National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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 464 out of 8,941

Result pages: prev   365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563   next


VAERS ID: 1874052 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-02-10
Onset:2021-09-27
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1491 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Result Unstructured Data: Test Result:Positive; Comments: Variant PCR-based: B.1.617.2 Variant Sequenced: n501y-positive: No
CDC Split Type: ATPFIZER INC202101508561

Write-up: SARS-CoV-2 infection; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053128. A 27-years-old female patient received bnt162b2 (COMIRNATY), dose 2 intramuscular on 10Feb2021 (Batch/Lot Number: EL1491) and dose 1 intramuscular on 20Jan2021 (Batch/Lot Number: EL1491) both as single dose for covid-19 immunisation . The patient medical history and concomitant medications were not reported. The patient experienced sars-cov-2 infection (vaccination failure) (medically significant) on 27Sep2021 with outcome of unknown. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 27Sep2021 Variant PCR-based: B.1.617.2 Variant Sequenced: n501y-positive: No. No follow-up attempts are possible. No further information expected


VAERS ID: 1874053 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-05-22
Onset:2021-09-27
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FCO681 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Variant Sequenced: n501y-positive: No
CDC Split Type: ATPFIZER INC202101508586

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053138. A 65-year-old female patient received BNT162B2 (COMIRNATY), via intramuscular route on 22May2021 (Batch/Lot Number: FCO681) as dose 2, single and dose 1 via intramuscular route on 10Apr2021 (Batch/Lot Number: Unknown) as dose 1, single, both doses for COVID-19 immunisation. The patient patient''s history and the concomitant medications were not reported. On 27Sep2021, the patient experienced SARS-COV-2 infection and had vaccination failure (as reported). The patient underwent lab tests and procedures which included COVID-19 PCR (polymerase chain reaction) test: positive on 27Sep2021 Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No. The outcome was unknown for the reported events. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1874054 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-14
Onset:2021-09-27
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD6840 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101508193

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053218. A 49-year-old female patient received second dose of bnt162b2 (COMIRNATY, formulation: Solution for injection, Batch/Lot Number: FD6840, Expiration date: was not reported), via intramuscular route of administration, administered anatomical location was not reported, on 14Jul2021, as dose 2, single for COVID-19 immunization and the patient received first dose of bnt162b2 (COMIRNATY, formulation: Solution for injection, Batch/Lot Number: FD0168, Expiration date: was not reported), via intramuscular route of administration, administered anatomical location was not reported, on 16Jun2021, as dose 1, single for COVID-19 immunization. The patient medical history was not reported. The patient concomitant medications were not reported. On 27Sep2021, the patient experienced SARS-CoV-2 infection. The patient underwent lab tests and procedures which included sars-cov-2 test: positive Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No on 27Sep2021. The outcome of the SARS-CoV-2 infection was unknown. No follow-up attempts possible. No further information expected.


VAERS ID: 1874055 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-17
Onset:2021-09-27
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET1831 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant Polymerase chain reaction: B.1.617.2 Variant sequenced: n501y-positive: No
CDC Split Type: ATPFIZER INC202101508299

Write-up: SARS-CoV-2 infection; Vaccination failure; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053222. A 82-year-old female patient received bnt162b2 (COMIRNATY, Solution for injection) intramuscular on 17Mar2021 (Batch/Lot Number: ET1831) as dose 2, single and via intramuscular on 24Feb2021 (Batch/Lot Number: EP2163) as dose 1, single both doses for COVID-19 immunization. There was no relevant medical history and concomitant medications reported for the patient. On 27Sep2021 the patient experienced SARS-CoV-2 infection, other, Vaccination failure. Seriousness of the event was medically significant. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive on 27Sep2021 Variant Polymerase chain reaction: B.1.617.2 Variant sequenced: n501y-positive: No. The outcome of the event SARS-CoV-2 infection was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1874057 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-03-17
Onset:2021-09-27
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET1831 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101508307

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053225. A 84-year-old male patient received second dose of bnt162b2 (COMIRNATY, formulation: solution for injection, Batch/Lot Number: ET1831), via intramuscular on 17Mar2021 as dose 2, single and received first dose of bnt162b2 (COMIRNATY, formulation: solution for injection, Batch/Lot Number: EP2163), via intramuscular on 24Feb2021 as dose 1, single both doses for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 27Sep2021 the patient experienced sars-cov-2 infection and vaccination failure. The patient underwent lab tests and procedures which included sars-cov-2 test with positive on 27Sep2021 (Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No). The outcome of the events was unknown. No follow-up attempts are possible, no further information is expected.


VAERS ID: 1874059 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-11
Onset:2021-09-27
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD6840 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Variant Sequenced: n501y-positive: No
CDC Split Type: ATPFIZER INC202101508303

Write-up: SARS-CoV-2 infection; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053227. A 52-year-old male patient received BNT162B2 (COMIRNATY, Formulation: Solution for injection, Batch/Lot number: FD6840, Expiration date was not reported), via intramuscular on 11Jul2021 as a dose 2, single and the patient received BNT162B2 (COMIRNATY, Formulation: Solution for injection, Batch/Lot number: FD1921, Expiration date was not reported), via intramuscular on 20Jun2021 as a dose 1, single for COVID-19 immunization. The patient''s medical history and concurrent conditions included: no relevant medical history was reported. The patient''s concomitant medications were not reported. On 27Sep2021, the patient experienced SARS-CoV-2 infection. On 27Sep2021, the patient underwent lab tests and procedures which included COVID-19 PCR test (SARS-CoV-2 test), resulted as positive, Variant PCR-based: B.1.617.2, Variant Sequenced, n501y-positive: No. The outcome of the events was unknown. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1874060 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-04
Onset:2021-09-27
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6136 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Result Unstructured Data: Test Result:Positive; Comments: Variant PCR-based: Variant Sequenced: n501y-positive: Unknown
CDC Split Type: ATPFIZER INC202101508310

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report received from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053231. A 52-year-old male patient received second dose of bnt162b2 (COMIRNATY, solution for injection, Lot Number: EJ6136), via intramuscular route of administration on 04Feb2021 as dose 2, single and received first dose via intramuscular route of administration on 14Jan2021 (Lot Number: EJ6796) as dose 1, single, both doses for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 27Sep2021, the patient had vaccination failure and sars-cov-2 infection. The patient underwent lab tests and procedures which included COVID-19 PCR test was positive (Variant PCR-based: Variant Sequenced: n501y-positive: Unknown) on 27Sep2021. Outcome of the event was unknown. No follow up attempts are possible, no further information is expected.


VAERS ID: 1874062 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-04-15
Onset:2021-09-27
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW2239 / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: No
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive
CDC Split Type: ATPFIZER INC202101508237

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB, regulatory authority number AT-BASGAGES-2021-053234. This serious spontaneous report was received from a Physician and concerns a Female patient A 57-years-old female patient received bnt162b2 (COMIRNATY formulation: Solution for injection, Lot Number: EY7015), via an intramuscular on 06May2021 as DOSE 2, SINGLE, received first dose nt162b2 (COMIRNATY formulation: Solution for injection, Lot Number: EW2239), via an intramuscular on 15Apr2021 as DOSE 1, SINGLE for COVID-19 immunisation. The patient medical history included as none. The patient''s concomitant medications were not reported. The patient experienced vaccination failure (medically significant) and sars-cov-2 infection (medically significant) both on 27Sep2021. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive on 27Sep2021. The clinical outcome of the events was unknown. Follow-up attempts are not possible. No expected further information.


VAERS ID: 1874063 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-23
Onset:2021-09-27
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0168 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Polymerase chain reaction (PCR) -based variant: B.1.617.2 Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101508318

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053235. A 43-years-old female (pregnant-unknown) patient received second dose of BNT162B2 (COMIRNATY, Solution for injection, Batch/Lot Number: FD0168), via intramuscular route on 23Jun2021 as dose 2, single; and first dose of BNT162B2 (COMIRNATY, Solution for injection, Batch/Lot Number: FC2473), via intramuscular route on 02Jun2021 as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced vaccination failure, and sars-cov-2 infection. On 27Sep2021, the patient underwent lab tests and procedures which included sars-cov-2 test: positive, Polymerase chain reaction (PCR) -based variant: B.1.617.2 Sequenced variant: n501y-positive: No. The outcome of the events was unknown. No follow-up attempts are possible. No further information expected.


VAERS ID: 1874064 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-06
Onset:2021-09-27
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW2239 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Result Unstructured Data: Test Result:Positive; Comments: Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101508229

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053236. A 53-year-old male patient received bnt162b2 (COMIRNATY, Formulation: Solution for injection), via intramuscular route of administration on 06Apr2021 (Batch/Lot Number: EW2239) as dose 2, single and dose 1 via intramuscular route of administration on 16Mar2021 (Batch/Lot Number: ET1831) as dose 1, single, both for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 27Sep2021 the patient experienced vaccination failure and sars-cov-2 infection. The patient underwent lab tests and procedures which included sars-cov-2 test positive on 27Sep2021 (Variant PCR-based: B.1.617.2 sequenced variant: n501y-positive: No). Outcome of the event was unknown. Follow-up attempts are not possible. No expected further information.


VAERS ID: 1874065 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-14
Onset:2021-09-27
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD1921 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: COVID-19 PCR test; Test Result: Positive ; Test Date: 20210927; Test Name: n501y-positive; Result Unstructured Data: Test Result:No; Test Date: 20210927; Test Name: Variant PCR-based; Result Unstructured Data: Test Result:B.1.617.2; Comments: Variant PCR-based: B.1.617.2; Test Date: 20210927; Test Name: Variant Sequenced; Result Unstructured Data: Test Result:unknown
CDC Split Type: ATPFIZER INC202101508314

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053237. A 50-years-old male patient received second dose of bnt162b2 (COMIRNATY, solution for injection) (lot number: FD1921), intramuscular on 14Jun2021 as dose 2, single and dose 1 (Lot Number: EY3014) intramuscular on 03May2021 as dose 1, single for COVID-19 immunization. The patient medical history and patient''s concomitant medications were not reported. On 27Sep2021, patient experienced vaccination failure, sars-cov-2 infection. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive, n501y-positive: no on 27Sep2021, Variant PCR-based: B.1.617.2, Variant Sequenced: unknown on 27Sep2021. No follow up attempts possible, no further information expected.


VAERS ID: 1874066 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-23
Onset:2021-09-27
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD4555 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variante PCR-basiert: B.1.617.2 n501y-positiv: No
CDC Split Type: ATPFIZER INC202101508242

Write-up: SARS-CoV-2 infection; Vaccination failure; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, Regulatory Authority number AT-BASGAGES-2021-053240. A 58-years-old male patient received second dose of bnt162b2 (COMIRNATY, solution for injection, Batch/Lot Number: FD4555; Expiration Date: Unknown) via intramuscular route on 23Jun2021 as dose 2, single and first dose of bnt162b2 (COMIRNATY, solution for injection, Batch/Lot Number: FA4598; Expiration Date: Unknown) via intramuscular route on 19May2021 as dose 1, single for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient experienced sars-cov-2 infection and vaccination failure on 27Sep2021. The patient underwent lab tests and procedures which included sars-cov-2 test on 27Sep2021 with Variante PCR-basiert: B.1.617.2 and n501y-positiv: No. The outcome of events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1874069 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-03
Onset:2021-09-27
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE6208 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Result Unstructured Data: Test Result:Positive
CDC Split Type: ATPFIZER INC202101508332

Write-up: SARS-CoV-2 infection; Vaccination failure; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, Regulatory Authority number AT-BASGAGES-2021-053247. A 34-year-old female patient received second dose of BNT162B2 (COMIRNATY, solution for injection, Batch/Lot Number: FE6208), via intramuscular route on 03Aug2021 as dose 2, single; and first dose of BNT162B2 (COMIRNATY, solution for injection, Batch/Lot Number: FD6840), via intramuscular route on 13Jul2021 as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced sars-cov-2 infection, and vaccination failure. On 27Sep2021, the patient underwent lab tests and procedures which included sars-cov-2 test resulted positive. Outcome of the events was unknown. No follow-up attempts are possible, no further information is expected.


VAERS ID: 1874238 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-05-27
Onset:2021-09-27
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1D012A / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Cough, Diagnostic procedure, Drug ineffective, Fatigue, Headache, Nasopharyngitis, Oropharyngeal pain, Polymerase chain reaction, Pyrexia
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: crossing threshold values; Result Unstructured Data: Test Result:14.3; Comments: Fa, PIIM, q Tower; Test Name: crossing threshold values; Result Unstructured Data: Test Result:13.3; Comments: Fa, PIIM, q Tower; Test Date: 20210927; Test Name: polymerase chain reaction; Test Result: Positive
CDC Split Type: DEPFIZER INC202101490653

Write-up: Fatigue; headache; cold; sore throat; dry cough; fever; COVID-19; Vaccination failure; This is a spontaneous report from a non-contactable consumer, downloaded from the regulatory authority, Regulatory authority number: DE-PEI-202100212290. A 51-years-old female patient received bnt162b2 (COMIRNATY), dose 2 intramuscular on 27May2021 (Batch/Lot Number: 1D012A) as dose 2, single, and dose 1 intramuscular on 14Apr2021 (Batch/Lot Number: E13045) as dose 1, single for Covid-19 immunization. The patient''s medical history were not reported. There were no concomitant medications. The patient experienced Covid-19 and vaccination failure on 27Sep2021, and fatigue, headache, cold, sore throat, dry cough and fever on an unknown date. The patient underwent lab tests and procedures which included polymerase chain reaction: positive on 27Sep2021 with crossing threshold values of 14.3 / 13.3 (Fa, PIIM, qTower). The events Covid-19 and vaccination failure had not resolved while the outcome of the rest of the events was unknown. Case Narrative: Reporter comment: Sender comment: Initials: BU, Symptoms: Fatigue, headache, cold, sore throat, dry cough, fever, positive polymerase chain reaction test for SARS-CoV-2 on 27Sep2021 with crossing threshold values of 14.3 /13.3 (Fa, PIIM, qTower) Case Summary: No follow-up attempts are possible. No further information is expected.


VAERS ID: 1874241 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-02
Onset:2021-09-27
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET3045 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Drug ineffective, Suspected COVID-19
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC202101490492

Write-up: Drug ineffective; Suspected COVID-19; This is a spontaneous report from a non-contactable consumer or other non hcp downloaded from the regulatory authority-WEB, regulatory authority number DE-PEI-202100213105. A 44-year-old female patient received BNT162B2 (COMIRNATY), first dose via an unspecified route of administration on 21Apr2021 (Lot Number: ET3045) as dose 1, single and second dose via an unspecified route of administration on 02Jun2021 (Lot Number: ET3045) as dose 2, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced drug ineffective and suspected COVID-19 on 27Sep2021. The symptoms were reported as cough, headache, loss of taste and smell. The outcome of the events was unknown. Sender comment: Initial.: (PRIVACY). Symptoms: Cough, headache, loss of taste and smell No follow-up attempts are possible. No further information is expected.


VAERS ID: 1874254 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-21
Onset:2021-09-27
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF0900 / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Drug ineffective, Headache, Nasopharyngitis, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC202101500878

Write-up: Cough; cold; nausea; vomiting; general weakness; headache; COVID-19: Symptoms: Cough, cold, nausea, vomiting, general weakness, headache; Drug ineffective; This is a spontaneous report from a non-contactable consumer or other non hcp downloaded from the regulatory authority-WEB, regulatory authority number DE-PEI-202100214425. A 48-years-old female patient received second dose of bnt162b2 (COMIRNATY, solution for injection, Batch/Lot Number: FF0900 and expiry date was not reported), intramuscularly on 21Jul2021, as DOSE 2, SINGLE, and first dose of bnt162b2 (COMIRNATY, solution for injection, Batch/Lot Number: FD9234 and expiry date was not reported) intramuscularly on 16Jun2021 as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced COVID-19, drug ineffective and symptoms cough, cold, nausea, vomiting, general weakness, headache. Outcome of the events were unknown. Sender''s comments: Initial: PRIVACY Symptoms: Cough, cold, nausea, vomiting, general weakness, headache. No follow-up attempts possible. No further information expected.


VAERS ID: 1874260 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SCKT8 / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Malaise, Palpitations, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC202101500853

Write-up: Generally unwell; Tinnitus; Palpitations; Paresthesia; This is a spontaneous report from a non-contactable consumer downloaded from the Regulatory Authority-WEB, regulatory authority number DE-PEI-202100214480. A 40-year-old female patient received BNT162B2 (COMIRNATY, Lot Number: SCKT8), intramuscular on 27Sep2021 (age at vaccination: 40 years old) as dose number unknown, single for COVID-19 immunization. Medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced being generally unwell, tinnitus, palpitations, and paresthesia, all side effects hours later. The patient was hospitalized for the events. The outcome of the events was unknown. Sender''s comment: previous exclusion tests without pathologies, differential diagnosis exclusion of cerebral vein thrombosis; Outpatient and inpatient treatment required, no information on this. Relatedness of drug to reactions/events for all events was assessed as D. Unclassifiable. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1874272 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-23
Onset:2021-09-27
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE8405 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Drug ineffective, Suspected COVID-19
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: DEPFIZER INC202101501063

Write-up: Suspected COVID-19; Vaccination failure; This is a spontaneous report from a non-contactable consumer or other non hcp downloaded from the regulatory authority-WEB, regulatory authority number DE-PEI-202100215045. A 38-years-old male patient received bnt162b2 (COMIRNATY, Formulation: Solution for injection, Batch/Lot Number: FE8405), via an unspecified route of administration on 23Jul2021 as DOSE 2, SINGLE and received bnt162b2 (COMIRNATY, Formulation: Solution for injection, Batch/Lot Number: FD7958), via an unspecified route of administration on 24Jun2021 as DOSE 1, SINGLE both for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced covid-19 and vaccination failure. The clinical outcome of the events was recovered on an unspecified date in 2021. Senders comments: Symptoms: runny nose, headache, loss of smell and taste, body aches, chills, fever Relatedness of drug to reaction(s)/event(s) : regulatory authority B. Indeterminate for both events. No follow-up attempts are possible. No further information is expected


VAERS ID: 1874284 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-30
Onset:2021-09-27
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SD7958 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 test; Test Result: Positive ; Comments: CT values: 20.7 / 21.2 / 20.9
CDC Split Type: DEPFIZER INC202101500961

Write-up: vaccination failure; COVID-19 (symptoms: cough, runny nose, odor and loss of taste ); This is a spontaneous report from a non-contactable consumer downloaded from the Regulatory Authority-WEB, regulatory authority number DE-PEI-202100215085. This is first of two cases. This case captures LOE events which occurred after both doses of the vaccine. A 44-year-old female patient received BNT162B2 (COMIRNATY solution for injection), first dose on 12May2021 (lot number: BX8680) at dose 1, single, then second dose on 30Jun2021 (lot number: SD7958) at dose 2, single; both via intramuscular at an unspecified age for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced vaccination failure and COVID-19 (symptoms: cough, runny nose, odor and loss of taste). The patient underwent COVID-19 test on 27Sep2021 with result: positive (CT values: 20.7 / 21.2 / 20.9). Outcome of the events was recovered on an unspecified date in 2021. Relatedness of BNT162B2 (COMIRNATY) to the events was B. indeterminate (source of assessment: RA). Sender''s comment: Symptoms experienced were cough, runny nose, odor and loss of taste. CT values: 20.7 / 21.2 / 20.9. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : DE-PFIZER INC-202101525456 same patient, same medication, different doses, different events


VAERS ID: 1874830 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-06
Onset:2021-09-27
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF3318 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101522627

Write-up: Vaccination failure / drug ineffective; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB, regulatory authority number AT-BASGAGES-2021-052854. This is one of two reports. A 32-year-old female patient received BNT162B2 (COMIRNATY, solution for injection), administered on 06Aug2021 (Batch/ lot number: FF3318, expiration date not reported) as dose 2, single and administered on 21Jun2021 (lot number: FD0168, expiration date not reported) as dose 1, single both intramuscularly administered and for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced SARS-CoV-2 infection and Vaccination failure / drug ineffective. Events were reported as serious, medically significant by the regulatory authority. The patient underwent lab tests and procedures which included COVID-19 PCR test: Positive (Variant PCR-based: B.1.617.2; Sequenced variant: , n501y-positive: No) on 27Sep2021. The outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : AT-PFIZER INC-202101546508 Same reporter, patient and product; different dose and event.


VAERS ID: 1874869 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-30
Onset:2021-09-27
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Amenorrhoea, Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MARVELON
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Contraception
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC202101505280

Write-up: Amenorrhea; Intermenstrual bleeding/ only spotting in 7 days break of her birth control; This is a spontaneous report from a contactable consumer received from the regulatory authority. The regulatory authority report number is GB-MHRA-WEBCOVID-202110282230112060-GZN1P, Safety Report Unique Identifier GB-MHRA-ADR 26137374. A 16-year-old female patient received BNT162B2 (COMIRNATY), dose 2 via an unspecified route of administration on 30Aug2021 (lot number: unknown) as dose 2, single for COVID-19 immunisation. Medical history included contraception. Patient had not had symptoms associated with COVID-19, Not had a COVID-19 test. Patient was not pregnant, Patient was not currently breastfeeding. Concomitant medication included desogestrel, ethinylestradiol (MARVELON) taken for contraception. Historical vaccine included the first dose of Comirnaty for COVID-19 immunisation. The patient experienced amenorrhea on 27Sep2021, intermenstrual bleeding in 2021. Patient last menstrual period date was 31Aug2021. Patient did not have had a period since her second covid shot, only spotting in 7 days break of her birth control. Patient did not report relate to possible inflammation of the heart (myocarditis or pericarditis). The outcome of the event Amenorrhea was not recovered. The outcome of other event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1874891 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8288 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure decreased, Blood pressure measurement, Cold sweat, Loss of consciousness, Oxygen saturation, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PROGRAM 20
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fainting (had blurry vision post first dose and had a history (2016) of fainting post Men C vaccination.)
Allergies:
Diagnostic Lab Data: Test Date: 202109; Test Name: Initial BP; Result Unstructured Data: Test Result:low at 93/53; Test Date: 202109; Test Name: Initial BP; Result Unstructured Data: Test Result:rose to 120/56; Test Date: 202109; Test Name: O2 saturation; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: GBPFIZER INC202101505134

Write-up: Loss of consciousness; Pale; clammy; Initial BP reading low at 93/53 (18:38) but rose to 120/56 by 19:05.; This is a spontaneous report from a contactable pharmacist. This is a report received from the Regulatory Agency (RA). The regulatory authority report number is GB-MHRA-WEBCOVID-202110301728172410-0A53C Safety Report Unique Identifier GB-MHRA-ADR 26143240. A male patient of an unspecified age received second dose of BNT162B2 (COMIRNATY), dose 2, via an unspecified route of administration on 27Sep2021 (Lot Number: FF8288) as DOSE 2, SINGLE for COVID-19 immunisation. Historical vaccine included first dose of Covid-19 vaccine (MANUFACTURER UNKNOWN) on unspecified date for COVID-19 immunisation. Medical history included syncope from 2016 to an unknown date had blurry vision post first dose and had a history (2016) of fainting post Men C vaccination. Patient has not had symptoms associated with COVID-19. Not had a COVID-19 test. Concomitant medication(s) included mestranol/norethisterone (PROGRAM 20). Within two minutes of administration, patient became pale and clammy to touch and their eyes rolled. Loss of conscious, however, the patient recovered within 30 seconds. Patient remained under observation in the resus area for circa 30 minutes until recovered. Physical observations taken and recorded on several occasions. Initial BP reading low at 93/53 (18:38) but rose to 120/56 by 19:05. Patient was provided with water as required. Patient subsequently left after the last BP reading as they did not want to stay any longer. They declined the offer to call someone to support and insisted they left independently with the plan to utilise public transport to get themselves home. No further action indicated or required. The patient underwent lab tests and procedures which included blood pressure measurement: low at 93/53 on Sep2021, blood pressure measurement: rose to 120/56 on Sep2021, oxygen saturation: unknown results on Sep2021. Patient has not tested positive for COVID-19 since having the vaccine. Patient is not enrolled in clinical trial. Outcome of the event clammy was not recovered, for other events was recovered. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1875290 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG7387 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Electrocardiogram, Headache, Loss of consciousness, Malaise, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: blood pressure measurement; Result Unstructured Data: Test Result:unknown results; Test Name: ECG; Result Unstructured Data: Test Result:unknown results
CDC Split Type: ITPFIZER INC202101502795

Write-up: loss of consciousness; convulsions; malaise; persistent headache; fainting; This is a spontaneous report from a contactable consumer downloaded from the regulatory authority-WEB, regulatory authority number IT-MINISAL02-804334. A 24-years-old female patient received bnt162b2 (COMIRNATY), dose 1 via an unspecified route of administration on 27Sep2021 (Batch/Lot Number: FG7387) (at the age of 24-years-old) as DOSE 1, SINGLE for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced fainting, loss of consciousness, convulsions, malaise, persistent headache all on 27Sep2021. At 15 minutes after the first dose, the patient was feeling unwell on 27Sep2021. The nurse was informed that the pressure was measured and subsequent loss of consciousness for about 1 minute with convulsions. The patient was transferred to hospital with Electrocardiogram (ECG) execution. From 27Sep2021 the strong and disabling headache persisted. Symptoms were present until about 13Oct2021. Subsequently in regression and on 22Oct2021 performed the second dose of vaccine. The patient was taking Moment Act and Aspirin for headache and magnesium and vitamin B12. Therapeutic measures were taken as a result of the event headache. The outcome of the events was resolving. No follow-up attempts possible. No further information expected.


VAERS ID: 1875299 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-26
Onset:2021-09-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dysstasia, Muscular weakness, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.; Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.; Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.; Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.; This case was initially received via European Medicines Agency (Reference number: IT-MINISAL02-804438) on 08-Nov-2021. The most recent information was received on 08-Nov-2021 and was forwarded to Moderna on 08-Nov-2021. This regulatory authority case was reported by a consumer and describes the occurrence of MYALGIA (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.), PAIN IN EXTREMITY (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.), DYSSTASIA (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.) and MUSCULAR WEAKNESS (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.) in a 32-year-old female patient who received mRNA-1273 (Spikevax) for COVID-19 immunisation. No Medical History information was reported. On 26-Sep-2021, the patient received dose of mRNA-1273 (Spikevax) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced MYALGIA (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.) (seriousness criterion medically significant), PAIN IN EXTREMITY (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.) (seriousness criterion medically significant), DYSSTASIA (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.) (seriousness criterion medically significant) and MUSCULAR WEAKNESS (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.) (seriousness criterion medically significant). At the time of the report, MYALGIA (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.), PAIN IN EXTREMITY (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.), DYSSTASIA (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.) and MUSCULAR WEAKNESS (Myalgia in the lower limbs. Started with weakness in the lower legs on the following day. Severe pain at the knee, calf and heel with difficulty standing.) had not resolved. Concomitant product use was not provided by the reporter. Patient experienced difficulty performing simple daily activities. The pain remains, though is milder, even when seated. Patient also experienced inability to work and after four hours of standing the legs hurt a lot. No treatment information was provided. Company Comment This regulatory authority case concerns a 32-year-old female patient with no relevant medical history who experienced serious unexpected events of myalgia, pain in extremity, dysstasia and muscular weakness who also complained of arthralgia, impaired work ability and lack of personal independence in daily activities. The events occurred approximately one day after the unspecified dose of the Moderna COVID-19 vaccine . Initially, the patient complained of myalgia in the lower limbs, with lower legs weakness the following day. The patient also experienced pain in knee, calf and heel with difficulty standing. The patient had difficulty performing simple daily activities. At the time of the report, the patient still persists however, it milder. The patient is unable to work due to leg pain after standing for hours at work. Rechallenge was not applicable since due to lack of information regarding number of doses administered, no rechallenge was done and therefore, recurrence was not applicable. The benefit-risk relationship of product is not affected by this report. Most recent FOLLOW-UP information incorporated above includes: On 08-Nov-2021: Significant follow-up received on 08-NOV-2021 contains seriousness criteria was updated. On 08-Nov-2021: Translated document received on 09-Nov-2021 contains event verbatim and narrative was updated.; Sender''s Comments: This regulatory authority case concerns a 32-year-old female patient with no relevant medical history who experienced serious unexpected events of myalgia, pain in extremity, dysstasia and muscular weakness who also complained of arthralgia, impaired work ability and lack of personal independence in daily activities. The events occurred approximately one day after the unspecified dose of the Moderna COVID-19 vaccine . Initially, the patient complained of myalgia in the lower limbs, with lower legs weakness the following day. The patient also experienced pain in knee, calf and heel with difficulty standing. The patient had difficulty performing simple daily activities. At the time of the report, the patient still persists however, it milder. The patient is unable to work due to leg pain after standing for hours at work. Rechallenge was not applicable since due to lack of information regarding number of doses administered, no rechallenge was done and therefore, recurrence was not applicable. The benefit-risk relationship of product is not affected by this report


VAERS ID: 1875569 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-22
Onset:2021-09-27
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB, Blood pressure measurement, Blood test, Body temperature, Cardiac failure, Echocardiogram, Ejection fraction, Heart rate, Myocarditis, N-terminal prohormone brain natriuretic peptide, Oxygen saturation, Respiratory rate, Troponin
SMQs:, Cardiac failure (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211004; Test Name: CK-MB; Result Unstructured Data: Test Result:24 IU/l; Test Date: 20211005; Test Name: CK-MB; Result Unstructured Data: Test Result:21 IU/l; Test Date: 20211004; Test Name: Blood pressure; Result Unstructured Data: Test Result:122 / 65 mmHg; Test Date: 20211005; Test Name: Blood pressure; Result Unstructured Data: Test Result:126/80 mmHg; Test Date: 20211008; Test Name: Blood test; Result Unstructured Data: Test Result: Unknown results; Test Date: 20211004; Test Name: Body temperature; Result Unstructured Data: Test Result:35.9 Centigrade; Test Date: 20211005; Test Name: Echocardiogram; Result Unstructured Data: Test Result:eccentric left ventricular hypertrophy, mild left; Comments: ventricular systolic dysfunction (left ventricular ejection fraction: 40 %).; Test Date: 20211008; Test Name: heart supersonic examination; Result Unstructured Data: Test Result:Unknown results; Test Date: 20211005; Test Name: Heart rate; Result Unstructured Data: Test Result:68; Test Date: 20211004; Test Name: Pulse rate; Result Unstructured Data: Test Result:85; Comments: times / score; Test Date: 20211004; Test Name: NT-proBNP; Result Unstructured Data: Test Result:16 pg/mL; Test Date: 20211004; Test Name: O2 saturation; Test Result: 97 %; Test Date: 20211004; Test Name: Respiratory rate; Result Unstructured Data: Test Result:18; Comments: times / min; Test Date: 20211004; Test Name: Troponin; Result Unstructured Data: Test Result:53 ng/L; Test Date: 20211005; Test Name: Troponin; Result Unstructured Data: Test Result:21 ng/L; Test Date: 20211005; Test Name: left ventricular ejection fraction; Test Result: 40 %
CDC Split Type: TWPFIZER INC202101571752

Write-up: MYOCARDITIS (MYOCARDITIS); HEART FAILURE; This is a spontaneous report from a non-contactable healthcare professional via Agency Regulatory Authority(Regulatory authority report number: TW-TFDA-TVS-1100009275), based on information received by Pfizer from BioNTech (manufacturer control number: TW-Fosun-2021FOS004600), license party for bnt162b2 (COMIRNATY). This is a spontaneous report received from a non-contactable HCP received via Agency Regulatory Authority. The regulatory authority report number is TW-TFDA-TVS-1100009275. A 16-year-old male patient started to receive a dose of (COMIRNATY) (batch number was reported as unknown) on 22Sep2021 via unknown route of administration at dose number unknown, single for COVID-19 immunization. Medical history was not reported. Concomitant medications and past product were not reported. The patient experienced myocarditis and heart failure on 27Sep2021. On 22Sep2021, the patient was injected BNT vaccine. From 27Sep2021 to 29Sep2021, the patient experienced occasional chest tightness chest pain. From 30Sep2021 to 01Oct2021, the patient''s symptoms have improved, and the uncomfortable can improved after have a rest. On 04Oct2021, the patient felt astham, chest tightness when the patient running and boating. At 7:00, the patient went to emergency, underwent the lab test of electrocardiogram, chest X-ray and blood test. Oxygen saturation (O2 SAT): 97%, body temperature: 35.9 centigrate, pulse: 85 times / score, respiratory rate: 18 times / min, blood pressure: 122 / 65mmHg. On 04Oct2021, high-sensitivity troponin (HS Troponint): 53 ng / L, NT-ProbNP: 16 pg / mL, CK-MB: 24 U / L. On 05Oct2021, high-sensitivity troponin (HS Troponint): 21 ng / L, CK-MB: 21 U / L. On 05Oct2021, the patient visited a doctor and underwent the lab test of electrocardiographs and heart supersonic inspections. It showed blood pressure (BP) 126/80 mmHg, heart rate (HR): 68 beats / min. Check results shown that: SM grade I overlsb (unspecified). On 05Oct2021, echocardiogram: eccentric left ventricular hypertrophy, mild left ventricular systolic dysfunction (left ventricular ejection fraction: 40 %).The patient instructed by the doctors for taking drugs: Diovan 160mg for each tablet (Valsartan), 0.5 tablet orally once daily after meals for 28 days (14 tablets); Syntrend 6.25mg for each tablet (Carvedilol), 1 tablet orally once daily for 28 days (28 tablets); FORXIGA 10mg for each table (Dapagliflozin), 1 tablet orally once daily before meals for 28 days (28 tablets);Uretropic 40mg for each tablet (Furosemide), 1 tablet orally once daily after meals for 7 days (7 tablets); Xanax 0.5mg for each tablet (Tube 4) (Alprazolam), 0.5 tablet orally once daily hora somni for 7 days (4 tablets). Physician diagnosis: mild heart failure and mitral valve prolapse, suspected myocarditis combined heart failure. The symptoms of chest pain, palpitations, and weak breathing are not improved. On 08Oct2021, the patient underwent the lab test of heart supersonic examination and blood test. Myocarditis and heart failure met the seriousness criterion of hospitalization. At the time of the report, the outcome of events were not recovered. Initial report was received on 03Nov2021. Follow-up closed, no further information is possible. The reporter and the company (BioNTech) both considered the events heart failure and acute myocarditis were possibly related to bnt162b2. No follow-up attempts are possible. Information on batch/lot number cannot be obtained. No further information expected.


VAERS ID: 1875642 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Bone pain, Cardiac imaging procedure, Chest pain, Dyspnoea exertional, Electrocardiogram, Electrocardiogram ambulatory, Neuromuscular pain, Troponin I
SMQs:, Peripheral neuropathy (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211013; Test Name: Cardiac imaging procedure; Result Unstructured Data: Test Result:Dilatation of la. Normal lv systolic function with; Comments: Dilatation of la. Normal lv systolic function with Normal Wall Motion. Normal RV Systolic Function with Normal Wall Motion. Grade 1 DiaStolic Dysfunction. Trivial TR.; Test Date: 20211013; Test Name: ECG; Result Unstructured Data: Test Result:EXERCISE LOADING; Test Date: 20211013; Test Name: ECG; Result Unstructured Data: Test Result:NORMAL SINUS RHYTHM; Test Date: 20211013; Test Name: Holter monitoring; Result Unstructured Data: Test Result:Normal; Test Date: 20211013; Test Name: Troponin I; Result Unstructured Data: Test Result:normal
CDC Split Type: TWPFIZER INC202101572720

Write-up: NEUROMUSCULAR SKELETON PAIN; NEUROMUSCULAR SKELETON PAIN; DYSPNEA ON EXERTION; CHEST PAIN; This is a spontaneous report from a non-contactable healthcare professional via regulatory authority (Regulatory authority report number: TW-TFDA-TVS-1100010174), based on information received by Pfizer from BioNTech SE (manufacturer control number: TW-Fosun-2021FOS004765), license party for bnt162b2 (COMIRNATY). This is a spontaneous report received from a non-contactable HCP received via Taiwan Center for Disease Control. The regulatory authority report number is TW-TFDA-TVS-1100010174. A 50-year-old male patient started to receive a dose of Tozinameran (COMIRNATY) (batch number: was not reported) on 27Sep2021 via Intramuscular at unknown dose with unspecified dosing frequency for COVID-19 immunization. Medical history, concomitant medication and past product were not reported. The patient experienced neuromuscular skeleton pain, dyspnea on exertion and chest pain on 27Sep2021. On 27Sep2021, The patient received a dose of vaccination. On the evening of 27Sep2021, The patient experienced Chest Pain, which was described as stabbing pain, Especially During Particular Movements. It Was Accompanied with Palpitation, Chest Tightness, Dyspnea on exertion, Left chest pain. On 30Sep2021, the patient was hospitalized. On 13Oct2021, the patient discharged. Related Diagnostics included Neuromuscular skeleton pain, Troponin i: Normal, Treadmill ECG Test: adequate EXERCISE LOADING, Negative for Ischemia. Cardiac 2D echo: Dilatation of la. Normal lv systolic function with Normal Wall Motion. Normal RV Systolic Function with Normal Wall Motion. Grade 1 DiaStolic Dysfunction. Trivial TR. ECG TEST: NORMAL SINUS RHYTHM. Holter Monitor: Normal. On 15Oct2021, The patient said that he has been discharged from hospital, and there is still chest tightness, chest pain, palpitations symptoms, and the patient had blood sugar and blood fat after injection of the vaccine (original no chronic medical history), the current medicine control, expect to go back to the Site next week Division of Division. VICP has been informed. The events met the seriousness criterion of Caused Hospitalisation. The action taken for Tozinameran (COMIRNATY) regarding the chest pain was not applicable. At the time of the report, the outcomes of events were unknown. Initial report was received on 03Nov2021. Follow-up closed, no further information is possible Causality assessment: Neuromuscular pain; Dyspnoea exertional; Chest pain Per Reporter=Possible, Per Company=Possible.


VAERS ID: 1876288 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-30
Onset:2021-09-27
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD6840 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No
CDC Split Type: ATPFIZER INC202101523071

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB AT-BASGAGES-2021-052814. This is a report from regulatory authority. This is first of two reports concerning the same patient. A 49-year-old female patient received bnt162b2 (COMIRNATY), dose 2 intramuscular on 30Jun2021 (Lot Number: FD6840) as dose 2, single, dose 1 intramuscular on 19May2021 (Lot Number: FA4598) as dose 1, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced vaccination failure (as reported) and sars-cov-2 infection on 27Sep2021. The events were serious medically significant with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive on 27Sep2021 (Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No). No follow-up attempts are possible, no further information is expected.; Sender''s Comments: Linked Report(s) : AT-PFIZER INC-202101553775 same patient and drug, different events


VAERS ID: 1876289 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-05-27
Onset:2021-09-27
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC0681 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Variant Sequenced: (blank) n501y-positive: No
CDC Split Type: ATPFIZER INC202101523093

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-052816. A 64-year-old male patient received bnt162b2 (COMIRNATY), intramuscular on 27May2021 (Batch/Lot Number: FC0681) as dose 2, single and intramuscular on 22Apr2021 (Batch/Lot Number: EW4815) as dose 1, single, for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced SARS-CoV-2 infection, other and Vaccination failure. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive on 27Sep2021 (Variant PCR-based: B.1.617.2 Variant Sequenced: (blank) n501y-positive: No). The outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1876292 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-12
Onset:2021-09-27
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE8244 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: unknown, Sequenced variant: n501y-positive: unknown
CDC Split Type: ATPFIZER INC202101522858

Write-up: SARS-CoV-2 infection; Vaccination failure; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-052825. A 13-year-old male patient received bnt162b2 (COMIRNATY) intramuscularly on 12Sep2021 (Batch/Lot Number: FE8244) as dose 2, single and intramuscularly on 22Aug2021 (Batch/Lot Number: FF0680) as dose 1, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced SARS-CoV-2 infection and vaccination failure on 27Sep2021. The patient underwent lab tests and procedures which included COVID-19 PCR test (27Sep2021): Positive (Variant PCR-based: unknown, Sequenced variant: n501y-positive: unknown). Outcome of events was unknown. No follow-up attempts are possible, no further information is expected.


VAERS ID: 1876294 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-07
Onset:2021-09-27
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD6840 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Variant PCR-based: B.1.617.2.; Result Unstructured Data: Test Result:Variant Sequenced: 01y-positive: No
CDC Split Type: ATPFIZER INC202101522581

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from a Regulatory Authority, regulatory authority number is AT-BASGAGES-2021-052829. A 37-year-old male patient received BNT162B2 (COMIRNATY, Solution for injection), intramuscular on 07Jul2021 (Batch/Lot Number: FD6840) as dose 2, single; and intramuscular on 21May2021 (Batch/Lot Number: FA4598) as dose 1, single both for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced SARS-CoV-2 infection, other, vaccination failure. The events were reported as serious. The patient underwent lab tests and procedures which included variant PCR-based: B.1.617.2.: sequenced variant: n501y-positive: no on 27Sep2021. The outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1876311 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-13
Onset:2021-09-27
   Days after vaccination:76
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE6208 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Variant Sequenced: n501y-positive: No
CDC Split Type: ATPFIZER INC202101523184

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB AT-BASGAGES-2021-052864. This is a report from regulatory authority. A 44-year-old female patient received bnt162b2 (COMIRNATY), dose 2 intramuscular on 13Jul2021 (Lot Number: FE6208) as dose 2, single, dose 1 intramuscular on 22Jun2021 (Lot Number: FD4555) as dose 1, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced vaccination failure and sars-cov-2 infection on 27Sep2021. The events were serious as medically significant with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive on 27Sep2021 (Variant PCR-based: B.1.617.2 Variant Sequenced: n501y-positive: No). No follow-up attempts are possible. No further information is expected.


VAERS ID: 1876317 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-25
Onset:2021-09-27
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD4555 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101522692

Write-up: Drug ineffective; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-052874. This is the first of two reports. A 41-year-old female patient received two doses of BNT162b2 (COMIRNATY), dose 2 on 25Jun2021 (Lot Number: FD4555) and dose 1 on 12May2021 (Lot Number: EY7015), both intramuscular as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced SARS-CoV-2 infection on 27Sep2021 with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive (Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No) on 27Sep2021. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : AT-PFIZER INC-202101553966 LOE/At risk


VAERS ID: 1876318 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-03-17
Onset:2021-09-27
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 300042721 / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: ATMODERNATX, INC.MOD20213

Write-up: Vaccination failure; SARS-CoV-2 infection; This case was received via Regulatory Authority (Reference number: AT-BASGAGES-2021-052875) on 09-Nov-2021 and was forwarded to Moderna on 09-Nov-2021. This regulatory authority case was reported by a physician and describes the occurrence of VACCINATION FAILURE (Vaccination failure) and COVID-19 (SARS-CoV-2 infection) in a 51-year-old male patient who received mRNA-1273 (Spikevax) (batch nos. 3001177 and 300042721) for COVID-19 vaccination. No Medical History information was reported. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Spikevax) (Intramuscular) 1 dosage form. On 14-Apr-2021, received second dose of mRNA-1273 (Spikevax) (Intramuscular) dosage was changed to 1 dosage form. On 27-Sep-2021, the patient experienced VACCINATION FAILURE (Vaccination failure) (seriousness criterion medically significant) and COVID-19 (SARS-CoV-2 infection) (seriousness criterion medically significant). At the time of the report, VACCINATION FAILURE (Vaccination failure) and COVID-19 (SARS-CoV-2 infection) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Sep-2021, SARS-CoV-2 test: positive (Positive) Positive. For mRNA-1273 (Spikevax) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Treatment information was not provided. Company Comment: This case concerns a 51-year-old, male patient with no relevant medical history reported, who experienced the unexpected events of COVID-19 (AESI) and vaccination failure. The events occurred 6 months and 11 days after the second dose of mRNA-1273 Moderna vaccine. The rechallenge was not applicable since the events happened after the second dose. The benefit-risk relationship of mRNA-1273 Moderna vaccine in not affected by this report. The seriousness was assessed by Regulatory Authority. Most recent FOLLOW-UP information incorporated above includes: On 09-Nov-2021: Translation received on 10-Nov-2021 and contains translated dosage text; Sender''s Comments: This case concerns a 51-year-old, male patient with no relevant medical history reported, who experienced the unexpected events of COVID-19 (AESI) and vaccination failure. The events occurred 6 months and 11 days after the second dose of mRNA-1273 Moderna vaccine. The rechallenge was not applicable since the events happened after the second dose. The benefit-risk relationship of mRNA-1273 Moderna vaccine in not affected by this report. The seriousness was assessed by Regulatory Authority.


VAERS ID: 1876327 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-10
Onset:2021-09-27
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9788 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2. Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101522769

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-052890. A 43-year-old male patient received two doses of BNT162b2 (COMIRNATY), dose 2 on 10Feb2021 (Lot Number: EK9788) and dose 1 on 20Jan2021 (Lot Number: EJ6797), both intramuscular as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced SARS-CoV-2 infection/vaccination failure on 27Sep2021 with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive (Variant PCR-based: B.1.617.2. Sequenced variant: n501y-positive: No) on 27Sep2021. No follow-up attempts possible. No further information expected.


VAERS ID: 1876336 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-25
Onset:2021-09-27
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF3318 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2. Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101522835

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority, regulatory authority number AT-BASGAGES-2021-052909. A 27-year-old female patient received two doses of BNT162b2, dose 2 on 25Jul2021 (Lot Number: FF3318) and dose 1 on 06Jul2021 (Lot Number: FE6208), both intramuscular as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced SARS-CoV-2 infection/vaccination failure on 27Sep2021 with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive (Variant PCR-based: B.1.617.2. Sequenced variant: n501y-positive: No) on 27Sep2021. No follow-up attempts possible. No further information expected.


VAERS ID: 1876337 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-02-11
Onset:2021-09-27
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6136 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2. Variant Sequenced: not reported, n501y-positive: no
CDC Split Type: ATPFIZER INC202101523222

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority, regulatory authority number AT-BASGAGES-2021-052913. A 45-years-old female patient received two doses of BNT162B2, the first dose on 21Jan2021 (Lot. EJ6134) and the second dose on 11Feb2021 (Lot. EJ6136), both intramuscularly, at single dose, for COVID-19 immunisation. Relevant medical history, concurrent conditions and concomitant medications were unknown. The patient''s weight was not reported, and height was not reported. The patient experienced SARS-CoV-2 infection, vaccination failure on 27Sep2021. The events SARS-CoV-2 infection, vaccination failure were serious as medically significant with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive on 27Sep2021, Variant PCR-based: B.1.617.2. Variant Sequenced: not reported, n501y-positive: no. No follow-up attempts are possible. No further information expected.


VAERS ID: 1876343 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-02-16
Onset:2021-09-27
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6790 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2; Sequenced variant: not reported; n501y-positive: No
CDC Split Type: ATPFIZER INC202101508363

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority (RA)-WEB, regulatory authority number AT-BASGAGES-2021-052977. An 81-year-old female patient received BNT162B2 (COMIRNATY), intramuscular on 26Jan2021 (Lot Number: EJ6134) as dose 1, single then on 16Feb2021 (Lot Number: EJ6790) as dose 2, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient''s weight and height were not reported. On 27Sep2021 the patient experienced SARS-CoV-2 infection, other, vaccination failure. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive on 27Sep2021, variant PCR-based: B.1.617.2; Sequenced variant: not reported; n501y-positive: No. The outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1876344 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-09
Onset:2021-09-27
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD6840 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-basiert: B.1.617.2 Sequenced variant: n501y-positive: No
CDC Split Type: ATPFIZER INC202101508369

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority, regulatory authority number is AT-BASGAGES-2021-052978. A 43-year-old female patient received BNT162B2, intramuscular on 09Jul2021 (Lot Number: FD6840) as dose 2, single and via unspecified indication on 28May2021 (Lot Number: FC2473) as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient experienced SARS-CoV-2 infection with positive COVID-19 PCR test (Variant PCR-basiert: B.1.617.2; n501y-positive: No) and had vaccination failure on 27Sep2021. The outcome of events was unknown. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1876350 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-28
Onset:2021-09-27
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF0680 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Variant Sequenced: n501y-positive: No
CDC Split Type: ATPFIZER INC202101508481

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053018. A 49-year-old female patient received bnt162b2 (COMIRNATY), intramuscular on 16Jun2021 (Batch/Lot Number: FD0168) as DOSE 1, SINGLE and then intramuscular on 28Jul2021 (Batch/Lot Number: FF0680) as DOSE 2, SINGLE for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced vaccination failure and SARS-CoV-2 infection on 27Sep2021. The reporter assessed the events as serious medically significant. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive (Variant PCR-based: B.1.617.2 Variant Sequenced: n501y-positive: No) on 27Sep2021. The outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1876355 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-03
Onset:2021-09-27
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE6208 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: Variant Sequenced: n501y-positive: Unknown
CDC Split Type: ATPFIZER INC202101508540

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority, regulatory authority number AT-BASGAGES-2021-053031. A 46-year-old female patient received bnt162b2, dose 2 intramuscular on 03Jul2021 (Lot Number: FE6208) and dose 1 intramuscular on 03Jun2021 (Lot Number: FC2473); both as single doses for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient''s weight was not reported, and height was not reported. On 27Sep2021 the patient experienced SARS-CoV-2 infection, other, Vaccination failure. The patient underwent lab tests and procedures which included SARS-CoV-2 test: positive on 27Sep2021 (Variant PCR-based: , Variant Sequenced: , n501y-positive: Unknown). The outcome of the events was unknown. This is a serious spontaneous report. No follow-up attempts are possible. No further information expected.


VAERS ID: 1876366 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-05-12
Onset:2021-09-27
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY7015 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: n501y-positive: Unknown; Result Unstructured Data: Test Result:n501y-positive: Unknown; Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive
CDC Split Type: ATPFIZER INC202101508196

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority, regulatory authority number AT-BASGAGES-2021-053076. A 73-years-old male patient received bnt162b2 (solution for injection, Batch/Lot Number: EY7015), dose 2 intramuscular on 12May2021 as dose 2, single and dose 1 intramuscular on 21Apr2021 (Batch/Lot Number: EW4815) as dose 1, single for covid-19 immunization. The patient''s medical history was not reported. There were no concomitant medications. The patient experienced sars-cov-2 infection and vaccination failure on 27Sep2021. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 27Sep2021, investigation: n501y-positive: unknown on 2021. The outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1876368 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-13
Onset:2021-09-27
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0168 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: Sequenced variant: n501y-positive: Unknown
CDC Split Type: ATPFIZER INC202101522647

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority, regulatory authority number AT-BASGAGES-2021-053103. This case was split as its LOE after second dose and Inappropriate Schedule of administration. This is the first of two reports, describing LOE events. A 61-year-old male patient received first dose of BNT162B2 (solution for injection) intramuscularly on 01May2021 (Batch/Lot Number: EY3014) as dose 1, single and second dose intramuscularly on 13Jun2021 (Batch/Lot Number: FD0168) as dose 2, single, both for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 27Sep2021 the patient experienced SARS-CoV-2 infection and vaccination failure (as reported). The patient underwent lab test which included COVID-19 PCR test: positive (Variant PCR-based: Sequenced variant: n501y-positive: Unknown) on 27Sep2021. Events were assessed as serious, medically significant. Outcome of both events was unknown. No follow-up attempts possible. No further information expected.; Sender''s Comments: Linked Report(s) : AT-PFIZER INC-202101553970 same patient, reporter, product; different dose and events


VAERS ID: 1876371 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-29
Onset:2021-09-27
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6134 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101523376

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053109. A 91-year-old female patient received two doses of BNT162b2 (COMIRNATY), dose 2 on 29Jan2021 (Lot Number: EJ6134) and dose 1 on 08Jan2021 (Lot Number: EJ6796), both intramuscular as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced SARS-CoV-2 infection/vaccination failure on 27Sep2021 with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive (Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No) on 27Sep2021. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1876375 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-04
Onset:2021-09-27
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6136 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2. Sequenced variant: n501y-positive: No
CDC Split Type: ATPFIZER INC202101523393

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician from the Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053115. A 70-year-old male patient received bnt162b2 (COMIRNATY), dose 2 intramuscular on 04Feb2021 (Batch/Lot Number: EJ6136) as single dose and dose 1 intramuscular on 14Jan2021 (Batch/Lot Number: EL1491) as single dose for covid-19 immunisation. The patient medical history and the patient''s concomitant medications were none. The patient experienced sars-cov-2 infection on 27Sep2021 with outcome of unknown. The patient underwent lab test which included sars-cov-2 test: positive on 27Sep2021 (Variant PCR-based: B.1.617.2. Sequenced variant: n501y-positive: No). No follow-up attempts possible. No further information expected.


VAERS ID: 1876377 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-12
Onset:2021-09-27
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE6208 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Test Date: 20210927; Test Name: Polymerase chain reaction (PCR) -based variant; Result Unstructured Data: Test Result:B.1.617.2; Comments: n501y-positive: No Sequenced variant: not provided
CDC Split Type: ATPFIZER INC202101508473

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053126. A 12-years-old female patient received bnt162b2 (COMIRNATY, solution for injection), intramuscular on 12Aug2021 (Lot Number: FE6208, expiry date not reported) as dose 2, single; and intramuscular on 22Jul2021 (Lot Number: FD6840, expiry date not reported) as dose 1, single; for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. It was unknown if the patient was pregnant at the time of the report. On 27Sep2021, the patient experienced vaccination failure and SARS-CoV-2 infection, which were reported as serious medically significant events. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive on 27Sep2021, and Polymerase chain reaction (PCR) -based variant: B.1.617.2 (Sequenced variant: not provided; n501y-positive: No). The outcome of the events was unknown. No follow-up attempts are possible. No further information expected.


VAERS ID: 1876381 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-16
Onset:2021-09-27
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE6208 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2. Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101522666

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-053141. A 26-years-old female patient received bnt162b2 (COMIRNATY), dose 2 intramuscular on 16Jul2021 (Batch/Lot Number: FE6208) as single dose and dose 1 intramuscular on 12Jun2021 (Batch/Lot Number: FD0168) as single dose for covid-19 immunisation. The patient medical history and the patient''s concomitant medications were none. The patient experienced sars-cov-2 infection on 27Sep2021 with outcome of unknown. The patient underwent lab test which included sars-cov-2 test: positive on 27Sep2021 (Variant PCR-based: B.1.617.2. Sequenced variant: n501y-positive: No). No follow-up attempts possible. No further information expected.


VAERS ID: 1876383 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-17
Onset:2021-09-27
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE6208 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No
CDC Split Type: ATPFIZER INC202101523591

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from a Regulatory Authority, regulatory authority number AT-BASGAGES-2021-053144. This is the first of two reports. A 55-year-old female patient received bnt162b2 (COMIRNATY), dose 2 intramuscular on 17Jul2021 (Lot Number: FE6208) as DOSE 2, SINGLE, dose 1 intramuscular on 05Jun2021 (Lot Number: FD1921) as DOSE 1, SINGLE for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced vaccination failure (medically significant), SARS-CoV-2 infection (medically significant) with outcome of unknown. The patient underwent lab tests and procedures which included SARS-CoV-2 test: positive on 27Sep2021 (Variant PCR-based: B.1.617.2, Sequenced variant: n501y-positive: No). No follow-up attempts possible. No further information expected.; Sender''s Comments: Linked Report(s) : AT-PFIZER INC-202101554428 Same patient, same vaccine, different event


VAERS ID: 1876384 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-03-31
Onset:2021-09-27
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3001531 / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: ATMODERNATX, INC.MOD20213

Write-up: Vaccination failure; SARS-CoV-2 infection; This case was received via reglatory Agency (Reference number: AT-BASGAGES-2021-053145) on 09-Nov-2021 and was forwarded to Moderna on 09-Nov-2021. This regulatory authority case was reported by a physician and describes the occurrence of VACCINATION FAILURE (Vaccination failure) and COVID-19 (SARS-CoV-2 infection) in a 78-year-old male patient who received mRNA-1273 (Spikevax) (batch nos. 3001939 and 3001531) for COVID-19 vaccination. No Medical History information was reported. On 31-Mar-2021, the patient received first dose of mRNA-1273 (Spikevax) (Intramuscular) 1 dosage form. On 28-Apr-2021, received second dose of mRNA-1273 (Spikevax) (Intramuscular) dosage was changed to 1 dosage form. On 27-Sep-2021, the patient experienced VACCINATION FAILURE (Vaccination failure) (seriousness criterion medically significant) and COVID-19 (SARS-CoV-2 infection) (seriousness criterion medically significant). At the time of the report, VACCINATION FAILURE (Vaccination failure) and COVID-19 (SARS-CoV-2 infection) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Sep-2021, SARS-CoV-2 test: positive (Positive) Positive. For mRNA-1273 (Spikevax) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications was provided. This case concerns a 78-year-old, male patient with no relevant medical history reported, who experienced the unexpected events of COVID-19 (AESI) and vaccination failure. The events occurred 5 months and 2 days after the second dose of mRNA-1273 Moderna vaccine. The rechallenge was not applicable since the events happened after the second dose. The benefit-risk relationship of mRNA-1273 Moderna vaccine in not affected by this report. The seriousness was assessed by Regulatory Authority.; Sender''s Comments: This case concerns a 78-year-old, male patient with no relevant medical history reported, who experienced the unexpected events of COVID-19 (AESI) and vaccination failure. The events occurred 5 months and 2 days after the second dose of mRNA-1273 Moderna vaccine. The rechallenge was not applicable since the events happened after the second dose. The benefit-risk relationship of mRNA-1273 Moderna vaccine in not affected by this report. The seriousness was assessed by Regulatory Authority.


VAERS ID: 1876387 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-22
Onset:2021-09-27
   Days after vaccination:67
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE6208 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Sequenced variant: n501y-positive: No.
CDC Split Type: ATPFIZER INC202101508198

Write-up: Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority (RA) -WEB, regulatory authority number AT-BASGAGES-2021-053220. A 17-years-old female patient received first dose bnt162b2 (COMIRNATY, solution for injection, lot number: FD0168), via intramuscular route of administration on 16Jun2021 as dose 1, single for covid-19 immunisation and second dose of bnt162b2 (COMIRNATY, solution for injection, lot number was FE6208), via intramuscular route of administration on 22Jul2021 as dose 2, single for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. On 27Sep2021, the patient experienced SARS-CoV-2 infection, other and vaccination failure. The report was assessed as serious by health authority. On 27Sep2021, the patient underwent lab tests and procedures which included sars-cov-2 test as positive, variant PCR-based B.1.617.2, sequenced variant, n501y-positive: no. The clinical outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1877962 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-01
Onset:2021-09-27
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002542 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Right arm; Nausea; Headache; This case was received via regulatory Agency (Reference number: DE-PEI-202100204999) on 09-Nov-2021 and was forwarded to Moderna on 09-Nov-2021. This regulatory authority case was reported by a consumer and describes the occurrence of HEADACHE (Headache), PARAESTHESIA (Right arm) and NAUSEA (Nausea) in a 28-year-old male patient who received mRNA-1273 (Spikevax) (batch nos. 3003609 and 3002542) for Prophylactic vaccination. No Medical History information was reported. On 01-Jun-2021, the patient received first dose of mRNA-1273 (Spikevax) (unknown route) 1 dosage form. On 30-Aug-2021, received second dose of mRNA-1273 (Spikevax) (unknown route) dosage was changed to 1 dosage form. On 27-Sep-2021, after starting mRNA-1273 (Spikevax), the patient experienced HEADACHE (Headache) (seriousness criterion hospitalization). On 06-Oct-2021, the patient experienced PARAESTHESIA (Right arm) (seriousness criterion hospitalization) and NAUSEA (Nausea) (seriousness criterion hospitalization). On 06-Oct-2021, PARAESTHESIA (Right arm) and NAUSEA (Nausea) had resolved. At the time of the report, HEADACHE (Headache) had not resolved. Medical history included underactive thyroid gland. Concomitant medication use information was not provided by reporter. It was reported that at night patient woke up and could no longer feel right arm. Motor function did not work and arm was completely cold. After trying to tighten the muscles over the shoulder blade, blood flow was restored and the motor function of the arm was restored. This was followed by paralysis in the right side of the face with subsequent nausea. Patient lay down, calmed down and fell asleep. After sleeping, patient had a headache that varied slightly in intensity but persisted despite medication (rizatriptan). This case concerns a 28-year-old, male patient with no relevant medical history, who experienced the unexpected events of headache, paresthesia and nausea, which required hospitalization. The events occurred approximately 28 day after the second dose of mRNA-1273. It was reported that at night patient woke up and could no longer feel right arm. Motor function did not work and arm was completely cold. After trying to tighten the muscles over the shoulder blade, blood flow was restored and the motor function of the arm was restored. This was followed by paralysis in the right side of the face with subsequent nausea. Patient lay down, calmed down and fell asleep. After sleeping, patient had a headache that varied slightly in intensity but persisted despite medication. The rechallenge was not applicable as events occurred after second dose and no further dosing was reported or planned, based on information provided. The benefit-risk relationship of mRNA-1273 is not affected by this report. Event seriousness assessed as per Regulatory Authority reporting. Most recent FOLLOW-UP information incorporated above includes: On 09-Nov-2021: Translation document received on 11 Nov 2021 include event Paresthesia verbatim updated, Medical history, event information and treatment information added in I-narrative from sender comments.; Sender''s Comments: This case concerns a 28-year-old, male patient with no relevant medical history, who experienced the unexpected events of headache, paresthesia and nausea, which required hospitalization. The events occurred approximately 28 day after the second dose of mRNA-1273. It was reported that at night patient woke up and could no longer feel right arm. Motor function did not work and arm was completely cold. After trying to tighten the muscles over the shoulder blade, blood flow was restored and the motor function of the arm was restored. This was followed by paralysis in the right side of the face with subsequent nausea. Patient lay down, calmed down and fell asleep. After sleeping, patient had a headache that varied slightly in intensity but persisted despite medication. The rechallenge was not applicable as events occurred after second dose and no further dosing was reported or planned, based on information provided. The benefit-risk relationship of mRNA-1273 is not affected by this report. Event seriousness assessed as per Regulatory Authority reporting.


VAERS ID: 1878636 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-25
Onset:2021-09-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1F039A / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: HKPFIZER INC202101558991

Write-up: BELL''S PALSY (LEFT); This is a spontaneous report from a non-contactable healthcare professional via Regulatory Authority (Regulatory Authority report number: DH/21/6276), based on information received by Pfizer from BioNTech SE (manufacturer control number: HK-Fosun-2021FOS005262), license party for BNT162B2 (COMIRNATY). A 56-years-old female patient received bnt162b2 (COMIRNATY Formulation: solution for injection, Lot Number: 1F039A) via unknown route of administration on 25Sep2021 as dose 2, single for COVID-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications and past product were not reported were not reported. The patient previously took first dose of bnt162b2 (COMIRNATY Formulation: solution for injection) via unspecified route of administration on an unknown date for COVID-19 immunisation. The patient experienced bell''s palsy on 27Sep2021. The patient experienced Bell''s palsy (Left) 2 days after vaccination with the 2nd dose of Comirnaty (27-Sep-2021). Bell''s palsy (Left) was considered as Important Medical Event. The outcome of event was unknown. Causality Assessments for event Bell''s palsy as per primary reporter and as per Company (BioNTech SE) was reported as possible. Follow-up closed, no further information is possible.


VAERS ID: 1878645 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-13
Onset:2021-09-27
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1F039A / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Myelitis transverse
SMQs:, Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: HKPFIZER INC202101566599

Write-up: Transverse myelitis; This is a spontaneous report from a non-contactable healthcare professional department of health (regulatory authority number: DH/21/6286) based on information received by Pfizer from BioNtech SE (manufacturer control number HK-Fosun-2021FOS005293), license party for bnt162b2 (COMIRNATY). This is a spontaneous report received from a non-contactable HCP received via Regulatory Authority. The regulatory authority report number is DH/21/6286. A 44-year-old female patient started to receive 1st dose of Tozinameran (COMIRNATY) (batch number: 1F039A) on 13-Sep-2021 via unknown route at unspecified dosing frequency for COVID-19 immunization. Medical history, concomitant medication(s) and past product were not reported. The patient experienced transverse myelitis 14 days after vaccination with the 1st dose of Comirnaty (27-Sep-2021). Transverse myelitis met the seriousness criterion of hospitalization. The action taken for Tozinameran (COMIRNATY) regarding the event was not applicable. At the time of the report, the outcome of the event was resolving. Initial report was received on 05-Nov-2021. Causality Assessment: Myelitis transverse. Per Reporter = Possible. Per Company (BioNTech SE) = Possible. Follow-up closed, no further information is possible.


VAERS ID: 1879070 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Blood creatine phosphokinase, Blood creatine phosphokinase MB, Dizziness, Echocardiogram, Electrocardiogram, Laboratory test, Myocarditis, Neurological examination, Troponin T
SMQs:, Anticholinergic syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211001; Test Name: Electrocardiogram; Result Unstructured Data: Test Result:sinus rhythm; Test Date: 20211001; Test Name: Laboratory test; Result Unstructured Data: Test Result:no leukocytosis; Comments: elevated cardiac enzymes of HS-Troponin T and creatine kinase (CK). The results of cardiac enzymes decreased in the next hour.; Test Date: 20211001; Test Name: Neurological examination; Result Unstructured Data: Test Result:no abnormality; Test Date: 20211001; Test Name: HS-TROPONIN T; Result Unstructured Data: Test Result:88 ng/L; Comments: (h); Test Date: 20211001; Test Name: HS-TROPONIN T; Result Unstructured Data: Test Result:67 ng/L; Comments: (h); Test Date: 20211001; Test Name: HS-TROPONIN T; Result Unstructured Data: Test Result:31 ng/L; Comments: (h); Test Date: 20211001; Test Name: CK; Result Unstructured Data: Test Result:406 IU/l; Comments: (h); Test Date: 20211001; Test Name: CK; Result Unstructured Data: Test Result:382 IU/l; Comments: (h); Test Date: 20211001; Test Name: CK-MB; Result Unstructured Data: Test Result:3.5 ng/ml; Test Date: 20211001; Test Name: CK-MB; Result Unstructured Data: Test Result:2.7 ng/ml; Test Date: 20211001; Test Name: Echocardiogram; Result Unstructured Data: Test Result:no significant defect
CDC Split Type: TWPFIZER INC202101571376

Write-up: MYOCARDITIS; DIZZINESS; This is a spontaneous report from a non-contactable healthcare professional via regulatory authority (regulatory authority number: TW-TFDA-TVS-1100009479), based on information received by Pfizer from BioNTech (manufacturer control number: TW-Fosun-2021FOS004740), license party for bnt162b2(COMIRNATY). This is a spontaneous report received from a non-contactable HCP received via regulatory authority. The regulatory authority report number is TW-TFDA-TVS-1100009479. A 15-year-old male patient started to receive the 1st dose of Tozinameran (COMIRNATY) (batch number was not reported) on 27-Sep-2021 via intramuscular at unknown dose with unspecified dosing frequency for COVID-19 immunization. Medical history, concomitant medication and past product were not reported. The patient experienced dizziness and myocarditis on 27-Sep-2021. On 27-Sep-2021, the patient received the 1st dose of BNT vaccine and experienced dizziness and headache. On 01-Oct-2021, the patient received neurological examination and it showed no abnormality. The patient received laboratory tests and it showed no leukocytosis, elevated cardiac enzymes of HS-Troponin T and creatine kinase (CK). The results of cardiac enzymes decreased in the next hour. The HS-Troponin T was checked 3 times and the results were 88, 67, 31 ng/L (h) respectively. The CK was checked twice and the results were 406, 382 Iu/L (h) respectively. The CK-MB was checked twice and the results were 3.5, 2.7 ng/ml respectively. The patient received electrocardiogram (EKG) examination and it showed sinus rhythm. The patient received cardiac echo examination and it showed no significant defect. On 03-Oct-2021, the patient''s situation was stable and discharged. Dizziness, myocarditis met the seriousness criterion of caused hospitalization. The actions taken for Tozinameran (COMIRNATY) regarding the events were not applicable. At the time of the report, the outcomes of the events were unknown. Initial report was received on 03-Nov-2021. Follow-up closed, no further information is possible. Causality Assessments with the drug Comirnaty for the events dizziness and myocarditis per reporter and per company was possible. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1879135 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1G042A-CDC / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: TWPFIZER INC202101571227

Write-up: SYNCOPE; DIZZINESS; This is a spontaneous report from a non-contactable healthcare professional via regulatory authority (regulatory authority number: TW-TFDA-TVS-1100009463), based on information received by Pfizer from BioNTech (manufacturer control number: TW-Fosun-2021FOS005185), license party for bnt162b2 (COMIRNATY). A 15-year-old female patient started to receive the 1st dose of Tozinameran (COMIRNATY) (batch/lot number: 1G042A-CDC) on 27-Sep-2021 (at the age of 15-year-old) via Intramuscular at dose 1, single for COVID-19 immunization. Medical history, concomitant medication and past product were not reported. The patient experienced dizziness on 27-Sep-2021, syncope on 29-Sep-2021. On 27-Sep-2021, the patient experienced dizziness after vaccination. On 29-Sep-2021, the patient experienced syncope. At the night of 29-Sep-2021, the patient was taken to Hospital (name redacted). According to telephone follow-up on 30-Sep-2021, the patient was in a stable situation and was required to drink more water and have more rest. On 05-Oct-2021, the patient recovered. Syncope met the seriousness criterion of Other Medically Important Condition. At the time of the report, the outcome of the events were recovered on 05Oct2021. Initial report was received on 03-Nov-2021. Follow-up closed, no further information is possible. Causality Assessments: Drug: Comirnaty. Events Syncope, Dizziness. Per Reporter = Possible; Per Company (BioNTech) = Possible. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1735499 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Neck pain, Tinnitus
SMQs:, Hearing impairment (narrow), Arthritis (broad)

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

Write-up: Wrist joint pain (both wrists), neck pain, shoulder joint pain, TINNITUS.


VAERS ID: 1735560 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-05
Onset:2021-09-26
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

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

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

Write-up: Pt returned to clinic on 9/26/21 for second dose of Pfizer COVID 19 vaccine and handed NP a vaccine card with a Janssen COVID vaccine admin on it. When questioned, pt states "I am going to be honest with you. I received a dose of Jannsen COVID 19 vaccine on 3/14/21, and a doctor told me that it was not keeping people from being intubated and to get the Pfizer also, so I signed up to received the Pfizer vaccine." informed patient that she could not received the second dose of Pfizer today and that it is not recommended to mix the vaccines or receive more than 1 vaccine series/ additional doses after being vaccinated with Janssen.


VAERS ID: 1735564 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048FLIA / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Presyncope
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Near syncope minutes after injection


VAERS ID: 1735568 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-23
Onset:2021-09-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: Severe diarrhea starting less than 72 hours after 1st Pfizer Covid-19 vaccine


VAERS ID: 1735574 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-01
Onset:2021-09-26
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Night sweats
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: Dutasteride0.5 mg, Pantoprazole40mg, Amlodipine2.5mg, Atorvastatin40mg,, Eliquis5mg, isosorbide mononitrate30mg,
Current Illness:
Preexisting Conditions: Heart murmur, triple bypass, herniated disc, stage 3 kidney disease, gall bladder removed.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Night-sweats. No treatment. No after effects.


VAERS ID: 1735613 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 1 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UT7376JA / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Dehydration, Dizziness
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Dehydration (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EMS stated that patient was dehydrated.
CDC Split Type:

Write-up: Pt felt dizzy and though he was going to pass out a couple of minutes after the shot. Blood pressure dropped to 109/63


VAERS ID: 1735615 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea exertional, Fatigue, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: Carvedilol, Lisinopril, aspirin, farxiga, protonix, sertraline
Current Illness: None
Preexisting Conditions: Dilated cardiomyopathy, under control as of now
Allergies: Penicillin allergy
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Fever and extreme fatigue day after shot. More important, and the reason to report, today I''ve been very short of breath with any exertion, and heart feels like it''s pounding.


VAERS ID: 1735625 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / IM

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

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

Write-up: Patient developed upper torso pruritus and 3 cm rash on right antecubital. Is being treated with 50mg diphenhydramine PRN TID x 3 days.


VAERS ID: 1735647 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cold sweat, Dizziness, Flushing, Hyperhidrosis, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Weakness-Mild, Additional Details: a female that came in with patient, was with him in vaccine waiting area. Hollered for help. We called 911 and pharmacist went to patient. Patient was helped to the ground from his chair and when asked his name he was able to respond. He had a pulse and was answering questions. Patient felt like he was clammy. We tried to take his blood pressure but got an error on the machine. EMS arrived quickly and checked his vitals and his blood sugar.


VAERS ID: 1735652 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Nausea
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Site: Bruising at Injection Site-Severe, Systemic: Nausea-Mild


VAERS ID: 1735656 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Dysphagia, Headache, Injection site erythema, Nausea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad)

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

Write-up: Site: Redness at Injection Site-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Headache-Medium, Systemic: Nausea-Mild, Additional Details: Sharp pain in left shoulder once


VAERS ID: 1735660 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1735666 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Product preparation error
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Medication errors (narrow)

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

Write-up: Patient was administered 0.3ml vaccine dose direct from vial (not diluted with NSS). The event was at 9:40am approximately and we were able to reach the patient at 2:30pm, which said she was ok, but experienced an episode of strong diarrhea. Doctor of patient will be called to be informed of the incident.


VAERS ID: 1735673 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, No adverse event, Wrong 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: unknown
Current Illness: hypertension
Preexisting Conditions: hypertension
Allergies: no known allegry
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came in to get a high dose flu shot, but technician mistakenly gave Moderna vaccine. Patient already finished her Covid vaccination series, but patient got Pfizer. No symptoms or adverse reaction reported at the time given.


VAERS ID: 1735674 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Headache, Respiratory disorder
SMQs:, Acute central respiratory depression (broad), Respiratory failure (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 ER 50mg, pregabalin100mg,muti-B vit,aspirin 81mg, potassium 99mg
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Adhesives
Diagnostic Lab Data: Chest x-rays
CDC Split Type:

Write-up: I have had a headache and respiratory problems ever since the second dose. And it seems to be getting worse. I have been given celebrex for the lungs and told to take tylenol for the headache. As of this date I still have both problems.


VAERS ID: 1735732 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Chest discomfort, Hallucination, Hyperhidrosis, Hypoaesthesia, Loss of consciousness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: prior history of seizures, no longer in need of seizure medication
Allergies: no known allergies
Diagnostic Lab Data: unknown at this time
CDC Split Type:

Write-up: Patient lost consciousness and had seizure activity. Upon regaining consciousness, patient became somewhat alert and reported loss of vision, which returned after a few minutes. He then reported hallucinations, numbness over whole body, and chest tightness. Could not find a radial pulse, but patient was breathing and fingernails remained pink. Patient was sweating through his shirt. 911 was called, responding within 10 minutes. Patient was transferred to a stretcher and taken to the hospital.


VAERS ID: 1735737 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Hyperhidrosis, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Patient Passed out immediately after giving vaccine, patient''s blood pressure was 68/47mmHg & pulse 52. Pt was sweating and hot. 911 was called and took her to the hospital for further check up.


VAERS ID: 1735738 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Presyncope, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient had vasovagal reaction. Fainted. Was able to communicate and give his mom''s phone number. Nurse, pharmacist and customer physician tended to the patient. He was still faint after 10 minutes so 911 was called and the squad took over patient care at that time.


VAERS ID: 1735740 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Paraesthesia oral
SMQs:, Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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: Simvastation
Current Illness:
Preexisting Conditions:
Allergies: Codine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt chills, Vitals were taken, Vitals within normal limits. Patient was in Obsveration for 60 mins, vitals still within normal limits, no chills/hot flashes, tingling sensation in mouth. Patient stated she has "cloudy" feeling. Patient able to tolerate foods and fliuds and able to communicate needs. NP visualize inside patients mouth/cleared. Patient was able to leave the clinc after 60 mins. patient is aware to follow up with MD if symtoms worsen.


VAERS ID: 1735765 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Erythema, Eye swelling, Hypersensitivity, Hyperventilation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: About 10 minutes after administration of Pfizer vaccine, patient started feeling shortness of breath and was hyperventilating. Her face was red and her eyes were swollen. Patient was administered Epipen 0.3mg in her right deltoid. Patient was driven by family member to Hospital to treat allergic reaction since it is 2 blocks away.


VAERS ID: 1735785 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Pain in extremity, Panic attack
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 159/102 157/84 99% 95% 97hr 69hr
CDC Split Type:

Write-up: PT complained of leg pain, chest closing and chest pain. She also had 2 panic attacks and had to be transported to the hospital.


VAERS ID: 1735786 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood glucose decreased, Blood pressure increased, Condition aggravated, Dizziness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Vestibular disorders (broad), Hypoglycaemia (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: Modafanil, Glimiperide, Desvenlafaxine, Metformin, Lisinopril, Amlodipine, Dicyclomine, Atorvastatin, Tamsulosin, Levothyroxine,
Current Illness: None
Preexisting Conditions: Diabetes, hypercholesterolemia, hypothyroidism, hypertension, other psychiatric diagnosis
Allergies: No known allergies
Diagnostic Lab Data: The patient''s blood pressure was 186/89, pulse 80. Blood glucose on first check was 51, after eating and waiting about 15 minutes it had increased to 98.
CDC Split Type:

Write-up: Within approximately 10 minutes after receiving this vaccination the patient reported feeling lightheaded and weak. He said that he thought his blood glucose was low (he had experienced low glucose levels before and said that the symptoms he was experiencing are typical for him when his glucose is low). I checked his blood pressure and his blood glucose level. His blood pressure was a bit elevated and his glucose was indeed low. I had him sit quietly in our vaccination room and had him eat a cereal bar and drink some orange juice. I rechecked his glucose approximately 15 minutes later and it had increased and the patient said he was feeling much better.


VAERS ID: 1735790 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-27
Onset:2021-09-26
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Dizziness, Fatigue, Headache, Hypoaesthesia, Lymphadenopathy, Nausea, Neck pain
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: swollen lymph nodes in the neck, chest, left side,. Dizzy, tired , nausea, left arm feels numb, headache that starts in the back of the neck and goes into my head.


VAERS ID: 1735801 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / UNK - / -

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

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

Write-up: Dizzy, sweaty and tingling in both hands.


VAERS ID: 1735810 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose 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: The patient received his primary series of Pfizer covid-19 vaccines on 04/01/2021 and 04/22/2021. He denied receiving any Covid-19 vaccine prior to the date of immunization on 9/26/2021. He received his booster dose less than six months after he received his primary series.


VAERS ID: 1735812 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Full spectrum CBD 25mg gummies
Current Illness: None
Preexisting Conditions: Endometriosis
Allergies: CT contrast dye
Diagnostic Lab Data: None. Emergency room visit with visual exam
CDC Split Type:

Write-up: Throat swelling. Delayed 11 hours after vaccine


VAERS ID: 1735826 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

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

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

Write-up: Right after giving her the vaccination while she was waiting the 15 minutes, she had nausea. She got up and walked around and felt better. She said she was ok.


VAERS ID: 1735833 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-14
Onset:2021-09-26
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Arterial disorder, C-reactive protein increased, Chest pain, Computerised tomogram thorax abnormal, Dyspnoea, Fibrin D dimer, Full blood count normal, Hyperhidrosis, Hypoxia, Intensive care, Lung disorder, Metabolic function test normal, Pallor, Pulmonary embolism, Respiratory viral panel, Scan with contrast abnormal, Viral test negative
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Morbid Obesity
Allergies: N/A
Diagnostic Lab Data: CBC and CMP were within normal limits. D-Dimer was 4,764.75, CRP 42.9, respiratory viral panel was negative. CT with contrast was obtained which revealed ''near occlusive filling defect in distal right main pulmonary artery, concerning for PE...clot burden extends into the RUL, RML, and RLL arteries.''
CDC Split Type:

Write-up: Patient reported to ED with 24 to 48 hour history of sudden onset chest pain and shortness of breath. On arrival patient was pale, diaphoretic, and hypoxic with O2 sats 60s-70s. Patient was placed on 15L HFNC. CT with contrast was obtained which revealed ''near occlusive filling defect in distal right main pulmonary artery, concerning for PE...clot burden extends into the RUL, RML, and RLL arteries.'' Heparin infusion was initiated and patient was transferred to PICU for higher level of care.


VAERS ID: 1735835 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Head injury, Injection site haemorrhage, Syncope, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Unknown details but patient expressed he experienced this with vaccines before but does not have a phobia of needles.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received his first dose of Moderna in his left deltoid muscle. There was some bleeding but nothing substantial (one cotton ball-full). Patient stood up and was fine. He spoke for approximately 2 minutes before he said, "Oh, I''m starting to feel it now." He then fainted against the wall and hit his head. He was alert but very out of it and began shaking. His father grabbed him and sat him up. The patient then vomited onto the ground. His father was able to raise him up in a chair. He felt lightheaded and said this has happened before. We called 911 and he left with EMS and his family.


VAERS ID: 1735836 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dysstasia, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Sexual dysfunction (broad)

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

Write-up: After the vaccine administration, when patient was about to go to the area of observation, she reports feeling dizzy and unable to get up. She reports her arm fell asleep.


VAERS ID: 1735843 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, magnesium, multivitamin, calcium, metoprolol, zoloft
Current Illness: None
Preexisting Conditions: Obesity
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diarrhea


VAERS ID: 1735844 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

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

Write-up: Tachycardia


VAERS ID: 1735849 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aurovela Fe 1/20
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I went to go get my flu vaccine and was accidentally administered a Pfizer COVID vaccine. I already received my first two doses of Pfizer 02/12/2021 and 03/12/2021. Although I do not expect to have any major issues. This was an error.


VAERS ID: 1735851 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Malaise, Nausea, Somatic symptom disorder
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Right after vaccine was given, patient started complaining of feeling nauseated. She then stated she wasn''t feeling well and began to slump in the chair. Patient passed out. Ambulance was called. Patient was alert before the ambulance arrived and was coherent. EMTs took patient''s vitals and determined issue was due to her not eating before getting vaccinated and having a normally low blood pressure. Vitals : bp - 112/78, pulse - 54 ( normal for patient), and oxygen - 99. EMTs observed patient until 12:22 pm and then advise patient to rest at home. I checked on patient at 6:45 pm. -- patient was feeling much better.


VAERS ID: 1735853 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Immunisation, Product leakage, Syringe issue, Underdose
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Client received first dose of COVID-19 pfizer vaccine in left deltoid at 3:22 PM. Vaccinator activated the plunger on the vanish point syringe which made an unusual clicking sound. When vaccinator withdrew syringe from client''s arm, the actual vaccine fluid out of the client''s arm. Vaccinator believed there was less than 50% of the dose still in the client''s arm as a lot of the vaccine squirted out of the client''s arm. Vaccinator alerted me of the situation as I was the co-lead of the site. I then notified our clinical care coordinator that gave the CDC guidance of revaccinating the client today if there was less than 50% of the first attempt administered. Client along with parents were notified of the situation and client was in agreement of revaccination.


VAERS ID: 1735858 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient fainted approximately less than 5 minutes after dose, Patient regained consciousness within 60 seconds and was taken by ambulance for observations. Patient stated nervousness with needles after event


VAERS ID: 1735862 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetyl-CH, Adaptacrine, Vitamin B-12, vit. D
Current Illness: N/A
Preexisting Conditions: None
Allergies: Cipr0, Amoxicillin, Diamox
Diagnostic Lab Data:
CDC Split Type:

Write-up: general malaise 9/25/2021 a few hours after receiving the 2nd shot, starting at 4:00 am 9/26/2021 Fever of 101.4 lasting all day, lethargic, passed out most of the day. It is 4:00 at night now and I still have the fever. With the first shot, I went home and 15 minutes later passed out on the front porch and was not able to get up for 20 hours.


VAERS ID: 1735875 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling cold
SMQs:

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

Write-up: Chills, feeling of being cold without relief


VAERS ID: 1735888 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient received 2nd dose of Pfizer vaccine 14 days after 1st dose instead of earliest possible day (day 17). Pt did not experience any adverse events from the vaccine after the dose that we are aware of.


VAERS ID: 1735897 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient received 2nd dose of Pfizer vaccine 14 days after 1st dose instead of the earliest possible day (day 17). No adverse reaction occurred that we are aware of.


VAERS ID: 1735903 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Erythema, Lymphadenopathy, Pain, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Sore Lt Shoulder with redness and slight swelling then very tender Left arm with swollen lymph nodes and ache with arm movement.


VAERS ID: 1735926 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Adverse reaction to Gardasil 15 years ago
Other Medications:
Current Illness:
Preexisting Conditions: Obesity
Allergies: Doyxycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, tingling of fingertips, sore L arm, headache


VAERS ID: 1735942 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Maternal exposure during breast feeding, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Neonatal exposures via breast milk (narrow)

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

Write-up: Pain in injection site Nausea 4 hours after vaccination that subsided alone Breastfed 20 month old increased breastfeeding following day, experienced low grade fever and fussiness starting 24 hours after vaccination. Unknown if related to mother''s vaccination.


VAERS ID: 1735953 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient came to the pharmacy to ask for 1st dose of Moderna. Patient denied of having any previous COVID-19 vaccine previously. After counseled patient on Moderna vaccine, and the vaccine was administered, pharmacist found out that patient had Johnson & Johnson vaccine via vaccine records in March 20, 2021. Even though patient was counseled by the pharmacist that J&J and Moderna haven''t been approved for any booster, patient didn''t disclose to the pharmacist that patient had J&J already. Patient and his spouse admitted that they did some research on J&J that wasn''t effective to protect them from the variant, so both of them decided to get Moderna, even pharmacist mentioned at consultation . No symptoms and adverse effects were reported at this point.


VAERS ID: 1735966 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient came to the pharmacy to ask for 1st dose of Moderna. Patient denied of having any previous COVID-19 vaccine previously. After counseled patient on Moderna vaccine, and the vaccine was administered, pharmacist found out that patient had Johnson & Johnson vaccine via vaccine records in March 20, 2021. Even though patient was counseled by the pharmacist that J&J and Moderna haven''t been approved for any booster, patient didn''t disclose to the pharmacist that patient had J&J already. Patient and her spouse admitted that they did some research on J&J that wasn''t effective to protect them from the variant, so both of them decided to get Moderna . No symptoms and adverse effects were reported at this point.


VAERS ID: 1735977 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Hormone level abnormal, Menstruation irregular, Mood swings, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Depression (excl suicide and self injury) (broad), Fertility disorders (broad)

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

Write-up: Hormonal Imbalance. Frequent bleeding every month in between periods lasting from ovulation through period. Periods now coming twice a month. Heavier periods. Mood swings. Linea nigra appeared (not pregnant).


Result pages: prev   365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=464&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166