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From the 11/19/2021 release of VAERS data:

Found 894,019 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 459 out of 8,941

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VAERS ID: 1821763 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1821767 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Unknown  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1821771 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1821772 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1821776 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1821778 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1821783 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1821786 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1821792 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1821794 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1821797 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Unknown  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1822012 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-17
Onset:2021-09-27
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Disorientation, Dizziness, Dysstasia, Fatigue, Feeling drunk, Gait disturbance, Influenza like illness, Mobility decreased, Nausea, Pupillary disorder, Vertigo, Vision blurred
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: blood mutation that makes me more likely to have blood clots
Allergies: eggs and milk
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: On Monday: The first thing, I was really dizzy and was unable to stay standing. I felt like I had intense vertigo and I was wobbling and difficult to stay up straight - lasted about 48 hours where it was intense. I felt like I was on a boat still after that. I could stand but it still wasn''t normal; still felt disorientated and that lasted the rest of the week. by Wednesday, I had extreme fatigue - no energy to get up or do anything. Saturday I felt like I had flu - nausea, dizziness and extreme fatigue and I went to Urgent Care (10/2) - they took vitals. When I told them about the dizziness they had me look to the corner of the room and they said my eyes weren''t focusing. It was like I was drunk and my pupils moved back and forth really fast. They said it was clear I was having balance issues. they said they couldn''t do much for me. They said to take Meclizine three times a day and Sudafed every 4 -6 hours and I did that for the next week. The dizziness is much less right now. There are still moment when I feel really disoriented but not as bad as that first week. I was probably in bed for three weeks with that fatigue and as of yesterday just starting to feel like I can sit up to my desk for a few hours at a time. My energy is still not back to normal yet.


VAERS ID: 1822770 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 RL / IM

Administered by: Work       Purchased by: ?
Symptoms: Computerised tomogram abdomen, Computerised tomogram neck, Full blood count, Imaging procedure, Laboratory test, Lymphocele, Metabolic function test
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen, amitriptyline hcl, prazosin hcl, myrbetriq, buspirone, propranolol hcl, zyrtec, gabapentin, D3, B12, calcium, and elderberry.
Current Illness:
Preexisting Conditions: Depression and nerve damage.
Allergies: Dogs, lactose and sulfa
Diagnostic Lab Data: CBC and Comprehensive Panel. 10/08/2021 CT scan of hospital. 0/09/2021 abdominal CT at Hospital. 10/08/21 10/10/2021 multiple test and images through 10/12/2021.
CDC Split Type:

Write-up: Lymphocele of the neck left side.


VAERS ID: 1823542 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-09-26
Onset:2021-09-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: LEVOTHYROXINE SODIUM; TRAZODONE; ESTRADIOL; PROZAC; CREST CAVITY PROTECTION
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (Known allergies-Yes); Arthritis; Asthma (asthma, low thyroid, fibromyalgia, arthritis, high cholesterol); Fibromyalgia; High cholesterol; Thyroid disorder NOS
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: Temperature; Result Unstructured Data: Test Result:102.2
CDC Split Type: USPFIZER INC202101287735

Write-up: Intense vomiting; Temperature measured at home with an oral thermometer was 102.2; nausea has continued for for 2 additional days; This is a spontaneous report from a contactable consumer (patient) reported for herself. A 67-years-old female non pregnant patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: 30145BA) via an unspecified route of administration in Arm Left on 26Sep2021 at 10:00 (Age at Vaccination: 67-years-old) as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 immunisation; influenza vaccine (FLU VACCINE VII), via an unspecified route of administration in Left arm from Sep2021 (Batch/Lot number was not reported) to Sep2021, at unspecified dose for immunisation. Medical history included asthma, low thyroid, fibromyalgia, arthritis, high cholesterol and allergies. Concomitant medications the patient received within 2 weeks of vaccination included levothyroxine sodium from Sep2021 to an unspecified stop date; trazodone taken, estradiol, fluoxetine hydrochloride (PROZAC) and sodium fluoride (CREST CAVITY PROTECTION). Prior to vaccination the patient was not diagnosed with COVID-19. Facility where the most recent COVID-19 vaccine was administered was at Pharmacy or Drug Store. Since the vaccination the patient has not been tested for COVID-19. Patient reported on 27Sep2021 at 6:00 AM, she experienced Intense vomiting starting the morning after the vaccine was administered and which lasted for 5-6 hours required admission to an emergency room. Temperature was measured at home with an oral thermometer was 102.2 and the nausea had continued for 2 additional days. Patient was treated by giving many doses of Zofran and a bag of fluids and the vomiting stopped and she was able to go home. The patient underwent lab test and procedure which included temperature which was 102.2 units unspecified on 27Sep2021. Outcome for fever was resolved on 29Sep2021. The outcome of the event Intense vomiting and nausea has continued for 2 additional days was recovering. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1823576 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Computerised tomogram, Crohn's disease, Immunisation, Off label use
SMQs:, Gastrointestinal premalignant disorders (narrow), Ischaemic colitis (broad), Immune-mediated/autoimmune disorders (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: LISINOPRIL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypertension
Allergies:
Diagnostic Lab Data: Test Date: 20210928; Test Name: CT scan; Result Unstructured Data: Test Result:ileitis
CDC Split Type: USPFIZER INC202101368149

Write-up: Patient with case of regional ileitis starting the day after his 3rd booster.; DOSE 3 (BOOSTER), SINGLE; DOSE 3 (BOOSTER), SINGLE; This is a spontaneous report from a contactable physician. A 53-years-old male patient received BNT162B2 dose 3 via an unspecified route of administration on 27Sep2021 (Batch/Lot number was not reported) as dose 3 (booster), single, at the age of 53-years-old, for COVID-19 immunisation. Medical history included hypertension (HTN). No Known allergy. The patient previously received the first dose of BNT162B2 on 23Dec2020 and second dose of BNT162B2 on 13Jan2021, both at the age of 53-years-old, for COVID-19 immunization. Concomitant medication included lisinopril. The patient did not receive other vaccine in four weeks. The patient was not diagnosed with covid prior vaccination. The patient had not had covid tested post vaccination. The patient with case of regional ileitis starting the day after his 3rd booster. Event (regional ileitis) onset date reported as 28Sep2021. Treatment received for the event (regional ileitis) that included antibiotics. Event (regional ileitis) resulted in physician office visit. The event (regional ileitis) was resolved in 2021. The patient underwent lab tests and procedures which included CT scan: ileitis on 28Sep2021. The lot number for BNT162B2, was not provided and will be requested during follow up.; Sender''s Comments: Based on temporal relationship the possibility of causal association between the events Crohn''s disease and the suspect drug BNT162B2 cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1825351 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-20
Onset:2021-09-27
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FDD0809 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arrhythmia, Blood pressure increased, Blood test, Echocardiogram, Electrocardiogram, Electrocardiogram ambulatory, Extrasystoles, Supraventricular tachycardia, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Hypertension (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Tachyarrhythmia terms, nonspecific (narrow), 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? No
Previous Vaccinations:
Other Medications: Nitrofurantoin Mono/Mac 100 mg Caps
Current Illness: UTI
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Holter monitor 10/07/21-10/14/21 EKG 10/01/21 Echocardiogram 10/18/21 Blood work 10/01/21
CDC Split Type:

Write-up: Sudden onset of tachycardia and heart dysrhythmias. On or around Monday September 27th while lying in bed I felt my heart skip a beat and then has some tachycardia. On Friday October 1st while driving my heart again went into tachycardia and I was seen in the ER and upon arrival my heart rate was 172 and my BP was elevated and I was told by the ER staff that they believed I had a run of SVT. Had another episode on 10/08/21, 10/09/21 and 10/21/21. I made an appointment with a cardiologist and he has diagnosed it as AV nodal re-entry tachycardia or PSVT.


VAERS ID: 1825536 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-20
Onset:2021-09-27
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Muscular weakness, Paralysis, Surgery
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

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

Write-up: Acute/progressive worsening of weakness resulting in flaccid paralysis (pt. unable to transfer d/t weakness in all extremities). Neuro surgical intervention required.


VAERS ID: 1825731 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-09-20
Onset:2021-09-27
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER FF2581 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: prescriptions: Levothyroxine, Calcitriol, Potassium, Cetrizine, Citalopram, Furosemide, Losartan, Carvedolol,
Current Illness: NONE
Preexisting Conditions: HYPOTHYROIDISM HIGH BLOOD PRESSURE TRACHEOTOMY
Allergies: MEDICATION ALLERGIES: CONTRAST DYES ALL BENZODIAZAPINES, LISINOPRIL, ATIVAN
Diagnostic Lab Data: BLOODWORK NO RESULTS DOCTORS THINK CARPEL TUNNEL
CDC Split Type:

Write-up: NUMBNESS IN FINGER TIPS NUMBNESS IN HANDS TREATED WITH HAND BRACE WITH NO CHANGE IN ADVERSE FEELINGS


VAERS ID: 1827444 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Chills, Lethargy, Vaccination site pain
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness: Back pain (Pertinent details: regenerative therapy 21Sep2021)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101300591

Write-up: Pain at injection site; Chills; Extreme leg weakness; Lethargy; This is a spontaneous report from a contactable consumer (patient). A 78-year-old female patient received bnt162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), dose 3 via an unspecified route of administration, administered in left arm on 27Sep2021 11:00 (Lot Number: FC3184) as dose 3 (booster), single for COVID-19 immunization (at the age of 78-year-old). Medical history included ongoing back pain from 2014 (Pertinent details: regenerative therapy 21Sep2021). Concomitant medication included paracetamol (TYLENOL). The patient previously received 1st dose of bnt162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), via an unspecified route of administration, administered in left arm on 10Feb2021 (Lot Number: EL9269) as dose 1, single for COVID-19 immunization (at the age of 78-year-old) and experienced pain. She also received 2nd dose of bnt162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), via an unspecified route of administration, administered in left arm on 14Mar2021 (Lot Number was not reported) as dose 2, single for COVID-19 immunization (at the age of 78-year-old) and experienced pain. On 27Sep2021 15:00, the patient experienced pain at injection site, chills, extreme leg weakness and lethargy. Seriousness of the events reported as disability. No treatment received for adverse events. As of 29Sep2021, the clinical outcome of the events was recovering. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1827474 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Blood pressure measurement, Blood test, Chest pain, Dyspnoea, Heart rate, Heart rate increased, Hypertension, Investigation, Laboratory test, Lymphoedema, Metabolic function test
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: Blood pressure high; Result Unstructured Data: Test Result:183/109; Comments: borderline and still elevated; Test Date: 20211013; Test Name: Blood pressure high; Result Unstructured Data: Test Result:152/100; Test Date: 20211013; Test Name: Blood pressure high; Result Unstructured Data: Test Result:178/104; Test Date: 20211013; Test Name: bloodwork; Result Unstructured Data: Test Result:pending results; Test Name: heart rate; Result Unstructured Data: Test Result:63-70; Test Date: 20210927; Test Name: heart rate; Result Unstructured Data: Test Result:Increased; Test Date: 20211013; Test Name: heart rate; Result Unstructured Data: Test Result:81; Test Date: 2021; Test Name: Sed Reactive Protein; Result Unstructured Data: Test Result:waiting for results; Test Date: 20210927; Test Name: Labs; Result Unstructured Data: Test Result:normal; Test Date: 2021; Test Name: comprehensive metabolic panel; Result Unstructured Data: Test Result:waiting for results
CDC Split Type: USPFIZER INC202101374824

Write-up: changes in his breathing which caller described as air hunger; pain in the thoracic area; increased heart rate; bad swelling on the left side of his neck that was also to the lymph node area/diagnosed with lymphoedema of the head and neck; blood pressure was "borderline" and still elevated at 183/109/his blood pressure was at 152/100 and 178/104; pain in the back.; abdominal pain; This is a spontaneous report from a contactable consumer (patient). A 60-year-old (also at the age at time of vaccination) male patient received bnt162b2 (COMIRNATY), via an unspecified route of administration administered in Arm Left on 27Sep2021 19:00 (Batch/Lot Number: 301308A) as DOSE 3 (BOOSTER), SINGLE for COVID-19 immunization at the Pharmacy. The patient medical history was not reported. There were no concomitant medications. The patient received the first dose of bnt162b2 (PFIZER BIONTECH COVID-19 VACCINE) on 28Jan2021 (Lot Number: EN5318) at the age of 59-years-old for COVID-19 immunization. Then, received the 2nd dose on 25Feb2021 (Lot Number: EN6198) at the age of 60-years-old for COVID-19 immunization. It was reported that the patient had fever, chills, and rapid heartbeat for a number of hours after the 2nd dose. Then, received the 3rd dose (booster) on 27Sep2021 19:00. The patient had no prior vaccinations (within 4 weeks). A little after 8 PM on 27Sep2021, he had very bad swelling on the left side of his neck that was also to the lymph node area. Once he got the emergency room (ER) he was informed he had swelling on the right as well. He then also realized and found out he had rapid high heart rate and blood pressure was high. He does not know how high the heart rate was in the Emergency Room, but his blood pressure was 183/109 (unit measure and normal range not provided). Other labs in the ER were normal. Due to the extreme swelling he was diagnosed with lymphoedema of the head and neck. The swelling has gotten better. He talked with the doctor at the ER yesterday and told to give this one more week and then will decide where to go from there. On the 02Oct2021 and 03Oct2021, he noticed some changes in his breathing which he described as air hunger with pain in the thoracic area. It was not like this before the booster. Out of concern, he called his primary care doctor on 06Oct2021 and was prescribed with prednisone pack to take for six days as treatment. He then followed up with his primary care doctor on 08Oct2021, and his blood pressure was borderline and still elevated. He got his bloodwork (pending results) done on 13Oct2021 (yesterday) after talking to the medical director of the ER. Last night (13Oct2021) his blood pressure was at 152/100 and 178/104; his heart rate was 81. Normally when he checks it, its 63-70 when using the pulse oximeter. He was waiting for results from a comprehensive metabolic panel and Sed Reactive Protein. The patient also mentioned that he experienced abdominal pain as well and pain in the back. It was mentioned that the swelling has not gone down completely and that the symptoms continue to emerge over time and blood pressure high was still ongoing (not recovered). Outcome of the other events were unknown. No follow up attempts are needed. No further information is expected.


VAERS ID: 1828446 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-11
Onset:2021-09-27
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dyspnoea, Hypoxia, Respiratory tract congestion, SARS-CoV-2 test positive, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL EXTRA STRENGTH) 500 MG tablet albuterol (VENTOLIN HFA) 108 (90 BASE) MCG/ACT HFA inhaler apixaban (ELIQUIS) 5 MG TABS tablet dronedarone (MULTAQ) 400 MG TABS tablet Fluticasone-Umeclidin-Vilant (TRELEGY ELLIPTA) 100-6
Current Illness: None known
Preexisting Conditions: Environmental allergies COPD (chronic obstructive pulmonary disease) (HCC) Hyperlipidemia Body mass index 31.0-31.9, adult Annual physical exam GERD (gastroesophageal reflux disease) Skin lesion Tobacco abuse, in remission Skin cancer, basal cell MVP (mitral valve prolapse) Palpitations PVC''s (premature ventricular contractions) NSVT (nonsustained ventricular tachycardia) (HCC) S/P cardiac cath 9/17/15 (12/20/16) CAD (coronary artery disease) S/P coronary artery stent placement - DES proximal LAD , PTCA diagonal br - 9/2015; RCA DES - 12/2016 , Cutting balloon PTCA Diagonal 11/2018 Chronic obstructive pulmonary disease, unspecified COPD type (HCC) Precordial chest pain Obesity, unspecified obesity severity, unspecified obesity type Left ankle injury DOE (dyspnea on exertion) Acute chest pain Other complicated headache syndrome Vitamin D deficiency Nodule of lower lobe of left lung Restrictive lung disease secondary to obesity Chronic pansinusitis Symptomatic bradycardia Bigeminy CAD S/P percutaneous coronary angioplasty
Allergies: Erythromycin (stomach pain)
Diagnostic Lab Data: COVID-19 test positive on 9/27/2021
CDC Split Type:

Write-up: Patient presented to emergency department on 10/6/2021 with worsening shortness of breath, loss of taste and smell, congestion, and cough that started 9/24/2021. He was found to be COVID-19 positive on 9/27/2021. He was found to be hypoxic and tachypneic in the ED and was admitted for further management. Patient was treated with dexamethasone and required 4L of oxygen. He was discharged home on 10/11/2021 without need for additional supplemental oxygen.


VAERS ID: 1828692 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-13
Onset:2021-09-27
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Asthenia, COVID-19, Chills, Cough, Fatigue, Oxygen saturation decreased, 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), Guillain-Barre syndrome (broad), Respiratory failure (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: N/A
Current Illness: N/A
Preexisting Conditions: High blood pressure, diabetic
Allergies: contract dye
Diagnostic Lab Data: Covid-19 test
CDC Split Type: vsafe

Write-up: I had cough, fever, chills, body ache, lost of taste and smells. I was very weak and fatigue. My oxygen levels was low. These symptoms last about 4 or 5 days. I still have the cough for a few weeks. I took a home Covid-19 test, positive result. Then I went to my doctor, took another Covid-19 test, positive results.


VAERS ID: 1829284 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-02-24
Onset:2021-09-27
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: iodine, celebrex,codeine, flu shot, morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized after testing positive for COVID.


VAERS ID: 1829324 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac stress test, Chest pain, Dyspnoea, Echocardiogram, Electrocardiogram, Electrocardiogram ambulatory, Hypertension, Injection site rash, Laboratory test, Palpitations, Supraventricular extrasystoles, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall XR 30mg Prozac 20 mg Xanax 0.5 mg prn Flexeril 10 mg prn
Current Illness: None
Preexisting Conditions: ADHD Fibromyalgia Anxiety
Allergies: None
Diagnostic Lab Data: Holter Monitor EKG Echo Stress test Lab work
CDC Split Type:

Write-up: Got vaccine at 3p, by 9p had chest pain and palpitations. Day 7 developed round rash around site, increased chest pain and palpitations and shortness of breath. Holter monitor showed PVCs and PACs. Have had high BP and PVCs since.


VAERS ID: 1829432 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-25
Onset:2021-09-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 6139685 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Dizziness, Dyspnoea, Fatigue, Headache, Heart rate increased, Nausea, Pain, Palpitations
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (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: Tylenol before vaccine
Current Illness: No
Preexisting Conditions: Unknown
Allergies: No none
Diagnostic Lab Data: I do not have a doctor, My location has horrible medical care, might as well go to a veterinarian I cannot go to ER, or urgent care because i am afraid of getting covid, i have too many responsibilities. Due to how i feel, i am afraid to get a second shot
CDC Split Type:

Write-up: I noticed my heart was beating faster a few days to a week after receiving shot, and my heart rate at night sleeping was higher, this is not something i was freaking out about but it has gotten worse, i am more tired during the day, headaches that are..different than i would get before. Increased fatigue after only a few hours after waking up, but when i go lay down my heart is beating so hard. Im "winded" usually i could and was walking minimum 2 miles a day...always busy, now i get winded after 1/2 mile. Over the last 12 days my chest is heavy off and on, as is between shoulder blades, a dull ache, mild dizziness off and on which usually coorosponds with heart beating fast My period was later, i could be menopausal but i dont think so. Chills and nausea is off and on, the nausea, i have always had an iron stomach,


VAERS ID: 1830720 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-12
Onset:2021-09-27
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Goitre, Heart rate, Hyperhidrosis, Insomnia, Thyroxine
SMQs:, Neuroleptic malignant syndrome (broad), Hypothyroidism (broad), Hyperthyroidism (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: Metoprolol; Lisinopril; Coumadin; Rosuvastatin; Tylenol; Fish Oil; Melatonin
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data: Test Name: TSH; Result Unstructured Data: Normal; Test Date: 20210927; Test Name: Pulse; Result Unstructured Data: Rapid pulse; Test Name: T4; Result Unstructured Data: Normal.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Some enlargement of thyroid; 3 weeks ago she started to have difficulty sleeping; 5 weeks ago She started to develop diaphoretic episodes that her clothes were soaked with sweat; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (5 weeks ago She started to develop diaphoretic episodes that her clothes were soaked with sweat), INSOMNIA (3 weeks ago she started to have difficulty sleeping) and GOITRE (Some enlargement of thyroid) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 006B21A and 040A21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included Metoprolol; Lisinopril; Coumadin; Rosuvastatin; Tylenol; Fish Oil; Melatonin for an unknown indication. On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced HYPERHIDROSIS (5 weeks ago She started to develop diaphoretic episodes that her clothes were soaked with sweat). On 04-Oct-2021, the patient experienced INSOMNIA (3 weeks ago she started to have difficulty sleeping). On an unknown date, the patient experienced GOITRE (Some enlargement of thyroid). At the time of the report, HYPERHIDROSIS (5 weeks ago She started to develop diaphoretic episodes that her clothes were soaked with sweat), INSOMNIA (3 weeks ago she started to have difficulty sleeping) and GOITRE (Some enlargement of thyroid) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Sep-2021, Heart rate: rapid pulse (abnormal) Rapid pulse. On an unknown date, Blood thyroid stimulating hormone: normal (normal) Normal. On an unknown date, Thyroxine: normal (normal) Normal. Treatment information was not provided.


VAERS ID: 1830942 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Nausea, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: ZOLOFT; FAMOTIDINE; VITAMIN B2 [RIBOFLAVIN]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101275692

Write-up: Itching; Nausea; Headache; This is a spontaneous report from a non-contactable healthcare professional, the patient. A 34-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2589) via an unspecified route of administration in the left arm on 27Sep2021 at 16:00 (at the age of 34-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included sertraline hydrochloride (ZOLOFT), famotidine (MANUFACTURER UNKNOWN) and riboflavin (VITAMIN B2); all from unknown dates for unknown indications and unknown if ongoing. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 27Sep2021, the patient experienced itching, nausea and headache. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events itching, nausea and headache was unknown at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1830950 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 INC202101281489

Write-up: Fever; Body ache; Nausea; This is a spontaneous report from a non-contactable consumer, the patient. A 49-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 27Sep2021 (at the age of 49-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. Prior to the vaccination, the patient was not diagnosed with COVID-19. On 27Sep2021, the patient experienced fever, body ache and nausea. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. No therapeutic measures were taken as a result of the events. The clinical outcome of the events fever, body ache and nausea was not resolved at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1830954 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-25
Onset:2021-09-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Erythema, Pain, Pruritus, Scar pain
SMQs:, Anaphylactic reaction (broad), Lipodystrophy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TOPIRAMATE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Migraine (migraines)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101282108

Write-up: Old BCG scar tender to the touch; Old BCG scar red; Old BCG scar itchy; Left armpit to breast is painful to raise or move arm; Left armpit is painful; Breast is painful; This is a spontaneous report from a contactable healthcare professional, the patient. A 37-year-old 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 25Sep2021 at 16:00 (at the age of 37-years-old) as a single dose for COVID-19 immunisation. Medical history included asthma and migraine. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included topiramate (MANUFACTURER UNKNOWN) started on an unknown date for unknown indication and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the arm left on 04Sep2021 at 12:00 (at the age of 37-years-old) as a single dose for COVID-19 immunisation. On 27Sep2021 at 04:00, the patient reported that her old BCG scar was red, itchy and tender to the touch. Scar was located same arm had Pfizer injection. Also, left armpit to breast was painful to raise or move arm. Both things occurred 2 days after injection. The patient was unable to use left arm without pain. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of events and included treatment with cetirizine hydrochloride (ZYRTEC) and cortisone (MANUFACTURER UNKNOWN) cream. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events old BCG scar was red, itchy and tender to the touch, left armpit to breast was painful to raise or move arm/unable to use left arm without pain were not recovered at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1830965 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / UNK LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Chills, Cough, Fatigue, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism; Shellfish allergy (Known allergies: Shellfish)
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: Body temperature; Result Unstructured Data: Test Result:100.4; Comments: Time: 23:00, Fever (100.4)
CDC Split Type: USPFIZER INC202101294607

Write-up: Feeling tired; Nausea; Fatigue; Fever (100.4); Chills; Cough; This is a spontaneous report from a contactable consumer, the patient. A 58-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0191) via intramuscular route of administration in the left arm on 27Sep2021 at 12:30 (at the age of 58-years-old) as a single dose for COVID-19 immunisation. Medical history included hypothyroidism and shellfish allergy. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included levothyroxine sodium (LEVOTHYROXIN), taken for an unspecified indication from an unknown date and unknown if ongoing. On 27Sep2021 at 23:00, the patient experienced feeling tired, nausea, fatigue, fever (100.4), chills and cough. The events did not result in a visit to the doctors or other healthcare professional office/clinic, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. On 27Sep2021 at 23:00, the patient underwent body temperature test and the result was 100.4 (unspecified units). Since the vaccination, it was unknown whether the patient had been tested for COVID-19. The clinical outcome of the events feeling tired, nausea, fatigue, fever (100.4), chills and cough was resolving at the time of this report.


VAERS ID: 1830967 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Lymphadenopathy
SMQs:, 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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101295059

Write-up: Swollen lymph nodes in left underarm; Dose 1: 05Mar2021Dose 2: 27Sep2021; This is a spontaneous report from a non-contactable consumer, the patient. A 53-year-old male patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2589) via an unspecified route of administration in the left arm on 27Sep2021 at 17:30 (at the age of 53-years-old) as a single dose for COVID-19 immunisation. The patient had no relevant 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''s concomitant medications were reported as not applicable. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6199) via an unspecified route of administration in the left arm on 05Mar2021 at 12:00 (at the age of 53-years-old) as a single dose for COVID-19 immunisation. On 30Sep2021 at 06:00, the patient experienced swollen lymph nodes in left underarm. The adverse event did not result in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the reported events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event swollen lymph nodes in left underarm was resolving at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1831024 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Immunisation, Off label use
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: VALSARTAN; SPIRONOLACTONE; ROSUVASTATIN; PRESERVISION
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergic reaction to analgesics (Known allergies: Opioids); Blood pressure high; COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?: Yes); High cholesterol; Sulfonamide allergy (Known allergies: Sulfa); Ulcerative colitis (Mild ulcerative colitis)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101326382

Write-up: Headache; Lightheadedness and dizziness; Off label use; A third (booster) dose of BNT162b2 is administered subsequent to the initial 2 dose regimen of BNT162b2; This is a spontaneous report from a non-contactable consumer, the patient. A 78-year-old non-pregnant female patient received the third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 27Sep2021 at 11:00 (at the age of 78-years-old) as a single dose for COVID-19 immunisation. Medical history included high blood pressure, high cholesterol, ulcerative colitis, COVID-19 and known allergies to sulfa and opioids. Prior to the vaccination, the patient was diagnosed with COVID-19. Concomitant medications included valsartan (MANUFACTURER UNKNOWN), spironolactone (MANUFACTURER UNKNOWN), rosuvastatin (MANUFACTURER UNKNOWN) and ascorbic acid/tocopheryl acetate/zinc oxide/cupric oxide/betacarotene (PRESERVISION); all from unknown dates for unknown indications and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 09Feb2021 at 11:15 (at the age of 77-years-old) as a single dose for COVID-19 immunisation and 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 02Mar2021 at 10:45 (at the age of 77-years-old) as a single dose for COVID-19 immunisation. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. On 28Sep2021 at 08:00, the patient experienced headache, lightheadedness and dizziness. 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 not been tested for COVID-19. The clinical outcome of the events headache, lightheadedness and dizziness was resolved on an unknown date in 2021. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1831027 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest discomfort, Dysgeusia, Fatigue, Hot flush, Insomnia, Myalgia, Pyrexia, Sinus pain, Tinnitus, Tonsillar disorder, Tonsillar hypertrophy, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101328623

Write-up: Tinnitus- started 2 days or so after vaccine; Sleeplessness; Fatigue; Muscle pain throughout body; Fever; Injection site pain; Painful left tonsil for a few days; Bad taste in mouth; Extreme back ache; Tightness in chest; Sinus pain; Swollen left tonsil for a few days; Hot and sweat flashes; This is a spontaneous report from a contactable consumer, the patient. A 48-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 27Sep2021 at 10:00 (at the age of 48-year-old) as a single dose for COVID-19 immunisation. Medical history includes COVID-19. The patient had no known allergies. Prior to the vaccination, the patient was diagnosed with COVID-19. Concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 27Sep2021, at 17:00, the patient experienced bad taste in mouth, fatigue, extreme back ache and muscle pain throughout body, sleeplessness, fever, tightness in chest, sinus pain, injection site pain, swollen painful left tonsil for a few days, hot and sweat flashes and on 29Sep2021, the patient experienced tinnitus which started 2 days or so after vaccine and still had it. Therapeutic measures were not taken as a result of the events. The events resulted in doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events of bad taste in mouth, fatigue, extreme back ache and muscle pain throughout body, sleeplessness, fever, tightness in chest, sinus pain, injection site pain, swollen painful left tonsil, hot and sweat flashes, tinnitus was not resolved at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1832076 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-16
Onset:2021-09-27
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Stomatitis, Tongue discomfort
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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:

Write-up: Burning sensation on the tongue, and a coatings on inside of mouth


VAERS ID: 1833687 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Dizziness, Dyspnoea, Headache, Pain, Pyrexia, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Within the hour I felt dizzy. I had a headache that continued to go on until the following day, which I noticed the right-side of my face swelling. I had a fever, body aches, chest tightness and shortness of breath. It felt as though I had COVID-19 all over again. This continued for over a week: fever of 102, body aches, chills, headache, chest tightness and shortness of breath. Still currently having shortness of breath and chest tightness.


VAERS ID: 1834266 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 OT / IM

Administered by: Military       Purchased by: ?
Symptoms: Incorrect route of product administration
SMQs:, Drug abuse and dependence (broad), Medication errors (narrow)

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

Write-up: Previous Vaers entered for patients 2nd dose administered in the ventrogluteal site. Chart review reflects patient also received first dose via ventrogluteal muscle versus the deltoid muscle. Patient reported no side effects from first vaccine.


VAERS ID: 1834273 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C1A / 1 OT / IM

Administered by: Military       Purchased by: ?
Symptoms: Incorrect route of product administration
SMQs:, Drug abuse and dependence (broad), Medication errors (narrow)

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

Write-up: Previous Vaers entered for patients 2nd dose administered in the ventrogluteal site. Chart review reflects patient also received first dose via ventrogluteal muscle versus the deltoid muscle. Patient reported no side effects from first vaccine.


VAERS ID: 1835362 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose, Blood glucose fluctuation
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: Blood sugar test; Result Unstructured Data: Test Result:Blood sugar going up and down
CDC Split Type: USPFIZER INC202101281601

Write-up: Blood sugar was going up and down after the vaccine; This is a spontaneous report from a non-contactable pharmacist. A 38-year-old female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2588) via intramuscular route of administration in the right arm on 27Sep2021 (at the age of 38-years-old) as a single dose for COVID-19 immunisation. Medical history of the patient was unknown. It was unknown whether the patient was pregnant. It was unknown if the patient had any allergies. It was unknown whether the patient was diagnosed with COVID-19 prior to the vaccination. Concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 27Sep2021, the patient experienced blood sugar going up and down after the vaccine. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. It was unknown if since the vaccination, the patient had been tested for COVID-19. On 27Sep2021, the patient underwent blood glucose test and the result was blood sugar going up and down. It was unknown whether the patient had taken therapeutic measures as a result of the event. The clinical outcome of the event blood sugar was going up and down after the vaccine was unknown at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1835365 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Immunisation, Malaise, Rhinorrhoea
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101282181

Write-up: Chills; Body malaise/muscle pain on affected area/not feeling well; Runny nose; Booster; This is a spontaneous report from a contactable nurse, the patient. A 36-year-old non-pregnant female patient received the booster dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an intramuscular route of administration in the right arm on 27Sep2021 at 14:15 (at the age of 36-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient had no known allergies. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously received the first and second dose of covid-19 vaccine (MANUFACTURER UNKNOWN) via an unspecified route of administration on unknown date as a single dose for COVID-19 immunisation. On 27Sep2021 at 23:00, the patient experienced chills, body malaise, runny nose, muscle pain on affected area. The patient was not feeling well after the COVID shot booster. Even she took Tylenol and still her symptoms did not go away. This is first time to experience this kind of side effects. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were taken as a result of events and included treatment with paracetamol (TYLENOL). Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events chills, runny nose and body malaise/muscle pain on affected area/not feeling well after the COVID shot booster was not resolved at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1835370 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, Diarrhoea, Headache, Lethargy, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: LETROZOLE; LIPITOR
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: High cholesterol; Malignant breast lump removal (Breast cancer surgery)
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: Body temperature; Result Unstructured Data: Test Result:100.9
CDC Split Type: USPFIZER INC202101288200

Write-up: Muscle pain; Lethargy; Headache; Temp of 100.9; Diarrhea; Nausea; This is a spontaneous report from a contactable consumer, the patient. A 78-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the right arm on 27Sep2021 at 10:00 (at the age of 78-years-old) as a single dose for COVID-19 immunisation. Medical history included breast cancer surgery in Nov2020 and high cholesterol. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient received other vaccine within four weeks prior to the vaccination. Concomitant medications included influenza vaccine inact split 4v (FLUZONE HIGH DOSE QUADRIVALENT) on 15Sep2021 for unknown indication; letrozole (MANUFACTURER UNKNOWN) and atorvastatin calcium (LIPITOR); both for unknown indications from an unknown date and unknown if ongoing. On 27Sep2021 at 20:30, the patient experienced muscle pain, lethargy, headache, temperature (temp) of 100.9, diarrhea and nausea. On the same day, the patient underwent body temperature test and the result was 100.9 (units unspecified). The events did not result in doctor or other healthcare professional office/clinic visit and emergency room/department, or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events muscle pain, lethargy, headache, temp of 100.9, diarrhea and nausea was resolving at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1835405 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWD164 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Contusion, Fatigue, Feeling abnormal, Headache, Immunisation, Myalgia, Nausea, Pain, Pain in extremity, Peripheral swelling, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: ZYRTEC [CETIRIZINE HYDROCHLORIDE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to molds (known allergies: molds); Food allergy (known allergies: Lactose); Ragweed allergy (known allergies: ragweed)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101319428

Write-up: Horrible bad headache; Body aches; Fever; Chills; Nausea; Feeling just awful; Tired; Arm pain & swelling; Arm pain & swelling; Bruised arm; Muscle pain; Slight body rash; Booster; This is a spontaneous report from a non-contactable consumer, the patient. A 66-year-old non-pregnant female patient received third (booster) dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EWD164) via an unspecified route of administration in the left arm on 27Sep2021 at 11:00 (at the age of 66-year-old), as a single dose for COVID-19 immunisation. Medical history included known allergy to lactose, ragweed and molds. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Concomitant medications included cetirizine hydrochloride (ZYRTEC) and unspecified vitamins; both for unknown indication from an unknown date and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL9267) via an unspecified route of administration in the left arm on 13Feb2021 (at the age of 65-year-old) and received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6205) via an unspecified route of administration in the left arm on 06Mar2021 (at the age of 65-year-old); both as a single dose for COVID-19 immunisation. On 28Sep2021 at 09:00, the patient experienced horrible bad headache, body aches, fever, chills, nausea, feeling just awful, tired, arm pain & swelling, bruised arm, muscle pain, and slight body rash. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were taken as a result of the events and included contacting pharmacy to enquire what should be done. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events horrible bad headache, body aches, fever, chills, nausea, feeling just awful, tired, arm pain & swelling, bruised arm, muscle pain, and slight body rash were resolved on an unknown date in 2021. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1835411 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Discomfort, Immunisation, Joint range of motion decreased, Lymph node pain, Off label use
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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 INC202101326656

Write-up: Moderate pain in lymphnodes; Moderate discomfort from in side elbow all the way to left flank/ Discomfort; Pain felt like severe bruising; Limited range of motion; Off-label use; Dose received: 3; This is a spontaneous report from a contactable healthcare professional, the patient. A 57-year-old non-pregnant female patient received third (booster) dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the deltoid left on 27Sep2021 (at the age of 57-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history and no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other medications within two weeks of vaccination. The patient did not receive any other vaccine within four weeks prior to the COVID vaccine. The patient previously received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date as a single dose for COVID-19 immunisation and the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date as a single dose for COVID-19 immunisation. On 29Sep2021 at 09:00, the patient experienced moderate pain in lymph nodes, moderate discomfort from in side elbow all the way to left flank, pain felt like severe bruising with limited range of motion. The events did not result in doctor/other health care professional office/clinic visit and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event moderate discomfort from in side elbow all the way to left flank were resolved on an unknown date in Oct2021 and moderate pain in lymph nodes, pain felt like severe bruising with limited range of motion were resolved on an unknown date in 2021. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1835469 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Immunisation
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: LEVOTHYROXINE; ROSUVASTATIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?: Yes); High cholesterol
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101346122

Write-up: Headache which lasted four or five days; Administration date 27Sep2021, dose number=3; This is a spontaneous report from a contactable consumer, the patient. A 79-year-old male patient received the third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the left arm on 27Sep2021 at 11:00 (at the age of 79-years-old) as a single dose for COVID-19 immunisation. Medical history included high cholesterol and COVID-19. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included levothyroxine (MANUFACTURER UNKNOWN) and rosuvastatin (MANUFACTURER UNKNOWN); both from an unknown date for an unknown indication and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the left arm on 09Feb2021 at 11:45 (at the age of 78-years-old) as a single dose for COVID-19 immunisation and also 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 02Mar2021 at 10:45 (at the age of 78-years-old) as a single dose for COVID-19 immunisation. On 27Sep2021 at 11:00, the patient had "administration date 27Sep2021, dose number=3". On 28Sep2021, the patient experienced headache which lasted four or five days. Therapeutic measures were not taken as a result of the event headache which lasted four or five days. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event headache which lasted four or five days was recovered on an unknown date in Oct2021. The clinical outcome of the event "administration date 27Sep2021, dose number=3" was unknown at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up


VAERS ID: 1835506 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-27
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Movement disorder
SMQs:, Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (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 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes); Hypertension (Htn); Nickel sensitivity (known allergies: Ni)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101371488

Write-up: Unable to lift right arm after receiving vaccine; This is a spontaneous report from a contactable consumer, the patient. A non-pregnant female patient of unspecified age received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the right arm on 09Sep2021 at 13:00 as a single dose for COVID-19 immunisation. Medical history included hypertension (Htn) and COVID-19. The patient had known allergies to nickel (Ni). Prior to vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications were not reported. On 27Sep2021, the patient was unable to lift right arm after receiving vaccine. The event did not result in doctor or other health care professional office/clinic visit, and emergency room/department or urgent care. It was unknown whether any therapeutic measures were taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event unable to lift right arm after receiving vaccine was unknown at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1836352 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-24
Onset:2021-09-27
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Computerised tomogram thorax, Dizziness, Dyspnoea, Eye pain, Headache, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Neck problems in my C2-C4 vertebrae. Scoliosis, bulging disk, Congenital deformities
Allergies: None
Diagnostic Lab Data: I went to my primary care physician on Wednesday 29th September 2021 and they order a COVID PMR test which came back negative. They also ordered and I had a Chest CT which they said did not show anything. As I now have headaches all the time, I am scheduled to go back to my primary care team for follow up on 11/04/21.
CDC Split Type:

Write-up: The covid vaccination was forced on me, against my will via mandate. I am a US Federal worker and was threatened with the loss of my job if I did not unwillingly get the vaccine. After being forced by mandate I got the J and J vaccine on Friday 24 September 2021 and on Monday 27th September 2021 I started feeling the below symptoms which got worse throughout the day and the week. Headaches, shortness of breath, joint aches, dizziness and eye pain. I continue to have headaches all the time which I never suffered from before. These headaches have caused pain, suffering and anxiety which continues to grow. I went to my primary care physician on Wednesday 29th September 2021 and they order a COVID PMR test which came back negative. They also ordered and I had a Chest CT which they said did not show anything. As I now have headaches all the time, I am scheduled to go back to my primary care team for follow up on 11/04/21.


VAERS ID: 1836900 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 2 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Diplegia, Dyspnoea, Guillain-Barre syndrome, Laboratory test, Muscular weakness, Pharyngitis, Polyarthritis, Subacute inflammatory demyelinating polyneuropathy
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pregabalin, aripiprazole, armodafinil, zofran PRN, melatonin, estrogen/progesterone, amlodipine, meloxicam, baclofen PRN, omeprazole, fluoxetine, clonazepam, duloxetine, zolpidem
Current Illness: NONE ACUTE
Preexisting Conditions: gastroesophageal reflux, fibromyalgia, hypertension, lumbar disc herniation with low back pain, neuropathy, major depressive disorder, shift-work sleep disorder
Allergies: NONE
Diagnostic Lab Data: she is awaiting neuro evaluation and further work-up; clinical diagnosis of guillain barre syndrome made
CDC Split Type:

Write-up: developed acute inflammatory demyelinating polyneuropathy, paralysis of lower extremities, global muscle weakness, severe polyarthritis, pharyngitis, dyspnea, hearing loss


VAERS ID: 1837018 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-28
Onset:2021-09-27
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Cough, Dyspnoea, Exposure to SARS-CoV-2, Laryngitis, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), 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), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler ALPRAZolam (XANAX) 0.5 mg tablet codeine-guaiFENesin (ROBITUSSIN-AC) 10-100 mg/5 mL liquid diclofenac (VOLTAREN) 75 mg EC tablet (Expired) drospirenone-ethinyl estradioL (YASMIN) 3-0.0
Current Illness:
Preexisting Conditions: Respiratory Exercise-induced asthma Digestive Gastroesophageal reflux disease without esophagitis Musculoskeletal Sprain of medial collateral ligament of left knee, subsequent encounter Other Controlled substance agreement signed Encounter for surveillance of contraceptive pills Annual physical exam
Allergies: PenicillinsHives / Urticaria, Swelling AcetazolamideRash Erythromycin-sulfisoxazoleNausea and Vomiting Sulfamethoxazole-trimethoprimRash VenlafaxineDizziness / Lightheaded
Diagnostic Lab Data: 10/18/2021 1100 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 10/18/21 1100 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result Detected Critical 10/18/2021 1100 COVID-19 PCR Collected: 10/18/21 1100 | Final result | Specimen: Swab from Nasopharynx 10/18/2021 11:35 AM EDT Chest xray was normal. Continue same plan we discussed.
CDC Split Type:

Write-up: Office Visit 10/18/2021 Family Medicine Cough Dx Cough Reason for Visit Chief Complaint Exposure to COVID-19 virus X''S 3 WEEKS was seen at UC ASSESSMENT and PLAN: Patient was seen today for cough. Patient presents with ? Cough 1. Cough/exposure COVID 19. Concern that she has now started to have a fever. Will check chest xray and COVID test. If evidence of bacterial infection, will start zpak likely. I recommend a trial of pred taper and monitoring symptoms. Symptomatic treatment with albuterol PRN and codeine cough syrup PRN at bed time. Should stay well hydrated. Let us know if symptoms are worsening or not improving. The patient was advised to follow up at the next regularly scheduled visit or sooner PRN. Note reviewed- UC The patient was advised to follow up at the next regularly scheduled visit or sooner PRN. SUBJECTIVE: Had a cough in her chest and was getting better but now has a fever of 101. This happened over the weekend. Has been using inhaler. Has been using medication which helped. Using OTC mucinex. Initially started 3 weeks ago and then went to UC one week ago. Was started on steroids and cough medication which was not helpful. Cough at night is keeping her up and having some discomfort from coughing. Was on a 10 day pred taper. Denies nausea, vomiting Denies sick contacts Has been vaccinated against COVID Denies diarrhea Denies runny nose, congestion 10/19/21 10:07 AM Note COVID 19 test POSITIVE Patient was notified of positive test results from test completed on 10/18/2021 Signs and symptoms: 1. When did your symptoms start? 10/16/2021 2. What symptoms have you experienced? Fever, cough, SOB, laryngitis Close contact questions: 1. # in household: 3 2. Have you been in close contact with anyone two days before symptoms including going to work while you were sick? yes


VAERS ID: 1839131 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-23
Onset:2021-09-27
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Alopecia, Condition aggravated, SARS-CoV-2 test
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hair thinning (I am genetically predisposed to gradual hair thinning with age)
Preexisting Conditions: Medical History/Concurrent Conditions: Sulfonamide allergy (Known allergies: All sulfa drugs)
Allergies:
Diagnostic Lab Data: Test Date: 20211008; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101360378

Write-up: Sudden onset of significant hair loss; Rapid significant onset of hair thinning; This is a spontaneous report from a contactable consumer, the patient. A 48-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3180) via an unspecified route of administration in the left arm on 23Sep2021 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. Medical history included sulfa drugs and she also had been experiencing normal thinning with age and was genetically predisposed to gradual hair thinning with age. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications were not reported. The patient previously received amoxicillin (MANUFACTURER UNKNOWN) and experienced drug allergy. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 27Sep2021 the patient experienced sudden onset of significant hair loss within a few days of receiving the vaccine. Handful of hair were coming out. The patient had obvious bald patches on her scalp. There was no way that was coincidental. There were no other changes. she also had been experiencing normal thinning with age and was genetically predisposed to gradual hair thinning with age, but this was different. A rapid significant onset that lasted about a week or so. The events did not result in doctor or other healthcare professional office/clinic visit. It was unknown whether any therapeutic measures were taken as a result of the event. Since the vaccination, the patient had been tested for COVID-19. On 08Oct2021, the patient underwent nasal swab and the result was negative. The clinical outcome of the events sudden onset of significant hair loss and rapid significant onset of hair thinning within a few days of receiving the vaccine was resolved with lasting effects on an unknown date in Oct2021.


VAERS ID: 1843727 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843734 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843736 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843738 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843743 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

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

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843745 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK RA / IM

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

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843752 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843757 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

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

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843759 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843775 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843776 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843778 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843783 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

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

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843785 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843788 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843791 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843793 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843796 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINE THAT WAS PAST BEYOND USE DATE. NO ADVERSE REACTION.


VAERS ID: 1843822 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1843842 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1843847 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1843848 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1843850 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

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

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1843853 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1843857 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1843859 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1843860 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

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

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1843863 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1844040 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK RA / IM

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

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1844043 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1844044 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

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

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1844046 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Unknown  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1844049 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Unknown  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT RECEIVED COVID VACCINATION THAT WAS PAST THE BEYOND USE DATE. NO ADVERSE REACTIONS NOTED.


VAERS ID: 1844050 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient received COVID-19 vaccination past the beyond use date. No adverse reactions noted.


VAERS ID: 1846690 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O39D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Cyanosis, Erythema, Fatigue, Feeling cold, Livedo reticularis, Pain, Pain in extremity, Peripheral swelling, Renal pain, Skin warm, Somnolence, Tinnitus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril and Levothyroxine; Juice Plus, Vitamin D3/K2, iodine, kelp
Current Illness: None
Preexisting Conditions: Thyroid and moderately high blood pressure
Allergies: Cefdinir
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 1. Almost immediately, my left arm became red and swollen and hot to the touch. This side effect lasted for almost 2 weeks. The arm was quite painful if I touched or bumped it for one week, then gradually got better and was fine on the 14th day. 2. That evening of the vaccine and for the following 24 hours, I felt very, very cold with blue skin under my fingernails and toenails and mottling of my skin on arms and legs. So cold, that even after/during sitting in a 140 degree sauna for 30 minutes, I did not even sweat. 3. Very fatigued for 2 days, slept most of the second day. 4. I had pulsing in my ears for one day, but this occurred a week or two later as well. 5. A sharp pain in my right kidney area also occurred but did not last long. The only effect that occurred after the first shot was redness and soreness for 2 days. Today, there seem to be no lasting side effects.


VAERS ID: 1847615 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-05-05
Onset:2021-09-27
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Pain in extremity, Peripheral swelling, X-ray
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Pain and swelling in the fingers of my left hand. Left arm also goes numb during regular intervals in the evenings where it didn''t before. This is the arm the injection was in. Diagnosis unconfirmed, just recommended ibuprofen as needed.


VAERS ID: 1848691 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848692 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848694 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848696 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY00584 / 3 AR / IM

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

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

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


VAERS ID: 1848704 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848707 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848710 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848714 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848716 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848717 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848718 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848720 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848730 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848732 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

Write-up: Error: Improper storage (temperature).


VAERS ID: 1848734 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


VAERS ID: 1848766 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 AR / IM

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

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

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


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