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From the 10/8/2021 release of VAERS data:

Found 781,870 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 433 out of 7,819

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VAERS ID: 1672487 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / OT

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

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

Write-up: left arm was hurting, where I got the shot; body aches; headaches; muscle pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (body aches), HEADACHE (headaches), MYALGIA (muscle pain) and VACCINATION SITE PAIN (left arm was hurting, where I got the shot) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) for COVID-19 vaccination. No Medical History information was reported. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced PAIN (body aches), HEADACHE (headaches) and MYALGIA (muscle pain). On 17-Aug-2021, the patient experienced VACCINATION SITE PAIN (left arm was hurting, where I got the shot). At the time of the report, PAIN (body aches), HEADACHE (headaches), MYALGIA (muscle pain) and VACCINATION SITE PAIN (left arm was hurting, where I got the shot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication of the patient was not reported. On 16-Aug-2021, the symptoms started a little, but it started again on 17-Aug-2021 after work. No treatment information was provided by the reporter.


VAERS ID: 1672526 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-09
Onset:2021-08-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E27A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination complication, Vaccination site erythema, Vaccination site pruritus, Vaccination site warmth
SMQs:

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

Write-up: Experienced a hot; Covid arm; itchy; red spot/Rash; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Experienced a hot), VACCINATION COMPLICATION (Covid arm), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE ERYTHEMA (red spot/Rash) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E27A) for COVID-19 vaccination. No Medical History information was reported. On 09-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced VACCINATION SITE WARMTH (Experienced a hot), VACCINATION COMPLICATION (Covid arm), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE ERYTHEMA (red spot/Rash). At the time of the report, VACCINATION SITE WARMTH (Experienced a hot), VACCINATION COMPLICATION (Covid arm), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE ERYTHEMA (red spot/Rash) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. No concomitant medications were reported. No Treatment medications were reported.


VAERS ID: 1672532 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-02
Onset:2021-08-16
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Menstrual disorder
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: LEXAPRO; TESTOSTERONE; ABILIFY
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: I did not have a period in over a year, and the day after the first and second vaccination I had my period; More than 35 days between first and second shot; This spontaneous case was reported by a consumer and describes the occurrence of MENSTRUAL DISORDER (I did not have a period in over a year, and the day after the first and second vaccination I had my period) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot) in a 21-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 05392114 and 041C21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included ESCITALOPRAM OXALATE (LEXAPRO), TESTOSTERONE and ARIPIPRAZOLE (ABILIFY) for an unknown indication. On 02-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot). On 17-Aug-2021, the patient experienced MENSTRUAL DISORDER (I did not have a period in over a year, and the day after the first and second vaccination I had my period). On 16-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot) had resolved. At the time of the report, MENSTRUAL DISORDER (I did not have a period in over a year, and the day after the first and second vaccination I had my period) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient says she takes testosterone as her body does not produce Estrogen and that she never has a period. treatment information was not provided This case was linked to MOD-2021-291006 (Patient Link).


VAERS ID: 1672550 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-19
Onset:2021-08-16
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache after the second shot; Pain all over body after the second shot; Low Grade Fever after the second shot; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache after the second shot), MYALGIA (Pain all over body after the second shot) and PYREXIA (Low Grade Fever after the second shot) in a 56-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. Concurrent medical conditions included Amputee (Left leg above knee). On 19-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced HEADACHE (Headache after the second shot), MYALGIA (Pain all over body after the second shot) and PYREXIA (Low Grade Fever after the second shot). On 18-Aug-2021, HEADACHE (Headache after the second shot), MYALGIA (Pain all over body after the second shot) and PYREXIA (Low Grade Fever after the second shot) had resolved. No Concomitant Medications were provided. No Treatment Medications were provided.


VAERS ID: 1672556 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-01-09
Onset:2021-08-16
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 3 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 100F
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Sore arm; Fever 100F; Tired; A day in bed; This spontaneous case was reported by a consumer and describes the occurrence of BEDRIDDEN (A day in bed), PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever 100F) and FATIGUE (Tired) in an 85-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025J20A and 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced BEDRIDDEN (A day in bed). On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever 100F) and FATIGUE (Tired). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 dosage form. On 17-Aug-2021, BEDRIDDEN (A day in bed) had resolved. At the time of the report, PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever 100F) and FATIGUE (Tired) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100f (High) 100F. Concomitant product use was not provided by the reporter. On 18 Aug 2021, the patient was feeling fine but not 100 percent. This case was linked to MOD-2021-290368, MOD-2021-290627 (Patient Link).


VAERS ID: 1672564 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-15
Onset:2021-08-16
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Inappropriate schedule of product administration, Myalgia, Pyrexia, Vaccination site erythema, Vaccination site swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: first dose of the Moderna COVID-19 vaccine on 15Apr2021 and the second on 16Aug2021; pressure headache; swelling where the injection was given; Rash the size of an eye patch where the injection was given; sweats; fever; chills; body aches; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (sweats), PYREXIA (fever), CHILLS (chills), MYALGIA (body aches) and HEADACHE (pressure headache) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 04C21A and 047A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in December 2020. On 15-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced HYPERHIDROSIS (sweats), PYREXIA (fever), CHILLS (chills) and MYALGIA (body aches). On 17-Aug-2021, the patient experienced HEADACHE (pressure headache), VACCINATION SITE SWELLING (swelling where the injection was given) and VACCINATION SITE ERYTHEMA (Rash the size of an eye patch where the injection was given). On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (first dose of the Moderna COVID-19 vaccine on 15Apr2021 and the second on 16Aug2021). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) for Headache, at an unspecified dose and frequency. On 17-Aug-2021, HYPERHIDROSIS (sweats), PYREXIA (fever), CHILLS (chills) and MYALGIA (body aches) had resolved. At the time of the report, HEADACHE (pressure headache), VACCINATION SITE SWELLING (swelling where the injection was given) and VACCINATION SITE ERYTHEMA (Rash the size of an eye patch where the injection was given) had not resolved and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (first dose of the Moderna COVID-19 vaccine on 15Apr2021 and the second on 16Aug2021) had resolved. No concomitant medications were provided by reporter.


VAERS ID: 1672568 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-07-12
Onset:2021-08-16
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Dyskinesia, Feeling hot, Flushing, Gait disturbance, Insomnia, Pain in extremity, Pruritus, Vaccination site pain, Vascular pain, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad), Arthritis (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LIPITOR
Current Illness: Food allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Feels warm; Could not sleep straight because every 2-3 hours he will wake up with his leg pain; flushed; pain on his legs but mostly on his right leg; Legs jerks and it will cause pain again; Pain round the ankle going up to the legs; right arm is very itchy; Right arm is painful; veins on his both legs looks swollen; Veins on his both legs very painful to touch,; Limping/can hardly stand on his feet at the time of the call; This spontaneous case was reported by a non-health professional and describes the occurrence of PRURITUS (right arm is very itchy), VACCINATION SITE PAIN (Right arm is painful), VASODILATATION (veins on his both legs looks swollen), VASCULAR PAIN (Veins on his both legs very painful to touch,) and GAIT DISTURBANCE (Limping/can hardly stand on his feet at the time of the call) in a 79-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Food allergy. Concomitant products included ATORVASTATIN CALCIUM (LIPITOR) for an unknown indication. On 12-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced PRURITUS (right arm is very itchy), VACCINATION SITE PAIN (Right arm is painful), VASODILATATION (veins on his both legs looks swollen), VASCULAR PAIN (Veins on his both legs very painful to touch,), GAIT DISTURBANCE (Limping/can hardly stand on his feet at the time of the call), DYSKINESIA (Legs jerks and it will cause pain again) and ARTHRALGIA (Pain round the ankle going up to the legs). On 17-Aug-2021, the patient experienced FEELING HOT (Feels warm), INSOMNIA (Could not sleep straight because every 2-3 hours he will wake up with his leg pain), FLUSHING (flushed) and PAIN IN EXTREMITY (pain on his legs but mostly on his right leg). At the time of the report, PRURITUS (right arm is very itchy), VACCINATION SITE PAIN (Right arm is painful), VASODILATATION (veins on his both legs looks swollen), VASCULAR PAIN (Veins on his both legs very painful to touch,), GAIT DISTURBANCE (Limping/can hardly stand on his feet at the time of the call), FEELING HOT (Feels warm), INSOMNIA (Could not sleep straight because every 2-3 hours he will wake up with his leg pain), FLUSHING (flushed), PAIN IN EXTREMITY (pain on his legs but mostly on his right leg), DYSKINESIA (Legs jerks and it will cause pain again) and ARTHRALGIA (Pain round the ankle going up to the legs) outcome was unknown. patient took vitamin C as concomitant medication and also mentioned that took his first dose on 12-JUL-2021 and experienced some events. No treatment medications are provided by reporter. This case was linked to MOD-2021-291444 (Patient Link).


VAERS ID: 1672603 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Allergy to vaccine, Disturbance in attention, Dizziness, Eyelid irritation, Fatigue, Hypersomnia, Vaccination complication
SMQs:, Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity (Sulfa); Food allergy (patient had other food allergies); Fruit allergy (watermelon); Fruit allergy (Apple); Latex allergy; Vegetable allergy (Carrots)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Still feels tired; Felt "in and out of it"; Felt like she feels when she has a sulfa allergy/she does have multiple allergies including Sulfa, latex, apples, watermelon, carrots, and other food allergies; Light headed; Couldn''t focus; Couldn''t keep her eyelids open; Slept for two days straight; This spontaneous case was reported by a consumer and describes the occurrence of ALLERGY TO VACCINE (Felt like she feels when she has a sulfa allergy/she does have multiple allergies including Sulfa, latex, apples, watermelon, carrots, and other food allergies), DIZZINESS (Light headed), DISTURBANCE IN ATTENTION (Couldn''t focus), EYELID IRRITATION (Couldn''t keep her eyelids open) and HYPERSOMNIA (Slept for two days straight) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Drug hypersensitivity (Sulfa), Fruit allergy (Apple), Fruit allergy (watermelon), Vegetable allergy (Carrots), Latex allergy and Food allergy (patient had other food allergies). On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced ALLERGY TO VACCINE (Felt like she feels when she has a sulfa allergy/she does have multiple allergies including Sulfa, latex, apples, watermelon, carrots, and other food allergies), DIZZINESS (Light headed), DISTURBANCE IN ATTENTION (Couldn''t focus), EYELID IRRITATION (Couldn''t keep her eyelids open) and HYPERSOMNIA (Slept for two days straight). On 17-Aug-2021, the patient experienced VACCINATION COMPLICATION (Felt "in and out of it"). On 19-Aug-2021, the patient experienced FATIGUE (Still feels tired). On 17-Aug-2021, EYELID IRRITATION (Couldn''t keep her eyelids open) and HYPERSOMNIA (Slept for two days straight) had resolved. On 19-Aug-2021, DIZZINESS (Light headed) and DISTURBANCE IN ATTENTION (Couldn''t focus) had resolved. At the time of the report, ALLERGY TO VACCINE (Felt like she feels when she has a sulfa allergy/she does have multiple allergies including Sulfa, latex, apples, watermelon, carrots, and other food allergies), VACCINATION COMPLICATION (Felt "in and out of it") and FATIGUE (Still feels tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.


VAERS ID: 1672841 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Heart rate, Insomnia, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Heart rate; Result Unstructured Data: High (Rapid heart beat during day time); Test Date: 20210816; Test Name: Heart rate; Result Unstructured Data: Increased
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: breathing very hard; could not even go to sleep; arm was also hurting; It was very sore that night; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (breathing very hard), INSOMNIA (could not even go to sleep), PAIN IN EXTREMITY (arm was also hurting) and PAIN (It was very sore that night) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 035C21A) for COVID-19 vaccination. No Medical History information was reported. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced DYSPNOEA (breathing very hard), INSOMNIA (could not even go to sleep), PAIN IN EXTREMITY (arm was also hurting) and PAIN (It was very sore that night). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 dosage form. At the time of the report, DYSPNOEA (breathing very hard), INSOMNIA (could not even go to sleep), PAIN IN EXTREMITY (arm was also hurting) and PAIN (It was very sore that night) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Aug-2021, Heart rate: increased (High) Increased. On an unknown date, Heart rate: high (High) High (Rapid heart beat during day time). The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. Patient felt heart beating was very fast and breathing very hard. It lasted for a while and patient could not even go to sleep. The next night was better. Previous day, patient had rapid heartbeat during the day. Patient never had any trouble with rapid heartbeat or breathing. It was very sore that night (same day of first vaccination), and for a couple of days it continued.


VAERS ID: 1672899 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-06
Onset:2021-08-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 - / OT

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

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

Write-up: tested positive for covid; This spontaneous case was reported by a pharmacist and describes the occurrence of COVID-19 (tested positive for covid) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025C21A) for COVID-19 vaccination. No Medical History information was reported. On 06-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced COVID-19 (tested positive for covid). At the time of the report, COVID-19 (tested positive for covid) 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 was reported. The treatment information was unknown.


VAERS ID: 1673037 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blister, Erythema, Fatigue, Feeling abnormal, Oral herpes, Pain, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: Started not felling good; Blisters on face; Cold sores/Fever bilisters; Redness legs/Redness feet; Swelling legs/Swelling feet; Achy; Tired; Felt feverish, but no fever; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Started not felling good), BLISTER (Blisters on face), ORAL HERPES (Cold sores/Fever bilisters), ERYTHEMA (Redness legs/Redness feet) and PERIPHERAL SWELLING (Swelling legs/Swelling feet) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced PAIN (Achy), FATIGUE (Tired) and PYREXIA (Felt feverish, but no fever). On 21-Aug-2021, the patient experienced FEELING ABNORMAL (Started not felling good), BLISTER (Blisters on face), ORAL HERPES (Cold sores/Fever bilisters), ERYTHEMA (Redness legs/Redness feet) and PERIPHERAL SWELLING (Swelling legs/Swelling feet). The patient was treated with IBUPROFEN (MOTRIN IB) at an unspecified dose and frequency. At the time of the report, FEELING ABNORMAL (Started not felling good), BLISTER (Blisters on face), ORAL HERPES (Cold sores/Fever bilisters), ERYTHEMA (Redness legs/Redness feet), PERIPHERAL SWELLING (Swelling legs/Swelling feet), PAIN (Achy), FATIGUE (Tired) and PYREXIA (Felt feverish, but no fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medication include steroid and anti-viral medication. Concomitant medication was not provided.


VAERS ID: 1673092 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-15
Onset:2021-08-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Asthenia, Back pain, Chest discomfort, Computerised tomogram, Feeling abnormal, Food aversion, Headache, Migraine, Musculoskeletal discomfort, Paraesthesia, Thirst, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210820; Test Name: CAT scan; Result Unstructured Data: normal.
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: anxiety state, unspecified; chest and neck feel intense which comes and goes; patient received intravenous migraine medication; not herself; lost 5 pounds; lower left back pain which feels internal; chest and neck feel intense which comes and goes; pressure tingly feeling in her head; weak; thirsty; food aversion, couldn''t eat, felt hungry, tasted disgusting; headache; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (patient received intravenous migraine medication) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 15-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced ASTHENIA (weak), THIRST (thirsty), FOOD AVERSION (food aversion, couldn''t eat, felt hungry, tasted disgusting), PARAESTHESIA (pressure tingly feeling in her head) and HEADACHE (headache). On 18-Aug-2021, the patient experienced CHEST DISCOMFORT (chest and neck feel intense which comes and goes). On an unknown date, the patient experienced MIGRAINE (patient received intravenous migraine medication) (seriousness criterion medically significant), FEELING ABNORMAL (not herself), WEIGHT DECREASED (lost 5 pounds), BACK PAIN (lower left back pain which feels internal), MUSCULOSKELETAL DISCOMFORT (chest and neck feel intense which comes and goes) and ANXIETY (anxiety state, unspecified). The patient was treated with IBUPROFEN ongoing from 18-Aug-2021 for Head pressure, at a dose of 1 dosage form. At the time of the report, MIGRAINE (patient received intravenous migraine medication), ASTHENIA (weak), THIRST (thirsty), FOOD AVERSION (food aversion, couldn''t eat, felt hungry, tasted disgusting), FEELING ABNORMAL (not herself), PARAESTHESIA (pressure tingly feeling in her head), WEIGHT DECREASED (lost 5 pounds), BACK PAIN (lower left back pain which feels internal), CHEST DISCOMFORT (chest and neck feel intense which comes and goes), MUSCULOSKELETAL DISCOMFORT (chest and neck feel intense which comes and goes), ANXIETY (anxiety state, unspecified) and HEADACHE (headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 20-Aug-2021, Computerised tomogram: normal (normal) normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. no concomitant information was provided by reporter. They gave her an IV of a migraine medication. she thinks it was Toradol but was unsure. Company Comment Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1673223 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Pain in extremity, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN; TYLENOL
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101058751

Write-up: Painful swollen lymph nodes under injection side arm; Hives/rash; Hives/rash; Sore arm; This is a spontaneous report from a non-contactable consumer (patient). A 14-years-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Right on 14Aug2021 17:00 at age of 14-years-old (Lot Number: FD8448) as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history was not reported. Concomitant medications included ibuprofen; paracetamol (TYLENOL). The patient experienced Painful swollen lymph nodes under injection side arm, hives, rash, sore arm on 16Aug2021 05:00 with outcome of recovering. The patient received Benadryl, hydrocortisone cream as treatment. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1673224 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Extra dose administered, Fatigue, Gait disturbance, Off label use, Somnolence
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101063929

Write-up: difficulty staying awake; dizziness; difficulty walking/could hardly walk; received third dose; received third dose; tiredness; This is a spontaneous report from a contactable Consumer. A 76-years-old female patient received third dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) via unspecified route of administration on 16Aug2021 at around 17:00 (age at the time of vaccination was 76-year-old) as a single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Previously patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) via unspecified route of administration in Jan2021 (age at the time of vaccination was 76-year-old) as a single dose, second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) via unspecified route of administration on an unspecified date, as a single dose for COVID-19 immunization. On 16Aug2021, the patient experienced tiredness, difficulty walking/could hardly walk and received third dose. On 17Aug2021, the patient experienced dizziness. On an unspecified date, the patient experienced difficulty staying awake. Subsequently experienced dizziness, tiredness, difficulty walking, and difficulty staying awake. Caller states he and his wife both received booster doses (third doses) of the Pfizer BioNTech Covid-19 Vaccine yesterday at 5PM. Caller states his wife began experiencing side effects such as ty walking, and difficulty staying awake. Caller states his wife has been lying down since she can hardly walk. Caller states his wife was sitting up now but her eyes are closed. Caller states they both received their first doses of the vaccine in Jan. He''s calling about the Pfizer Covid 19 booster, clarified the third dose. He reports he and his wife both received their booster dose yesterday afternoon, 16Aug2021 around 5:00PM. In the last 10-15 minutes his wife got dizzy and could hardly walk, she had to lay down. He was asking if this could be a side effect. Outcome of all the events was unknown. Outcome of all the events was unknown. The lot no number of the vaccine [BNT162B2] was not provided and will be requested during follow up.


VAERS ID: 1673228 (history)  
Form: Version 2.0  
Age: 2.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Accidental exposure to product by child, Body temperature, Pyrexia, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Viral infection (fever and hives are some sort of viral infection which she has had in past, but not these kind).
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: fever; Result Unstructured Data: Test Result: low grade around 100 degrees F.
CDC Split Type: USPFIZER INC202101068628

Write-up: Got ahold of bandage and broke out in fever, hives and rash on arms and legs; Got ahold of bandage and broke out in fever, hives and rash on arms and legs; Got ahold of bandage and broke out in fever, hives and rash on arms and legs; Got ahold of bandage and broke out in fever, hives and rash on arms and legs; This is a spontaneous report from a contactable consumer. This consumer (patient mother) reported for a 2-year-old female patient. A 2-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection. Batch/Lot number was not reported), via an unspecified route of administration on 16Aug2021 (at the age of 2-yers-old) as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 immunization. Medical history included viral infection (She saw where fever and hives are some sort of viral infection which she has had in past, but not these kind) from an unknown date and unknown if ongoing. There were no concomitant medications. Patient history and investigation assessment: No. It was reported that, consumer said she received the 2nd dose of the Pfizer-BioNTech COVID-19 Vaccine on 16Aug2021, Monday. She said her husband received his 1st dose on the same day, and they never had any reaction, however, her 2-year-old got ahold of bandages from vaccine and somehow a couple of hours later broke out in fever and hives. She was not sure if it was related. She just wonders if any trace amount of vaccine got on her skin. She had not been in contact with anyone else. She works from home and they are diligent and strict about restrictions. She would like to know if the fever, hives and rash that her daughter experienced after playing with the Band-Aids after she and her husband got vaccinated could be related to the Pfizer COVID vaccine. It was mentioned that, I also told the consumer that since their daughter has not received the vaccine yet, then Pfizer cannot assess whether the reaction she had caused by the Pfizer-BioNTech COVID-19 Vaccine. Then, I referred them to their daughter''s doctor as they would be in the best position to give them advice on the appropriate actions to be taken. She will wait a couple of days to see if it improves before she decides to go to the doctor. It has not gotten any worse as of yet. She came home and her daughter has a thing for band-aids. They set them on counter and she had them in her hand and was playing with them. The fever has persisted and it is low grade around 100. It gets better with Motrin. The hives go away with Benadryl, but they come back. She gave it yesterday morning and it was back by evening. By the evening, she gave more and they were back by morning. She saw where fever and hives are some sort of viral infection which she has had in past, but not these kind. They are going away with this antihistamine. She had been in the house all day. The rash on her daughter was on her arms and legs, but viral rashes are normally on her torso and this was not. No further details provided. Separate report completed to document his experience. The outcome of the event accidental exposure to product by child was unknown while other events were not recovered. The lot number was not provided. Information on lot number has been requested during follow up.


VAERS ID: 1673277 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, COVID-19, Cough, Fatigue, Pain, Pyrexia, SARS-CoV-2 test, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), 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? 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: 20210816; Test Name: Fever; Result Unstructured Data: Test Result: 37.8 Centigrade; Test Date: 20210818; Test Name: PCR; Test Result: Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202101082237

Write-up: Patient covid positive; Patient covid positive; feel body pains; fatigue; fever (37.8C); Cough; This is a spontaneous report from a contactable consumer (reported for himself). A 40-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EN6205/Batch number was not reported), dose 1 via an unspecified route of administration, administered in arm left on an unspecified date (at the age of 40-years-old) as dose 1, single and dose 2 via an unspecified route of administration on an unspecified date (Lot Number: EW0158/Batch number was not reported) as dose 2, single for covid-19 immunisation at other. The patient medical history and concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19. The patient experienced feel body pains, fatigue, fever (37.8 Centigrade), cough on 16Aug2021 and patient covid positive on 18Aug2021. The event patient covid positive assessed as serious (medically significant). The patient underwent lab tests and procedures which included body temperature: 37.8 Centigrade on 16Aug2021 and sars-cov-2 test: positive on 18Aug2021 (nasal swab). The outcome of the events was not resolved. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1673289 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: PCR/nasal Swab; Test Result: Positive ; Comments: PCR and 2 at home tests
CDC Split Type: USPFIZER INC202101082628

Write-up: I got covid 3 months after being fully vaccinated with the Pfizer Vaccine.; I got covid 3 months after being fully vaccinated with the Pfizer Vaccine.; This is a spontaneous report from a contactable consumer (patient). A 37-years-old male patient received first dose of bnt162b2 (Pfizer covid-19 vaccine, Solution for injection, Lot number: er8731), via an unspecified route of administration in the left arm on 14Apr2021 at 15:00 (age at vaccination: 37-year-old) and second dose of bnt162b2 (Pfizer covid-19 vaccine, Solution for injection, Lot number: Ew0173) via an unspecified route of administration in the left arm on an unspecified date, both as a single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, patient was not diagnosed with COVID-19. On 16Aug2021 at 17:00, patient got COVID 3 months after being fully vaccinated with the Pfizer Vaccine. Adverse event resulted in Doctor or other healthcare professional office/clinic visit. Patient did not receive any treatment for the events. The patient underwent lab test and procedure which included PCR covid test post vaccination, nasal Swab: positive on 18Aug2021 and 2 at home tests. The clinical outcome of COVID-19 was recovering. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1673296 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Headache, Nasal congestion, 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: 20210816; Test Name: Covid-19 virus test; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC202101082669

Write-up: mild headache; some nasal congestion; Unfortunately, I became infected last weekend, testing positive on 16Aug; I received both of my Pfizer vaccine shots in April. Unfortunately, I became infected last weekend; This is spontaneous report from a contactable consumer(patient). An unknown age and gender patient received bnt162b2 (BNT162B2, formulation: solution for injection, Batch/Lot number were not reported) dose 2 via an unspecified route of administration on an unspecified date as dose 2, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient past drug history included bnt162b2 (BNT162B2, formulation: solution for injection, Batch/Lot number were not reported) dose 1 via an unspecified route of administration on an unspecified date as dose 1, single for COVID-19 immunisation. The patient received both of my Pfizer vaccine shots in April. Unfortunately, patient became infected last weekend, testing positive on 16Aug2021. patient symptoms, which were a mild headache and some nasal congestion, would have likely been severe if not for your vaccine. The patient underwent lab tests and procedures which included Covid-19 virus test was positive on 16Aug2021. The outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1673370 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angioedema, Ear pruritus, Erythema, Eye pruritus, Hypersensitivity, Pruritus, Rash macular, Swelling face, Throat irritation
SMQs:, Anaphylactic reaction (broad), 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: CONCERTA; CYMBALTA; ARMOUR THYROID
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism; Latex allergy; Migraine headache; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101092114

Write-up: Progressed to symptoms of angioedema.; Systemic " itching "- head, arms, upper anterior thighs bilaterally, vaguely within about 20-30 minutes.; Facial swelling; red face; blotchy red patches arms, back, legs face; severe itchy (10) inside of ears (deep), eyes; severe itchy (10) inside of ears (deep), eyes; scratchy throat; Next morning, allergic reaction covered by medication; This is a spontaneous report from a contactable Nurse (patient). A 58-year-old female patient not pregnant received first dose of bnt162b2 (BNT162B2), via an unspecified route of administration, administered in Arm Left on 16Aug2021 19:00 (Lot Number: fc3181) as single dose (at age of 58-year-old) for covid-19 immunisation. Medical history included migraine headache (h/a), hypothyroid, latex allergy, penicillin (PCN) allergy. Concomitant medications included methylphenidate hydrochloride (CONCERTA); duloxetine hydrochloride (CYMBALTA); thyroid (ARMOUR THYROID). Facility type vaccine: Pharmacy or Drug Store. It was unknown if patient had COVID prior vaccination and was not tested for COVID post vaccination. On 16Aug2021 patient experienced progressed to symptoms of angioedema, systemic " itching "- head, arms, upper anterior thighs bilaterally, vaguely within about 20-30 minutes, facial swelling, red face, blotchy red patches arms, back, legs face, severe itchy (10) inside of ears (deep), eyes, scratchy throat, next morning, allergic reaction covered by medication. Events resulted in Doctor or other healthcare professional office/clinic visit. Clinical course was reported as follows: Systemic "itching "- head, arms, upper anterior thighs bilaterally, vaguely within about 20-30 minutes. Progressed to symptoms of angioedema. Facial swelling, red face, blotchy red patches arms, back, legs face, although much more severe itchy (10) inside of ears (deep), eyes, and scratchy throat. Patient had no food or anything else but water after the vaccination. These symptoms evolved over two hours, increasing in intensity. Patient had Benadryl and prednisone in her medicine box and took 75 mg Benadryl, (liquid) 50 ng prednisone at 10:00 pm. Was up until 12:00 midnight; symptoms quelled 80% by 12:30 am. Next morning, allergic reaction covered by medication. General practitioner (GP), notified and was documented. Patient was treated for the events. Patient was recovering from all the events, at the time of the report.


VAERS ID: 1673412 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-24
Onset:2021-08-16
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 RA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Rapid Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101110265

Write-up: lack of efficacy- contracted COVID-19; lack of efficacy- contracted COVID-19; This is a spontaneous report from a contactable consumer (patient). A 40-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 intramuscular administered in Arm Right on 05Feb2021 (Lot Number: EM9810) at age of 39-year-old, dose 2 intramuscular administered in Arm Right on 24Feb2021 (Lot Number: EN6202) at age of 39-year-old, both at single dose for covid-19 immunisation. Medical history included asthma. No covid prior vaccination. There were no concomitant medications. The patient previously took cefaclor (CECLOR) and experienced drug hypersensitivity. No other vaccine in four weeks. The patient experienced lack of efficacy- contracted covid-19 on 16Aug2021. Events resulted in [Doctor or other healthcare professional office/clinic visit]. No treatment received. The patient underwent lab tests and procedures which included sars-cov-2 test (Rapid Nasal Swab): positive on 25Aug2021. The outcome of events was recovering. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1673416 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Fatigue, Headache, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101110549

Write-up: backaches; extreme fatigue; leg and body aches; leg and body aches; recurring headaches; This is a spontaneous report from a contactable consumer reporting for granddaughter (patient) via medical information team. A 14-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: unknown, expiration date: unknown), via an unspecified route administered on 13Aug2021 (at the age of 14-year-old) as DOSE 2, SINGLE for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: unknown, expiration date: unknown) administered via unknown route on an unknown date as DOSE 1, SINGLE for COVID-19 immunization. The patient had no history of adverse events with any previous vaccines. No additional Vaccines Administered on Same Date of the Pfizer Suspect. Reporter stated that patient received her second dose of the vaccine on 13Aug2021, after which she developed backaches on 26Aug2021, leg and body aches, recurring headaches, and extreme fatigue on 16Aug2021. The back ache was intermittent. Reporter stated that the extreme fatigue vary from tired to very tired and it is persistent with some extreme fatigue and that it goes up and down. It was reported that no medical treatment was given and patient just took Tylenol. No further details provided. The outcome of all the events was not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1673442 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-08-16
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: COVID test/Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101119771

Write-up: I tested positive for a breakthrough infection of COVID-19; I tested positive for a breakthrough infection of COVID-19; This is a spontaneous report from a non-contactable consumer (patient). A 28-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EW0185), via an unspecified route of administration on arm right on 16May2021(age at vaccination: 28 Years) as dose 2, single and received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EW0171), via an unspecified route of administration on arm right on 25Apr2021 as dose 1, single for COVID-19 immunization at Pharmacy or Drug Store. The patient medical history was not reported. The patient has not received any other vaccines within 4 weeks prior to the COVID vaccine. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient Concomitant medications were not reported. On 16Aug2021, the patient tested positive for a breakthrough infection of COVID-19. The event resulted in Doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient has tested for COVID-19. Treatment received was reported as no. The lab test included SARS-CoV-2 test(Nasal Swab): positive on 17Aug2021.The outcome of event was resolving. No follow up attempts are possible. No further information is expected.


VAERS ID: 1674862 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Induration, Nodule, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swollen eyes and then hard, red, purple lumps in tear troughs . Still not resolved. GP prescribed corticosteroid.


VAERS ID: 1674869 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-21
Onset:2021-08-16
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Heart rate increased, Magnetic resonance imaging heart, Palpitations, Ventricular extrasystoles, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multi-vitamin, protein supplement
Current Illness: Anxiety
Preexisting Conditions: None that I know
Allergies:
Diagnostic Lab Data: Blood work, x ray, cardiac mri
CDC Split Type:

Write-up: Rapid heart rate 2 weeks after 2nd dose; Palpitations/PVC 3weeks after 2nd dose.


VAERS ID: 1674938 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-08-16
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin 500mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving my first shot 2-3 weeks later I started having very heavy long period. I have a birth control implant for 2yrs now and it stops me from having regular periods. Now they come every 2-3 weeks and last 6 days I?ve never had that happen to me before.


VAERS ID: 1675041 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-07
Onset:2021-08-16
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Cough, Fatigue, Muscle fatigue, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fineasteride, omeprozale
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Multiple visits to urgent care. Negative Covid test 9/2/21
CDC Split Type:

Write-up: Severe fatigue, muscle fatigue, cough and chest pain developed 9 days later.


VAERS ID: 1675049 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphthous ulcer, Asthenia, Balance disorder, Diarrhoea, Dizziness, Electric shock sensation, Feeling abnormal, Flushing, Groin pain, Headache, Hyperhidrosis, Insomnia, Nausea, Pain, Rash, Skin warm, Temperature intolerance, Vertigo, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin C, Zinc, Tizanidine, Maxalt, Fiorcet
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Complete blood work done 9/3/21.
CDC Split Type:

Write-up: 15 minutes after receiving first dose, got up to leave the pharmacy and the room started spinning and the floor felt like it was moving. I almost fell. Since then I have had headache, room spinning, dizziness, nausea, blurred vision, electrical shocks in legs and chest, diarrhea, sweating, heat intolerance, unsteady walking, flushed face, groin pain, body aches, insomnia, vertigo, weakness, canker sores, burning body rash, brain fog.


VAERS ID: 1675367 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-05
Onset:2021-08-16
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxyl Flovent Adderal Zyrtec
Current Illness: None
Preexisting Conditions: Asthma Hypothyroidism
Allergies: Amoxicillin
Diagnostic Lab Data: Positive Covid test
CDC Split Type:

Write-up: Fever, chills, loss of smell/taste, cough, difficulty breathing


VAERS ID: 1675698 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Limb discomfort, Pain
SMQs:, 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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: No Known Allergies
Diagnostic Lab Data: No testing
CDC Split Type:

Write-up: Patient reported a joint pain on the medial elbow that was not present before they shot, he states it feels like an "arthritic, joint pain" in the elbow. He states that it worsened during the week of his first shot but after that week seemed to get better but still has pain when lifting objects and when making a fist that he feels discomfort.


VAERS ID: 1675773 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discharge, Erythema, Induration, Lymphadenopathy, Pain, Skin irritation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (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: Juice Plus
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: under left arm my lymph-nope became hard and swollen and tons of puss came out.. very painful. still red and irratated d as of today.


VAERS ID: 1676259 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-02-25
Onset:2021-08-16
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Chest pressure, difficulty breathing (aug 16-present)


VAERS ID: 1677133 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-19
Onset:2021-08-16
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / OT

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

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

Write-up: Administered today from a vial that was punctured more than 12 hours ago; This spontaneous case was reported by a consumer and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administered today from a vial that was punctured more than 12 hours ago) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 088D21A and 051C21A) for COVID-19 vaccination. No Medical History information was reported. On 19-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administered today from a vial that was punctured more than 12 hours ago). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Administered today from a vial that was punctured more than 12 hours ago) had resolved. No concomitant medications were reported. No treatment information was reported.


VAERS ID: 1677138 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Nausea, Presyncope, Vaccination site discomfort, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it; During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it; I felt nausea Tuesday I was not feeling great and today the Lightheadedness was very significant; I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side; I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOMFORT (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side), DIZZINESS (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it), PRESYNCOPE (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it), VACCINATION SITE PAIN (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side) and NAUSEA (I felt nausea Tuesday I was not feeling great and today the Lightheadedness was very significant) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 050C21A) for COVID-19 vaccination. Concomitant products included MULTIVITAMIN [VITAMINS NOS] for an unknown indication. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced VACCINATION SITE DISCOMFORT (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side) and VACCINATION SITE PAIN (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side). On 17-Aug-2021, the patient experienced NAUSEA (I felt nausea Tuesday I was not feeling great and today the Lightheadedness was very significant). On 19-Aug-2021, the patient experienced DIZZINESS (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it) and PRESYNCOPE (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it). At the time of the report, VACCINATION SITE DISCOMFORT (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side), DIZZINESS (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it), PRESYNCOPE (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it), VACCINATION SITE PAIN (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side) and NAUSEA (I felt nausea Tuesday I was not feeling great and today the Lightheadedness was very significant) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Other concomitant medications reported include thyroid medications unspecified. The patient experienced major lightheadedness and felt like was close to passing out and had an uncomfortable pain in injection site arm today the side effects were quite significant. The symptoms are still ongoing. Treatment information was not provided.


VAERS ID: 1677440 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Pyrexia, Tenderness
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? 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 INC202101065376

Write-up: Her arm was tender today; got second shot yesterday 16Aug2021 and was a little tired and felt feverish; got second shot yesterday 16Aug2021 and was a little tired and felt feverish; This is a spontaneous report from a contactable other Health Care Professional.A female patient of an unspecified age received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration on 16Aug2021 (Batch/Lot Number: FA7484; Expiration Date: 01Sep2021) as DOSE 2, SINGLE for covid-19 immunization.The patient medical history was not reported.The patient''s concomitant medications were not reported.On 16Aug2021 the patient experienced got second shot yesterday 6aug2021 and was a little tired and felt feverish. The outcome of event was unknown.


VAERS ID: 1677553 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AMLODIPINE; LOSARTAN; LOVASTATIN; LEVOTHYROXINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure abnormal; Stroke (Verbatim: Stroke); Thyroidectomy (Verbatim: Thyroid removed)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101127606

Write-up: possibly been exposed to Covid; Sore arm; This is a spontaneous report from a contactable consumer (patient) received from Pfizer-sponsored program Support. A 56-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot Number: EW0179), via an unspecified route of administration in the upper left arm on 16Aug2021 (at the age of 56-years-old) as dose 1, single for COVID-19 immunization. Medical history stroke, blood pressure abnormal from an unknown date and unknown if ongoing and thyroidectomy, thyroid removed from 29May2020 to an unknown date. Concomitant medication(s) included amlodipine taken for blood pressure abnormal, been on this medication since had a stroke at age 46, losartan taken for blood pressure abnormal, been taking since age 46, stated blood pressure had improved with thyroidectomy and is on so much less blood pressure medicine, lovastatin taken for blood pressure abnormal, stated began taking at age 46, pretty much started taking all blood pressure medicines at the same time, levothyroxine taken for thyroid from 29May2020 and ongoing, began taking the moment the caller had thyroid removed on 29May2020. The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. The reporter stated that, she had possibly been exposed to Covid. The exposure to Covid occurred on 23Aug2021. The patient was asking if she was to be tested for Covid and the test was positive will the patient be able to receive the second dose Pfizer Covid Vaccine. The patient also experienced a sore arm (16Aug2021) for one day after receiving the first dose Pfizer Covid Vaccine. The patient further stated that began the day she received the first dose Pfizer Covid Vaccine on 16Aug2021, the arm soreness went away on 18Aug2021, she did not take Tylenol. The caller states she recovered completely from the sore arm. The reporter also reported that she still wears a mask and takes precautions. The patient autoimmune panel was completely gone, plus last parathyroid. The patient was really nervous about that, patient would love for the Pfizer Covid Vaccine to work and be a real thing. The events did not resulted in physician room or emergency room visit. Patient did not receive any treatment for sore arm. The clinical outcome for possibly been exposed to Covid was unknown and sore arm was recovered on 18Aug2021.


VAERS ID: 1679131 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NSAID
Current Illness: Shoulder surgery 1.5 month ago
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Hundreds of little itchy red bumps all over hands and legs. Took loratadine and applied hydrocortisone 1% cream. Lasted for 10 days.


VAERS ID: 1679238 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-11
Onset:2021-08-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 RA / SYR

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested postive on 08-16-2021 for Covid . Admitted to hospital on 08/23/2021. Stayed in Hospital until 09/05/2021 being treated for Covid. Released with Oxgen


VAERS ID: 1679545 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (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: Iron pill
Current Illness: None reported
Preexisting Conditions: Anemia
Allergies: None reported
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient came to facility for 2nd dose of Pfizer. Patient reported she felt woozy one hour after her 1st dose. Patient reported she took Tylenol and symptom went away.


VAERS ID: 1679975 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-10
Onset:2021-08-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Lymph node pain, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Physician completed exam
CDC Split Type:

Write-up: Approximately 6 days after vaccination #1, my son developed a lump under his left armpit, same side as his injection. After receiving his 2nd dose, 21 days later, in the same arm, the condition worsened. It is now larger and painful to the touch. Physician completed exam and determined it to be Lymphadenopathy due to Covid vaccine.


VAERS ID: 1681445 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BNT 162
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: Patient has no known drug allergies, healthy.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210905638

Write-up: RECEIVED PFIZER VACCINE AFTER BEING FULLY VACCINATED WITH JANSSEN COVID 19 VACCINE; This spontaneous report received from a patient concerned a 60 year old female. The patient''s weight was 203 pounds, and height was not reported. The patient''s concurrent conditions included: no alcohol use, and non smoker, and other pre-existing medical conditions included: Patient has no known drug allergies, healthy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802068, expiry: 23-AUG-2021) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination. Concomitant medications included BNT 162 for prophylactic vaccination. On 16-AUG-2021, the patient experienced received Pfizer vaccine after being fully vaccinated with Janssen covid 19 vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of received Pfizer vaccine after being fully vaccinated with Janssen covid 19 vaccine was not reported. This report was non-serious. This case, from the same reporter is linked to 20210909424 and 20210909555.


VAERS ID: 1681557 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Feeling cold, Heart rate, Nausea, Pain in extremity, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: No relevant medical history was provided.
Allergies:
Diagnostic Lab Data: Test Date: 20210821; Test Name: Heart rate; Result Unstructured Data: Abnormal
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: After 6 days later, his head had a funny feeling with weird sensation; He felt really cold; He was shaking really bad; He had nausea; He had chills.; He had a sore right arm on that day.; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (He had a sore right arm on that day.), FEELING ABNORMAL (After 6 days later, his head had a funny feeling with weird sensation), FEELING COLD (He felt really cold), TREMOR (He was shaking really bad) and NAUSEA (He had nausea) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No relevant medical history was provided. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced PAIN IN EXTREMITY (He had a sore right arm on that day.). On 21-Aug-2021, the patient experienced FEELING ABNORMAL (After 6 days later, his head had a funny feeling with weird sensation), FEELING COLD (He felt really cold), TREMOR (He was shaking really bad), NAUSEA (He had nausea) and CHILLS (He had chills.). At the time of the report, PAIN IN EXTREMITY (He had a sore right arm on that day.), FEELING ABNORMAL (After 6 days later, his head had a funny feeling with weird sensation), FEELING COLD (He felt really cold), TREMOR (He was shaking really bad), NAUSEA (He had nausea) and CHILLS (He had chills.) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 21-Aug-2021, Heart rate: increased (abnormal) Abnormal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Pain medicines were taken as concomitant medication. Treatment medication was not provided.


VAERS ID: 1681791 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Covid test; Result Unstructured Data: Test Result:COVID-19 diagnosis
CDC Split Type: USPFIZER INC202101069108

Write-up: Covid diagnosis; Covid diagnosis; This is a spontaneous report from a contactable consumer (parent). A 27-year-old male patient received an unknown dose number of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: unknown) via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunization at workplace clinic. Medical history and concomitant medications were not reported. Patient previously received Psyllins on an unspecified date and experienced allergy. Patient did not receive any other vaccine within four weeks of COVID-19 vaccine. Patient was not tested for COVID prior vaccination. On 16Aug2021, patient was diagnosed with COVID-19. Patient was tested for COVID-19 post vaccination on an unspecified date [test type: unknown] and had diagnosis of COVID-19. AE resulted in Doctor or other healthcare professional office/clinic visit. Patient did not receive any treatment in response to the event. Outcome of the event was resolving. That information on the Lot/batch number has been requested.


VAERS ID: 1681792 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dizziness, Gait disturbance, Palpitations
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101069313

Write-up: extreme dizziness; weakness; heart was racing; had trouble walking; This is a spontaneous report from a contactable consumer. This 59-year-old female consumer (patient) reported for herself. A 59-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE Solution for injection Lot number was not reported) via an unspecified route of administration on 16Aug2021 as dose 1, single (age at vaccination: 59 years) for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On 16Aug2021, she experienced extreme dizziness and weakness, my heart was racing immediately after receiving the shot. It was pretty bad for one hour, had trouble walking and with 2-3 hours it was completely gone and queried that she had a side effect after first dose and if she should get the 2nd Pfizer covid vaccine dose. The clinical outcome of the events was resolved. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1681793 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lymphadenopathy, Paraesthesia, Skin disorder
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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? 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 INC202101069327

Write-up: swollen lymph nodes in the groin area; she had bumps all over her body, painful to the touch, in her groin, collar bone, and arm; she had bumps all over her body, painful to the touch, in her groin, collar bone, and arm; This is a spontaneous report from a contactable pharmacist. A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN), dose 2 via an unspecified route of administration on 14Aug2021 as a single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. Patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unspecified date as a single dose for covid-19 immunization. On 16Aug2021, two days after receiving the dose, the patient experienced swollen lymph nodes in the groin area, she had bumps all over her body, painful to the touch, in her groin, collar bone, and arm. The bumps are on the side of the body where she received the vaccine, the left side. The patient reports feeling the same today, according to the caller. Outcome of the event was unknown. Information about lot/batch number has been requested.


VAERS ID: 1681796 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysgeusia, Extra dose administered, Off label use, Pain
SMQs:, Taste and smell disorders (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101069770

Write-up: received his third dose/booster dose of the Pfizer COVID 19 vaccine on 16Aug2021; received his third dose/booster dose of the Pfizer COVID 19 vaccine on 16Aug2021; achiness; metallic taste in his mouth; This is a spontaneous report from a contactable consumer (patient). A 48-year-old male patient received third dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: Unknown, and Expiration date: Unknown), via an unspecified route of administration on 16Aug2021 as dose 3, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Previously the patient received first and second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: Unknown, and Expiration date: Unknown) on an unspecified date for COVID-19 immunization. It was reported that a 48 year male "received his third dose/booster dose of the Pfizer COVID 19 vaccine on 16Aug2021" and since then had "achiness, which has gone away", but "still has a metallic taste in his mouth". The patient had not seen this listed as a common side effect. He was wondering if this had been reported. "Because it is not getting any better". The outcome of the event achiness was reported as resolved on an unspecified date in 2021. The outcome of the event "metallic taste in his mouth" was reported as not resolved. Follow-up attempts have been completed. Batch/lot number not available for BNT162B2. No further information is expected.


VAERS ID: 1681821 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-09
Onset:2021-08-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / OT

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Glycosylated haemoglobin, Idiopathic pulmonary fibrosis, Joint dislocation, Platelet count decreased, Platelet disorder, SARS-CoV-2 test
SMQs:, Haematopoietic thrombocytopenia (narrow), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: OXYCONTIN; GABAPENTIN; OXYCODONE; VALIUM; ATENOLOL
Current Illness: Anxiety; Back pain; Neuropathy
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high; Fatty liver (Verbatim: Fatty liver); Gallbladder removal (Verbatim: gallbladder taken out); Herniated disc (Verbatim: Herniated disc Other conditions: from 2009 five herniated disc as of today)
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: Test Result:120/80; Test Date: 20210709; Test Name: Blood work; Result Unstructured Data: Test Result:Unknown results; Test Date: 20210816; Test Name: Blood work; Result Unstructured Data: Test Result:Unknown results; Test Name: A1C; Result Unstructured Data: Test Result:High; Test Name: IPF; Test Result: 12.2 %; Test Name: MPFL; Result Unstructured Data: Test Result:13.0; Test Date: 202011; Test Name: platelets; Result Unstructured Data: Test Result:83; Test Date: 20210709; Test Name: platelets; Result Unstructured Data: Test Result:117; Test Date: 20210816; Test Name: platelets; Result Unstructured Data: Test Result:88; Comments: platelets down to 88; Test Date: 202011; Test Name: COVID-19; Test Result: Negative
CDC Split Type: USPFIZER INC202101076871

Write-up: Platelets down to 88; This is a spontaneous report from a contactable consumer (patient). A 51-years-old male patient received bnt162b2 (Pfizer-BioNTech COVID-19 Vaccine, solution for injection), dose 1 intramuscular, administered in Arm Left on 09Aug2021 11:00 (at the age of 51-years-old) (Batch/Lot Number: EW0187) as DOSE 1, SINGLE for covid-19 immunisation. Medical history included gallbladder taken out from Nov2020 to an unknown date, intervertebral disc protrusion (herniated disc, other conditions: from 2009 five herniated disc as of today (on reporting date)) from an unknown date and unknown if ongoing, hepatic steatosis (fatty liver) from an unknown date and unknown if ongoing, high blood pressure from an unknown date and unknown if ongoing and ongoing anxiety, neuropathy and back pain. Patient was hospitalized in Nov2020 for gallbladder predating treatment with the Pfizer COVID 19 vaccine. Also before the vaccine, caller mentions in the past his A1C was high and he ask his doctor if he could just take Metformin and drink black tea. He was in the prediabetic stage and then it went to the normal stage. Mentions he also get examined by every year since 2016. They are the ones who first noticed his platelets were down to 148 and they have been monitoring it since. Concomitant medication included oxycodone hydrochloride (OXYCONTIN) and gabapentin both drugs taken for neuropathy and back pain from an unspecified start date and ongoing; oxycodone taken for an unspecified indication from an unspecified start date and ongoing; diazepam (VALIUM) taken for anxiety from an unspecified start date and ongoing; atenolol taken for blood pressure measurement from an unspecified start date and ongoing. The patients platelets down to 88 (platelet count decreased) on 16Aug2021. It was reported that a week later after vaccination he has an issue with his blood platelets; they have never been this low before except when he was in the hospital last year. The only time it was even close was when his platelets went down to 83 during that hospitalization; he was fine after that. He went back to normal. Adds he was in the hospital in Nov2020. He had a negative COVID test at that time. He had a bile duct that was blocked, and he was all yellow; after a bunch of tests they pulled out his gallbladder. The only thing was his liver enzymes were high so, he had blood work done on 09Jul2021. he had a full blood work and was just going back again in Oct2021. His platelets on 09Jul2021 were at 117; When he saw his doctor for the blood work last Monday, mentions his doctor was pleased with his weight loss and said his blood pressure was 120/80. After he got the first dose of the vaccine on 09Aug2021, he ask them to check his platelets again and they had dropped to 88. He noticed the IPF percentage which has to do with bone marrow and producing new platelets and also a section where they check MRNA. Patient; mentions he lost 27 pounds since 09Jul2021; states he has severe spine problems from herniated disc so he decided to lose weight on purpose. On 09Jul2021 before he got the shot; he gets blood work for liver, A1C (Glycosylated haemoglobin) (was high on unspecified date) and blood platelets. The blood platelets were a concern for him. This past Monday, 16Aug2021, he had new blood work done; found it in his My Chart, adds he understood what he was reading except the IPF (Idiopathic pulmonary fibrosis). His blood platelets were 88; IPF was 12.2%; MPFL (Joint dislocation) 13.0; adds those three work together. Blood platelets were 117 on 09Jul2021. For treatment he was going to see a doctor; a haematologist. Outcome of the event was unknown.


VAERS ID: 1681956 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO168 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Chest pain, Fatigue, Headache, Pyrexia, SARS-CoV-2 test, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: FLUVOXAMINE; ESTRADIOL; TRAZODONE; ASPIRIN [ACETYLSALICYLIC ACID]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210821; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101103005

Write-up: possible stroke; Seizure; Fever; chest pain; headache; extreme fatigue.; This is a spontaneous report from a contactable consumer. This 54-year-old non-pregnant female consumer (patient) reported that she received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EWO168, Expiry Date: Unknown), via an unspecified route of administration, administered in left arm on 16Aug2021 at 10:15 AM (at the age of 54 years) as dose 2, single for covid-19 immunisation. Medical history included known allergies (unspecified). Concomitant medications in two weeks included Fluvoxamine, Estradiol, Trazadone, aspirin [acetylsalicylic acid] (ASPIRIN [ACETYLSALICYLIC ACID]). The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EWO168, Expiry Date: Unknown), via an unspecified route of administration, administered in left arm on 26Jul2021 at 12:15 PM (at the age of 54 years) as dose 1, single for covid-19 immunisation. No other vaccine in four weeks. No covid test prior vaccination. Facility type vaccine was public health clinic/veterans administration facility. Covid test performed post vaccination. The patient experienced fever, chest pain, headache. Seizure, possible stroke, extreme fatigue on 16Aug2021 at 13:00. Adverse event resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. No treatment received. The patient underwent lab tests and procedures which included Nasal swab: negative on 21Aug2021. The outcome of event was not resolved. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1681972 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Feeling abnormal, Hypersomnia, Memory impairment
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (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: TRIAMTERENE; HCTZ
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101106233

Write-up: Short term memory; brain fog; sleeping a lot; out of breath; This is a spontaneous report from a non-contactable consumer reported for himself. This 79-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, NDC 59267-1000-01) via unspecified route of administration on 14Aug2021 01:00 AM at the age of 79 years old at single dose for COVID-19 immunization. Medical history included patient was diagnosed with COVID-19 prior to vaccination. No known allergies. Concomitant medications included triamterene, HCTZ. The patient experienced short term memory, brain fog, sleeping a lot, out of breath on 16Aug2021 with outcome of not recovered. Since the vaccination, the patient has not been tested for COVID-19. The lot number for BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1682064 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-30
Onset:2021-08-16
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia, SARS-CoV-2 test, Vaccination site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: PCR test; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101138604

Write-up: Localized pain in left arm where the injection was placed/mild throbbing pain in that area; Developing some tingling down arm to fingers; This is a spontaneous report from a contactable consumer, the patient. A 36-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 30Apr2021 at 10:30 (at the age of 36-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any concomitant medications. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 02Apr2021 at 15:30 (at the age of 36-years-old) as a single dose for COVID-19 immunisation. On 16Aug2021, the patient started experiencing localized pain in the left arm where the injection was placed. The patient was experiencing mild throbbing pain in that area and developed some tingling down the arm to the fingers. The events 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 events. Since the vaccination, the patient had been tested for COVID-19. On 17Aug2021, the patient underwent polymerase chain reaction (PCR) test for COVID- 19 and the result was negative. The clinical outcome of the events localized pain in left arm where the injection was placed/mild throbbing pain in that area and developing some tingling down arm to fingers were not resolved at the time of this report. The batch/lot numbers for, BNT162b2, were not provided and will be requested during follow up.


VAERS ID: 1682199 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052EZ1A / 1 LA / IM

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

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

Write-up: No period


VAERS ID: 1682516 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Seizure like phenomena
SMQs:, Convulsions (narrow)

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

Write-up: The patient was vaccinated with his 1st dose of the Pfizer vaccine. Approximately 10 minutes after injection, it was witnessed that the patient was experiencing seizure like behavior that lasted for approximately 10 seconds. After this incident, the patient was instructed to recline his seat. The patient refused as he was more comfortable sitting up. 911 was called. The patient''s blood pressure was taken x 2 - 92/60. The patient was given a water and ice pack that the patient applied to his neck. The patient quickly recovered, within a few minutes of incident. He was alert and oriented. He was talking and joking with staff regarding the incident. The patient was assessed by EMS. The patient refused to be transported to the hospital..


VAERS ID: 1682603 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Night sweats, Oropharyngeal pain, Pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: fatigue, body aches, sore throat, night sweats fro 3 weeks


VAERS ID: 1682627 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-03
Onset:2021-08-16
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chest pain, Chills, Cough, Diarrhoea, Dyspnoea, Eye pain, Fatigue, Headache, Myalgia, Nasal discomfort, Pain, Pneumonia, Positive airway pressure therapy, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension/High Blood Pressure, Obesity (BMI $g 40), Former smoker
Allergies:
Diagnostic Lab Data: 08/18/2021 Antigen + COVID-19 test at medical Practice; 08/23/2021 PCR+ COVID-19 test at Hospital
CDC Split Type:

Write-up: Fever $g100.4, Subjective fever (felt feverish), Chills, Muscle or body aches, New loss of taste or smell, Runny nose/Congestion, Cough (new onset or worsening of chronic cough), Shortness of breath or difficulty breathing, Chest pain, Fatigue or tiredness, Headache, Diarrhea ($g/=3 loose/looser stools in 24 hr period), eye pain, nostril burning, ear ringing. Bilateral Pneumonia. 9/1/2021 BiPAP machine at hospital. Scheduled to move to ICU


VAERS ID: 1682771 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-06
Onset:2021-08-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Seizure, Speech disorder
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PATIENT DOES NOT HAVE ANY HEALTH ISSUES OR TREATMENTS
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: ALLERGY TO PENICILLIN FAMILY ANTIBIOTICS AND ORAL PREDNSONE (STOMACH SICKNESS)
Diagnostic Lab Data:
CDC Split Type:

Write-up: CONVULSIONS. DIFFICULTY SPEAKING. DIFFICULTY BREATHING. WEAKNESS


VAERS ID: 1682917 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Patient was under the age of 18 and received JJ by accident. Both patient and provider were informed.


VAERS ID: 1683662 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Superficial vein thrombosis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Superficial thrombosis; Redness in her leg 3 days after her second shot; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Redness in her leg 3 days after her second shot) and THROMBOPHLEBITIS SUPERFICIAL (Superficial thrombosis) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced ERYTHEMA (Redness in her leg 3 days after her second shot). On an unknown date, the patient experienced THROMBOPHLEBITIS SUPERFICIAL (Superficial thrombosis). At the time of the report, ERYTHEMA (Redness in her leg 3 days after her second shot) and THROMBOPHLEBITIS SUPERFICIAL (Superficial thrombosis) outcome was unknown. No relevant concomitant medications were reported. No treatment information was provided.


VAERS ID: 1683678 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Electrocardiogram normal, Troponin I normal
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Anxiety
Allergies: None
Diagnostic Lab Data: 8/21/21 -- Normal trop I, normal EKG
CDC Split Type:

Write-up: Dyspnea, chest pressure. ER evaluation 8/21/21 normal. Symptoms have been slowly improving..


VAERS ID: 1683717 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-02
Onset:2021-08-16
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood test, Computerised tomogram abdomen, Computerised tomogram head, Hepatic enzyme, Migraine
SMQs:, Liver related investigations, signs and symptoms (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: get flu vaccination every year for 25+ years. About 8 years ago, I got a rash from one of the flu vaccinations. Visited a der
Other Medications: only one prescription :levothyroxine sodium 50 MCG; other supplements include glucosamine, Vitamin D3 (50mcg), Iron, (65mcg), aspirin (81mg), super b-complex, B-12 (1000mcg) and Preservision (areds 2)
Current Illness: none
Preexisting Conditions: none - Kidney donor in 2008
Allergies: IV contrast and any drug with mercury in them as a preservative
Diagnostic Lab Data: Had Covid test on Aug 18, 2021. negative result Had CT scan of head and abdomen - without contrast due to allergy. Both normal. Repeated blood work on Sept 3, 2021: AST liver enzyme was normal and ALT had dropped by half but was still twice the normal range. Other blood tests back to normal range. Will follow up with another round of blood work in 6 weeks.
CDC Split Type:

Write-up: Massive migraine headache for 12 days starting Aug 16. Never had them before. Acetaminophen helped but then got migraine relief OTC and it knocked it back. Slight fever 1-2 degrees. Had full panel of blood work done on Aug 23, 2021. Liver enzymes (AST and ALT were 500 to 1000% over the normal range. Six other blood tests were out of normal range, HDL cholesterol, triglycerides, white blood count, red blood count, Hematocrit, and platelet count.


VAERS ID: 1684466 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA J88D21A / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 150mg Bupropion
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heavy menstrual bleeding starting a few days after date of vaccination. (Normal period ended just before vaccination) Heavy menstrual bleeding for almost 28 days straight and counting. Passing abnormally large clots everyday and soaking through both a super tampon and super pad together in about an hour.


VAERS ID: 1684781 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Rash, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: Prenatal vitamins, iron supplement
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pregnant (due 11/4/2021) no symptoms prior to vaccination, first dose of covid Pfizer vaccine 8/13/2021 shot in left arm. Skin rash/sores begin 8/15/2021 under arms, under breasts, upper thighs/groin, spreading to neck. Reported to community physicians 8/18/21, Obgyn on 8/19/2021. Asked about rash being vaccine side effect. They were both unsure of what is causing. Told to take OTC Benadryl and to contact primary care physician should rash spread. By the time of 2nd dose of Pfizer vaccine, some rash sores beginning to clear up. After 2nd dose was received as shot in left arm on 9/3/2021, rash became worse in groin, causing pain and also became worse under arms and across stomach and neck. New sore beginning on left eyelid. Scheduled appt with primary care physician who could not confirm cause of rash, even when I asked if related to vaccine, and prescribed me prednisone steroid to treat sores.


VAERS ID: 1684942 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-10
Onset:2021-08-16
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Cough, Dialysis, Dyspnoea, Dyspnoea exertional, Food intolerance, Haemorrhoids, Nausea, Pneumonia viral, SARS-CoV-2 test positive, Vomiting
SMQs:, Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, albuterol-ipratropium, allopurinol, ammonium lactate topical, aspirin, carvedilol, cinacalcet, diphenhydramine, fluticason-salmeterol, gabapentin, insulin regular, nitroglycerin, oxycodone-acetaminophen, rosuvastatin, zolpidem
Current Illness:
Preexisting Conditions: COPD, ESRD on HD, diabetes type 2, obesity, OSA, hypertension, CAD, hyperlipidemia, hx multiple myeloma, hemorrhoids, chronic opioid dependence
Allergies: shellfish
Diagnostic Lab Data: 8/17/2021: COVID-19 PCR positive
CDC Split Type:

Write-up: 8/16/2021: admitted. Chief Complaint: shortness of breath.3 days of shortness of breath, moderate, worse on exertion, associated with dry irritating cough, also nausea/vomiting, poor oral tolerance, feeling hemorrhoids are irritated. He had some mild cough on 8/11, was at dialysis at the time, underwent covid testing, apparently he was told it was positive just before he was about to go for dialysis on 8/13, was unable to get dialysis, so has missed a dialysis session as well. Diagnosed with Covid 19 viral pneumonia, acute hypoxic respiratory failure. Discharged 8/23/21. Note: previously received J&J COVID-19 vaccine on 03/10/21 Lot Number 1805029


VAERS ID: 1684964 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-08-16
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Confusional state, Cough, Dysarthria, Fatigue, SARS-CoV-2 test positive, Toxic encephalopathy
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: furosemide, gabapentin, glipizide, insulin NPH, lactulose, parparoxetine, rifaximin, spironolactone
Current Illness:
Preexisting Conditions: decompensated liver cirrhosis secondary to hepatitis-C and alcohol abuse, esophageal varices, hepatic encephalopathy, hyperbilirubinemia, ascites, chronic left lower extremity lymphedema, DM and portal hypertension
Allergies: nka
Diagnostic Lab Data: Tested positive for Covid via PCR on 8/16/21.
CDC Split Type:

Write-up: 8/16/2021: admitted. presents to ED with complaints of generalized weakness, slurred speech, mild confusion, nagging non productive cough and feels run down since last week. Wife (at bedside) thought his weakness and slurred speech were related to high ammonia level so patient has been taking lactulose daily. COVID 19 PCR was positive. Note: patient previously vaccinated with Pfizer COVID-19 vaccine: First dose: 05/29/21 Lot Number;EW0180; Second dose: 06/18/21 Lot Number EW0196 Diagnosed with: toxic metabolic encephalopathy, COVID-19 infection Discharged 8/22/21.


VAERS ID: 1684997 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster, Induration, Inflammation, Skin warm
SMQs:, Extravasation events (injections, infusions and implants) (broad), Opportunistic infections (broad)

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

Write-up: Local inflammation with large, hot induration measering 4cmx9cm. Received second dose elsewhere on 09/03/2021 (Lot FA7485 Exp. 10/1/2021) and reports a similar reaction with the second dose. Resolved without treatment. Developed shingles a week after second dose.


VAERS ID: 1685038 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-23
Onset:2021-08-16
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 08/16/2021 PCR+ COVID-19 test at Hospital.
CDC Split Type:

Write-up: Breakthrough COVID-19 case


VAERS ID: 1685614 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-01
Onset:2021-08-16
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 10981 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xycal Prozac Singular Lorazepam Flonase Vitamins
Current Illness: None
Preexisting Conditions: Compromised immune system
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: I tested positive for covid 19 on aug, 19th 2021 Coughing Headache Chills Fever Body aches Shortness of breath Extreme fatigue Loss of smell and taste


VAERS ID: 1685775 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-12
Onset:2021-08-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW09191 / 2 AR / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Anion gap, Antinuclear antibody, Blood albumin decreased, Blood calcium decreased, Blood chloride normal, Blood creatine phosphokinase decreased, Blood creatinine normal, Blood glucose normal, Blood immunoglobulin G, Blood phosphorus, Blood potassium normal, Blood sodium decreased, Blood urea increased, C-reactive protein increased, Carbon dioxide normal, Glomerular filtration rate normal, Haematocrit decreased, Haemoglobin decreased, Inflammatory marker increased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Myalgia, Myoglobin blood, Platelet count increased, Polyarthritis, Red blood cell count decreased, Red blood cell sedimentation rate increased, Red cell distribution width normal, Troponin T normal, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Hyponatraemia/SIADH (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Arthritis (narrow), Tumour lysis syndrome (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? Yes
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, asa, symbicort, metoprolol, atorvastatin, nitroglycerin, clobidogrel , singulair
Current Illness: CAD, asthma, obesity
Preexisting Conditions: obesity, ACS with CAD, asthma
Allergies: nkda
Diagnostic Lab Data: Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Troponin T 0.00 - 0.03 ng/mL <0.01 Encounter Summary Related to Troponin T Component 08/24/21 08/24/21 08/12/21 08/05/21 07/19/21 06/05/21 Troponin T <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 Contains abnormal data Sedimentation rate, automated Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Sed Rate 0 - 25 mm/hr 31 High Encounter Summary Related to Sedimentation rate, automated Component 08/28/21 08/25/21 08/24/21 08/21/21 07/19/21 Sed Rate 121 High 96 High 31 High $g140 High 46 High Contains abnormal data C-Reactive Protein Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago CRP 0.00 - 0.74 mg/dL 5.38 High Encounter Summary Related to C-Reactive Protein Component 08/28/21 08/27/21 08/25/21 08/24/21 08/17/21 07/19/21 CRP 10.80 High 9.49 High 7.37 High 5.38 High 16.20 High 3.65 High Contains abnormal data RENAL FUNCTION PANEL Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Sodium 135 - 147 mmol/L 135 Potassium 3.5 - 5.0 mmol/L 4.1 Chloride 96 - 108 mmol/L 102 CO2 22 - 32 mmol/L 23 Calcium 8.6 - 10.6 mg/dL 8.8 Glucose 82 - 115 mg/dl 102 Creatinine 0.7 - 1.2 mg/dL 0.7 BUN 8 - 20 mg/dL 21 High Albumin 3.5 - 4.8 g/dL 3.0 Low Phosphorus 2.4 - 4.7 mg/dL 3.3 Anion Gap 7.0 - 16.0 mmol/L 10.0 eGFR $g60 mL/min/1.73m? $g60 Encounter Summary Related to RENAL FUNCTION PANEL Component 08/31/21 08/28/21 08/25/21 08/24/21 08/22/21 08/21/21 Sodium 138 136 138 135 137 140 Potassium 3.9 3.8 4.4 4.1 4.3 4.0 Chloride 101 103 104 102 103 105 CO2 22 23 23 23 24 23 Calcium 9.1 8.6 8.9 8.8 8.9 8.9 Glucose 160 High 119 High 168 High 102 160 High 132 High Creatinine 0.8 0.7 0.8 0.7 0.6 Low 0.7 BUN 18 20 23 High 21 High 20 17 Albumin 3.4 Low 2.9 Low 3.2 Low 3.0 Low 2.9 Low ? Phosphorus ? ? ? 3.3 4.0 ? Anion Gap 15.0 10.0 11.0 10.0 10.0 12.0 eGFR $g60 $g60 $g60 $g60 $g60 $g60 View all related data Contains abnormal data Antinuclear Antibodies, HEp-2 Substrate, IgG, Serum Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Comments Antinuclear Ab, HEp-2 Substrate, S <1:80 (Negative) Positive 1:160 Abnormal -------------------ADDITIONAL INFORMATION------------------- Method: Immunofluorescence using HEp-2 cellular substrate. ANA Titer 1:160 ANA Pattern Speckled Encounter Summary Contains abnormal data CBC (Hemogram) no Auto Diff Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago WBC Count 4.0 - 10.0 k/mcL 13.7 High RBC 3.90 - 5.80 M/mcL 3.76 Low HGB 13.0 - 17.3 g/dL 10.8 Low HCT 38.0 - 51.0 % 33.7 Low MCV 81.0 - 95.0 fl 89.6 MCH 26.5 - 34.0 pg 28.7 MCHC 32.0 - 36.0 g/dL 32.0 RDW 11.5 - 15.0 % 13.4 Platelets 140 - 450 k/mcL 479 High MPV 9.4 - 12.4 fl 8.4 Low Encounter Summary Related to CBC (Hemogram) no Auto Diff Component 08/31/21 08/28/21 08/25/21 08/21/21 08/20/21 08/17/21 WBC Count 12.8 High 11.9 High 13.7 High 12.8 High 12.0 High 12.2 High RBC 3.79 Low 3.73 Low 3.76 Low 3.67 Low 3.84 Low 3.99 HGB 10.6 Low 10.8 Low 10.8 Low 10.7 Low 11.1 Low 11.7 Low HCT 34.1 Low 33.2 Low 33.7 Low 33.0 Low 34.2 Low 34.6 Low MCV 90.0 89.0 89.6 89.9 89.1 86.7 MCH 28.0 29.0 28.7 29.2 28.9 29.3 MCHC 31.1 Low 32.5 32.0 32.4 32.5 33.8 RDW 13.9 13.9 13.4 13.4 13.2 12.9 Platelets 461 High 430 479 High 433 434 333 MPV 8.3 Low 8.3 Low 8.4 Low 8.7 Low 8.5 Low 8.6 Low View all related data Antibody to Extractable Nuclear Antigen (ENA) Evaluation, S Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 13 d ago Comments Jo 1 Ab, Igg, S <1.0 (Negative) U <0.2 Rnp Ab, Igg, S <1.0 (Negative) U <0.2 Sm Ab, Igg, S <1.0 (Negative) U <0.2 Scl 70 Ab, Igg, S <1.0 (Negative) U <0.2 Ss-B/La Ab, Igg, S <1.0 (Negative) U <0.2 SS-A/RO AB, IGG, S <1.0 (Negative) U <0.2 Encounter Summary Contains abnormal data Myoglobin -STAT Specimen: Blood - Blood specimen (specimen) Component Ref Range & Units 1 d ago Myoglobin 28 - 72 ng/mL <21 Low Encounter Summary Contains abnormal data CK (Creatine Kinase) -STAT Specimen: Blood - Blood specimen (specimen) Component Ref Range & Units 1 d ago CK (Creatine Kinase) 39 - 308 IU/L 16 Low
CDC Split Type:

Write-up: crippling polyarthritis and polymyalgia''s with elevated inflammatory markers.


VAERS ID: 1689073 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-14
Onset:2021-08-16
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Decreased appetite, Dyspnoea, Fatigue, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes Mellitus, Cardiovascular disease
Allergies:
Diagnostic Lab Data: 08/16/2021 PCR+ COVID-19 test at facility, 08/24/2021 PCR+ COVID-19 test at hospital
CDC Split Type:

Write-up: Breakthrough COVID-19 case, Shortness of breath or difficulty breathing, Fatigue or tiredness, loss of appetite, hospitalized at hospital and was admitted on 08/17/2021 for COVID-19 pneumonia


VAERS ID: 1689076 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 6023825 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, Gait disturbance, Genital herpes, Influenza like illness, Insomnia, Pain, Pain in extremity, Pyrexia, Vulvovaginal pain, Vulvovaginal pruritus
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall Valtrex
Current Illness: N/A
Preexisting Conditions: Genital Herpes
Allergies: N/A
Diagnostic Lab Data: Medical testing in 2014 & 2018 reaffirming diagnosis Most recent breakout - Self diagnosable
CDC Split Type:

Write-up: Vaccine caused my genital herpes to re-emerge. I have not had a breakout in 7 years prior to this and now I have one that will not heal up. Flu like symptoms (fatigue, fever, aches and pains in left leg) Pain, itching and clusters of sores on left side of vagina. Clusters of sores have have white heads, the white heads fell off and the sores are leaking pus and blood, Difficulty walking & sleeping. Have been taking Valtrex & Naproxen to combat Herpes outbreak since August 17th to no avail. Epsom salt baths. Sitting on ice packs. I can''t wear panties as it rubs the site and makes the pain worse.


VAERS ID: 1689096 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-08-16
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Dyspnoea, Hypoxia, SARS-CoV-2 test positive, Vaccine breakthrough infection, Viral sepsis
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin, levothyroxine, meclizine, metformin, triamterene, hydrochlorothiazide
Current Illness:
Preexisting Conditions: hypertension, hyperlipidemia, diabetes mellitus type 2 and depression
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breakthrough COVID-19 case. 66 year old female presents to ED with worsening shortness of breath. Patient tested COVID positive on 8/16/21 at a Care Center. She was started on Prednisone, Tessalon Perles and antihistamine. She previously received Johnson&Johnson COVID-19 vaccine on 4/10/21. Patient hypoxic with SpO2 90% on room air which improved to 96% on 3L NC. 8/22/21. admitted. Diagnosed and treated for viral sepsis secondary to covid-19, COVID-19 pneumonia. 8/26/21: discharged


VAERS ID: 1689448 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-12
Onset:2021-08-16
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19, COVID-19 pneumonia, Cough, Dyspnoea, Dyspnoea exertional, Malaise, Pain, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, losartan-hydrochlorothiazide
Current Illness:
Preexisting Conditions: high blood pressure, OSA, peptic ulcer disease
Allergies: nka
Diagnostic Lab Data: Tested positive for covid-19 via PCR in hospital on 8/23/21.
CDC Split Type:

Write-up: COVID-19 Breakthrough case. 8/21/21: patient presents to the emergency department complaining of progressively worsening shortness of breath for the past 5 days associated with cough, generalized malaise, generalized body aches and progressively worsening weakness. Has become so severe that she is severely short of breath with minimal exertion. This prompted her to go to an outpatient clinic where she tested positive for COVID 19 today and was administered Regeneron. Admitted 8/21/21. Note: PFizer Covid-19 vaccine given on 12/21/20 & 1/12/21. Diagnosed and treated for covid-19 pneumonia and acute hypoxic respiratory failure. 9/3/21: discharged Admitted 8/21/21. Tested positive for covid in hospital on 8/23/21. Covid vaccine on 1/12/21. Diagnosed and treated for covid pneumonia and acute hypoxic respiratory failure. 8/3/21: dischaged


VAERS ID: 1689749 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER FC3181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Fall, Head injury, Syncope, Wound haemorrhage
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Spirinolactone 50 mg (2 pills a day) JuiceFestive supplement 2 vegetables 2 fruit per day Calcium 600iu D3 1000 mg Viviscal Professional 2 pills aday. Muiti Vitamin 2 gummy pills
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: My doctor sent me to have chest xray, there is no fracture in the bone on Aug 17, but I still have pain on the left side as of today. I''m consulting with my doctor what must I do for the next step for the chest pain. As for my head injury, I''m seeing a neuro to find the root cause.
CDC Split Type:

Write-up: 1) Aug 16 at 3 am, I fainted out of no reason. I took Spironolactone over 2 years ago and I didn''t have any side effect. The only new variant introduced to my body 5 days ago prior to the faint was Pfizer vaccine. I was taken to ER the same night. My head was bleeding due to this fall as I hit the bathroom floor hard. = 2) Aug 17 next day I have chest pain (both sides) today, my chest pain still existed on the left side and it doesn''t seem to go away.


VAERS ID: 1689957 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Patient recieved the vaccine and then had pain in the arm that was "excruciating" and wanted to go to the ER to have it seen but decided to wait until the following monday due to cost. He was given Colchicine as the Doctor thought it might be due to gout. The colchicine did not help at all. He came back to have it seen again a few days later by another physician and was told to continue on the colchicine and he did without relief. He came back again and recieved Diclofenac and Gabapentin for the pain that was from the top of the arm to the wrist and recieved a referal to a neurologist.


VAERS ID: 1691461 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 3 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cold sweat, Feeding disorder, Headache, Nausea, Pain in extremity, Pyrexia, SARS-CoV-2 test, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: 20210821; Test Name: COVID-19 test; Test Result: Negative ; Result Unstructured Data: Negative; Test Date: 20210822; Test Name: COVID-19 test; Test Result: Negative ; Result Unstructured Data: Negative
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: every time she drinks something it makes her stomach turn.; can''t eat and unable to keep food or solids down. She reported that she is just able to drink fluids currently; wakes up in cold sweats at night; she became "queasy",; the chills like a burning cold sensation inside of her body; nausea; fever; headache; pain in right arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in right arm), FEEDING DISORDER (can''t eat and unable to keep food or solids down. She reported that she is just able to drink fluids currently), COLD SWEAT (wakes up in cold sweats at night), NAUSEA (she became "queasy",) and CHILLS (the chills like a burning cold sensation inside of her body) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Previously administered products included for COVID-19 vaccination: Pfizer COVID-19 vaccine on 16-Mar-2021 and Pfizer COVID-19 vaccine on 07-Apr-2021. On 16-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced PAIN IN EXTREMITY (pain in right arm), NAUSEA (nausea), PYREXIA (fever) and HEADACHE (headache). On 21-Aug-2021, the patient experienced FEEDING DISORDER (can''t eat and unable to keep food or solids down. She reported that she is just able to drink fluids currently), COLD SWEAT (wakes up in cold sweats at night), NAUSEA (she became "queasy",) and CHILLS (the chills like a burning cold sensation inside of her body). On 24-Aug-2021, the patient experienced VOMITING (every time she drinks something it makes her stomach turn.). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. On 18-Aug-2021, PAIN IN EXTREMITY (pain in right arm), NAUSEA (nausea), PYREXIA (fever) and HEADACHE (headache) had resolved. At the time of the report, FEEDING DISORDER (can''t eat and unable to keep food or solids down. She reported that she is just able to drink fluids currently) and COLD SWEAT (wakes up in cold sweats at night) outcome was unknown and NAUSEA (she became "queasy",), CHILLS (the chills like a burning cold sensation inside of her body) and VOMITING (every time she drinks something it makes her stomach turn.) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 21-Aug-2021, SARS-CoV-2 test: negative (Negative) Negative. On 22-Aug-2021, SARS-CoV-2 test: negative (Negative) Negative. The patient was not taking any concomitant medications. Patient stated that the doctor ordered some tests for her, but the results were not come back yet and mentioned her doctor thought the events could be associated with a stomach bug but was unsure.


VAERS ID: 1691569 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-01
Onset:2021-08-16
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pruritus, SARS-CoV-2 antibody test, Swelling, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

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

Write-up: itching; swelling; big reaction; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (itching), SWELLING (swelling) and VACCINATION COMPLICATION (big reaction) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. No Medical History information was reported. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced PRURITUS (itching), SWELLING (swelling) and VACCINATION COMPLICATION (big reaction). At the time of the report, PRURITUS (itching) and SWELLING (swelling) had resolved and VACCINATION COMPLICATION (big reaction) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 antibody test: negative (Negative) Negative. No concomitant medications were provided by reporter. No treatment medications were provided by reporter. This case was linked to MOD-2021-229580 (Patient Link).


VAERS ID: 1691593 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / OT

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

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

Write-up: Left arm tender; Lump at injection site; Diarrhea; Pain in left arm; The injection hurt a lot; This spontaneous case was reported by a consumer and describes the occurrence of TENDERNESS (Left arm tender), VACCINATION SITE MASS (Lump at injection site), DIARRHOEA (Diarrhea), PAIN IN EXTREMITY (Pain in left arm) and VACCINATION SITE PAIN (The injection hurt a lot) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017E21A) for COVID-19 vaccination. No Medical History information was reported. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced TENDERNESS (Left arm tender), VACCINATION SITE MASS (Lump at injection site), DIARRHOEA (Diarrhea), PAIN IN EXTREMITY (Pain in left arm) and VACCINATION SITE PAIN (The injection hurt a lot). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and IBUPROFEN (ADVIL [IBUPROFEN]) at an unspecified dose and frequency. At the time of the report, TENDERNESS (Left arm tender), DIARRHOEA (Diarrhea), PAIN IN EXTREMITY (Pain in left arm) and VACCINATION SITE PAIN (The injection hurt a lot) outcome was unknown and VACCINATION SITE MASS (Lump at injection site) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The consumer that about 1 hour later of receiving first dose, her left arm became tender, painful, and developed a lump the size of a quarter. The consumer stated that the injection hurt a lot and the lump still has not gone away. He has taken Tylenol, Advil, and put ice on her left arm as treatment. No concomitant product use was provided by the reporter.


VAERS ID: 1691730 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-01
Onset:2021-08-16
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling abnormal, Inappropriate schedule of product administration, Malaise
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular 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: HUMIRA
Current Illness:
Preexisting Conditions: Comments: No Medical History information was reported.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Felt specially dizzied; Space out/ Spacie; Not filling 100 percent/ Feeling crappy; Feel fatigue since getting their third shot for two days, and still on going but in on and off; Second dose on 29March2021 and the third shoot on 16Aug2021; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Felt specially dizzied), FEELING ABNORMAL (Space out/ Spacie), MALAISE (Not filling 100 percent/ Feeling crappy), FATIGUE (Feel fatigue since getting their third shot for two days, and still on going but in on and off) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose on 29March2021 and the third shoot on 16Aug2021) in a 56-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011d21a, 028a21a and 027a21a) for COVID-19 vaccination. No Medical History information was reported. Concomitant products included ADALIMUMAB (HUMIRA) for an unknown indication. On 01-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced FATIGUE (Feel fatigue since getting their third shot for two days, and still on going but in on and off) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose on 29March2021 and the third shoot on 16Aug2021). On 28-Aug-2021, the patient experienced DIZZINESS (Felt specially dizzied), FEELING ABNORMAL (Space out/ Spacie) and MALAISE (Not filling 100 percent/ Feeling crappy). On 16-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose on 29March2021 and the third shoot on 16Aug2021) had resolved. At the time of the report, DIZZINESS (Felt specially dizzied), FEELING ABNORMAL (Space out/ Spacie), MALAISE (Not filling 100 percent/ Feeling crappy) and FATIGUE (Feel fatigue since getting their third shot for two days, and still on going but in on and off) had not resolved. The patient stated that the concomitant medication Humira had a side effect of lowering the immune system. Treatment information was not provided. The patient felt fatigue since getting third shot for two days which was still on going but in on and off. This case was linked to MOD-2021-300555 (Patient Link). Reporter did not allow further contact


VAERS ID: 1692064 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 6W0179 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Cough, Fatigue, Headache, Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210406; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101069804

Write-up: I start feeling like i was getting a cold; I was feeling so tired and on tuesday I was whit a full cold runny nose sore throat cough; I was feeling so tired and on tuesday I was whit a full cold runny nose sore throat cough; I was feeling so tired and on tuesday I was whit a full cold runny nose sore throat cough; I was feeling so tired and on tuesday I was whit a full cold runny nose sore throat cough; a litttle bit off pain on my chest; more tired I can even get up my body hurts and anything that I drink is working and today wednesday I have headache; This is a spontaneous report from a contactable consumer. A 32-years-old nonpregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection and Batch/Lot Number: 6w0179), via an unspecified route of administration on 16Aug2021 11:00 as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient did not have any known allergies. The patient did not have COVID prior vaccination. The patient did not receive any other vaccine in 4 weeks. The patient got her last vaccine on Monday and later that (16Aug2021) day she starts feeling like she was getting a cold and she was feeling so tired and on Tuesday. The patient was whit a full cold runny nose sore throat cough and a little bit off pain on her chest and more tired she can even get up my body hurts and anything that the patient drink was working and today Wednesday she had headache and like she had really bad cold. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 06Apr2021. The patient received advild and motrin treatment for events. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1692066 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-10
Onset:2021-08-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101074881

Write-up: Chest pain; This is a spontaneous report from a contactable consumer or other non hcp. A 37-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: FC3180), dose 1 via an unspecified route of administration, administered in Arm Left on 10Aug2021 at 11:00 (Age at vaccination: 37 years) as dose 1, single for covid-19 immunisation. Relevant medical history was reported as None. There were no concomitant medications. Prior vaccinations within 4 weeks were None. The patient experienced chest pain on 16Aug2021 at 02:00. It was reported that chest pain has improved, the first time it was too much. Reporter states the chest pain was off and on, that was her concern. The outcome of the event was recovering. Follow up (19Aug2021): This is a Follow-up spontaneous report from a contactable consumer. Follow-up activities closed. No further information is expected. .


VAERS ID: 1692069 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-15
Onset:2021-08-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (If covid prior vaccination: Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101081754

Write-up: The day after the vaccine, I started developing a red rash on my right thigh. I dismissed it initially but the rash kept developing further into sores, which turned out to be shingles.; The day after the vaccine, I started developing a red rash on my right thigh. I dismissed it initially but the rash kept developing further into sores, which turned out to be shingles.; This is a spontaneous report from a contactable consumer (patient). A 45-year-old female non-pregnant patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection, Lot number: ew0177, Expiration Date: not reported) via an unspecified route of administration in left arm on 15Aug2021 16:00 as dose 1, single for COVID-19 immunization (at the age of 45-year-old, non-pregnant). Medical history patient had covid prior vaccination from an unknown date and known allergies was none. There were no concomitant medications. Patient did not receive other vaccine in four weeks and other medications in two weeks was none. COVID was not tested post vaccination. The patient experienced the day after the vaccine, she started developing a red rash on her right thigh. She dismissed it initially but the rash kept developing further into sores, which turned out to be shingles on 16Aug2021 13:00. AE resulted in doctor or other healthcare professional office/clinic visit. Patient was prescribed anti-viral medication for shingle. Outcome of the events was not recovered. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1692213 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-09
Onset:2021-08-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Factor XII deficiency (diagnosed over 25 years ago)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: covid/PCR test; Test Result: Positive ; Comments: contracted covid; Test Date: 20210816; Test Name: covid/rapid test; Test Result: Positive ; Comments: contracted covid
CDC Split Type: USPFIZER INC202101127162

Write-up: contracted covid; This is a spontaneous report from a contactable consumer. This 56-year-old female consumer (patient) reported for herself that. A 56-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: FD8448), dose 1 via an unspecified route of administration, administered in Arm Left on 09Aug2021 17:30 as (At the age of 56-years) dose 1, single for covid-19 immunisation. Medical history included ongoing factor xii deficiency diagnosed over 25 years ago It was reported that she was Factor XII deficient, and reporter spoke to her hematologist and he said it was safe for her to get the Pfizer COVID Vaccine. There were no concomitant medications. No other Additional vaccine was Administered on Same Date of the Pfizer Suspect. No Prior Vaccinations within 4 weeks. The patient experienced contracted covid on 16Aug2021. It was reported that 56-year-old female received her first dose of the Pfizer Covid-19 Vaccine on 06Aug2021. She tested positive for COVID-19 6 days later. Caller is due for her second dose of the Pfizer Covid-19 Vaccine today. Caller is seeking guidance. She had a PCR test last Friday and is awaiting the results due back today. Upon Follow-up it was reported that patient received the 1st dose of the Pfizer Covid19 vaccine and is due for the 2nd dose today and had contracted covid after the 1st dose of the vaccine. Caller is wondering what the protocol is for getting the 2nd dose of the Pfizer Covid vaccine and having had covid. Caller verified the information provided by the transferring agent and states she contracted covid 6 days after she had the 1st dose of the vaccine. Caller states her patient card has no expiry date or NDC written on it. States she was diagnosed with covid and her symptoms started the Sunday after the 1st dose of the vaccine and symptoms began on 15Aug2021 and she took PCR test that came back positive on 16Aug2021 and took a rapid test at home the same day which was also positive. States she called her physician and he prescribed stuff over the phone and she went and picked it up and took an inhaler of Albuterol right away to keep her lungs clear and she is doing two puffs every 6 hours and started the Albuterol on 18Aug2021. It was reported that predisposing factors e.g., immunosuppression, contact with other infected persons include patient had Factor XII deficient and also states she was at a hotel trade show and got it from somebody. The patient underwent lab tests and procedures which included sars-cov-2 test: positive and contracted covid, sars-cov-2 test: positive on 16Aug2021. Patient did not require to visit Emergency Room or Physician Office. The outcome of events was unknown. PC filed. Caller was provided the contact information for Pfizer (withheld) option #3 and was placed on hold; caller was warm transferred to (withheld). Description of Product Complaint: Vaccine Supplemental Form completed in additional context. Caller on the line who received the 1st dose of the Pfizer Covid19 vaccine and is due for the 2nd dose today and had contracted covid after the 1st dose of the vaccine. States she contracted covid 6 days after she had the 1st dose of the vaccine. Caller states her patient card has no expiry date written on it. States she was diagnosed with covid and her symptoms started the Sunday after the 1st dose of the vaccine and symptoms began on 15Aug2021 and she took PCR test that came back positive on 16Aug2021 and took a rapid test at home the same day which was also positive. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1692289 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, COVID-19, Drug ineffective, SARS-CoV-2 test, Taste disorder
SMQs:, Lack of efficacy/effect (narrow), Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: 20210816; Test Name: COVID-19; Test Result: Positive ; Test Date: 20210830; Test Name: COVID-19; Test Result: Positive
CDC Split Type: USPFIZER INC202101151483

Write-up: does not fully have his taste and smell back; does not fully have his taste and smell back; first dose vaccination on 12Aug2021, tested positive on 16Aug2021 and still tested positive to COVID-19 on 30Aug2021; testing positive to COVID-19; This is a spontaneous report from a Pfizer Sponsored Program from a contactable consumer (patient). A male patient of unspecified age received BNT162B2 (COMIRNATY, Formulation: Solution for Injection, Lot Number: unknown), dose 1 via an unspecified route of administration on 12Aug2021 as dose 1, single for COVID-19 immunization. The patient reported that second dose scheduled on 02Sep2021. The patient''s medical history and concomitant medications was not reported. On 16Aug2021, the patient experienced testing positive to COVID-19 and reported that still tested positive to COVID-19 on 30Aug2021 and also reported currently, patient did not fully have his taste and smell back and completed his required isolation. On 16Aug2021 and 30 Aug2021 patient underwent lab test and procedure includes COVID-19: SARS-CoV-2 test and result reported as positive. Patient asked if could get the second dose of the Comirnaty vaccine up to 4 days after the scheduled date. The clinical outcome of all events was unknown. Information about lot/batch number has been requested.


VAERS ID: 1693140 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported having heart palpitations 2 days after vaccine. Patient did not have any angina or blood pressure issues. Patient felt a little lightheaded. She did not see a doctor. She reports that symptoms went away and was on and off for 2 days.


VAERS ID: 1693225 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-01
Onset:2021-08-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fear, Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: I had been passing huge, greater than 3 mm clots during menses since the vaccine in August 2021. Literally passing blood clots on day 1 through 6 of menses. I use to have small, 1mm clots on day 3 of my menses prior to the vaccine. Now the clots have trippled in size, it makes loud splash noises in the toilet and are constant. I am concerned and fearful for my health. I am aware of the changes because I know my body.


VAERS ID: 1693274 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:1981-01-26
Onset:2021-08-16
   Days after vaccination:14812
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Back pain, Fatigue, Heavy menstrual bleeding, Menstruation irregular, Pain, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Fertility disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Caused me to have heavy menstural bleeding for 2 weeks. I do not typically have a cycle due to birth control (nexplanon). Also, I was fatigued, weak, with leg, back and overall bodyaches.


VAERS ID: 1693326 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-11
Onset:2021-08-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0090214 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: None
Current Illness: None
Preexisting Conditions: Heart murmur
Allergies: penicillin
Diagnostic Lab Data: None so far. In fact, haven''t yet reported the problem to my provider. Doubt there''s anything they can do about it but will report it on Monday and make an appointment.
CDC Split Type:

Write-up: A few days after I got the shot, maybe a week, I noticed I wasn''t seeing out of my left eye, it was blurred and felt like and still feels like it has a film over it. I do wear corrective lenses and I had my annual eye exam and ordered some new glasses shortly before vaccination. At first I thought it was the glasses, but problem persisted even with glasses off.


VAERS ID: 1693342 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Body temperature increased, Fatigue, Feeling abnormal, Memory impairment, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Guillain-Barre syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hydroxychloroquine, methotrexate, folic acid, zinc, vitamin D, biotin, multi-vitamin
Current Illness: Mixed Connective Tissue Disease, Raynauds Syndrome, Rheumatoid Arthritis
Preexisting Conditions:
Allergies: sulfa, penicillin
Diagnostic Lab Data: August 20 blood work normal
CDC Split Type:

Write-up: Initially, I was a little tired on the same day and the next morning. By 1 pm I felt off, a little odd after church so I went home. My temp was 100.4 and I was extremely fatigued. This passed within 24 hours after rest and Tylenol. Three days after the vaccine, I felt pins and needles in all four extremities. This was constant 24/7. I also felt a little off, foggy and forgetful. I was seen by my rheumatologist four days later. Labs came back normal, referred me to a neurologist. Pending appointment in October but I feel this is starting to improve. Pins and needles are not as extreme but still present. I had mild case of Covid19 in August 2020. I tested positive for antibodies even up to the day before my vaccine.


VAERS ID: 1694068 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Anaphylactic reaction, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Request list
Current Illness: No
Preexisting Conditions: No
Allergies: Apple; peaches; pears; cantaloupe; yeast; broccoli; coconut; dairy milk; grass; red oak; mold; fungus; dust mite
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anaphylaxis lasted about until 8/18/2021 at 2:16 am. Back to normal except tongue a little swollen.


VAERS ID: 1694482 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-08-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: rash/red bumps starting on left side of neck now spreading to right side and chest


VAERS ID: 1694492 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-05
Onset:2021-08-16
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Cardiac stress test, Computerised tomogram normal, Dyspnoea, Echocardiogram, Electrocardiogram, Electrocardiogram ambulatory, Heart rate increased, Magnetic resonance imaging heart
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Cat scan on lung 0 ok. EKG and echo, Holter monitor 30 days. Stress test on 2Sep2021. MRI on 14OCt2021.
CDC Split Type: vsafe

Write-up: 16 Aug, 180 heart rate, my heart rate went up and shortness of breath, I was not go up and down the stairs. 17Aug2021 ER, showing sign of A-fib.


VAERS ID: 1694892 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-08-09
Onset:2021-08-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 1 RA / IM

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

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

Write-up: Patient continues to complain of pain at the injection site at second dose. Pain comes and goes. No numbness or tingling, but occasional pain. Pain eased by rubbing injection site. No redness, swelling or tenderness noted at time of visit.


VAERS ID: 1695595 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Unknown  
Location: Oregon  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Adverse reaction, Cold sweat, Dizziness, Headache, Heart rate, Nausea, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Heart disorder
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: HEART RATE; Result Unstructured Data: High heart rate for 15 minutes.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: blurry vision; extreme dizziness; felt clammy; really bad reaction; headache,; nausea; This spontaneous case was reported by a consumer and describes the occurrence of VISION BLURRED (blurry vision), DIZZINESS (extreme dizziness), COLD SWEAT (felt clammy), ADVERSE REACTION (really bad reaction) and HEADACHE (headache,) in a 37-year-old patient of an unknown gender 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 Heart disorder. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced VISION BLURRED (blurry vision), DIZZINESS (extreme dizziness), COLD SWEAT (felt clammy), ADVERSE REACTION (really bad reaction), HEADACHE (headache,) and NAUSEA (nausea). At the time of the report, VISION BLURRED (blurry vision), DIZZINESS (extreme dizziness) and NAUSEA (nausea) had resolved and COLD SWEAT (felt clammy), ADVERSE REACTION (really bad reaction) and HEADACHE (headache,) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Aug-2021, Heart rate: increased (High) High heart rate for 15 minutes.. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. No treatment information was provided. Three minutes after the first dose, really bad reaction with high heart rate for 15 minutes, blurry vision, headache, nausea, extreme dizziness was reported. The patient was not sweating but felt clammy. The patient stated that his blurry vision did not last as long but his nausea and dizziness lasted for 3 to 4 hours.


VAERS ID: 1695684 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-06
Onset:2021-08-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 - / OT

Administered by: Unknown       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Tested positive for COVID-19; This spontaneous case was reported by a pharmacist and describes the occurrence of SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19) in a 31-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. No Medical History information was reported. On 06-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19). At the time of the report, SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Aug-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant details were not reported by the reporter. Treatment details were not reported by the reporter. Patient reported that he did not took any treatment and had tested negative.


VAERS ID: 1695690 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pruritus, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: I started getting itchy, in hands, feet, it was so strange; sleepy; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (sleepy) and PRURITUS (I started getting itchy, in hands, feet, it was so strange) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 16-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced SOMNOLENCE (sleepy). On 24-Aug-2021, the patient experienced PRURITUS (I started getting itchy, in hands, feet, it was so strange). On 18-Aug-2021, SOMNOLENCE (sleepy) had resolved. At the time of the report, PRURITUS (I started getting itchy, in hands, feet, it was so strange) outcome was unknown. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1695761 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Dry mouth, Erectile dysfunction, Fatigue, Injection site pain, Libido decreased, Migraine, Pain, Paraesthesia, Pyrexia, Sneezing, Tinnitus, Tremor, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Warafin St. John''s Wort Vitamin B12 Vitamin D3 Vitamin C Zinc Men''s Multivitamin Ginger Melatonin Apple Cider Biotin
Current Illness: None
Preexisting Conditions: Portal vein thrombosis
Allergies: Hyperactivity to Mucinex-D
Diagnostic Lab Data: 8/28: Uranalysis, Chemistry Panel, White Blood Cell Differential, and Complete Blood Count
CDC Split Type:

Write-up: 8/16: Soreness at injection site, fever 101 degrees F, chills, tremors, bodily pains, tingling in fingers and toes, migraines, dry mouth, fatigue, blurred vision, ringing in both ears, coughing, and sneezing, reduced sex drive, inability to become erect 8/17: Soreness at injection site, fever 101 degrees F, chills, tremors, bodily pains, tingling in fingers and toes, migraines, dry mouth, fatigue, coughing, and sneezing, reduced sex drive, inability to become erect 8/18: Soreness at injection site, bodily pains, migraines, dry mouth, fatigue, reduced sex drive, inability to become erect 8/19: Soreness at injection site, bodily pains, migraines, fatigue, reduced sex drive, inability to become erect 8/20: Soreness at injection site, bodily pains, migraines, fatigue, reduced sex drive, inability to become erect 8/21: Soreness at injection site, bodily pains, migraines, fatigue, reduced sex drive 8/22: Soreness at injection site, bodily pains, migraines, fatigue 8/23: Soreness at injection site, bodily pains, migraines, fatigue 8/24: Soreness at injection site, bodily pains, migraines, fatigue 8/25: Soreness at injection site, bodily pains, migraines, fatigue 8/26: Soreness at injection site, bodily pains, migraines, fatigue 8/27: Soreness at injection site, bodily pains, migraines, fatigue 8/28: Soreness at injection site, bodily pains, migraines, fatigue 8/29: Soreness at injection site, bodily pains, migraines, fatigue 8/30: Soreness at injection site, bodily pains, migraines, fatigue 8/31: Soreness at injection site, bodily pains, migraines, fatigue 9/1: Soreness at injection site, bodily pains, migraines, fatigue 9/2: Soreness at injection site, bodily pains, migraines, fatigue


VAERS ID: 1696109 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / IM

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

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

Write-up: Severe headaches for 10 days


VAERS ID: 1696318 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no medications, or prescriptions. i take black oxygen that has fulvic acid and some other minerals.
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: i have a doctors appointment scheduled to talk to my doctor about this.
CDC Split Type:

Write-up: Whenever I walk up my stairs now my chest is tight and my heart is beating hard, im unable to catch my breath. this is 1 flight of stairs thats making me feel like i just ran a mile. really anything that gets my heart beating takes 90% faster to make me feel winded and needing time to get my heart to stop beating so fast. i didn''t know if this was anxiety at first but it is now clear to me with my apple watch and checking my heart rate that it is indeed beating extremely fast after just minimal physical activity


VAERS ID: 1696389 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Immediate post-injection reaction, Induration, Injection site pain, Joint swelling, Limb discomfort, Mobility decreased, Muscle twitching, Pain in extremity, Sensory disturbance, Sleep disorder
SMQs:, Peripheral neuropathy (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Day of vaccine: Patient felt immediate swelling of right ankle. Sharp stabbing pain along left shin, which did subside. Twitching of ankles, causing patient not to sleep. Patient reports legs feel heavy and hard to bend. Patient reports headache, injection site soreness, and hard to the touch for over one week. Patient reports taking tylenol to relieve pain only the first evening of the vaccine, which resolved pain. Ongoing: Patient reports twitching from top of knees to feet in both extremities and throbbing sensation in arch of foot.


VAERS ID: 1696524 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norethindrone 0.35mg
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient states that 4 days after receiving the first dose of the Pfizer covid-19 vaccine, she developed a rash on her left foot, then spread to left arm and face.


VAERS ID: 1696903 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Incomplete course of vaccination, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loratadine
Current Illness: None
Preexisting Conditions: Asthma Disthensia?full body numbness and doctors have no idea why.
Allergies: Loratab, aspirin, year round allergies, dairy allergies
Diagnostic Lab Data: No medical testing was done. Just an office visit and checkup
CDC Split Type:

Write-up: I waited at the pharmacy for 20-25 minutes after I got the first dose. I have a history of reacting to almost every medication I have been given. When I have been vaccinated in the past I haven?t had any reactions. Within the first few minutes of getting the first dose I was itching over my entire body. After an hour, my breathing began to be restricted. Over the next two days the itching got worse, no rash, but my breathing was terrible though my oxygen levels were above 90. The pharmacy suggested I contact my allergy doctor so I got in to see Dr. on Thursday of that week I believe. She put me on steroids for 10 days. The steroid didn?t help my breathing so I ended up doing breathing treatments for 10 days. The first week I did the treatments every 4 hours during the day and after that I was able to get by with 1 treatment until I felt ok. It was suggested that even though my reaction was severe, it was immediate and I couldn?t get the second dose.


VAERS ID: 1700199 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Diarrhoea, Dyspnoea, Intensive care, Pain in extremity, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Sept 2 test for Covid and current in the hospital in ICU
CDC Split Type:

Write-up: Arm sore. Then right after started running fever cough diarrhea shortness of breath.


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