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

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

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 468 out of 8,941

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VAERS ID: 1763092 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

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

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

Write-up: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.


VAERS ID: 1763096 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

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

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

Write-up: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.


VAERS ID: 1763099 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

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

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

Write-up: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.


VAERS ID: 1763106 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

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

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

Write-up: Vaccine expired in refrigerator on 9/25/2021. Vaccine administered on 9/26/2021 (vaccine stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/2021 would have been the 31st day). Vaccine was not pulled from the refrigerator the day it expired on 9/25/2021, hence accidental continued use by another pharmacist on 9/26/2021. Pfizer reported, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.


VAERS ID: 1763109 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 RA / IM

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

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

Write-up: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.


VAERS ID: 1763111 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

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

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

Write-up: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.


VAERS ID: 1763114 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

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

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

Write-up: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.


VAERS ID: 1763117 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 RA / IM

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

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

Write-up: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.


VAERS ID: 1763120 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

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

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

Write-up: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.


VAERS ID: 1763668 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 RA / 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: Please verify dose, typical MFG recommendation for 1-2 years old is 75-80mg/dose (this is 128mg/dose). Thank you!


VAERS ID: 1763675 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

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

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

Write-up: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.


VAERS ID: 1764642 (history)  
Form: Version 2.0  
Age: 98.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-28
Onset:2021-09-26
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: breakthrough COVID-19


VAERS ID: 1764712 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-19
Onset:2021-09-26
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Blood culture negative, Blood fibrinogen increased, Blood lactic acid, Blood pressure decreased, Chest X-ray, Chest pain, Chills, Computerised tomogram abdomen abnormal, Computerised tomogram head, Diarrhoea, Dizziness postural, Dyspnoea, Electrocardiogram normal, Fibrin D dimer increased, Full blood count, Haematocrit normal, Haemoglobin increased, Hepatic steatosis, Hypophagia, Hypotension, Leukocytosis, Lipase increased, Malaise, Metabolic function test, Mononucleosis heterophile test negative, Neutrophil percentage increased, Pharyngitis streptococcal, Platelet count decreased, Procalcitonin increased, Pulmonary mass, SARS-CoV-2 antibody test positive, SARS-CoV-2 test negative, Streptococcus test positive, Thrombocytopenia, Transaminases increased, Ultrasound abdomen abnormal, White blood cell count increased, White blood cells urine positive
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Agranulocytosis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amoxicillin, clindamycin, ondansetron
Current Illness: Wednesday 9/29 with general malaise and some difficulty breathing. PCP was seen, COVID test negative but Strep swab positive. Sent home with Amoxicillin . During this time, had decreased oral intake and diarrhea. Patient experienced dizziness upon standing and ambulating. He was receiving acetaminophen and ibuprofen at home. No recent travel. The patient received the second COVID vaccine 2 weeks ago prior, on 9/19/2021. Saturday, 10/2, symptoms persisted and the patient went to Urgent Care where he received IV fluids and IV steroids. Antibiotics for strep throat were switched from amoxicillin to clindamycin.
Preexisting Conditions: Obesity, Asthma, Borderline hypertension
Allergies: Latex
Diagnostic Lab Data: Sunday 10/3, At the ED the patient underwent a broad workup: CXR, CT head, CT abdomen, and abdominal ultrasound (for appendicitis). Overall unremarkable, however, CT abdomen demonstrated tiny dense pulmonary nodule "incompletely imaged though highly likely benign", and a liver w/ "hepatic steatosis" (also seen on ultrasound). Outside hospital labs: Blood cultures drawn and no growth, procalcitonin 14, lactic acid 3.0, urinalysis was w/out signs of infection but with 20-50 WBC, BMP all WNL, COVID PCR negative, CBC: WBC 16, Hgb 16 Hct 42, plt 87, 84% neutrophils, hepatic panel w/ mildly elevated transaminases, lipase 132, and mono negative. Pt was given ibuprofen, acetaminophen, Mylanta, famotidine, ceftriaxone (at 1940) and clindamycin (most recently at 2238).
CDC Split Type:

Write-up: Patient was transfer to ED from an outside hospital for concerns of hypotension likely secondary to MIS-C vs post-COVID vaccine myocarditis. Per family, symptoms started on Wednesday 9/29 with general malaise and some difficulty breathing. The patient was evaluated by the PCP where he received a COVID test, which was negative, and a Strep swab which was found to be positive. The patient was sent home with an Amoxicillin prescription. Thereafter, the patient experienced decrease in oral intake and diarrhea. Additional complaints included dizziness upon standing and ambulating. The patient was receiving acetaminophen and ibuprofen at home. There has been no recent travel and no new animal exposures. The patient recently received the second COVID vaccine 2 weeks prior. On Saturday, 10/2, symptoms persisted prompting a visit to an Urgent Care where he received IV fluids and IV steroids. At his time the antibiotics were switched to from amoxicillin to clindamycin. On (Sunday 10/3), the patient presented to an outside hospital ED after waking with chills, chest pain, and difficulty breathing. Per report, patient was in the process of being discharged when his blood pressures dropped into the 70s and 80s range. With new hypotension post receiving a total of 3 L of normal saline, the decision was made to transfer to ED for further treatment. In ED: Patient complained of chest pain and blood pressures were intermittently in the mid 80''s. He was given 1L IVF via bolus and started MIVF. EKG normal, cardiology contacted who recommended epinephrine drip initiation for BP support. The patient was anxious and started on wall O2 via face-mask for comfort only. Lab work-up was repeated and significant for an inflammatory process with elevated Procalcitonin, D-dimer, and Fibrinogen. COVID IgG positive and COVID capsid positive, demonstrative of likely previous COVID infection and current immunized status. Thrombocytopenic to 81, leukocytosis to 18.


VAERS ID: 1764770 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-16
Onset:2021-09-26
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NA / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NA / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Decreased appetite, Fatigue, Pyrexia, Vaccine breakthrough infection, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic conditions/PMH HTN, HLD, DM, Huntington''s disease.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This case meets criteria for vaccine breakthrough review. SxS include fever, weakness, fatigue, loss of appetite, emesis.


VAERS ID: 1764946 (history)  
Form: Version 2.0  
Age: 97.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-15
Onset:2021-09-26
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Fall, Rhabdomyolysis, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (narrow), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen, amLODIPine, DAPAgliflozin, glimepiride, latanop
Current Illness:
Preexisting Conditions:
Allergies: NOne
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted as observation on 09/26/2021 and upgraded to inpatient status on 09/27/2021 due to Rhabdomyolysis and a fall with weakness. Patient was tested for COVID-19 and was positive on 09/26/2021.


VAERS ID: 1765053 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Immediate post-injection reaction, Injection site discomfort, Loss of consciousness, Muscle tightness, Musculoskeletal stiffness, Pain, Pain in extremity, Pallor, Pyrexia, Seizure, Seizure like phenomena, Skin tightness, Tremor
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), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 I am aware of
Diagnostic Lab Data: We did not go in to any doctors for tests
CDC Split Type:

Write-up: Day of Injection 25Sep21: Dizziness, seizure and loss of consciousness within minutes of the injection. Immediate feelings of tightness at the injection site, followed by tightness and pain in the left arm, shoulder and neck. These issues continued for a week following the injection. 26Sep21: Woke up feeling tired, fatigued with full body aches. laid down for a nap around 2pm, woke up around 2:45pm experiencing extreme body shakes, similar to a seizure. Face was pale, lips were white (no color in face) with extreme chills. Laid down and continued extreme shaking for about an hour and a half. Fever was 104.5. After that 1.5 hours, fever reduced to 103, he slept for a while, checked temp again at 5:30, reduced to 101.5 and color had returned to his face. Fatigue continued that evening. The next day he woke up feeling better, but still had the stiffness in his left arm, shoulder and especially in the neck. as of today, the extreme shaking/seizures have not returned but the future is of course unknown.


VAERS ID: 1765195 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Redness at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Additional Details: redness and itching at injection site


VAERS ID: 1765217 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-23
Onset:2021-09-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Eye pain, Full blood count normal, Influenza like illness, Lip swelling, Lymph node pain, Lymphadenopathy, Neck mass, Ocular hyperaemia, Periorbital swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Lump in neck (current) Swollen sore Lymph nodes in armpit (lasted 3 days) Bottom Lip swollen and went away over night Skin around eyes swollen and left eye red and sore current Flu symptoms


VAERS ID: 1765253 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: None
CDC Split Type:

Write-up: Heavy fever of 103 degree on the 2nd and 3rd day of vaccination. Muscle and body aches and hard to breathe still ongoing for over a week.


VAERS ID: 1765369 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Loss of personal independence in daily activities
SMQs:, Dementia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: doctor appointment to follow up on problem on Monday 10/4. Referral to pediatric neurologist - appointment pending
CDC Split Type:

Write-up: Headache for the past 10 days since receiving the second shot of this vaccine. The headache is ongoing and is not responding to general courses of treatment - over the counter medications throughout the day. This has interfered with her ability to go to school or to participate in her normal activities.


VAERS ID: 1765399 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Heart rate increased, Skin warm
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Patient has stated she has had reactions to many medications in the past.
Diagnostic Lab Data: None provided
CDC Split Type:

Write-up: Patient said 12 hours after receiving 1st dose of pfizer vaccine her heart rate went up to 180 per smartwatch. She stated she went to hospital and had 102 degree fever and her arm was very hot (says they took temperature of her arm with ir thermometer and was 110). She said the providers thought she may be having an allergic reaction to the COVID vaccine and stated she had to stay in hospital for 8 days (did not give specifics of admittance/stay). She said she has since recovered from it.


VAERS ID: 1765447 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-19
Onset:2021-09-26
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cellulitis, Joint swelling, Ligament sprain, X-ray limb
SMQs:, Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin; Tamsulosin; PRILOSEC; 81 mg aspirin; ADVIL; Multivitamin; Vit C
Current Illness: no
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: X-rays - wrist
CDC Split Type: vsafe

Write-up: I was aware of discomfort and slight swelling in left wrist and the next day the swelling was more pronounced. I sought care and that time the diagnosis was made of a sprang. I was given a wrist guard and ibuprofen. The next day, the swelling was much more pronounced and I went back and they diagnosed cellulitis and I was given a prescription for Doxycycline. That began to resolve the symptoms by the next morning. I am 8 days down the line now and it isn''t totally resolved but it''s getting much better (about 90%).


VAERS ID: 1765470 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (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: NORTRIPTYLINE, PROPRANOLOL ER
Current Illness:
Preexisting Conditions: DEPRESSION
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: SWOLLEN ARMPIT RIGHT.


VAERS ID: 1765525 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-21
Onset:2021-09-26
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: diabetes, thrombocytopenia, Sarcoidosis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was hospitalized for Covid 19


VAERS ID: 1765541 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-06
Onset:2021-09-26
   Days after vaccination:263
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: PATIENT HAD PFIZER VACCINE ON 01/06/2021, 01/27/2021, AND TESTED POSITIVE TO COVID


VAERS ID: 1766135 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025AZIA / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bronchitis, COVID-19, Chest discomfort, Chills, Cough, Disturbance in attention, Dyspnoea, Ear discomfort, Fatigue, Feeling abnormal, Headache, Lymphadenopathy, Pain, Paranasal sinus discomfort, Pneumonia, Pyrexia, SARS-CoV-2 test positive, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: Rapid test 9/28 PCR test 9/28
CDC Split Type:

Write-up: I was vaccinated with my first shot 03/03/2021. I had my second dose on 03/31/2021. Both at a drug store. Both times I had adverse reactions and was unable to work for 5 days. I reported this earlier today in another report. I also had a breakthrough case of COVID and am just now stating to get better. 9/26/2021 I started having early symptoms of a slight fever of 100.5 and fatigue. 9/27 I had 103 and could not get out of bed. Extreme chills, extreme body aches, swollen glands, shortness of breath. Persistent cough and tightness in my chest. Extreme fatigue. I began isolating then. 9/28 I went to patient first urgent care. The rapid test was negative. They gave me antibiotics for a lung infection and cough medicine prescription. They also conducted a PCR test. They told me I had bronchitis that was developing into pneumonia. I again had 103 - unless on Advil then it was between 101 - 102, chills, extreme body aches, tightness in my chest, shortness of breath, persistent cough. 9/29-9/30 - still unable to work same as above symptoms. New symptom on 9/30 extreme headache. Sinus pressure. Painful. Fever 102.5 10/01 - test came back confirming I had a breakthrough case of COVID. Same as above symptoms. Still 102.5 fever. Still could not work. Went to my reg doctor for a check up. They confirmed the antibiotics were working for my lungs infection. Later that evening I was better able to maintain a 100.5 fever with meds. They also prescribed new cough medication. 10/2-10/4 stayed at home. Continued to medicate with prescriptions given and and isolated. Each day over the weekend and Monday the fever improved. 10/5 - felt good enough to work a half day from home. I am still very fatigued and feel foggy. Like I cannot concentrate. Also like my ears are clogged even though I am not congested.


VAERS ID: 1766150 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-16
Onset:2021-09-26
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood gases abnormal, COVID-19, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Condition aggravated, Discomfort, Dyspnoea exertional, Hypoxia, Lung infiltration, Lung opacity, Malaise, PO2 decreased, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Lactic acidosis (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amitriptyline, aspirin, glipizide, levothyroxine, metformin
Current Illness:
Preexisting Conditions: hypothyroidism type 2 diabetes Clotting disorder, Environmental allergies, Hypothyroid, Lupus, Migraine, Proteinuria, Sleep apnea, SOB (shortness of breath) on exertion, and Uterine cancer
Allergies: None
Diagnostic Lab Data: 9/27/21 COVID19: positive 10/3/21 chest xray: Minimal patchy infiltrate right upper lobe. 10/3/21 CTA chest: No evidence of pulmonary emboli. Scattered ground-glass opacities within the lungs right greater than left. Patient is positive for COVID-19.
CDC Split Type:

Write-up: presented to the ER on 10/3/21 with shortness of breath. Patient started feeling COVID like symptoms on Sunday the 26th. Patient when had a COVID swab done on 27th which was positive. She began to feel slightly worse few days ago in regards to her respiratory status. Her dyspnea has been getting progressively worse with activity. When she felt even worse and decided come to the ER to be evaluated. Patient denies any cough fever chills. Her GI symptoms seem to be improving. When she arrived to the ER she was found to be hypoxic an ABG done revealed a PO2 of 55. Patient''s has been placed on 2 L of oxygen via nasal cannula. She will be admitted overnight to see if we can wean her off oxygen. Being treated with Decadron and remdesivir. Respiratory support. Over the course of hospitalization patient stopped requiring oxygen, her breathing discomfort improved and she was ambulating in the room going to washroom without any difficulty and without any oxygen requirement. Patient is medically stable to be discharge Home on 10/5/21


VAERS ID: 1766171 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Dizziness, Feeling abnormal, Headache, Injection site pain, Loss of personal independence in daily activities, Magnetic resonance imaging, Migraine, Sinus pain, X-ray
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine
Other Medications: phillips colon health probiotic (1 pill in PM)
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: MRI CT Scan X Ray (10/ 4) negative, but I need to follow up with a neurologist and primary doctor for dizziness, migraines, headaches and brain fog.
CDC Split Type:

Write-up: I received my first Pifzer covid vaccine on 9/25/21. Day one and two after receiving my vaccine I had the typical sore left arm but also a pounding headache. During descent on my flight home two days later I had pounding pain in my L sinus area in my forehead that caused me to be holding my forehead for the entire landing. Since the 26th, I have had daily migraines, dizzy spells, feeling of faintness and fogginess. I have always been a very active / healthy person and since the shot, I have been very restricted. Below is a timeline of my recent activities for your information: 9/30 : I called the delta covid nurse line to report my symptoms. They instructed me that I should follow up with a primary doctor or proceed to an urgent care. 10/1: I had a Teledoc appointment. The doctor, after finding out I had already been taking ibuprofen, said he did not feel comfortable prescribing me anything further and recommended that I visit an urgent care. 10/3: My husband took me to Urgent Care where the doctor listened to my symptoms, and prescribed a migraine medication. 10/4: After taking the mediation, the dizzy spells and brain fog became so strong that I almost passed out. My husband drove me to the Emergency Room. I was in the ER undergoing X-Rays, CT-Scans, an MRI, Blood Tests, and so on trying to get to the root of the problem. I have never in my life dealt with headaches nor allergies or migraines. All the tests came back negative. The doctor prescribed me an even stronger migraine medication and has now instructed me to follow up with a neurologist to continue finding out why I am having these negative reactions post vaccination. 10/6: I tried an allergy pill followed later in the day by a migraine pill. The migraines returned so I visited a Chiropractor to see if there was a correlation between my alignment and migraines. The doctor said I was out of alignment in my neck. I am returning to the chiropractor for the next three days to see if this helps. I am writing this email post adjustment, with a throbbing migraine behind my left eye. I am having migraines/ headaches/ dizziness at all hours of the day, with no correlation to meals/ time of day/ water intake/ sleep amount. etc.


VAERS ID: 1766336 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-05
Onset:2021-09-26
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Deep vein thrombosis, Pain in extremity, Ultrasound scan normal
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nope none
Current Illness: None
Preexisting Conditions: Nope
Allergies: Nope
Diagnostic Lab Data: Gave me ultrasound. Ran lots of blood work and all blood work came back normal so far. Still running blood work.
CDC Split Type:

Write-up: Starting early last week I was having awful pain in calf. Went to ER and they gave me an ultrasound. Diagnosed with dvt. I?m not for sure saying it is from the vaccine just that I definitely think it could be as I have no other factors that would make sense of why me, a young 26 year old healthy girl has a blood clot.


VAERS ID: 1766952 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-28
Onset:2021-09-26
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure fluctuation, Blood pressure measurement, Feeling abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AMLODIPINE
Current Illness: Blood pressure high
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210926; Test Name: Blood pressure; Result Unstructured Data: was up (could not remember the numbers).; Test Date: 20210928; Test Name: Blood pressure; Result Unstructured Data: at 2 o''clock BP was 140/98; Test Date: 20210928; Test Name: Blood pressure; Result Unstructured Data: a little while ago it was down to 123/87; Test Date: 20210928; Test Name: Blood pressure; Result Unstructured Data: a little while ago it was down to 124/88
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: blood pressure was up, at 2 o''clock her BP was 140/98, was down to 123/87 and 124/88; Didn''t feel good/felt fuzzy; This spontaneous case was reported by a consumer and describes the occurrence of BLOOD PRESSURE FLUCTUATION (blood pressure was up, at 2 o''clock her BP was 140/98, was down to 123/87 and 124/88) and FEELING ABNORMAL (Didn''t feel good/felt fuzzy) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 051E21A and 020F21A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high. Concomitant products included AMLODIPINE for Blood pressure high. On 28-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Sep-2021, the patient experienced BLOOD PRESSURE FLUCTUATION (blood pressure was up, at 2 o''clock her BP was 140/98, was down to 123/87 and 124/88) and FEELING ABNORMAL (Didn''t feel good/felt fuzzy). At the time of the report, BLOOD PRESSURE FLUCTUATION (blood pressure was up, at 2 o''clock her BP was 140/98, was down to 123/87 and 124/88) and FEELING ABNORMAL (Didn''t feel good/felt fuzzy) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 26-Sep-2021, Blood pressure measurement: high (High) was up (could not remember the numbers).. On 28-Sep-2021, Blood pressure measurement: 140/98 (High) at 2 o''clock BP was 140/98, 123/87 (High) a little while ago it was down to 123/87 and 124/88 (High) a little while ago it was down to 124/88. No treatment information was provided by the reporter.


VAERS ID: 1766969 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-09-26
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Lymphadenopathy, Vaccination site erythema, Vaccination site pruritus
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Area around the injection site very red; Area around the injection site very, very itchy; Lymph nodes under left arm swollen; This spontaneous case was reported by a patient and describes the occurrence of VACCINATION SITE ERYTHEMA (Area around the injection site very red), VACCINATION SITE PRURITUS (Area around the injection site very, very itchy) and LYMPHADENOPATHY (Lymph nodes under left arm swollen) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 047C21A and 015E21A) for COVID-19 vaccination. No Medical History information was reported. On 21-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Sep-2021, the patient experienced VACCINATION SITE ERYTHEMA (Area around the injection site very red), VACCINATION SITE PRURITUS (Area around the injection site very, very itchy) and LYMPHADENOPATHY (Lymph nodes under left arm swollen). At the time of the report, VACCINATION SITE ERYTHEMA (Area around the injection site very red), VACCINATION SITE PRURITUS (Area around the injection site very, very itchy) and LYMPHADENOPATHY (Lymph nodes under left arm swollen) outcome was unknown. No Concomitant medication reported. No treatment medication reported This case was linked to MOD-2021-335046 (Patient Link).


VAERS ID: 1767005 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-01
Onset:2021-09-26
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 RA / OT

Administered by: Unknown       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: USMODERNATX, INC.MOD20213

Write-up: Bell''s Palsy on the right side of his face; This spontaneous case was reported by a consumer and describes the occurrence of BELL''S PALSY (Bell''s Palsy on the right side of his face) in a 58-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 058E21A and 091D21A) for COVID-19 vaccination. No Medical History information was reported. On 01-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Sep-2021, the patient experienced BELL''S PALSY (Bell''s Palsy on the right side of his face) (seriousness criterion medically significant). At the time of the report, BELL''S PALSY (Bell''s Palsy on the right side of his face) outcome was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided. Wife is calling to report that her 58-year-old husband received the first dose of Moderna COVID-19 vaccine on 01AUG2021 in the Right arm (Lot# 091D21A & Exp. Date: Unknown). He had the second Moderna COVID-19 vaccine on 29AUG2021, in the left arm (Lot# 058E21A & Exp. Date: Unknown ). Wife states that on 26SEP2021, He developed Bell''s Palsy on the right side of his face (Not confirmed by HCP). Wife states that they have not informed his doctor yet and have not called VAERS. Company comment: This case concerns a 58 year old male with no relevant medical history who experienced Serious expected event of Bell''''s palsy approximately a less than a month after receiving the second dose of Moderna Covid 19 vaccine. Rechallenge was not applicable. The benefit-risk relationship is not affected by this report.; Sender''s Comments: This case concerns a 58 year old male with no relevant medical history who experienced Serious expected event of Bell''''s palsy approximately a less than a month after receiving the second dose of Moderna Covid 19 vaccine. Rechallenge was not applicable. The benefit-risk relationship is not affected by this report.


VAERS ID: 1767049 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-20
Onset:2021-09-26
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back disorder, Discomfort, Musculoskeletal discomfort, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Knocked her on her back; knot in her shoulder; a little discomfort; low grade fever; This spontaneous case was reported by a consumer and describes the occurrence of BACK DISORDER (Knocked her on her back), MUSCULOSKELETAL DISCOMFORT (knot in her shoulder), DISCOMFORT (a little discomfort) and PYREXIA (low grade fever) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. No Medical History information was reported. On 20-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 26-Sep-2021, the patient experienced BACK DISORDER (Knocked her on her back), MUSCULOSKELETAL DISCOMFORT (knot in her shoulder), DISCOMFORT (a little discomfort) and PYREXIA (low grade fever). At the time of the report, BACK DISORDER (Knocked her on her back), MUSCULOSKELETAL DISCOMFORT (knot in her shoulder), DISCOMFORT (a little discomfort) and PYREXIA (low grade fever) outcome was unknown. No concomitant medication details was reported. No treatment medication details was reported.


VAERS ID: 1767115 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-30
Onset:2021-09-26
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3004960 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Abdominal tenderness, Alanine aminotransferase increased, Arthralgia, Aspartate aminotransferase increased, Back pain, Biopsy skin, Blood albumin, Blood creatinine increased, Blood fibrinogen normal, Blood magnesium decreased, Blood potassium normal, Blood sodium decreased, Calcium ionised decreased, Chest X-ray normal, Cholelithiasis, Chromaturia, Computerised tomogram abdomen abnormal, Cryptorchism, Decreased appetite, Echocardiogram, Ejection fraction, Electrocardiogram normal, Erythema, Gastrointestinal oedema, Glucose urine absent, Haematocrit normal, Haemoglobin increased, Hepatitis B surface antibody, Hepatitis B surface antigen, Lip dry, Lipase, Lymphocyte count, Malaise, Mucosal hypertrophy, Myalgia, Neutrophil count, Oedema, Oedema peripheral, Pain, Papule, Petechiae, Platelet count normal, Protein total, Protein urine absent, Rash, Red blood cell sedimentation rate increased, Red blood cells urine, Scan with contrast abnormal, Skin plaque, Urinary sediment present, Vasculitis, White blood cell count normal, White blood cells urine positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Congenital, familial and genetic disorders (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gallbladder related disorders (narrow), Gallstone related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vasculitis (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4 days prior to admission, patient suddenly noted bipedal edema, pitting in character along with petechial rashes on the bilateral feet. Rashes were non ? tender and non ? pruritic. No other associated signs and symptoms. No medications taken. No consult done. 3 days prior to admission, bipedal edema persisted and rashes progressed above the knee. The patient experienced joint and muscle pains which were intermittent and migratory. It would occur on the knees or the elbows or on the low back area. No fever noted. No consult done. 1 day prior to admission, symptoms persisted, hence teleconsult was done and was requested the following labs: Urinalysis: yellow, clear, acidic, negative protein and sugar, 0-1RBC, 0-1WBC, 0-1 pus, few epithelial cells Crea 70.72 SGPT 230 (increased) ESR 37 (increased) HBsAg and AntiHBs non-reactive Before being able to follow up, the patient developed severe generalized abdominal pain, crampy in character, 10/10 on the pain score which would last for a few minutes to hours then will spontaneously resolve. This was not aggravated by food intake. Few hours prior to the admission, the pain was no longer bearable, hence consult at the ER and subsequent admission. ROS: (+) chronic low back pain, work up showed normal results (-) Anosmia, ageusia, lower urinary tract symptoms, BM changes (-) Chest pain, palpitations, orthopnea, edema Past Medical History: Unremarkable Injected with 1st dose of COVID Vaccine (Moderna) last August 30, 2021 Family History: Unremarkable Social History: Non-smoker, non-alcoholic beverage drinker, denies illicit drug use Patient is a Pastor. He lives with pregnant wife and 2 toddlers in a studio-type apartment. Upon arrival at the ER, he was awake, in severe pain Vital Signs: BP 100/80 HR 71 RR 22 Temp: 36.2 O2 sat: 98% at RA Anicteric sclerae, pink palpebral conjunctivae, no CLADS Nondistended neck veins, dry lips and moist oral mucosa Clear breath sounds Normal rate regular rhythm, no murmurs Soft abdomen with normoactive bowel sounds, (+) tenderness on all quadrants more prominent on the right hemiabdomen Full pulses, grade 1 bipedal and bilateral hand edema (+) Multiple, dusky erythematous, well-defined, round non-blanchable papules and plaques on the lower extremities Course in the Wards: The patient was admitted as a possible case of COVID Vaccine Induced HSP given the timeline of events. He was referred to the Nephrology, Rheumatology, Gastroenterology, Hematology and Infectious Disease Services. Work up was done. Steroids were started along with pain medications. Due to difficulty of eating due to the feeling of unwellness, patient was started on IV hydration. After initiation of steroids, there was significant decrease in abdominal pain. On the 1st hospital day, the patient is stable with less abdominal pain. He was referred to the Dermatology service and biopsy of the skin lesions were done. Results are still pending. CT Scan of the whole abdomen with IV contrast was also done and showed gastric and bowel wall edema, irregular mucosal thickening and undue enhancement with fat stranding and adjacent prominent sub centimeter lymph nodes which may be secondary to a non-specific vasculitis. Management was continued. On the 2nd up to current hospital day, patient subjectively feels better. Edema is resolving along with rashes. Abdominal pain is less and patient has better appetite. 09.30.21 HEMATOLOGY Hemoglobin 162 hematocrit 46 WBC 5 -10 x 10^9 / L 8.0 Neutrophils 72 lymphocytes 28 Platelets 150 09.30.21 SERUM CHEMISTRY Sodium 135 Potassium 3.7 Mg 0.64 Ionized Calcium 1.25 Albumin Mass 41 SGOT 41.55 (1.0003x) SGPT 140.23 (3.5x) TP 68.53 A 41 G 27.53 Lipase 6.42 Fibrinogen 2.4 09.30.2021 CHEST XRAY: CLEAR ECG: NORMAL SINUS RHYTHM 2D ECHO: 77% EF Normal left ventricular dimensions with adequate contractility and systolic function Normal atria Normal valves Normal left ventricular diastolic function Normal pulmonary artery systolic pressure WHOLE ABDOMINAL CT SCAN WITH IV CONTRAST Impression: 1. Gastric and bowel wall edema, irregular mucosal thickening and undue enhancement with fat stranding and adjacent prominent sub centimeter lymph nodes, as detailed above. In this patient with a history of bipedal edema and purpuric rashes in both lower extremities, findings may be secondary to a non-specific vasculitis. The possibility of gastric and bowel wall infarct or inflammatory changes cannot be entirely excluded. Direct endoscopic visualization is suggested. 2. Cholecystolithiases with no evidence of cholecystitis during the time of examination. 3. Small undescended left testicle.


VAERS ID: 1768033 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-01
Onset:2021-09-26
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac arrest, Fatigue, Hyperhidrosis, Implantable defibrillator insertion, Pyrexia, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No over the counter meds
Current Illness: I was diagnosed with cardio myopathy in December due to have had Covid back in March of 2020
Preexisting Conditions: Asthma High blood pressure
Allergies: White fish
Diagnostic Lab Data: I was rushed to hospital. Many tests were done and an icd was put in me.
CDC Split Type:

Write-up: That night I was ok- I woke up a little wet so I thought I must have had a fever but I was ok. Then around 1:15 I started getting tired and then I started vomiting and then I went into cardiac arrest. The 2nd dose kept me in bed for 2 days with flu like symptoms so I was expecting that. But this time my heart stopped


VAERS ID: 1768409 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-08
Onset:2021-09-26
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breakthrough COVID+ case after completing full vaccination series.


VAERS ID: 1768442 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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: Was advised by health department that patient had received 3rd shot at a pharmacy before returning to our pharmacy for her 3rd. After looking at our system and the patient''s vaccination card we determined that patient had only received 2 shots and was due to receive her third. She did not disclose that she had already received a 3rd shot.


VAERS ID: 1769022 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient reported severe muscle soreness throughout body that has lasted since vaccine (about 2 weeks).


VAERS ID: 1769272 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-26
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: Patient developed shingles within 3 weeks of vaccine.


VAERS ID: 1770477 (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: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

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

Write-up: receiving a Moderna COVID19 vaccine dose after 2 doses of Pfizer''s COVID19 vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (receiving a Moderna COVID19 vaccine dose after 2 doses of Pfizer''s COVID19 vaccine) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Previously administered products included for an unreported indication: PFIZER BIONTECH COVID-19 VACCINE (patient had received 2 doses of the Pfizer''s COVID19 vaccine). On 26-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Sep-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (receiving a Moderna COVID19 vaccine dose after 2 doses of Pfizer''s COVID19 vaccine). On 26-Sep-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (receiving a Moderna COVID19 vaccine dose after 2 doses of Pfizer''s COVID19 vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided by the reporter. Treatment information was not provided.


VAERS ID: 1770587 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101266662

Write-up: Almost immediately lost vision; Had a seizure for about 5 seconds; This is a spontaneous report from a contactable consumer (patient). A 22-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 via an unspecified route of administration, administered in the left arm on 26Sep2021 at 10:45 (Batch/Lot Number: FF2589) as dose 1, single (at the age of 22 years-old) for Covid-19 immunisation. Medical history was not reported. There were no concomitant medications. No other medications in four weeks. Pharmacy did not monitor after the vaccine was administered. The patient came out to the car and almost immediately lost vision and had a seizure for about 5 seconds on 26Sep2021 at 11:15 AM. The patient had no Covid prior to the vaccination and Covid was not tested post vaccination. No treatment was administered for the events. The outcome of the events was unknown. The events resulted in: Doctor or other healthcare professional office/clinic visit. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1771203 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Constipation, Dizziness, Dyspepsia, Feeling hot, Gastrointestinal disorder, Headache
SMQs:, Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad)

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

Write-up: Headache almost every day since the vaccine Heartburn almost every day since the vaccine Bowel issues including constipation Fluttering in chest periodically Periods of overheating and lightheadedness None of these symptoms are normal for me


VAERS ID: 1771730 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Chills, Deafness unilateral, Dizziness, Dyspnoea, Electrocardiogram, Eye haemorrhage, Headache, Hypotension, Palpitations, Tinnitus
SMQs:, Anaphylactic reaction (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Not applicable
Current Illness: Not applicable
Preexisting Conditions: Not applicable
Allergies: Amoxicillin
Diagnostic Lab Data: Ekg, blood tests were done on 9/27/21
CDC Split Type:

Write-up: After receiving the johnson johnson vaccine I began to feel a bit of chest palpitation on my drive back home. Early the next morning I felt extremely winded I checked my vitals. My B/P was significantly lower than normal and my heart was racing averaging 119 to 128. I felt dizziness and as if I''d faint if I bent down. Massive craking headache and chills ensued. I decided to go the urgent care where they did and ekg and found abnormal reading that doesn''t correlate with my normal ekg when I go to my provider. They insisted that I betaken to the ER via ambulance. The ER also reproduced the same abnormal readings. I was advised to see my primary. And my primary advised for me to see a cardiologist. Soon after my hearing in my left ear became diminished with ringing and a blood shot developed in my right eye.


VAERS ID: 1771817 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Chest pain, Condition aggravated, Feeling abnormal, Gastritis, Headache, Impaired work ability, Memory impairment, Oesophageal pain, Pain, Pyrexia, Sensation of foreign body, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Tetanus shot - have sore arm after (it usually lasts a day) (can''t remember the last time I had one though)
Other Medications: No
Current Illness: No
Preexisting Conditions: Gastritis - started several years ago (it comes and goes); Migraines
Allergies: Lactose; Codeine; Aleve
Diagnostic Lab Data: No labs or medical test - just a physical exam.
CDC Split Type: vsafe

Write-up: I started having (on Sunday - after midnight, actually) started vomiting all the rest of the morning long. Husband administered Phenergan to me - I have it on hand for Migraines. The rest of the day, I had achiness, headache, fever (got to 101 for awhile then to 9.6). I had those symptoms until Tuesday. I couldn''t go to work on Monday. I don''t remember if I took migraine medicine or not during that time. I have had brain fog - there are things I can''t remember. I was prescribed Omeprazole - the Saturday following the week I got the shot. Because I started getting a burning sensation up esophagus and a sharp pain up in the center underneath my breast bone - felt like someone was stabbing me with a knife) - I went to the Walk-in Clinic (same doctor''s office that I go to - Family Medicine) on that Saturday after I had the symptoms. The doctor thought my gastritis had a flare up again. I have had this sensation since I''ve had the shot. Omeprazole - haven''t been having the sharp pains that I was having but I still feel a lump in my throat. She told me to watch the foods I eat - it''s eating a lot a bland food which is hard to do when I am working outside the home. Still have the stomach issues.


VAERS ID: 1772076 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-10
Onset:2021-09-26
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Headache, Hot flush, Malaise, Myalgia, Neck pain, Oropharyngeal pain, Pain, Ventricular extrasystoles
SMQs:, Rhabdomyolysis/myopathy (broad), Ventricular tachyarrhythmias (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypokalaemia (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: toprol , paxil, lipitor, motrin,
Current Illness: seasonal allergies
Preexisting Conditions: LVNC, heart valve prolapses, cardiomyopathies, ect.
Allergies: sulpha, cardizem, latex.
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: As soon as I woke up in the morning I felt sick, my throat hurt my glands head and neck hurt, I had a severe headache body aches, chills, heat flashes more PVC then I normally have, weak and tired, super strong muscle pains, I took, motrin, xanax, flexxeril and alka selter sinus and chloraseptic for my throat pain , prn, I am due to have my 2nd booster shot today and I still have all the same symptoms but much milder now, but is seems to change constantly. I sure hope this next one causes no more side effects and I will have immunity to this virus.


VAERS ID: 1772991 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chest discomfort, Chest pain
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Levoxil - 25 mcg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left shoulder pain and weakness - 2 weeks Chest tightness and pain - randomly for 2 weeks


VAERS ID: 1773150 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Neck mass
SMQs:, Peripheral neuropathy (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: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Burning sensation in hands, chronic on and off. Lump in neck/clavicle area.


VAERS ID: 1773441 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2020-12-30
Onset:2021-09-26
   Days after vaccination:270
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Body temperature, Decreased appetite, Feeling abnormal, Headache, Myalgia, Pyrexia, Vaccination site pain, Vaccination site pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: BODY TEMPERATURE; Result Unstructured Data: fever of 99.2.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: has a sore arm with some itching as of today 29Sep2021only her arm is still affected; The following day everything hurt but her hair, she could stay up a half hour then; fever of 99.2; joint pain; bad headache; Her 3rd injection was on 26Sep2021 at 11:30AM that day she had a sore arm; she started feeling bad; she hardly ate or drank all day; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (she started feeling bad), DECREASED APPETITE (she hardly ate or drank all day), VACCINATION SITE PRURITUS (has a sore arm with some itching as of today 29Sep2021only her arm is still affected), MYALGIA (The following day everything hurt but her hair, she could stay up a half hour then) and PYREXIA (fever of 99.2) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 30-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Sep-2021 at 11:30 AM, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Sep-2021, the patient experienced FEELING ABNORMAL (she started feeling bad), DECREASED APPETITE (she hardly ate or drank all day), MYALGIA (The following day everything hurt but her hair, she could stay up a half hour then), PYREXIA (fever of 99.2), ARTHRALGIA (joint pain), HEADACHE (bad headache) and VACCINATION SITE PAIN (Her 3rd injection was on 26Sep2021 at 11:30AM that day she had a sore arm). On 29-Sep-2021, the patient experienced VACCINATION SITE PRURITUS (has a sore arm with some itching as of today 29Sep2021only her arm is still affected). On 28-Sep-2021, FEELING ABNORMAL (she started feeling bad), DECREASED APPETITE (she hardly ate or drank all day), MYALGIA (The following day everything hurt but her hair, she could stay up a half hour then), PYREXIA (fever of 99.2), ARTHRALGIA (joint pain), HEADACHE (bad headache) and VACCINATION SITE PAIN (Her 3rd injection was on 26Sep2021 at 11:30AM that day she had a sore arm) had resolved. At the time of the report, VACCINATION SITE PRURITUS (has a sore arm with some itching as of today 29Sep2021only her arm is still affected) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 99.2 (High) fever of 99.2.. No concomitant medication reported. No treatment information was provided. This case was linked to MOD-2021-335962, MOD-2021-335979, MOD-2021-335962 (Patient Link).


VAERS ID: 1773626 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lethargy, Oropharyngeal pain, Pain in extremity, Pharyngitis streptococcal, Pyrexia, SARS-CoV-2 test
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LAMOTRIGINE; VYVANSE; QUETIAPINE; PRISTIQ
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bipolar disorder; Chronic anxiety; Chronic depression; Cyclothymia; Epilepsy; Obesity
Allergies:
Diagnostic Lab Data: Test Date: 202109; Test Name: COVID test name: ID NOW; Test Result: Negative ; Comments: Post vaccination: Test type: Blood test Test name: ID Now
CDC Split Type: USPFIZER INC202101277936

Write-up: then sore throat. It was reported that it almost felt like strep; Sore throat; sore arm; Fever; Lethargy; This is a spontaneous report from a non-contactable consumer (patient). A 28-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), dose 1 via an unspecified route of administration, administered in Arm Right on 25Sep2021 12:30 (Batch/Lot Number: FF2587) (at the age of 28 years, as reported) as DOSE 1, SINGLE for covid-19 immunisation. Medical history included epilepsy, cyclothymic disorder, bipolar disorder, depression, anxiety, obesity, all from an unknown date and unknown if ongoing. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Concomitant medications included lamotrigine; lisdexamfetamine mesilate (VYVANSE); quetiapine; desvenlafaxine succinate monohydrate (PRISTIQ); all taken for an unspecified indication, start and stop date were not reported. The patient previously took remeron and experienced drug hypersensitivity. It was reported that on 26Sep2021 10:30, the patient experienced sore throat, no coughing or runny nose, the normal sore arm, fever, lethargy, and then sore throat. It was reported that it almost felt like strep. The patient was negative for Covid. The events occurred almost 22 hours after the first dose vaccine. No treatment was received for the events. The outcome of events was not recovered. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient been tested for COVID-19. Results of tests and procedures for investigation of the patient: COVID Test type post vaccination: Blood test, COVID Test name post vaccination: ID Now, Result: Negative. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1774911 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-23
Onset:2021-09-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Computerised tomogram head normal, Endotracheal intubation, Enterovirus test positive, Facial bones fracture, Fall, Human rhinovirus test positive, Injury, Mechanical ventilation, Seizure, Unresponsive to stimuli, Walking aid user
SMQs:, Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: gabapentin (NEURONTIN) 400 mg capsule Take 800 mg by mouth 3 times a day dilTIAZem (CARTIA XT) 180 mg extended release capsule Take 180 mg by mouth 1 time per day metFORMIN (GLUCOPHAGE XR) 500 mg extended release tablet Take 1,000 mg by m
Current Illness: Admitted to hospital after weakness and fall at home post vaccine with nasal fracture. Rhino/enterovirus infection detected on 9/26. Discharged to swing bed. Readmitted October 8 with new onset seizure activity, intubated on invasive vent support now.
Preexisting Conditions: DM, HTN, HFrEF, CKD.
Allergies: morphine, lasix, allopurinol.
Diagnostic Lab Data: CT head negative for acute findings. Awaiting neurology consult and EEG.
CDC Split Type:

Write-up: He reported weakness ever since the vaccine. He now reportedly required a walker to get around. He became weaker to the point of suffer a fall 9/26, 3 days after vaccine and was hospitalized with trauma and nasal fracture. Also found to have tested + for rhino/enterovirus. Subsequently discharged to swing bed and readmitted on October 8 with new onset SEIZURES, now unresponsive and intubated on vent support.


VAERS ID: 1775104 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Fibrin D dimer, Laboratory test, Pulmonary venous thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: smoker
Allergies: none
Diagnostic Lab Data: CTA angio chest in hospital, D dimer, labs
CDC Split Type:

Write-up: pulmonary vein thrombosis


VAERS ID: 1775426 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-26
Onset:2021-09-26
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaemia, Blood test
SMQs:, Haematopoietic erythropenia (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: Ability Tegratol Effexor Trazadone Hydroxyzine
Current Illness:
Preexisting Conditions: Mood disorder
Allergies: Lamictal
Diagnostic Lab Data: Blood work 9/26/2021 Bloodwork 10/06/21
CDC Split Type:

Write-up: Anemia


VAERS ID: 1775659 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-01-26
Onset:2021-09-26
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Atypical pneumonia, Body temperature increased, COVID-19, COVID-19 pneumonia, Cardiac failure congestive, Chest X-ray abnormal, Condition aggravated, Dizziness, Fall, Hepatic mass, Lung infiltration, Lung opacity, Pulmonary oedema, SARS-CoV-2 test positive
SMQs:, Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 36 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amiodarone, lovastatin, allopurinol, fish oil, lisinopril/hydrochlorothiazide, magnesium, metoprolol succinate, omeprazole, spironolactone, trihexyphenidyl, ventolin inhaler PRN, warfarin
Current Illness:
Preexisting Conditions: ? GERD (gastroesophageal reflux disease) ? Injury of kidney ? Orthostatic hypotension ? Atherosclerotic heart disease ? Acute on chronic combined systolic and diastolic heart failure ? Presyncope ? Dyslipidemia ? Ventricular fibrillation arrest 05/2014 s/p ICD ? Pernicious anemia ? Hypothyroidism ? Thrombocytopenia ? Pre-diabetes ? Hyperuricemia ? Parkinson disease ? Stroke ? Internal derangement of knee ? S/P ICD (internal cardiac defibrillator) 2014 ? Ventricular tachycardia( NSVT) Abnormal T wave alternans s/p AICD 2007 ? Nonalcoholic steatohepatitis (NASH) ? Chronic kidney disease, stage III (moderate) ? Hernia of abdominal cavity ? Pancytopenia ? Ventricular flutter ? Chronic atrial fibrillation ? Benign nodular prostatic hyperplasia ? Chronic total occlusion of coronary artery RCA ? Anticoagulated on Coumadin ? Ischemic cardiomyopathy(Moderate-Severe LV dysfunction) LVEF 30-35% 2019 ? Chorea ? Falls frequently ? Community acquired pneumonia ? MDS (myelodysplastic syndrome) ? Fall ? Liver mass, left lobe ? Coagulopathy ? Sepsis due to Klebsiella
Allergies: Levofloxacin
Diagnostic Lab Data: 9/6/21 COVID19: positive 9/5/21 chest xray: Slightly worsening opacities within the left upper lobe and right mid lung primary differential consideration includes developing pneumonia multifocal pneumonia or possibly asymmetric edema. 9/6/21 chest xray: Interval worsening in pulmonary parenchymal opacification pattern. Findings suspicious for atypical pneumonia with underlying pulmonary edema not excluded.
CDC Split Type:

Write-up: On 8/29/21, patient was watching TV when he starting to feel very dizzy and had a fall but denies any loss of consciousness. Patient denies any chest pain or shortness of breath or palpitations. Patient denies any abdominal pain or nausea or vomiting or constipation or diarrhea. No fever no chills. Patient was found to have a hepatic mass and CHF. Patient was admitted and COVID was negative on 8/29. On 9/6/21 patient got another COVID19 test done due to spike in temperature and chest xray showed infiltrate. and it came back positive. He also developed COVID 19 infection with pneumonia and was treated with steroids, ceftriaxone and doxy and Remdesivir, off oxygen and off isolation. He was discharged to a nursing home on 10/5/21 for rehab. He will complete antibiotic course with Augmentin 875-125 mg bid for 7 days and Fluconazole 200 mg daily for 7 days.


VAERS ID: 1776060 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Pain in extremity, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Systemic: Numbness (specify: facial area, extremities)-Mild, Systemic: Tinnitus-Medium, Additional Details: Aches along the edge of his ulna bone on his left arm. Patient also describes tingling in the heel of his left had. Tinnitus worse in left ear than right.


VAERS ID: 1776362 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH B01358A / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, Hydrochlorothiazide, Metformin, Levothyroxine, Atorvastatin, Vit B-12, Vit D-3, Multivitamin, Fish Oil, Glucosamine-Chondroitin, Alpha-Lipoic Acid
Current Illness: None
Preexisting Conditions: Controlled high blood pressure, prediabetes
Allergies: Penicillin, Percodan
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 26 hours after shot my hands began to itch and 27 hours after shot my tongue swelled. Hands had stopped itching. All Urgent Cares closed on Sunday evening. Talked to a pharmacist and was advised to take Benadryl. Took 2 pills every 4 hours for a total of 6 pills. Tongue returned to normal size within 4 hours of first 2 pills. Contacted my internist the next morning (Monday). Since reaction had reversed, I did not visit doctor office.


VAERS ID: 1776384 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-01
Onset:2021-09-26
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: KIDNEY & PANCREAS TRANSPLANT 2020, CAD S/P STENT PLACEMENT X 2, OSA, HTN
Allergies:
Diagnostic Lab Data: NASOPHARYNGEAL COVID-19 PCR 10/10/21 - POSITIVE
CDC Split Type:

Write-up: SYMPTOMATIC COVID-19 - SPO2 64% ON RA, PROGRESSIVE SOB; PRODUCTIVE, PURULENT COUGH


VAERS ID: 1776523 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness bilateral, Ear pain, Hypoacusis, Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: I LOST HEARING IN BOTH EARS. I AM EXPERIENCING TINNITIS IN ONE EAR WHICH IS ABOUT HALF VOLUME W MUFFLED SOUND AND SHARP PAIN AND EVEN LESS HEARING WITH EVEN MORE MUFFLED IN LEFT EAR.


VAERS ID: 1776704 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-26
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Angiogram cerebral, Antithrombin III, Arteriogram carotid, Blood glucose, Blood homocysteine, Blood immunoglobulin G, Blood immunoglobulin M, Blood magnesium, Blood phosphorus, C-reactive protein, Cardiolipin antibody, Cerebrovascular accident, Chest X-ray, Coagulation factor VIII level, Computerised tomogram head, Differential white blood cell count, Echocardiogram, Electrocardiogram, Full blood count, Gene mutation identification test, Glomerular filtration rate, Glycosylated haemoglobin, Hypoaesthesia, Laboratory test, Lipids, Magnetic resonance imaging head, Metabolic function test, Muscular weakness, Perfusion brain scan, Prothrombin level, Prothrombin time, Red blood cell sedimentation rate, SARS-CoV-2 antibody test, SARS-CoV-2 test, Scan with contrast, Troponin I, Ultrasound Doppler, Urine analysis, Venogram
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT HEAD W/O CONTRAST Sep 28, 2021 TEE COMPLETE Sep 28, 2021 HOMOCYSTEINE Sep 28, 2021 ECHO COMPLETE Sep 27, 2021 US CAROTID DUPLEX Sep 27, 2021 US LOWER EXTREMITY VENOUS BILAT Sep 27, 2021 CT HEAD W/O CONTRAST Sep 27, 2021 CBC WITHOUT DIFFERENTIAL Sep 27, 2021 BASIC METABOLIC PANEL Sep 27, 2021 MAGNESIUM Sep 27, 2021 PHOSPHORUS Sep 27, 2021 PROTHROMBIN TIME Sep 27, 2021 ACTIVATED PARTIAL THROMBOPLA? Sep 27, 2021 MISC LAB - TYPE IN, BLOOD Sep 27, 2021 FACTOR II MUTATION BY PCR Sep 27, 2021 FACTOR V LEIDEN BY PCR Sep 27, 2021 CARDIOLIPIN ANTIBODIES, IGG & IGM Sep 27, 2021 ANTITHROMBIN III Sep 27, 2021 FACTOR VIII ASSAY Sep 27, 2021 ESTIMATED GLOMERULAR FILTRATI? Sep 27, 2021 LIPID PANEL Sep 27, 2021 COMPREHENSIVE METABOLIC PANEL Sep 27, 2021 COMPLETE BLOOD COUNT Sep 27, 2021 DIFFERENTIAL Sep 27, 2021 ESTIMATED GLOMERULAR FILTRATI? Sep 27, 2021 MRI BRAIN W/ AND W/O CONTRAST Sep 26, 2021 MRV BRAIN W/O CONTRAST Sep 26, 2021 POC URINALYSIS DIPSTICK Sep 26, 2021 XR CHEST 1 VIEW Sep 26, 2021 HEMOGLOBIN A1C Sep 26, 2021 C-REACTIVE PROTEIN, (CRP HS, CAR? Sep 26, 2021 HOMOCYSTEINE Sep 26, 2021 SEDIMENTATION RATE, WESTERGREN Sep 26, 2021 CT BRAIN PERFUSION Sep 26, 2021 CTA HEAD & NECK Sep 26, 2021 SARS-COV-2 MOLECULAR(RAPID-AB? Sep 26, 2021 CT HEAD W/O CONTRAST Sep 26, 2021 COMPLETE BLOOD COUNT Sep 26, 2021 ACTIVATED PARTIAL THROMBOPLA? Sep 26, 2021 PROTHROMBIN TIME Sep 26, 2021 TROPONIN I, HIGH-SENSITIVITY Sep 26, 2021 COMPREHENSIVE METABOLIC PANEL Sep 26, 2021 DIFFERENTIAL Sep 26, 2021 ESTIMATED GLOMERULAR FILTRATI? Sep 26, 2021 ECG ROUTINE 12 + LEADS Sep 26, 2021 POC GLUCOSE Unknown Provider Sep 26, 2021
CDC Split Type:

Write-up: Stroke; at 1:30 pm Sept.26 left arm became non-responsive; called 911; in ER left side of face began to feel numb and left leg was becoming weaker; doctors administered stroke medicine at 5pm after which left arm started responding, but fingers were still numb;


VAERS ID: 1776788 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-09
Onset:2021-09-26
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / UNK UN / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blepharospasm, Cerebral infarction, Dyskinesia, Dysstasia, Epilepsy, Facial paralysis, Loss of consciousness, Posture abnormal, Slow response to stimuli, Wheelchair user
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), Ischaemic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dyskinesia (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Gatifloxacin, Cipro, Levaquin, Penicillins, Quinolones, Latex
Current Illness:
Preexisting Conditions: UNSPECIFIED SEQUELAE OF CEREBRAL INFARCTION 5/12/2021 noted in the medical record CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED 3/24/2021 ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS 3/24/221 GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS hyperlipidemia CONTACT WITH AND (SUSPECTED) EXPOSURE TO COVID-19 3/24/2021 CEREBRAL INFARCTION, UNSPECIFIED 3/24/2021
Allergies: Gatifloxacin, Cipro, Levaquin, Penicillins, Quinolones, Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: the resident was noted to be leaning to the right side from w/c almost falling to the floor before cna caught her and assisted her upright. loss of consciousness noted, jerking to the left side, left eye twitching approximately 1 minute. assisted to bed to assess, unable to follow direction, unable to stand, mouth drawn to the left side. she began to arouse in and out with verbal stimuli but was not able to follow directions. . Sent to ER for medical evaluation Diagnosis updated: 9/29/2021 - EPILEPSY, UNSP, NOT INTRACTABLE, WITHOUT STATUS EPILEPTICUS, I69.398: OTHER SEQUELAE OF CEREBRAL INFARCTION The patient started on Keppra


VAERS ID: 1776869 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-09-26
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / 2 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009B323A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Headache, Nausea, Oropharyngeal pain, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: sore throat, headache, cough, nausea and vomiting


VAERS ID: 1776915 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-09-26
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, Cough, Decreased appetite, Dyspnoea, Fatigue, Pyrexia, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: fever, runny nose, fatigue, cough, shortness of breath, no appetite, loss of smell


VAERS ID: 1776947 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-26
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Fatigue, Headache, Nasal congestion, Oropharyngeal pain, Pain, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: runny nose, sore throat, headache, fatigue, cough, achy; and nasal congestion


VAERS ID: 1777002 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-09-26
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable event
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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1777006 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram head, Electrocardiogram, Gait disturbance, Hypoaesthesia, Hypoaesthesia oral, Pharyngeal hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vit D3 5000 iu, Amlodipine 5mg daily. multi vit daily, occasional omeprazole -last dose 6 months ago
Current Illness: sinusitis and ear effusion - treated with Amoxil about one month prior- resolved
Preexisting Conditions: hypertension and occasional GERD
Allergies: Aleve and lisinopril
Diagnostic Lab Data: Ekg, CT head, blood work, given hydration , solumedrol, lexpro, prednisone and benadryl
CDC Split Type:

Write-up: Symptoms started within 0ne minute s/p vaccine- started numbness tongue/throat/ mouth, the palms, feet, lower legs and developed intense severe burning in center of chest. no improvement after 45- left . Call PMD from home told to take Benadryl. -told to get medical attention if not improvement. Went to urgent care a couple hours later because no improvement.- told to go back to hospital. Went to hospital waited 7 hours to be seen. They did ECG and blood work and neuro checks- discharged told to follow up with PMD. Burning and numb kept intensifying and had right groin pain (last a couple hours), tourniquet feeling in spine and head, difficulty walking. saw PMD next day given Lexpro- no improvement. Symptoms continued to intensify and she went Hospital 9/30/21 - Provider said he seen this reaction from the vaccine and gave her Normal saline, Solumedrol, CT head, ECG and blood work. Discharge home with prednisone. symptoms decreased by a good amount. Better but still having numbness in feet, lower leg , spine, ,back of head, biceps and hands since vaccine.


VAERS ID: 1778975 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-01-06
Onset:2021-09-26
   Days after vaccination:263
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Headache, Myalgia, Nasal congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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: Positive Covid-19 PCR test
CDC Split Type:

Write-up: Complaint of cough, chills, headache, runny nose/congestion, and myalgia


VAERS ID: 1779267 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Cardiac monitoring, Chest pain, Dyspnoea, Electrocardiogram, Palpitations, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG''s. Pediatric cardiologist currently has her on 30 day monitor
CDC Split Type:

Write-up: My daughters heart races (tachycardia) and goes into afib. She gets short of breath and also has chest pains.


VAERS ID: 1779565 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-04-06
Onset:2021-09-26
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Dyspnoea, Fatigue, Fibrin D dimer increased, Full blood count abnormal, Liver function test abnormal, Myalgia, Ultrasound scan abnormal, White blood cell count abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol; multivitamin
Current Illness: No
Preexisting Conditions: Asthma
Allergies: Amoxicillin; iodine; seafood
Diagnostic Lab Data: Labs WBC, CBC panel, D-dimer results were positive, but they have not determined why. Chemistry panel, liver function panel, thyroid test, CT, ultrasound. All results turned out positive.
CDC Split Type: vsafe

Write-up: On 09/26/2021 I have shortness of breath, fatigue and muscle soreness and it still continues. The doctor originally thought it might be a blood clot, but that was ruled out.


VAERS ID: 1779638 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-09-26
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid (generic)
Current Illness: none
Preexisting Conditions: none
Allergies: non
Diagnostic Lab Data: 9/28/2021: PCR Covid test
CDC Split Type:

Write-up: Positive Covid diagnosis


VAERS ID: 1782406 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-10
Onset:2021-09-26
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamins, vitamin B 3, fish oil, probiotics, vitamin c, Allegra, Flonase, Pepcid, Eliquis, lisinopril
Current Illness:
Preexisting Conditions: high blood pressure. Had another blood clot in 2012 in her leg.
Allergies: Erythromycin
Diagnostic Lab Data: Hospital has all records.
CDC Split Type:

Write-up: began having shortness of breath and chest pain in September 2021. Went to ER and had both lungs with Pulmonary Emboli. Client had covid virus October 2020.


VAERS ID: 1782442 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-01
Onset:2021-09-26
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012A21A / UNK LA / IM

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

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

Write-up: COVID 19


VAERS ID: 1782503 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047CZ1A / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nurtec 75mg PO every other day, mirtazipine 30mg PO QHS, cyclobenzaprine 5mg PO QD PRN
Current Illness: N/A
Preexisting Conditions: SVT, gastritis, insomnia
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Started as mild rash on left hip on Sunday (2 days after injection) Spread for several days until it was intolerable on Monday 10/4/21. It had become very large on my left hip/flank area, spread to both arms, my chest, and lower back. Spoke to infection control nurse at work on Monday 10/4. She recommended I be seen. Went to ER physician. He said it was a systemic reaction to vaccine. My throat felt odd that night and worsened the next morning. Started Prednisone and antihistamine Tuesday 10/5 AM.


VAERS ID: 1782873 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-23
Onset:2021-09-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test, Joint swelling, Urine analysis
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: citalopram 20 mg at bedtime
Current Illness: Urinary tract infection
Preexisting Conditions: None
Allergies: Penicillin, sulfa, bactrim
Diagnostic Lab Data: Laboratory blood work and urine collected on 10/8/21
CDC Split Type:

Write-up: Pain and swelling of joints related to knuckles of both hands and right anterior ankle; no injury to either of these sites.


VAERS ID: 1782962 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-02
Onset:2021-09-26
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Myalgia, Nausea, Pyrexia, SARS-CoV-2 test, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Type 1 diabetes and cerebrovascular disease
Allergies:
Diagnostic Lab Data: SARS-CoV-2 Antigen specimen collected 10/5/21 and 2019 Coronavirus RNA specimen collected 10/7/21
CDC Split Type:

Write-up: Hospitalized for covid; symptoms include subjective fever, cough, nausea/vomiting, fatigue, and myalgia


VAERS ID: 1783051 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect route of product administration, Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash, Injection site swelling
SMQs:, Drug abuse and dependence (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily Multivitamin, Calcium supplement, valtrex PRN. Daily Collagen supplement
Current Illness: None
Preexisting Conditions: None
Allergies: Ceclor
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm with baseball sized, raised, painful, itchy, red welt. Not sure if it was due to the vaccine or the fact that the shot was not given in the appropriate spot. It was given lower in my arm and not in the delt


VAERS ID: 1783140 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-31
Onset:2021-09-26
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blister, Interchange of vaccine products, Lip blister, Oral herpes, Oral mucosal blistering
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetic, Copd. Arthritis..
Preexisting Conditions: Diabetic, Copd. Arthritis.
Allergies: codeine I was told today by my doctor that the Pfizer booster shot i got on 09/21/2021 After the booster shot on 09/21/2021. about a week later I started having severe cold sore in my mouth my hand and my face on some of my feet. Please contact me for the info I don''t want to have this happen to others who mixed up vaccines..
Diagnostic Lab Data: None
CDC Split Type:

Write-up: my body severe blister in my mouth . Lips face hand, face, Arm, and foot spreading.


VAERS ID: 1783784 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Dyspnoea, Gait disturbance, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone
Current Illness: COPD LBB
Preexisting Conditions: COPD LBB
Allergies: IVP Dye, Iodine, Shellfish
Diagnostic Lab Data: Doctor prescribed 40 mg of Prednisone daily for 7 days.
CDC Split Type:

Write-up: Much more than usual, extreme shortness of breath. Unable to walk from one room to another. Having oxygen constant. Chest pain. Shoulder and arm pain.


VAERS ID: 1785474 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-26
Onset:2021-09-26
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Ear swelling, Herpes zoster, Nasopharyngitis, Pain in jaw, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone; methotrexate; Enbrel
Current Illness: No
Preexisting Conditions: RA
Allergies: Sulfa drugs
Diagnostic Lab Data: 12Sep2021 & 1Oct2021 clinic covid test was negative
CDC Split Type: vsafe

Write-up: I was having cold symptoms and was having small bubbles temple on my face on the right and it spread to the entire top side of face. Lots of swelling on the ear and jaw and pain. I had two at home test that was positive but clinic test was negative. Clinic for covid testing on 12Sep2021 & 1Oct2021. Urgent care on 29Sep2021 diagnosed as shingles and went to eye doctor the next am. Shingles was on eyelid.


VAERS ID: 1785526 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-01-08
Onset:2021-09-26
   Days after vaccination:261
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Headache, Malaise, Nasal congestion, Nausea, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Positive PCR Covid-19 test.
CDC Split Type:

Write-up: Complaint of cough, chills, elevated temperature, headache, runny nose/congestion, malaise and nausea/vomiting.


VAERS ID: 1785965 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient described fever and fatigue 24 hours after vaccination. Upon going to get her flu shot about 2 weeks after she noticed a goose egg type ball near the site of the injection. From my memory when vaccinating the goose egg was already present on the arm before vaccination but worth noting. The patient did not report any redness or noticeable swelling post vaccination and it wasnt until the next vaccine that it was noticed.


VAERS ID: 1786569 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-18
Onset:2021-09-26
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arteriosclerosis coronary artery, Bipolar I disorder, COVID-19, Cerebrovascular accident, Chest X-ray abnormal, Chronic kidney disease, Computerised tomogram head normal, Condition aggravated, Confusional state, Delirium, Essential hypertension, Gait disturbance, Leukocytosis, Lung opacity, Mental status changes, Metabolic encephalopathy, Neurological symptom, Pneumonia, Polyneuropathy, Pyrexia, SARS-CoV-2 test positive, Urinary tract infection, Vascular dementia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Chronic kidney disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (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? Yes
Hospitalized? Yes, 18 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet ascorbic acid, vitamin C, (VITAMIN C) 500 mg tablet aspirin 81 mg chewable tablet bisacodyL (DULCOLAX) 5 mg EC tablet divalproex (DEPAKOTE) 500 mg 24 hr tablet donepeziL (ARICEPT) 10 mg tablet mag
Current Illness:
Preexisting Conditions: Non-Hospital Hyperlipidemia History of malignant neoplasm of prostate Postoperative urethral stricture Prediabetes Spinal stenosis in cervical region Metabolic encephalopathy Normal pressure hydrocephalus Falls
Allergies: Metoclopramide HclHives / Urticaria Escitalopram OxalateOther (document details in comments) LamotrigineOther (document details in comments) Ziprasidone HclOther (document details in comments)
Diagnostic Lab Data: 10/07/2021 1830 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 10/07/21 1830 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result Detected Critical 10/07/2021 1830 COVID-19 PCR - Communal Living / SNF Placement (Asymptomatic) Collected: 10/07/21 1830 | Final result | Specimen: Swab from Nasopharynx Procedure Component Value Ref Range Date/Time X-ray chest 1 view, Portable [3307066337] Resulted: 10/11/21 1451 Order Status: Completed Updated: 10/11/21 1451 Narrative: XR CHEST 1 VW PORT IMPRESSION: Slight increased opacity to both lungs may represent mild pneumonia on a poor inspiration chest END OF IMPRESSION: INDICATION: fever. TECHNIQUE: Portable COMPARISON: CXR 9/26/2021 FINDINGS: Mild opacity seen in both lungs. The heart and vascularity mediastinum are normal. Poor inspiration is obtained. VP shunt is seen over the right thorax. Postsurgical changes are seen spine and sternum. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT head stroke without contrast [3305293441] Resulted: 09/26/21 2013 Order Status: Completed Updated: 09/26/21 2013 Narrative: CT HEAD STROKE WO CONTRAST IMPRESSION: 1. There is no CT evidence of acute intracranial abnormality. 2. Ventriculoperitoneal shunt catheter in good position, and the appearance of the cerebral ventricles is unchanged when compared to the prior study. The ventricle size is stable. Note: I personally communicated the results of this examination directly by telephone to doctor in the emergency room at approximately 8:10 PM this evening. END OF IMPRESSION: INDICATION: stroke. Increasing confusion over the past 2 hours. Male, 78 years TECHNIQUE: Head CT was performed without intravenous contrast. Up-to-date CT equipment and radiation dose reduction techniques were employed. CTDIvol: 31.0 mGy. DLP: 625 mGy-cm. COMPARISON: May 22, 2021 FINDINGS: The ventricles and sulci are normal in size and symmetric, with some symmetric prominence of the lateral ventricles unchanged compared to the prior study earlier this year. There is also a ventriculoperitoneal shunt catheter noted within the right lateral ventricle, unchanged in position. There is no evidence of midline shift, mass effect or altered cerebral ventricles. The ventricular size is unchanged from prior study. There is no evidence of acute intracranial hemorrhage. There is no CT evidence of acute territorial infarction. Limited visualization of the orbits and paranasal sinuses is unremarkable. There is no evidence of skull fracture. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view [3305293442] Resulted: 09/26/21 1925 Order Status: Completed Updated: 09/26/21 1925 Narrative: XR CHEST 1 VW PORT IMPRESSION: No acute process. END OF IMPRESSION: INDICATION: Stroke symptoms. Male; 78 years TECHNIQUE: Portable AP upright chest 7:07 PM COMPARISON: May 22, 2021 FINDINGS: Ventriculoperitoneal shunt catheter overlies the right chest. There are sternotomy wire sutures from previous CABG. Spinal surgical changes are noted involving the lower cervical and upper thoracic spine. The lungs are clear with no evidence of any active cardiopulmonary, mediastinal, or pleural process. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient.
CDC Split Type:

Write-up: ED to Hosp-Admission Current 9/26/2021 - present (18 days) COVID-19 Principal problem Hospital Problems POA * (Principal) Toxic metabolic encephalopathy Yes Coronary arteriosclerosis Yes Multi-infarct dementia with delirium Yes Bipolar affective disorder, depressed, in full remission Yes Stage 3a chronic kidney disease Yes Essential hypertension Yes Polyneuropathy associated with underlying disease Yes VP (ventriculoperitoneal) shunt status Not Applicable Ambulatory dysfunction Yes Medical Problems Plan: Admit patient to MedSurg under observation status. PT evaluation to gauge patient''s mobility as the wife is able to take care of him as long as he is able to walk with a walker Toxic metabolic encephalopathy has resolved, patient is at baseline, wife is at bedside to confirm. Continue home medications Avoid benzodiazepines and opiates to prevent delirium, frequent reorientation, maintain sleep-wake circadian rhythm. Consult infectious diseases the patient has a history of VRE in the urine looks infected however it is difficult to gauge if the patient is actually symptomatic. He does have mild leukocytosis. Addendum: spiked fever overnight, will switch abx to linezolid. Culture reviewed, only sensitive to linezolid. ID consult is pending. VTE prophylaxis: Heparin Full Code History of Present Illness Chief Complaint Patient presents with ? Altered Mental Status Patient is an 78 y.o. male. Past medical history of VP shunt, dementia, ambulatory dysfunction dependent on a walker, BPH status post proctectomy complicated by urinary incontinence. Patient is accompanied by his wife who is at the provider of history. She states that he was in his usual state of health and he was sitting in his recliner in the garage which he normally does. She went out to go check on him and asked him to come inside so she can change his diaper at that point the patient would not get out of the chair and look like no one was home. She denies seeing any tonic-clonic like activity. She called over a neighbor to help get patient out of the chair and when they were not able to, they called EMS. Patient is pleasantly demented and is symptom free. He is seen eating a sandwich and appears to be very comfortable. Wife is at bedside who states that he is back to his baseline mental status. She does straight cath him every other day. In the ER labs are notable for mild leukocytosis with urine that appears to be infected. He was given ceftriaxone in the ER. Labs and imaging reviewed.


VAERS ID: 1788165 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-13
Onset:2021-09-26
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Cough, Decreased appetite, Dyspnoea, Fatigue, Nausea, Peripheral swelling, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient presented to the ED with increasing shortness of breath, cough, fatigue, nausea, decrease in appetite and bilateral leg swelling. He was found to be COVID positive and admitted for further management of COVID pneumonia. He was discharged 12 days later in stable condition.


VAERS ID: 1788228 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-01
Onset:2021-09-26
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

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

Write-up: COVID hospitalization after full vaccination.


VAERS ID: 1788236 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-01
Onset:2021-09-26
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID hospitalization after full vaccination.


VAERS ID: 1788464 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Patient received Janssen COVID vaccine. After vaccine was administered it was identified that patient was 16 years old and did not meet EUA age requirements. No adverse reactions were noted.


VAERS ID: 1789483 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / SYR
VARZOS: ZOSTER (SHINGRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Discomfort, Eye inflammation, Fatigue, Headache, Inflammation, Musculoskeletal pain, Myalgia, Neck pain, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac
Current Illness: None
Preexisting Conditions: RA
Allergies: Sulfasalazine, Lamictal
Diagnostic Lab Data: I am going to urgent care tomorrow for labs recommended by my insurance.
CDC Split Type:

Write-up: Body wide inflammation, muscular pain, heaviness, rash on lower back, squeezing chest pain, pain between shoulder blades, headaches, painful neck glands, fatigue, eye inflammation, and joint pain.


VAERS ID: 1789945 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Joint swelling, Myalgia, Pain in extremity, Pain of skin
SMQs:, Rhabdomyolysis/myopathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: aspirin, antibiotics, beer
Diagnostic Lab Data: Dr said it was normal when emailed
CDC Split Type:

Write-up: 4 weeks of extreme fatigue, joint swelling and pain in hands, feet, muscles. skin around joints hurts to touch at night.


VAERS ID: 1790836 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101281536

Write-up: Hives; This is a spontaneous report from a contactable consumer (patient). A 17-year-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration, administered in right arm on 24Sep2021 at 12:30 (at the age of 17-years-old) as dose 2, single for COVID-19 immunisation. The patient previously received the first dose of bnt162b2 on 02Sep2021 at 12:00. The patient had no relevant medical history. There were no concomitant medications. The patient experienced hives on 26Sep2021 at 12:00. The event was treated with Benedryl. The outcome of event was not recovered. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1790868 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-16
Onset:2021-09-26
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FP8448 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous
SMQs:, Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101285693

Write-up: Confirmed Miscarriage; This is a spontaneous report from a contactable nurse (patient). A 29-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in Arm Left on 16Sep2021 07:15 (Lot Number: FP8448) at the age of 29-year-old, as dose 2, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. No other vaccine was administered in four weeks. The patient did not have COVID-19 prior to vaccination and was not tested for COVID-19 post vaccination. Historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number=FP8448) via an unspecified route of administration, administered in Arm Left on 26Aug2021 at 08:00 AM at the age of 29-year-old at single dose for COVID-19 immunisation. The patient had confirmed miscarriage on 26Sep2021. The event resulted in Doctor or other healthcare professional office/clinic visit. No treatment was received. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on the current limited available information and the drug-event temporal association, a possible contributory role of the suspect product BNT162B2 to the development of event Abortion spontaneous cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1790891 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 3 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Fatigue, Off label use, Vaccination site bruising, Vaccination site erythema, Vaccination site pain, Vaccination site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101288120

Write-up: redness / redness all above the upper arm; there was a little bruise at the site where injected; she has swelling on her upper arm, near the injection site about two inches by 2 inches; a little tired; sore arm; she received the booster dose on Sunday, 26Sep2021; she received the booster dose on Sunday, 26Sep2021; This is a spontaneous report from a contactable consumer (patient). A 70-year-old female patient received the third dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in left arm on 26Sep2021 (Batch/Lot Number: 301358A) (at the age of 70 years old) as single dose for Covid-19 immunisation. The patient medical history was not reported. The first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) was administered on 04Feb2021 (Lot: EL9269, Expiration: Unknown) (at the age of 69 years old) via an unspecified route of administration, administered in left arm for Covid-19 immunisation and experienced a little tiredness and soreness in arm. The second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) was administered on 26Feb2021 (Lot: EN6203, Expiration: Unknown) (at the age 69 years old) via an unspecified route of administration, administered in left arm and experienced a little tired and had little bit like had the flu. The patient also had a second dose of Pneumonia vaccine 2 years ago for immunization and arm became swollen. The patient''s concomitant medications were not reported. The patient received the booster dose on Sunday, 26Sep2021 and felt a little tired and had sore arm. On 29Sep2021, the patient experienced she has swelling on her upper arm, near the injection site about two inches by 2 inches. There was also some redness. Redness all above the upper arm and there was a little bruise at the site where injected. She noted that she just started experiencing this today (29Sep2021). She had taken Benadryl to reduce the swelling. The patient recovered from tiredness on 27Sep2021. Outcome of the other events was unknown. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1790908 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Fatigue, Muscle twitching, Sleep disorder, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Supraventricular tachyarrhythmias (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ELIQUIS; MONTELUKAST; AMLODIPINE; MELATONIN; BUDES
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: AFib (a fib); Asthma; Blood pressure high; High cholesterol; Thoracic aortic aneurysm
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101288404

Write-up: shaky; my hands having a slight twitch; tired; slept all day; sustained readings of "signs of atrial fib."; This is a spontaneous report from a contactable consumer. A 68-year-old male consumer (patient) reported that received the third dose (booster dose) of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number unknown), on 26Sep2021 at 12:30 (at the age of 68-years-old) at single dose for COVID-19 immunization. The patient had received another dose of BNT162B2 on 15Feb2021 at 12:45 PM in the Left arm. Within 4 weeks prior the booster dose on 13Sep2021, the patient had received flu vaccine - left arm. Medical history: included atrial fib; mild asthma; high blood pressure; high cholesterol; thoracic aortic aneurysm. No known allergies. Concomitant drugs included eliquis; montelukast; amlodipine; melatonin, budes. Prior to vaccination, the patient was not diagnosed with COVID-19. On 26Sep2021 04:30 PM approximately four hours after the shot the patient''s Apple Watch showed sustained readings of "signs of atrial fib." On the next morning he was shaky, with his hands having a slight twitch. He was tired and slept all day. On the subsequent day (i.e. day 2) he was fine. The event resulted in Doctor or other healthcare professional office/clinic visit. no treatment was given. Since the vaccination, has the patient has not been tested for COVID-19. The outcome of the event was recovered on 28Sep2021. The Lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1790921 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Body temperature, Feeling cold, Headache, Malaise, Pain in extremity, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE; RALOXIFENE; CALCIUM; D3; KRILL OIL.
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism (Other medical history: hypo-thyroid, osteopenia, mild MGUS); MGUS; Osteopenia.
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: Temperature; Result Unstructured Data: Test Result:102.8; Test Date: 20210928; Test Name: Temperature; Result Unstructured Data: Test Result:99; Comments: Temperature down to 99 on Tues. morn. Normal later in day; Test Date: 20210928; Test Name: Temperature; Result Unstructured Data: Test Result:Normal; Comments: Temperature down to 99 on Tues. morn. Normal later in day; Test Date: 20210929; Test Name: Temperature; Result Unstructured Data: Test Result:99; Comments: Back to 99 Wed. night.
CDC Split Type: USPFIZER INC202101288871

Write-up: severe hives on trunk of body; general malaise; temperature of 102.8 next day; Very sore arm; mild headache; cold/unable to get warm in middle of first night (Sun.); This is a spontaneous report from a contactable consumer (patient). A 71-year-old non-pregnancy female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in Arm Left on 26Sep2021 14:30 (Lot Number: EW0176, at age of 71 years old) as single dose for COVID-19 immunisation. Medical history included hypo-thyroid, osteopenia, mild MGUS. Concomitant medications included levothyroxine; raloxifene; calcium; colecalciferol (D3); krill oil. The patient previously took codeine and amoxicillin and experienced drug allergy. The patient experienced very sore arm and a mild headache a few hours after (at 04:30 PM on 26Sep2021) and throughout, cold/unable to get warm in middle of first night (Sun. on 26Sep2021), general malaise and temperature of 102.8 next day (Mon. on 27Sep2021), severe hives on trunk of body (discovered on 2nd day (Tues on 28Sep2021), but did not undress on Monday (on 27Sep2021) so don''t know if were there on Mon (on 27Sep2021). Temperature down to 99 on Tues. morn (on 28Sep2021). Normal later in day (on 28Sep2021). Back to 99 Wed. night (on 29Sep2021). Hives remain but less solid. Self-treating temperature with tylenol beginning Mon. (on 27Sep2021) and starting benadryl Wed. night (on 29Sep2021). The outcome of events hives and fever was recovering, the outcome of rest events was unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1791090 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Massachusetts  
Vaccinated:2021-04-01
Onset:2021-09-26
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       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: 20210926; Test Name: Covid-19 virus; Test Result: Positive
CDC Split Type: USPFIZER INC202101302983

Write-up: I vaccinated twice in early April however I was tested positive with the Covid-19 virus last Sunday; I vaccinated twice in early April however I was tested positive with the Covid-19 virus last Sunday; This is a spontaneous report from Pfizer sponsored program a contactable consumer or other non health care professional (Patient). A patient of unspecified age and gender received BNT162B2 (BNT162B2 Formulation: Solution for injection Batch/Lot number: not reported Expiration date: Unknown) via an unspecified route of administration on Apr2021 as dose 1, single and BNT162B2 (BNT162B2 Formulation: Solution for injection Batch/Lot number: not reported Expiration date: Unknown) via an unspecified route of administration on Apr2021 as dose 2, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient stated that he/she got vaccinated twice in early April however patient was tested positive with the COVID-19 virus last Sunday on 26Sep2021. Patient further mentions, they were told not wear mask in public if vaccinated but this is false. Thank you and stay safe all. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 26Sep2021. Outcome of events was unknown. The lot number for, the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1791147 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101311607

Write-up: went into four separate series of seizures.; woke up vomiting; This is a spontaneous report from a contactable consumer (patient). A 43-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: fc3182), via an unspecified route of administration, administered in left arm on 24Sep2021 08:00 (at the age of 43-years-old) as single dose for COVID-19 immunization. Medical history reported as none. There were no concomitant medications. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: ff2588), via an unspecified route of administration, administered in left arm on 03Sep2021 12:00 PM for COVID-19 immunization. Vaccination facility type was Pharmacy or Drug Store. The patient had no other vaccine in four weeks and no other medications in two weeks. It was reported that last Friday (24Sep2021), the patient received his second vaccination. On Sunday morning (26Sep2021 04:00), the patient promptly woke up vomiting and went into four separate series of seizures. His wife contacted EMS and services were administered. The patient had no COVID prior vaccination and has not been tested for COVID post vaccination. The events resulted in emergency room/department or urgent care. Therapeutic measures were taken as a result of both events. The outcome of the events was unknown.


VAERS ID: 1791200 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-26
Onset:2021-09-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adiposis dolorosa, Contusion, Neoplasm progression, Off label use, Pain, Product use issue, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Malignancy related conditions (narrow), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (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: CYMBALTA; BUSPIRONE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dercum''s disease (verbatim: Diagnosed with Dercum''s Disease ( a rare progressive connective tissue disorder)); Fibromyalgia; Food allergy (known allergies: Beef, pepper); Lipedema; Type II diabetes mellitus
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101318296

Write-up: Steadily sharp increase in dercum''s pain; Steadily sharp increase in dercum''s pain; swelling; bruising; Dercums tumors from days 2-7; other vaccine same date product=Flu shot, other vaccine same date vaccine date=26Sep2021; other vaccine same date product=Flu shot, other vaccine same date vaccine date=26Sep2021; This is a spontaneous report from a contactable consumer (patient) or other non hcp. A 58-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: FF2588) via an unspecified route of administration, administered in Arm Left on 26Sep2021 12:15 (at the age of 58-years-old) as dose 3, booster, single for COVID-19 immunization. The patient received influenza vaccine (FLU VACCINE VII), (Batch/Lot number was not reported) via an unspecified route of administration from 26Sep2021 to 26Sep2021, as dose 1, single for an unspecified indication. Medical history included known allergies: Beef, known allergies: pepper, Dercum''s Disease (progressed; a rare progressive connective tissue disorder) by 2 researchers several years ago.), Lipedema, Diabetes 2 and Fibromyalgia. Concomitant medications included duloxetine hydrochloride (CYMBALTA); buspirone (BUSPIRONE). The patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EN6199) via an unspecified route of administration, administered in Arm Right on 02Mar2021 13:00 PM (at the age of 58-years-old) as dose 1, single for COVID-19 immunization and bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8730) via an unspecified route of administration, administered in Arm left on 23Mar2021 15:30 PM (at the age of 58-years-old) as dose 2, single for COVID-19 immunization. No COVID prior to the vaccination. COVID not tested post vaccination. On 26Sep2021, the patient received other vaccine same date product=flu shot, other vaccine same date vaccine date=26sep2021. On 27Sep2021 12:00, the patient experienced steadily sharp increase in dercum''s pain, swelling, bruising and dercums tumors from days 2-7. There is no reliable treatments for Dercums. No treatment was given for adverse events. The outcome of the events was not recovered. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1793590 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-09-26
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Muscle spasms
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (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: lisinopril 5mg supre B complex zinc 50mg womens one a day D3 mcg milk thistle lexapro 20 mg lunesta 3 mg tizanidine 2mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I received the second dose of the vaccine on august 21, 2021. on september 26, 2021, I started my menstrual cycle and as of today, october 16, 2021 I am still bleeding. it has been 21 days with occasional cramping. I will see my gynocologist for an exam on thursday, october 21, 2021


VAERS ID: 1793611 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-24
Onset:2021-09-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Extra dose administered, Fatigue, Interchange of vaccine products, Lymphadenopathy, Pain
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Pravastatin, Lorsartin, triamcinolone cream
Current Illness:
Preexisting Conditions: High blood pressure, diabetes, psoraisis
Allergies: Kiwi, Argentine shrimp
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Received Moderna 12/31/ 2020 Received Moderna. 1/28/2021 Received Pfizer. 9/24/2021 -- Day 1: exhaustion , Day 2: redness from shoulder to elbow & burning pain, Day 3: large swollen gland in right armpit and on neck under ear lasted 7 days approx.


VAERS ID: 1794154 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 1 LA / IM

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

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

Write-up: Fatigue, headache, sore arm


VAERS ID: 1794417 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-09-26
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-10-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Encephalopathy, Inappropriate schedule of product administration, Seizure, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Not responsive; Brain seizure; Encephalopathy; Received second dose more than 35 days after the first dose; This spontaneous case was reported by a consumer and describes the occurrence of UNRESPONSIVE TO STIMULI (Not responsive), SEIZURE (Brain seizure) and ENCEPHALOPATHY (Encephalopathy) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Sep-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received second dose more than 35 days after the first dose). On an unknown date, the patient experienced UNRESPONSIVE TO STIMULI (Not responsive) (seriousness criteria hospitalization prolonged and medically significant), SEIZURE (Brain seizure) (seriousness criteria hospitalization prolonged and medically significant) and ENCEPHALOPATHY (Encephalopathy) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized on 01-Oct-2021 due to ENCEPHALOPATHY, SEIZURE and UNRESPONSIVE TO STIMULI. On 26-Sep-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received second dose more than 35 days after the first dose) had resolved. At the time of the report, UNRESPONSIVE TO STIMULI (Not responsive), SEIZURE (Brain seizure) and ENCEPHALOPATHY (Encephalopathy) outcome was unknown. Patient was taken by ambulance to ER of hospital, he was admitted that night and has been there ever since, discussing to move him into palliative care. No concomitant medication were provided. No treatment information were provided. Company comment: This case of inappropriate schedule of vaccine administered concerning a 75-year-old male patient with no reported medical history, who experienced the unexpected events of encephalopathy, unresponsive to stimuli and seizure. The events occurred following an unspecified date after the administration of the second dose of mRNA-1273 (Spikevax). The rechallenge was not applicable as the event occurred after the second vaccine dosing. Causality for the reported event was not provided by the reporter. The benefit-risk relationship of Spikevax is not affected by this report. Events assessed as serious as the events resulted in hospitalization and considered as important medical event. Encephalopathy is an adverse event of special interest.; Sender''s Comments: This case of inappropriate schedule of vaccine administered concerning a 75-year-old male patient with no reported medical history, who experienced the unexpected events of encephalopathy, unresponsive to stimuli and seizure. The events occurred following an unspecified date after the administration of the second dose of mRNA-1273 (Spikevax). The rechallenge was not applicable as the event occurred after the second vaccine dosing. Causality for the reported event was not provided by the reporter. The benefit-risk relationship of Spikevax is not affected by this report. Events assessed as serious as the events resulted in hospitalization and considered as important medical event. Encephalopathy is an adverse event of special interest.


VAERS ID: 1794909 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-25
Onset:2021-09-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Fatigue, Headache, Magnetic resonance imaging head, Pain
SMQs:

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

Write-up: THE DAY OF I WAS OKAY THE NEXT DAY I WAS TIRED AND THE NEXT COUPLE OF DAYS I WAS REALLY TIRED AND HAD HEADACHES AND THEN ON 10/02 I WENT TO THE CLINIC AND THEY GAVE ME STEROIDS AND COUPLE OF OTHER MEDICATION FOR MY PAIN. I TOOK THE MEDCICINES AND IT DID NOT GOT BETTER AND THEN I WENT TO THE ENT AND THEY ORDERED A MRI FOR MY BRAIN AND GAVE MY MTRIX FOR MY HEADACHE AND THEN THE NEXT DAY I WANT TO THE EMERGENCY ROOM AND THEY GAVE ME A COUPLE OF MEDICINES.


VAERS ID: 1795359 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-01
Onset:2021-09-26
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-10-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Deafness unilateral, Magnetic resonance imaging, Sudden hearing loss, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/27/21. Seen by otolaryngologist. Oral steroids commenced on that day along with hearing test confirming loss. 10/4/21 follow up hearing test showing no change. 10/6/21 mri. 10/6/21 commenced steroid injections into the ear. 10/12/21 completed third injection.
CDC Split Type:

Write-up: Sudden hearing loss in left ear followed by onset of tinnitus.


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