that she had soreness before with the other 2 vaccines. He did not visit emergency room or physician office. She said that she took some Tylenol and put ice on it for uncomfortable arm. The outcome of events wound had a considerable amount of blood was recovered on 24Aug2021, event arm developed a bruise the size of a silver dollar was recovering, and outcome of other events was unknown, event arm developed a bruise the size of a silver dollar was not resolved. No follow-up attempts were possible. No further information was expected.


VAERS ID: 1711392 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3181 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Feeling cold, Hypoaesthesia, Pain, 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: Medical History/Concurrent Conditions: CIDP; Reaction unevaluable (reaction to Gardasil vaccine); Retinal detachment
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101119118

Write-up: I had a very cold sensation in the middle of my chest/then my lower legs have a on and off cold sensation; tingling; numbness; irritating bilateral pain; This is a spontaneous report from a contactable consumer, other healthcare professional. This 35-year-old female consumer (patient) reported for herself. A 35-years-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; solution for injection, Lot Number: FC3181), dose 1 via an unspecified route of administration, administered in Arm Left on 24Aug2021 08:45 (at the age of 35-years-old) as a single dose for covid-19 immunization. Medical history included retinal detachment, chronic inflammatory demyelinating polyradiculoneuropathy CIDP, unevaluable event- reaction to Gardasil vaccine. There were no concomitant medications. The patient had no other vaccine within four weeks. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 24Aug2021 09:00, In the first 5 minutes, the patient had a very cold sensation in the middle of her chest with tingling and numbness down the left side of her arm to her fingertips. After 40 minutes that resolved and then her lower legs have a on and off cold sensation with irritating bilateral pains that have become worse each day. Adverse event resulted in doctor or other healthcare professional office/clinic visit. The patient did not receive any treatment. Outcome of the event was not recovered.


VAERS ID: 1711414 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101127461

Write-up: Bell''s palsy; This is a spontaneous report from a contactable consumer (patient). A 47-years-old non-pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration, administered in the left arm on 24Aug2021 at 15:30 (Batch/Lot Number: Fd8448) as single dose for COVID-19 immunisation in the pharmacy. The patient has no medical history. There were no concomitant medications. The patient was not pregnant at the time of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient does not have covid prior to vaccination and was not tested positive post vaccination. On 24Aug2021 at 19:15, after experiencing numbness and eye lid not closing, patient visited the emergency room (ER) and Bell''s palsy was the diagnosis. The patient was treated with steroids and antivirus medications and had a follow up with neuro. The outcome of the event was unknown. No follow- up attempts are needed. No further information is expected.


VAERS ID: 1711420 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-17
Onset:2021-08-24
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: 20210824; Test Name: Nasal Swab; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101127574

Write-up: Colleague was fully vaccinated and tested positive for COVID on 24Aug; Colleague was fully vaccinated and tested positive for COVID on 24Aug; This is a spontaneous report from a contactable other hcp. A 53-years-old female patient received first dose bnt162b2 (BNT162B2, Solution for injection, Batch/Lot Number: EN5318) via intramuscular route of administration in Arm Left on 27Jan2021 (age at vaccination:53 Years) as DOSE 1, SINGLE, second dose bnt162b2 (BNT162B2,Solution for injection, Batch/Lot Number: EN5318) via intramuscular route of administration in Arm Left on 17Feb2021 (age at vaccination:53 Years)as DOSE 2, SINGLE for COVID-19 immunisation. Patient was not pregnant at the time of vaccination. The patient medical history and concomitant medications were not reported. On 24Aug2021 the patient experienced colleague was fully vaccinated and tested positive for covid on 24aug, colleague was fully vaccinated and tested positive for covid on 24aug. Treatment received for the events was reported as unknown. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 24Aug2021 Nasal Swab. The outcome of the events vaccination failure, covid-19 was unknown. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on the information available the lack of efficacy of the vaccine BNT162B2 cannot be excluded.


VAERS ID: 1711521 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Fatigue, Inflammation, 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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 positive for antibody before a week of the vaccination because she had mild cold due to Covid-19
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: Test Result: 99-100 Fahrenheit; Test Date: 20210830; Test Name: Body temperature; Result Unstructured Data: Test Result: 102.4 Fahrenheit; Test Date: 20210830; Test Name: Body temperature; Result Unstructured Data: Test Result: 100.3 Fahrenheit; Comments: gave her some more Ibuprofen and fever went to be like 100.3; Test Date: 20210830; Test Name: Body temperature; Result Unstructured Data: Test Result: 102.7 Fahrenheit; Comments: We went to home by the afternoon around 2 and her fever was like 102.7; Test Date: 20210830; Test Name: Body temperature; Result Unstructured Data: Test Result:100 Fahrenheit; Comments: gave her some more Ibuprofen and it lowered her fever at about 100; Test Date: 20210830; Test Name: Body temperature; Result Unstructured Data: Test Result: 102 Fahrenheit; Comments: fever got elevated 102 by 8 o''clock, her fever was like 103.3 overnight.; Test Date: 20210830; Test Name: Body temperature; Result Unstructured Data: Test Result: 103.3 Fahrenheit; Comments: fever got elevated 102 by 8 o''clock, her fever was like 103.3 overnight.
CDC Split Type: USPFIZER INC202101137273

Write-up: Started having terrible Chills; Very tired; fever; inflammatory response from the vaccine; This is a spontaneous report from a contactable consumer reporting on daughter. A 14-years-old female patient received bnt162b2 (BNT162B2), via an unspecified route of administration, administered in arm left on 23Aug2021 (Batch/Lot Number: FC3182) (at the age of 14 years old) as dose 1, as a single dose for COVID-19 immunisation. Medical history included COVID-19 from Dec2020 to an unknown date, described she was positive for antibody before a week of the Covid-19 vaccination because she had mild cold due to Covid-19 infection back in December. The patient''s concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 24Aug2021, the patient experienced fever and inflammatory response from the vaccine. On 25Aug2021, the patient was very tired. On 29Aug2021, the patient started having terrible chills. The patient visited the physician''s office and treatment was received due to these events. The doctor determined that it was definitely some type of inflammatory response from the vaccine. The patient underwent lab tests and procedures which included body temperature 99-100F on an unspecified date, body temperature 102.4F on 30Aug2021, body temperature 100.3F on 30Aug2021 gave her some more ibuprofen and fever went to be like 100.3, body temperature 102.7F on 30Aug2021 we went to home by the afternoon around 2 and her fever was like 102.7, body temperature 100F on 30Aug2021 gave her some more ibuprofen and it lowered her fever at about 100, body temperature 102F on 30Aug2021 fever got elevated 102 by 8 o''clock, her fever was like 103.3 overnight, body temperature: 103.3F on 30Aug2021 fever got elevated 102 by 8 o''clock, her fever was like 103.3 overnight. The patient took ibuprofen, Motrin and Tylenol as treatment for fever reducing but started again to have fever and becoming difficult to control. The reporter stated that these side effects are actually worse than the Corona Virus right now she has like-Corona virus and now she is going sick for a week and it actually got worse and it didn''t get better. She was some better today and hoping that may be the side effects completely go away by tomorrow. The outcome of the events fever, inflammatory response, very tired and chills was not recovered. Follow-up (02Sep2021), Follow-up attempts are completed. No further information is expected.


VAERS ID: 1711523 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Malaise, Pyrexia, SARS-CoV-2 antibody test
SMQs:, 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? 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: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20210824; Test Name: Body temperature; Result Unstructured Data: Test Result:102 Fahrenheit; Comments: 102 degree Fahrenheit fever; Test Date: 20210830; Test Name: Body temperature; Result Unstructured Data: Test Result:above 102 Fahrenheit; Comments: morning she woke up with a fever above 102 degree Fahrenheit; Test Date: 20210830; Test Name: Body temperature; Result Unstructured Data: Test Result:103 Fahrenheit; Comments: Monday night she had a 103 degree Fahrenheit fever; Test Date: 20210823; Test Name: antibody test; Test Result: Positive ; Comments: she was positive for antibodies
CDC Split Type: USPFIZER INC202101137445

Write-up: chills; 102 degree fever. She then had a low grade fever for the next few days; not feeling great; This is a spontaneous report from a contactable consumer (caregiver). A 14-years-old female (daughter) patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 23Aug2021 as dose 1, single for COVID-19 immunisation. Medical history included Covid-19 on Dec2020. The patient''s concomitant medications were not reported. It was reported that the consumer was a caregiver for her 14 year old daughter who received the first dose of BNT162B2 on 23Aug2021. The next day on 24Aug2021, she had a 102 degree Fahrenheit fever and was not feeling great. She then had a low grade fever for the next few days. On 28Aug2021 (Saturday) she was feeling a little bit better. On Sunday (29Aug2021) she began experiencing chills, her fever rose, and she was given ibuprofen. On Monday (30Aug2021) morning she woke up with a fever above 102 degree Fahrenheit, and she brought her to the doctor. By Monday night she had a 103 degree Fahrenheit fever after 6 doses of ibuprofen during the day, going up and down. She had a little and then began alternating Tylenol and ibuprofen every 3 hours. Yesterday (31Aug2021) she was feeling a little better. She actually did have Covid-19 in Dec2020, but it was mild; It was suggested that she get an antibody test prior to vaccination so we did that the morning before she got the vaccine on 23Aug2021, but we went ahead and she got the vaccine anyway after that. Monday on 23Aug2021, when she went to the doctor the doctor said she was positive for antibodies. The doctor wants her to wait three months before she gets the second dose of BNT162B2 and then test her for antibodies. The caregiver was asking if this pattern of fever/malaise was consistent with side effects experienced by most after BNT162B2 vaccination. The caregiver was asking if her daughter''s previous Covid-19 could have caused her side effects to be worse post-vaccination with BNT162B2. No seriousness was provided. Treatment received included ibuprofen and Tylenol for all events. The patient visited physician office for all events. The outcome of the events was recovering. The Centers for Disease Control and Prevention (CDC) provides information regarding "Possible Side Effects After Getting a COVID-19 Vaccine". COVID-19 vaccination will help protect you from getting COVID-19. You may have some side effects, which are normal signs that your body is building protection. These side effects may affect your ability to do daily activities, but they should go away in a few days. Some people have no side effects. Serious side effects that could cause a long-term health problem are extremely unlikely following any vaccination, including COVID-19 vaccination. Vaccine monitoring has historically shown that side effects generally happen within six weeks of receiving a vaccine dose. For this reason, the FDA required each of the authorized COVID-19 vaccines to be studied for at least two months (eight weeks) after the final dose. The FDA-approved COMIRNATY (COVID-19 Vaccine, mRNA) and the FDA authorized Pfizer-BioNTech COVID-19 Vaccine under Emergency Use Authorization (EUA) have the same formulation and can be used interchangeably to provide the COVID-19 vaccination series. There was a remote chance that the vaccine could cause a severe allergic reaction. A severe allergic reaction would usually occur within a few minutes to one hour after getting a dose of the vaccine. For this reason, your vaccination provider may ask you to stay at the place where you received your vaccine for monitoring after vaccination. Signs of a severe allergic reaction can include: Difficulty breathing, swelling of your face and throat, a fast heartbeat, a bad rash all over your body, dizziness and weakness, myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining outside the heart) have occurred in some people who have received COMIRNATY (COVID-19 Vaccine, mRNA) or the Pfizer BioNTech COVID-19 Vaccine. In most of these people, symptoms began within a few days following receipt of the second dose of vaccine. the chance of having this occur is very low. you should seek medical attention right away if you have any of the following symptoms after receiving the vaccine: chest pain, shortness of breath, feelings of having a fast-beating, fluttering, or pounding heart, side effects that you may experience throughout the rest of your body; (systemic side effects) including fever and chills were observed with the first 1 to 2 days after vaccination and resolved shortly thereafter. This follow-up is being submitted to notify that the lot/batch number is not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected.


VAERS ID: 1711565 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Nevada  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FD8338 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Limb discomfort, Paraesthesia, Skin discolouration, Thrombosis
SMQs:, Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Artificial crown procedure; Blood pressure high; COVID-19 (I was a COVID long hauler); Foot discomfort; Heart disorder (On 03Jan2020. I picked up my prescriptions for a serious heart condition.); Hypercoagulation (if I skinned my knee, cut my leg there was no bleeding, just instant coagulation.); Illness; Injury (Jul2021 for the first when I received a small cut, there was a tiny flow of blood. I was thrilled.); Injury; Skin discoloration; Tingling feet/hands
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101139661

Write-up: Blood clots; terrifies me; serious concerns; My hands suddenly started tingling; My feet started to feel as if they were gnarling up; My finger tips were blue; This is a spontaneous report from a contactable consumer. A 77-year-old patient of an unspecified gender received the first dose of bnt162b2 (BNT162B2, Lot Number: FD8338), via an unspecified route of administration on 24Aug2021 as a single dose for COVID-19 immunization. Medical history included COVID-19 (reported as "was a COVID long hauler"), an unspecified illness (reported as "I became dreadfully ill") from an unknown date and unknown if ongoing at the time that COVID 19 was just becoming known between Christmas 2019 and New Years 2020, cardiac disorder ("serious heart condition") from an unknown date and unknown if ongoing, tingling feet/hands, skin discoloration (reported as "finger tips and toes would turn blue"), foot discomfort (reported as "my feet would gnarl up"), blood pressure high, dental crown procedure, hypercoagulation (reported as "instant coagulation" after cutting leg shaving) and small cut. Prior to the "hypercoagulation" the patient also reports always having had a strong blood flow (reported a "to the point that people would ask if I was a haemopheliac"). The patient''s concomitant medications were not reported. The patient experienced blood clots which was medically significant on an unspecified date with outcome of unknown, my hands suddenly started tingling on 24Aug2021 with outcome of recovered, her feet started to feel as if they were gnarling up on 24Aug2021 with outcome of recovered, her finger tips were blue on 24Aug2021 with outcome of recovered. Further description of what happened after vaccination (reported as "35 - 40 minutes later") was reported by the patient and is as follows: "About 30 - 45 minutes later my hands suddenly started tingling. My finger tips were blue. Then my feet started to feel as if they were ''gnarling up.'' This lasted for about 30 minutes and suddenly the tingling blue tips went away and I have been fine since. This seriously concerns me because at the time that Covid 19 was just becoming known between Christmas 2019 and New Years 2020. I became dreadfully ill. Among other things my finger tips would tingle and turn blue. My toes would turn blue and my feet gnarl up to where they didn''t really look like feet. The tingling blue fingers situations took place every day lasting for about 4 hours, then suddenly disappeared. On 03Jan2020. I picked up my prescriptions for a serious heart condition at withheld The Pharmacist didn''t know what to make of it. Then I cut my leg shaving and I didn''t bleed. Previously, I have always had a strong blood flow to the point where people would inquire as to whether I was a haemophiliac. When I went to the dentist for a routine check up my fingertips were tingling and blue. The dental assistant took my blood pressure. It was over 180. About 15 minutes later the tingling stopped. I had her immediately check my blood pressure which had suddenly dropped to 120. Over time the tingling and blue tips slowly dissipated. When I saw my primary care physician (Dr. withheld) she was convinced I was a COVID long hauler. News reports had begun to show much younger people developing blood clots with COVID, experiencing the same gnarled feet and tingling of fingers. I could not understand why, at 77, I experienced the same reactions as people 40 years younger, but did not die. Although I was no longer experiencing tingling and blue tips if I skinned my knee, cut my leg there was no bleeding, just instant coagulation. In Jul2021 for the first when I received a small cut, there was a tiny flow of blood. I was thrilled. Because of blood clots I had been wary of taking any COVID 19 vaccine. However, the tightening of rules that you have to be fully vaccinated to enter certain places caused me to inquire about the vaccine. My doctor''s PA said he couldn''t advise. I would have to make my own decision or ask my pharmacist. The druggist said he couldn''t advice but they gave two types and if I decided to get it, he''d recommend Pfizer. He also advised drinking ''lots and lots of water.'' I told him could not since I was restricted to consuming no more than 62 ounces of including liquid in food in any 24 hour period. I decided to get the first dose (FD 8338) and experienced the same tingling and blue tip side effect that I hadn''t experienced in a year. That terrifies me." No lab data was reported. Treatment information was not reported.


VAERS ID: 1711621 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Hypersensitivity, Oropharyngeal pain, Pharyngeal swelling, Pruritus, Rash, Swollen tongue, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), 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? 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:
CDC Split Type: USPFIZER INC202101145862

Write-up: Swelling in one of her eye/one eye was a little swollen; Sore throat/throat was sore; Swollen tongue/tongue swelled up; rash; allergic reactions; Break out with hives/hives under her armpit; Still itch; Probably throat closing up/feeling tight; swelling of her tongue and throat; This is a spontaneous report from a contactable consumer (patient). This 69-year-old female patient received bnt162b2, dose 2 via an unspecified route of administration, administered in arm right on 24Aug2021 10:00 (Batch/Lot Number: FD8448) as dose 2, single at the age of 69-year-old for covid-19 immunisation. First dose was received on 03Aug2021 11:00 am (LOT: EW0198) injection in right arm at the age of 69-year-old for covid-19 immunisation. There were no medical history and concomitant medications and investigation assessment. No AE following prior vaccinations. Vaccination facility type: pharmacy. No additional vaccines administered on same date of the Pfizer suspect. No other vaccinations within four weeks prior to the first administration date of the suspect vaccine. Patient got her 2nd dose of the bnt162b2 vaccine on 24Aug2021. Following that night, she broke out with hives. Subsequently she reported being treated with Prednisone and Benadryl. Following that, it went away. But when she started weaning off prednisone, the hives and rash keep coming back on all different parts of her body. She also reported experiencing on Sunday, 29Aug2021, waking up with hives under her armpit, swelling in one of her eye, sore throat and swollen tongue. In line with this, patient would like to know if these are reported AEs post vaccination? If so, she also wanted to know how long these lasts and if she had to be aware of anything that may happen aside from having hives (probably throat closing up). Patient stated she had the second Pfizer vaccine on 24Aug2021 and right after that, that night she started breaking out in hives, and they got so severe, had to go to the doctors and be put on prednisone and diphenhydramine hydrochloride (BENADRYL), she went through the course of that and started weaning down off the prednisone and the hives came back with a vengeance all over her body, in the groin area, all over. She stated the questions she had, she knew with clinical trials, they did say people got hives and rashes, but are these very extreme, like where the throat closed up and tongue swelled up? She was concerned because was there a length of time that these allergic reactions go away after the shot? Is the experience through the trials or something else she should be looking for? She stated as of right now, she was on prednisone, and they have gone away, but as soon as she started weaning down they come back on different parts of the body. She stated when she first got them, they started in the back of her neck on the day of the shot, at the crown of the neck. Then by the next day, 25Aug2021, her groin and top part of her legs were covered with these large hives and the back of her left knee and left ankle. She stated that Sunday, 29Aug2021, was when she weaning off prednisone, she woke up that morning, had hives all underneath armpits, one eye was a little swollen, throat was sore, tongue swelled up could feel hard hives on it. She was put back on prednisone, diphenhydramine hydrochloride and she doesn''t know the name, cetirizine hydrochloride (ZYRTEC ALLERGY) tabs, it''s celutine, or something, that she needed to take still. Treatment included prednisone: She stated she started with 60mg, cut down to one tablet a day, by mouth; diphenhydramine hydrochloride: 25mg, she stated she can''t read it, the dosage, it''s too small, she doesn''t have her glasses with her. Stated she took it every 4-6 hours, 25 mg tablet. The doctor also still wanted her to take it with the prednisone. Lot: ABF082, expiry Date: Nov2022. She stated the hives are not as bad as the initial hives, but they are in a different part of her body, it''s not as raised, but they still itch. She stated the only thing more severe was the swelling of her tongue and throat, it started to feeling tight. Hives: stated began again on 29Aug2021, it went away after she started prednisone and diphenhydramine hydrochloride, well higher dose, and it did go away. She stated she had recovered completely for now, it actually went down the next day, 30Aug2021. She stated she didn''t have any medical problems, that''s one reason about why she called, because she wasn''t sure if through the trials maybe they found out something that somebody gets, like after the adverse event if there is something else after that or in connection with it that may happen so she can be prepared so she can get medical attention right away. No emergency room visit. Physician office visit on Thursday after the shot. The outcome of event break out with hives/hives under her armpit was recovered on 30Aug2021. The outcome of event still itch was not recovered. The outcome of other event was unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1712040 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: 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:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetes; Penicillin allergy (Known allergies: Penicillin)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101194240

Write-up: Swollen lymph node at neck/shoulder of right side; This is a spontaneous report from a non-contactable consumer, the patient. A 59-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the right arm on 23Aug2021 at 07:30 (at the age of 59-years-old) as a single dose for COVID-19 immunisation. Medical history included diabetes and 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 COVID-19 vaccine. Concomitant medications were not reported. On 24Aug2021, the patient had swollen lymph node at neck/shoulder of right side. The event did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event swollen lymph node at neck/shoulder of right side was not resolved at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1712049 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Feeling abnormal, Formication, Lacrimation increased
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dementia (broad), Lacrimal disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101196820

Write-up: Head felt like things were crawling all over; Eyes started watering; Forehead started to get red; Felt like something burst inside head/ head still feels weird; This is a spontaneous report from a contactable consumer, the patient. A 57-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FD8448) via an unspecified route of administration in the left arm on 24Aug2021 at 15:00 (at the age of 57-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. The patient previously received metformin (MANUFACTURER UNKNOWN) for an unspecified indication on unknown date and experienced drug allergy. On 24Aug2021 at 15:00, within just a few seconds of receiving the shot, the patient felt like something burst inside her head and within minutes her head felt like things were crawling all over, also eyes started watering and forehead started to get red. The patient''s head still felt weird where that "pop" happened. Therapeutic measure was taken as a result of the events which included treatment with diphenhydramine (BENADRYL) given by pharmacist and the patient waited around another 15 minutes or so. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events head felt like things were crawling all over, eyes started watering, forehead started to get red was unknown; whereas the event felt like something burst inside head/ head still feels weird was not resolved at the time of this report.


VAERS ID: 1713475 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 EC3184 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METOPROLOL SUCC ER, HCTZ, LOSARTAN
Current Illness: NO
Preexisting Conditions: HYPERTENSION, HYPOTHYROIDISM, RHEUMATOID ARTHRITIS, SPONDYLITIS
Allergies: PENICILLIN AND SULFA, IODINE CONTRAST
Diagnostic Lab Data: NO
CDC Split Type:

Write-up: AFTER THE INJECTION REPORTED BEING LIGHT HEADED/DIZZINESS FOR 15 MINUTES. THAT EVENING INTERMITTITENT CHEST PAIN FOR 4 DAYS.


VAERS ID: 1713545 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-06-11
Onset:2021-08-24
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 LA / UN

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Blood test, Computerised tomogram
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase.
Current Illness: no
Preexisting Conditions: asthma and seasonal allergies
Allergies: unknown
Diagnostic Lab Data: 8/24/2021 ran CT scan and blood work. Determined that I had a stomach bug. Incidentally found Tarlov cyst on spine of tailbone.
CDC Split Type:

Write-up: Went to ER 8/24 - several weeks after last Moderna shot. Intense stomach and back pain.


VAERS ID: 1713935 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-22
Onset:2021-08-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

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

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: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NONE
Diagnostic Lab Data: UNKNOWN
CDC Split Type:

Write-up: Patient reported that he had inflammation of the chest. Patient and mother went to the hospital and they said the reaction should subside in a few days. The patient was told to take tylenol and advil. Unknown if the patient stayed in hospital or had further tests or medications provided.


VAERS ID: 1714177 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1714871 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 LA / IM

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

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1714876 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FA6780 / 2 LA / IM

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

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1714877 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FA6780 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1714879 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FA6780 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1714883 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FA6780 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1714887 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Body aches, headache, fatigue. Lasted 2 days. 10 days later raised welts at injection site.


VAERS ID: 1714906 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FA6780 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt is refusing to repeat dose due to side effects she experienced after the 1st administration.


VAERS ID: 1714909 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FA6780 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Exposure during pregnancy, Product preparation issue
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt refused to repeat dose due to pregnancy. Will reconsider in post partum. EDC 1/13/2022. G3P2


VAERS ID: 1714916 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1715122 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-07
Onset:2021-08-24
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cardiac monitoring normal, Cardiac stress test normal, Chest discomfort, Echocardiogram normal, Electrocardiogram normal, Heart rate increased, Palpitations, Tinnitus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Sulfa.
Diagnostic Lab Data: EKG- 8/24/2021; Stress test-8/31/2021; Echocardiogram-8/31/2021.
CDC Split Type:

Write-up: Rapid heartbeat with palpitations and chest discomfort. Received EKG, stress test and echocardiogram. Had to wear at home heart monitor. All tests were negative. Received no treatment. It went on for weeks. My other symptom was tinnitus. I had a swishing sound in my right away for a few days.


VAERS ID: 1715151 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Head discomfort, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal 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: Multi vitamin.
Current Illness: None
Preexisting Conditions: None.
Allergies: None
Diagnostic Lab Data: None. I thought this was just simply a side effect, but got scared when my vision got blurry.
CDC Split Type:

Write-up: * I got my vision blurry for 4 consecutive days after the vaccine. * Really bad headaches for over a 1 week. I don''t suffer of migraine or headaches in a regular basis. * Felt like my brain got inflamed. * My head doesn''t feel the same after the vaccine.


VAERS ID: 1715283 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-24
   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 EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test abnormal, C-reactive protein increased, Chest X-ray, Computerised tomogram thorax, Echocardiogram, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Echocardiogram, Cardiac CT, Chest X-ray, blood work (Cardiac CRP High Res)
CDC Split Type:

Write-up: Pericarditis - hospitalized for 5 days. Discharged with the following medicines: Colchicine and Ibuprofen.


VAERS ID: 1715323 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Immunisation, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1715329 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1715363 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-14
Onset:2021-08-24
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Decreased appetite, Fatigue, Headache, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma; Theologica; COVID
Allergies:
Diagnostic Lab Data: COVID-19 test
CDC Split Type: vsafe

Write-up: I had headache, server coughing, fatigue, lost of apatite. I had a fever of 102. I went to see the doctor. He sent me to get antibodies. I did a COVID-19 test, positive.


VAERS ID: 1715373 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Immunisation, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1715397 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Immunisation, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1715408 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Attempted to notify pt of the need to repeat the vaccine.


VAERS ID: 1715425 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 003F21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Attempted to reach pt to notify of the need to repeat the 2nd dose.


VAERS ID: 1715428 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 EW0196 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Site: Swelling at Injection Site-Medium, Systemic: RIGHT ARM SWOLLEN SINCE THE DAY OF THE VACCINE.-Medium, Additional Details: RIGHT ARM SWOLLEN SINCE THE DAY OF VACCINE, PATIENT WILL BE SCHEDULING AN APPOINTMENT WITH PCP.


VAERS ID: 1715442 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: 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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt was scheduled to repeat on 9/15/21 and did not show. Have since attempted to reschedule.


VAERS ID: 1715452 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and Agency. As per recommendation from agency, affected dose should be repeated. Pt was notified and all questions answered. Pt no showed for 9/15/21 appt, attempted to contact to reschedule f/u appt.


VAERS ID: 1715466 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FA6780 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Immunisation, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1715477 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt was scheduled to repeat dose on 9/15/21, pt cancelled appt.


VAERS ID: 1715483 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: 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: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt was scheduled to repeat dose on 9/15/21, pt did not attend the appt..


VAERS ID: 1715493 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FA6780 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Immunisation, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1715508 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FA6780 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1715577 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1715590 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 FC3180 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Immunisation, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and agency. As per recommendation from agency, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.


VAERS ID: 1715680 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-08-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: two weeks post vaccine pt had heavy menstral bleeding and clotting


VAERS ID: 1715702 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Myalgia, Neck pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Tingling over entire body, pain in the back of neck and head, muscle pain.


VAERS ID: 1715795 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Injection site pain, Migraine, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamin (daily), Epicor (daily)
Current Illness: None
Preexisting Conditions: None
Allergies: Pennicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme fatigue, 103.2F fever- not responsive to ibuprofen or acetaminophen, severe joint aches in hips and knees, nausea, migraine headache, radiating pain from injection site (elbow to shoulder of left arm), chills. These symptoms lasted for 10-12 hours beginning approximately 20 hours after receiving the shot


VAERS ID: 1716922 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 / SYR

Administered by: Pharmacy       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? 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: My right arm got tingly and then numb.


VAERS ID: 1717979 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-25
Onset:2021-08-24
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 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: Comments: Medical history was not provided.
Allergies:
Diagnostic Lab Data: Test Date: 20210824; Test Name: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: POSITIVE
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: $g35 days since first dose - has not received second dose at this time; Tested positive for COVID after first dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE ($g35 days since first dose - has not received second dose at this time) and COVID-19 (Tested positive for COVID after first dose) in a 36-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 059E21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced COVID-19 (Tested positive for COVID after first dose). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE ($g35 days since first dose - has not received second dose at this time). At the time of the report, PRODUCT DOSE OMISSION ISSUE ($g35 days since first dose - has not received second dose at this time) had resolved and COVID-19 (Tested positive for COVID after first dose) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: positive (Positive) POSITIVE. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient was advised not to take second dose on scheduled time due to COVID positive Concomitant medications were not provided. Treatment information was not provided


VAERS ID: 1718348 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-24
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Maternal exposure during pregnancy, SARS-CoV-2 test, Umbilical cord abnormality
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Nasal Swab; Result Unstructured Data: Test Result:Unknown result; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101206741

Write-up: Dose 1/Dose 2/The day after my pregnant wife received the vaccine, the doctors identified concerns with the pregnancy (related to blood flow in the umbilical cord); The day after my pregnant wife received the vaccine, the doctors identified concerns with the pregnancy (related to blood flow in the umbilical cord); This is a spontaneous report from a contactable consumer (husband). This consumer reported for reported information for both mother and fetus. This is the maternal report. A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, lot number and expiry date were not reported) via an unspecified route of administration on 23Aug2021 as dose 2, single; and via an unspecified route of administration on an unknown date as dose 1, single; for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient had no other vaccine in four weeks. The patient had no covid prior vaccination. The patient had no known allergies. The day after the patient received the second dose of the vaccine, on 24Aug2021, the doctors identified concerns with the pregnancy (related to blood flow in the umbilical cord). These concerns ultimately to patient had delivered at 29 weeks and baby ultimately passing away on the same day. The events resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care, hospitalization from 24Aug2021, life threatening illness (immediate risk of death from the event), and disability or permanent damage. The patient was tested for covid post vaccination on an unknown date which included nasal swab (unknown results). The outcome of the events was unknown. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.; Sender''s Comments: Linked Report(s) : -PFIZER INC-202101210524 fetal case


VAERS ID: 1718351 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-24
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Foetal distress syndrome, Foetal exposure during pregnancy, Premature baby
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Neonatal disorders (narrow)

Life Threatening? Yes
Birth Defect? Yes
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101210524

Write-up: Dose 1/Dose 2/The day after my pregnant wife received the vaccine, the doctors identified concerns with the pregnancy (related to blood flow in the umbilical cord).; The day after my pregnant wife received the vaccine, the doctors identified concerns with the pregnancy (related to blood flow in the umbilical cord).; These concerns ultimately to my son being delivered at 29 weeks and ultimately passing away on the same day; This is a spontaneous report from a contactable consumer (parent). This consumer reported for reported information for both mother and fetus. This is the fetal report. A male fetal patient (reported as son) received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, lot number and expiry date were not reported) transplacental on 23Aug2021 as dose 2, single for covid-19 immunisation. The mother received dose 1, single of BNT162B2, transplacental for Covid-19 immunization on an unspecified date. The patient''s mother of unspecified age received BNT162B2 via an unspecified route of administration. The patient''s and mother''s medical history and concomitant medications were not reported. The mother had no other vaccine in four weeks. The patient''s mother had no covid prior vaccination. The patient''s mother had no known allergies. The day after the patient received the second dose of the vaccine, on 24Aug2021, the doctors identified concerns with the pregnancy (related to blood flow in the umbilical cord). These concerns ultimately to patient being delivered at 29 weeks and ultimately passing away on the same day. The events resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care, hospitalization from 24Aug2021, life threatening illness (immediate risk of death from the event), disability or permanent damage, congenital anomaly or birth defect and death. The patient''s mother was tested for covid post vaccination which included nasal swab (unknown results). The patient died on 24Aug2021. The causes of death were "the mother received the vaccine, the doctors identified concerns with the pregnancy (related to blood flow in the umbilical cord))" and "patient being delivered at 29 weeks". It was unknown if an autopsy was performed. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101206741 mother case; Reported Cause(s) of Death: The day after my pregnant wife received the vaccine, the doctors identified concerns with the pregnancy (related to blood flow in the umbilical cord).; The day after my pregnant wife received the vaccine, the doctors identified concerns with the preg


VAERS ID: 1718768 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-01
Onset:2021-08-24
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Mood altered, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (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: No
Current Illness: No
Preexisting Conditions: No
Allergies: Fruits
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 101.3, full body aches, chills, exhaustion, moodiness started 9pm on 8/24/21. And continued until 8/27/21. When these symptoms stopped I had a vague headache. Needed tylenol every day and sometimes twice a day and slept with an ice pack on my head every night until 9/7/21


VAERS ID: 1718818 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient presented to clinic for COVID vaccine. Patient signed consent form and denied receiving previous COVID vaccine. Patient provided a name and when searched this name in system found no results. Patient given 1st dose of Moderna COVID vaccine. No adverse reaction noted or reported by patient. On further review found an entry in system under the name Nickname. All other info such as DOB and address match. Information in system for "Nickname" showed that he received 2 doses of Pfizer COVID vaccine and 1 dose of Janssen COVID vaccine prior to receiving Moderna on 8/24/21. Called the facilities that administered the previous doses to verify and patient did receive all the listed vaccines. Patient not given second dose of Moderna. No adverse reactions have been reported by patient.


VAERS ID: 1719083 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-24
   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 FC3183 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Adenovirus test, Blood creatine phosphokinase MB, Body temperature increased, Bone pain, Bordetella test negative, Brain natriuretic peptide increased, Brain natriuretic peptide normal, Chest X-ray normal, Chest pain, Chlamydia test negative, Coronavirus test negative, Culture, Echocardiogram abnormal, Ejection fraction normal, Electrocardiogram ST segment abnormal, Electrocardiogram T wave abnormal, Enterovirus test negative, Fibrin D dimer increased, Human metapneumovirus test, Human rhinovirus test, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Mitral valve incompetence, Mycoplasma test negative, Pain, Prohormone brain natriuretic peptide increased, Respiratory syncytial virus test negative, SARS-CoV-2 antibody test negative, SARS-CoV-2 test negative, Sinus tachycardia, Tachypnoea, Tricuspid valve incompetence, Troponin I increased, Troponin increased, X-ray normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (broad), Osteonecrosis (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: methylphenidate
Current Illness: None
Preexisting Conditions: Autism; Seizures
Allergies: None
Diagnostic Lab Data: 8/28 EKG: SINUS TACHYCARDIA 8/27 ECHO: No structural abnormalities seen. Mild tricuspid regurgitation. Trivial to mild mitral regurgitation. Qualitatively normal biventric Lab/diagnostic tests continued: No left ventricular regional wall motion abnormalities noted. No significant pericardial effusion. 8/27 EKG: SINUS TACHYCARDIA ANTEROLATERAL ST T-WAVE CHANGES NORMAL AXIS, INTERVALS, and VOLTAGES SARS CoV 2 by PCR Not Detected RSV by PCR Not Detected Adenovirus Not Detected Coronavirus 229E by PCR Not Detected Coronavirus HKU1 by PCR Not Detected Coronavirus NL63 by PCR Not Detected Coronavirus OC43 by PCR Not Detected MetapneumovirusNot Detected Rhino/Entero by PCRNot Detected Influenza ANot Detected H1N1 (Swine)Not Detected Influenza A H1 by PCRNot Detected Influenza A H3 by PCRNot Detected Influenza BNot Detected Parainflu 1Not Detected Parainflu 2Not Detected Parainflu 3Not Detected Parainfluenza 4 by PCRNot Detected Bordetella pertussis by PCRNot Detected Bordetella Parapertussis PCRNot Detected Chlamydia pneumoniae by PCRNot Detected Mycoplasma pneumoniae by PCR Not Detected , Microbiology Culture and Sensitivity Details No cultures . , Lab results 08/29/2021 05:31 EDT CKMB i STAT 0.5 ng/mL 08/29/2021 05:30 EDT BNP iSTAT 103 pg/mL HI
CDC Split Type:

Write-up: 12-year-old female with past medical history significant for autism spectrum disorder, seizure disorder, ADHD on methylphenidate while in school who received first dose of Pfizer vaccine on 8/20/2021 and started on 8/24/2021 with chest pain. Per mother she woke up on 8/24/2021 complaining of a mild retrosternal chest pain she otherwise felt well, mom thought it was muscular in origin so she gave Aleve and patient went to school. On arrival from school pain was still there. The following day the pain persisted but she still went to school when she arrived it was worse mom again gave Aleve and applied ice with some relief in the pain. On Thursday she still went to school but after she arrived the pain was worse so mom took her to ED. On arrival at outside hospital her temperature was 101.7 blood pressure 126/86 heart rate of 160 respiratory rate 22 and O2 sat 99% in room air Labs were significant for elevated troponin a mildly elevated proBNP, elevated D-dimer and an abnormal EKG with sinus tachycardia and minimal anterior T wave changes, chest x-ray was negative. She received naproxen, Tylenol and normal saline bolus and she was transferred for further management. In our ED she was afebrile continues to be tachycardic with heart rate between 101 120. She was also tachypneic with respiratory rate between 20 and 32 O2 sat remained at 99 to 100% in room air. Repeat troponin I of 1.17 (normal value up to 0.08), CK-MB at 8.1 and BNP of 100. She was admitted and started on ibuprofen around-the-clock. Since admission she has remained afebrile but continues to be tachycardic and tachypneic. EKG on admission showed sinus tachycardia with anterolateral ST wave changes. Echocardiogram showed no structural abnormalities, mild tricuspid regurgitation trivial to mild mitral regurgitation and normal biventricular systolic function. No significant pericardial effusion. Ejection fraction was 0.63. Overnight she had worsening of the pain and required dose of IV Toradol. 8/29: Overnight, patient required one dose of IV Toradol last at 430pm when patient had peristent reproducible clavicular pain. Father mentioned that patient had prior L clavicular fracture, and patient tried to pick up older brother on day of admission. EKG obtained at time of persistent pain which showed sinus tachycardia. Remaining pain management tolerated with oral toradol and tylenol. XR of clavicle showed no evidence of fracture, and patient no evidence of COVID19 prior infection given IgG negative with RPP negative. Troponin and CKMB continue to improve with overall stable BNP (103). Pain well controlled for over $g12 hours will oral pain medications, so will discharge home with PO toradol and tylenol with follow up in 1 week. PCP updated on plan of care and will follow up with patient within a week. Instructed to hold methylphenidate.


VAERS ID: 1719475 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dyspnoea, Injection site erythema, Injection site pruritus
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (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: None
CDC Split Type:

Write-up: Pharmacy called patient to remind her to come for her second COVID vaccine. Patient said she did not want to get second vaccine yet because she had a reaction. She said that she got "COVID arm" a large red patch that was itchy appeared on her arm near the injection site. Patient also said that later on she felt that she had trouble breathing. She took benadryl to treat the symptoms. She said she experienced anaphylaxis in the past and felt that if she did not take benadryl she may have went into anaphylaxis.


VAERS ID: 1719514 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-24
Onset:2021-08-24
   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 WMT579 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Injected limb mobility decreased, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headaches, fatigue, soreness at injection arm, lost mobility in arm.


VAERS ID: 1719543 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-20
Onset:2021-08-24
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Nasopharyngitis, Pyrexia, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: asthma
Allergies: no
Diagnostic Lab Data: COVID test - positive result - Walgreens
CDC Split Type: vsafe

Write-up: Sinus, head cold congestion. Mild fever at times - it didn''t last long. Biggest thing has been fatigue. I had a cough - the cough didn''t last very long. I didn''t have trouble with breathing. I did several doctor appts over the phone. No treatment. They gave me antibiotics but that was before I knew it was COVID - I am still taking those antibiotics and I am taking vitamin supplements. I am still tired - it is getting better every day. I still have some sinus stuff.


VAERS ID: 1720083 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Gait disturbance, Headache, Hypoaesthesia, Neuralgia, Pain in extremity, Peripheral coldness, Vision blurred
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc vitamin c ibuprofen prn
Current Illness: None
Preexisting Conditions: None
Allergies: Peanut butter
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I woke up the next morning with sciatic nerve pain from my waist down to my toes. I could barley walk or sit. The pains were very sharp. My vision was blurry on and off for two days. I now have had headaches with sharp pain in the back of my head since the vaccine. I have sharp pain in my arms and my hands go numb throughout the day. I also have had chills and feel cold. These symptoms have been happening since the day after the vaccine. I never had these symptoms before.


VAERS ID: 1721892 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-11
Onset:2021-08-24
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epstein-Barr virus infection, Illness, Infectious mononucleosis
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
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 INC202101103400

Write-up: diagnosed with Mono/mononucleosis; Epstein-Barr virus; sick; This is a spontaneous report from a contactable Nurse (mother of patient) reported her son. A 17-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number was not reported and Expiration date: unknown), dose 1 via an unspecified route of administration, administered in Deltoid Left on 11Aug2021 at 11:00 (not 100 percent sure about time) (at the age of 17-year-old) as DOSE 1, SINGLE for covid-19 immunisation. There were no additional Vaccines Administered on Same Date of the Pfizer Suspect. Medical history was none. There were no concomitant medications. Patient medical history (including any illness at time of vaccination) was none. The patient had no family medical history relevant to AE. No other vaccinations within four weeks prior to the first administration date of the suspect vaccine. No AE(s) following prior vaccinations. On 24Aug2021, the patient diagnosed with mononucleosis, Epstein-Barr virus and had been sick for like a week. The clinical details of the events as follows: Caller was calling about her son who is 17 years old. The caller is a NP. The patient received his first dose of the Pfizer COVID-19 Vaccine on 11Aug2021. Patient now had been diagnosed with Mono. Because of this new diagnosis, the caller was now hesitant to get him the second dose of his vaccine that he is supposed to receive on 02Sep2021. Caller requested to speak to a scientist or doctor with Pfizer regarding her situation and other cases possibly. The caller understanded that there was minimal information available on teens, but she would like to get further guidance on what the recommendation would be for her son having had the 1st dose and now having Mono. She did not mention speaking to a higher level than a RN several times with the backing that she is not trying to undermine. She would like to know if this was something Pfizer has knowledge about. She stated that this was above her medical knowledge as a practicing Nurse Practitioner as well. She stated that her situation was unique, and she understands this. Caller also stated that her HCP, nobody knows anything about anything to be honest. Caller stated obviously as a medical provider myself, I am not giving him the 2nd vaccine. I am not messing with his immune system while he is fighting mono. The patient went to the physician office due to the events. The caller son now has mononucleosis, Epstein-Barr Virus. The caller was asking for guidance on the son receiving the second dose Pfizer Covid Vaccine. The caller stated she knows there was no data on someone with mononucleosis and the Pfizer Covid Vaccine. The caller son now has mononucleosis within 3 weeks of receiving the Pfizer Covid Vaccine and the patient was due for his second dose Pfizer Covid Vaccine. The caller did not think the patient should receive the second dose Pfizer Covid Vaccine, knows the Pfizer Covid Vaccine effects the immune system. The caller was not happy about the situation. The caller is a Nurse Practitioner and was on the fence about her son receiving the Pfizer Covid Vaccine, but the caller did the right thing for her son. The caller wanted to speak to someone about guidance on the second dose Pfizer Covid Vaccine. The caller did think the son was going to receive the second dose Pfizer Covid Vaccine. Relevant Tests were none. Now has mononucleosis, Epstein-Barr Virus, the caller stated she knew this was not a side effect. She stated mononucleosis and Epstein-Barr virus were Unrelated to Pfizer Covid Vaccine. There was no Investigation Assessment provided. The patient outcome of the events was unknown at the time of this report. Causality: The caller stated this was not a side effect of the Pfizer Covid Vaccine. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1721944 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-08-24
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TIROSINT; VITAMIN D NOS; BIOTIN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101219652

Write-up: Moderate abdominal cramping about 30 mins following the vaccine; This is a spontaneous report from a contactable consumer, the patient. A 31-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date in Aug2021 (at the age of 31-years-old), as a single dose for COVID-19 immunisation. Medical history was not reported. 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 COVID vaccine. Concomitant medications included levothyroxine sodium (TIROSINT), vitamin D NOS (MANUFACTURER UNKNOWN), prenatal (MANUFACTURER UNKNOWN) and biotin (MANUFACTURER UNKNOWN); all from unknown dates for unknown indications and unknown if ongoing. On 24Aug2021, about 30 minutes following the vaccine, the patient experienced moderate abdominal cramping, lasting about 30 minutes where the patient had to lay day and it was bad. The moderate abdominal cramping did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event moderate abdominal cramping was resolved an unknown date in Aug2021. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1722550 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-23
Onset:2021-08-24
   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 FA7485 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Axillary pain, Blood test, Chest X-ray, Chest discomfort, Chills, Dizziness, Electrocardiogram, Fatigue, Feeling cold, Flushing, Headache, Hyperhidrosis, Hypertension, Hyperventilation, Injection site nodule, Migraine, Nausea, Oedema peripheral, Pain in extremity, Panic attack, Pulmonary pain, Pyrexia, Urine analysis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 20 mg of paxil 200 mg of lamatrogine
Current Illness: none
Preexisting Conditions: GAD
Allergies: none
Diagnostic Lab Data: Doctor visit: 9/21/2021 urine, blood drawn, EKG, X-ray of lungs and heart
CDC Split Type:

Write-up: tired, nauseated, bone cold chills, pain in lungs, headache, soreness in entire arm that was injected, knot of injection, armpit swollen and sore to touch, anxiety and panic attacks, chest heavy, dizzy, hyperventilate, blood pressure extremely high, entire body sweats, flushed, fever, migraine Symptoms started 8/23/2021 and still ongoing as of 9/22/2021


VAERS ID: 1722615 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-11
Onset:2021-08-24
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Demyelination, Electromyogram abnormal, Guillain-Barre syndrome, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Optic nerve disorders (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Headaches
Allergies: None1
Diagnostic Lab Data: Weakness, loss of reflexes. EMG/Nerve Conduction indicating demyelination consistent with Guillian Barre syndrome.
CDC Split Type:

Write-up: Paresthesias, muscle weakness: Guillian Barre syndrome. Onset 12 days following first COVID vaccination. No other acute illness typically associated with GB.


VAERS ID: 1722762 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-14
Onset:2021-08-24
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Magnetic resonance imaging, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 mg tablet, Vytorin 10/20, levothyroxine 50 mcg tablet, multivitamin tablet, Xyzal 5 mg tablet
Current Illness: Had tested positive Covid 19 on December 24th 2020
Preexisting Conditions: None
Allergies: Use Xyzal 5 mg tablet to control Hives
Diagnostic Lab Data: Multiple Cat Scans and MRI''s
CDC Split Type:

Write-up: Started as a diagnose of TSI then changed to seizures.


VAERS ID: 1722940 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / N/A LA / IM

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

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

Write-up: Patient received Moderna vaccine first dose on 7-27.21. Returned to clinic on 8-24-21 for second dose and confirmed she was getting Pfizer vaccine. COVID card was not available to provider at the time of the injection. Patient received second dose as Pfizer vaccine. No treatment given. No signs or symptoms. No adverse reactions.


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