National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/14/2022 release of VAERS data:

Found 1,031,637 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 479 out of 10,317

Result pages: prev   380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578   next


VAERS ID: 1929172 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1929185 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1929217 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-28
Onset:2021-11-23
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Condition aggravated, Pain, SARS-CoV-2 test positive, Wound drainage, Wound infection
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: diabetes
Allergies:
Diagnostic Lab Data: Covid Postive
CDC Split Type:

Write-up: The patient present wound infections. The patient surgical wound opened up. There was a mild amount of drainage and complained about increased pain.


VAERS ID: 1929250 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine (PEDS) pediatric formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1929256 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1929312 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Immunisation, Underdose
SMQs:, Medication errors (broad)

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

Write-up: Client was first given a Moderna booster dose (half dose). Ensuing discussion about scheduling highlighted the error, that client had wanted a first dose. Client was informed and offered a second half dose , she accepted and was given the remainder of the dose expected.


VAERS ID: 1929839 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-14
Onset:2021-11-23
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 2 LA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1929848 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-21
Onset:2021-11-23
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1929855 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-28
Onset:2021-11-23
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1929861 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-01
Onset:2021-11-23
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: nn
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1929865 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-04
Onset:2021-11-23
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 RA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: nn
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1929869 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-04
Onset:2021-11-23
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 RA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: nne
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1929874 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-10
Onset:2021-11-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 LA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1929880 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-17
Onset:2021-11-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1929991 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-26
Onset:2021-11-23
   Days after vaccination:301
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Decreased activity, Fatigue, Headache, Oropharyngeal pain, Paranasal sinus discomfort, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None listed
Current Illness:
Preexisting Conditions: None listed
Allergies: Latex
Diagnostic Lab Data: 11/23/21 SARS-CoV-2 PCR Detected Abnormal
CDC Split Type:

Write-up: 11/23/21 Reports 3 yo is positive for coivd and she began having a cough on Sunday, 2 days ago She did 2 test at the high school drive in and they were both positive. Review of Systems Constitutional: Positive for activity change, chills and fatigue. Negative for appetite change and fever. HENT: Positive for congestion, postnasal drip, rhinorrhea, sinus pressure and sore throat. Negative for ear pain and sinus pain. Respiratory: Positive for cough. Negative for shortness of breath and wheezing. Gastrointestinal: Negative for abdominal pain, diarrhea, nausea and vomiting. Neurological: Positive for headaches.


VAERS ID: 1929994 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-02
Onset:2021-11-23
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 2 RA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1929998 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-09
Onset:2021-11-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 RA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1930000 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-09
Onset:2021-11-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1930002 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-09
Onset:2021-11-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 RA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1930007 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-03
Onset:2021-11-23
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Other       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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Administration of improperly stored vaccines.


VAERS ID: 1930010 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-03
Onset:2021-11-23
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1930014 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-13
Onset:2021-11-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Blood albumin decreased, Chapped lips, Conjunctivitis, Kawasaki's disease, Laboratory test, Lip erythema, Pyrexia, Rash, White blood cell count increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vasculitis (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), 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? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Turner''s Syndrome
Allergies: NKDA
Diagnostic Lab Data: Labs from 11/30 & 12/1 KD relevant labs - WBC 20, Albumin 2.9, ALT 68
CDC Split Type:

Write-up: Incomplete/Atypical Kawasaki''s Disease development- presented (11/30) with 6 days of fever developed 3 of 5 typical symptoms of KD - nonpurulent, limbic sparing conjunctivitis, red/cracked lips and rash. Began with conjunctivitis and lips and on day 2 of hospitalization (12/1) developed a rash.


VAERS ID: 1931512 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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 INC202101646695

Write-up: he said he was going where he didn''t want to go and darkness in front of his eyes; I saw him swaying back and forth in the shower and about to fall; he was conscious but his lips were pale; This is a spontaneous report received from a contactable consumer. The reporter is the parent. A 5-year-old male patient received bnt162b2 (BNT162B2), intramuscular, administered in arm left, administration date 22Nov2021 (Lot number: FK5127) at the age of 5 years as dose 1, single for covid-19 immunisation. The patient had no relevant medical history. There were no concomitant medications. The vaccine was administered in pharmacy or drug store. There were no other vaccine in four weeks and no other medications in two weeks. The patient did not have Covid-19 prior vaccination, was not tested for Covid-19 post vaccination. He had no known allergies and no other medical history. The following information was reported: SYNCOPE (medically significant) with onset 23Nov2021 08:30, outcome "recovered", described as "he said he was going where he didn''t want to go and darkness in front of his eyes"; PRESYNCOPE (non-serious) with onset 23Nov2021 08:30, outcome "recovered", described as "I saw him swaying back and forth in the shower and about to fall"; PALLOR (non-serious) with onset 23Nov2021 08:30, outcome "recovered", described as "he was conscious but his lips were pale". The parent reported that patient took vaccine yesterday evening. He was okay. In the morning, he woke up around 8:30 am and went to shower. After 15-20 minutes in shower, the parent saw him swaying back and forth in the shower and about to fall. The parent picked patient up, he was conscious but his lips were pale. The parent asked him what happened and he said "he was going where he didn''t want to go" and darkness in front of his eyes. Therapeutic measures were not taken as a result of syncope, presyncope, pallor. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1931519 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-05
Onset:2021-11-23
   Days after vaccination:263
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 - / -

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: Medical History/Concurrent Conditions: Headache
Allergies:
Diagnostic Lab Data: Test Date: 20211123; Test Name: COVID; Test Result: Positive
CDC Split Type: USPFIZER INC202101647434

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This is a spontaneous report received from a contactable reporter(s) (Consumer - patient''s husband) from medical information team and product quality group. A 56-year-old female patient received BNT162B2, administration date 05Mar2021 (Lot number: EN6198) at the age of 55 years as dose 2, single and administration date 2021 (Lot number: EN6198) as dose 1, single for covid-19 immunisation. Relevant medical history included: "Headache" (unspecified if ongoing). The patient''s concomitant medications were not reported. Past drug history included: ADVIL for Headache. The following information was reported: DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant) all with onset 23Nov2021, outcome "unknown" and all described as "COVID-19 confirmed by positive COVID-19 test". The patient has contracted COVID on 23Nov2021, testing positive after receiving both the Pfizer COVID vaccines. Therapeutic measures were not taken as a result of drug ineffective, covid-19. Product Quality Group provided investigational results on 24Nov2021 for BNT162B2: Conclusion of Previously Completed Investigation:The complaint for lack of effect of the PFIZERBIONTECH COVID-19 VACCINE lot EN6198 was investigated. The investigation included a review of manufacturing and packaging batch records, deviation investigations, and an analysis of complaint history for the reported lot. The final scope included the reported finished goods lot EN6198, fill lot EN5330, and the formulated drug product lot EN5319. A complaint sample was not returned, and photographs were not received. No related quality issues were identified during the investigation. There is no impact to product quality. No root cause or corrective/preventative actions were identified as the complaint was not confirmed. All release testing performed prior to the release of the reported batch was within specifications. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1931522 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3302680 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Lymphadenopathy
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
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 INC202101648420

Write-up: Chest pain; Shortness of breath; Full lymph nodes under her left arm; This is a spontaneous report received from a contactable Consumer or other non HCP for a Pfizer sponsored program (159558). The reporter is the patient. A 47-year-old female patient received bnt162b2 (BNT162B2), administered in arm left, administration date 22Nov2021 (Lot number: 3302680) at the age of 47 years as dose 2, single for covid-19 immunisation. The patient had no relevant medical history. The patient''s relevant medical history and concomitant medications were not reported. Vaccination history included: Bnt162b2 (First vaccine: , Date: 01Nov2021, Lot: FH8020, Site: left arm), administration date: 01Nov2021, for COVID-19 immunization. The following information was reported: CHEST PAIN (non-serious) with onset 23Nov2021, outcome "not recovered", described as "Chest pain"; DYSPNOEA (non-serious) with onset 23Nov2021, outcome "not recovered", described as "Shortness of breath"; LYMPHADENOPATHY (non-serious) with onset 23Nov2021, outcome "not recovered", described as "Full lymph nodes under her left arm".


VAERS ID: 1932279 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-10
Onset:2021-11-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 RA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1932280 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-10
Onset:2021-11-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 RA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1932289 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1932293 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Other       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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: administration of improperly stored vaccines


VAERS ID: 1932308 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1932374 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-18
Onset:2021-11-23
   Days after vaccination:309
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Exposure to SARS-CoV-2, 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED with SOA that started several days prior and was worsening. He was exposed to someone with COVID at his nursing home an tested positive here. He is still inpatient.


VAERS ID: 1932426 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213D21A / 2 LA / IM

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

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

Write-up: Numbness in left cheek, lasted about 10-15 minutes


VAERS ID: 1932430 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1932443 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
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: Lisinopril, bupropion, duloxetine, famotidine
Current Illness: None noted
Preexisting Conditions: Hypertension, GERD, depression or anxiety?
Allergies: Steroids
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received their booster dose too early. Previous doses were 5/10/21 and 7/8/21.


VAERS ID: 1932584 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 3 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Lip swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness:
Preexisting Conditions: Alzheimer''s disease, urinary incontinence, depression, cataracts
Allergies: No known allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient experienced some lip swelling following Moderna booster dose. Staff/patient noted lip swelling, patient was responsive. No complaints of itching, or any other symptoms. No rash/hives noted on chest, back, arms, or legs. Blood pressure and pulse ox were taken and within normal limits. Patient was given dose of diphenhydramine 25mg liquid at 11:48 AM. Followed up at 12:10 PM, patient responded well to dose of diphenhydramine. Lip swelling had gone down and vitals were still within normal limits. Patient feeling well and was counseled on signs and symptoms to continue monitoring.


VAERS ID: 1932597 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abortion incomplete, Abortion spontaneous, Amniorrhoea, Blood test normal, Chills, Exposure during pregnancy, Fatigue, Hot flush, Hyperhidrosis, Muscle spasms, Ultrasound scan abnormal, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Dystonia (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (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? Yes
Hospitalized? No
Previous Vaccinations: Pfizer-BioNTech 2nd dose, age 38, 04/15/2021, CoVid, Sensitivity to light and sound, chills, fatigue for about 16hrs
Other Medications: Prenatal, D3
Current Illness: Ache on left side
Preexisting Conditions: Environmental Allergies
Allergies: NKA
Diagnostic Lab Data: 11/25 Blood work(normal) UltraSound(Miscarriage, Incomplete Abortion)
CDC Split Type: vsafe

Write-up: (11/23/2021) Early morning was awaken with alternating chills and hot flashes(sweats) that lasted about 2hrs before I could return to sleep. The following 14 hrs had chills and fatigue. The following day around 7:30am had a event where my mucos plug and a small amount of amniotic fluid came out, called OBGYN nurse was advised to keep watch if any changes happen. Cramps on the evening of the 24th that still continues to this day. Later on 11/25 small amounts of dark blood spotting and as the day progressed around 3:00PM CT it changed to red blood and went to the ER. There they did blood work and Ultrasound. Blood work came back fine but UltraSound showed the baby was only 5wk 6days but was already at week 8. (week 5 was before the booster) NOTE: In first trimester morning sickness was light compared to my previous pregnancy. EST DUE DATE: July 6, 2022


VAERS ID: 1932672 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-26
Onset:2021-11-23
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 3 LA / IM

Administered by: Private       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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Budesonide; duloxetine; furosemide; gabapentin; Klor-Con; omeprazole; Pentasa; Synthroid. manganese oxide; B; B12; C; calcium; coq-10; cranberry; D; glucosamine chondroitin; iron; multivitamin; Octaviate; omega 369.
Current Illness: No
Preexisting Conditions: Lymphedema; Arthritis; Crohn''s; Hyperthyroidism
Allergies: Poppy seeds; codeine
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: 11/23/2021 muscle aches from my neck thru my torso, lasted for about six hours. It recurred again in about 5 days, then again after about 4/5 days later.


VAERS ID: 1932788 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1932791 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19 Vaccine PEDS pediatric formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9% NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1932802 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1932808 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA FG3527 / 3 LA / IM

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

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

Write-up: Patient had asked for Pfizer COVID 19 vaccine but was given Moderna COVID 19 vaccine in error


VAERS ID: 1932824 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 3 RA / IM

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

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

Write-up: Patient was administered incorrect dose of Moderna booster. Instead of receiving 0.25ml she received 0.5ml. No serious reaction or side effects reported.


VAERS ID: 1932920 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Disturbance in attention, Dizziness, Headache, Influenza virus test negative, Muscle spasms, Muscular weakness, Myalgia, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (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: AMLODIPINE BESYLATE 5mg, Aspirin 81mg, Atorvastatin Calium 10mg, Omeprazole 20mg
Current Illness:
Preexisting Conditions: High Blood Pressure
Allergies: none
Diagnostic Lab Data: ER visit showed no blood clots, no heart attack or other heart conditions, COVID and Flu negative, essentially no indications of an emergent condition on 7 Dec 2021
CDC Split Type:

Write-up: Overall body weakness, dizziness, pain and muscle cramps in both arms and hands, constant headache, lightheaded, difficulty concentrating , muscle weakness in legs


VAERS ID: 1933047 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-18
Onset:2021-11-23
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, White blood cell count decreased
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes HTN
Allergies: Proxicam
Diagnostic Lab Data: WBC 3.2
CDC Split Type:

Write-up: Pt SOB, came to ER admitted, given Remdesivir, decadron, was able to wean off O2 and discharged home.


VAERS ID: 1935213 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-11-17
Onset:2021-11-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330268D / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad)

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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atenolol, protonix, potassium, triamterene/hydrochlorothiazide, valtrex
Current Illness: none
Preexisting Conditions: morbid obesity, prediabetes, hypertension
Allergies: septra, vicodin, zoloft
Diagnostic Lab Data: CTA confirmed. 12/7/21
CDC Split Type:

Write-up: with in one week, pt developed multiple PEs


VAERS ID: 1935005 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Accidental underdose, 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.MOD20214

Write-up: Received a booster (0.25ml) dose as a second dose in the primary series; Received Moderna as second dose after Pfizer first dose; This spontaneous case was reported by an other health care professional and describes the occurrence of ACCIDENTAL UNDERDOSE (Received a booster (0.25ml) dose as a second dose in the primary series) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received Moderna as second dose after Pfizer first dose) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Previously administered products included for Product used for unknown indication: Pfizer vaccine (First dose) on 04-Feb-2021. Past adverse reactions to the above products included No adverse event with Pfizer vaccine. On 23-Nov-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .25 ml. On 23-Nov-2021, the patient experienced ACCIDENTAL UNDERDOSE (Received a booster (0.25ml) dose as a second dose in the primary series) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received Moderna as second dose after Pfizer first dose). On 23-Nov-2021, ACCIDENTAL UNDERDOSE (Received a booster (0.25ml) dose as a second dose in the primary series) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received Moderna as second dose after Pfizer first dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment medications were reported. This case was linked to MOD-2021-406082, MOD-2021-406033, MOD-2021-406212, MOD-2021-405950 (Patient Link).


VAERS ID: 1935135 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure measurement, Hallucination, Hypertension, Immunisation, Interchange of vaccine products, Off label use, Product use issue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Medication errors (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:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lung cancer; Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20211124; Test Name: blood pressure; Result Unstructured Data: Test Result:extremely high
CDC Split Type: USPFIZER INC202101659842

Write-up: hallucinations; extremely high blood pressure; Fever; other vaccine same date product=Influenza; Patient received Moderna as dose 1 and dose 2; BNT162B2 as dose 3 for booster./Other vaccine same date product=Influenza; Patient received Moderna as dose 1 and dose 2; BNT162B2 as dose 3 for booster.; DOSE 3 (BOOSTER), SINGLE; This is a spontaneous report received from a contactable reporter (Other HCP). The reporter is the patient. A 62 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm left, administration date 23Nov2021 16:00 (Batch/Lot number: unknown) at the age of 62 years as dose 3 (booster), single for covid-19 immunisation; influenza vaccine (INFLUENZA VACCINE), administered in arm right, administration date 23Nov2021 (Batch/Lot number: unknown) as dose 1, single for immunisation. Relevant medical history included: "Known allergies: Penicillin" (unspecified if ongoing); "Lung cancer" (unspecified if ongoing). There were no concomitant medications. Vaccination history included: Moderna (Dose Number: 2; Location of injection: Arm Right; Vaccine Administration Time: 12:00 PM), administration date: 17Feb2021, when the patient was 61 years old, for COVID-19 immunization; Moderna (Dose Number: 1; Location of injection: Arm Right; Vaccine Administration Time: 09:30 AM), administration date: 15Jan2021, when the patient was 61 years old, for COVID-19 immunization. The following information was reported: OFF LABEL USE (medically significant) with onset 23Nov2021, outcome "unknown", described as "Patient received Moderna as dose 1 and dose 2; BNT162B2 as dose 3 for booster./Other vaccine same date product=Influenza"; INTERCHANGE OF VACCINE PRODUCTS (medically significant) with onset 23Nov2021, outcome "unknown", described as "Patient received Moderna as dose 1 and dose 2; BNT162B2 as dose 3 for booster."; PRODUCT USE ISSUE (non-serious) with onset 23Nov2021, outcome "unknown", described as "other vaccine same date product=Influenza"; IMMUNISATION (medically significant) with onset 23Nov2021, outcome "unknown", described as "DOSE 3 (BOOSTER), SINGLE"; HALLUCINATION (medically significant) with onset 24Nov2021 18:00, outcome "recovering", described as "hallucinations"; HYPERTENSION (non-serious) with onset 24Nov2021 18:00, outcome "recovering", described as "extremely high blood pressure"; PYREXIA (non-serious) with onset 24Nov2021 18:00, outcome "recovering", described as "Fever". The events "hallucinations", "extremely high blood pressure" and "fever" were evaluated at the emergency room visit. The patient underwent the following laboratory tests and procedures: blood pressure measurement: (24Nov2021) extremely high. Therapeutic measures were taken as a result of hallucination, hypertension, pyrexia. Patient had no Covid prior vaccination and no Covid tested post vaccination. The lot number for the vaccine, [bnt162b2 ], was not provided and will be requested during follow up.; Sender''s Comments: Based on the information available, the causal relationship between the reported events and suspect drug BNT162B2 cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate


VAERS ID: 1935224 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-13
Onset:2021-11-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood cholesterol normal, Blood immunoglobulin E, Blood test, Cough, Differential white blood cell count normal, Erythema, Full blood count normal, Glycosylated haemoglobin, High density lipoprotein normal, Hypersensitivity, Inflammation, Low density lipoprotein normal, Mechanical urticaria, Pruritus, Red blood cell sedimentation rate normal, Rhinorrhoea, SARS-CoV-2 test negative, Sinus disorder, Swelling, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Influenza (Seasonal) Fluzone Quadrivalent
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Blood Panel: 12/03/2021 - Respiratory Allergy IGE Panel: Stable results; 12/03/2021 - Erythrocyte Sedimentation Rate: Stable results; 12/03/2021 - Complete Blood Count: Stable results; 12/03/2021 - Cholesterol: Stable results; 12/03/2021 - Low Density Lipoprotein Cholesterol: Stable results; 12/03/2021 - High Density Lipoprotein Cholesterol: Stable results; 12/03/2021 - Hemoglobin A1C: Stable results; 12/03/2021 - White Blood Cell Differential: Stable results. COVID-19 Test: 12/06/2021- Molecular Assay, NAA/PCR: Negative result.
CDC Split Type:

Write-up: First experienced itchiness everywhere on body on 11/23/2021. Woke up with hives on skin the next day. Hives were treated with Allegra medication, which worked for some time. Allegra stopped working after a few days. Presented to urgent care and was prescribed Prednisone and Vistaril. Medication was taken as prescribed but flares continued happening. Presented to general practitioner and was told it was just an allergy which caused urticaria. Developed a cough and runny nose with head sinus issues on 12/05/2021. Noticed on 12/08/2021 that the flare-ups could be induced by irritating the skin via scratching, which caused the spot on skin to be inflamed and raised with a red pigmentation (dermatographia or pressure urticaria).


VAERS ID: 1935238 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Difficulty breathing, congestion


VAERS ID: 1935392 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-11
Onset:2021-11-23
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Private       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: One a day prenatal
Current Illness:
Preexisting Conditions:
Allergies: Thimerosal, glutaraldehyde, augmentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives all over body, started in hands and feet, then succeeding days progressed to other parts of the body. Prednisone (3days) and antihistamines (5days) were taken but hives are still coming and going


VAERS ID: 1935567 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-19
Onset:2021-11-23
   Days after vaccination:308
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Flank pain, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: 11/23/21 presents to ED for "pain in his left side not eating, some diarrhea and nausea". PMHx of "Afib, CAD, HTN, HLP, DM"


VAERS ID: 1935569 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-11-23
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/22/21 SARS-CoV-2 (COVID-19) by NAA detected
CDC Split Type:

Write-up: 11/23/21 presents to OR for "Right VP Shunt Removal". PMHx "Glioblastoma"


VAERS ID: 1935570 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-23
Onset:2021-11-23
   Days after vaccination:273
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/23/21 SARS-CoV-2 (COVID-19) by NAA detected
CDC Split Type:

Write-up: 11/23/21 presents to radiology for "post biopsy left sided pneumothorax ". PMHx "HTN, HLD, h/o brain aneurysm s/p surgery, depression/anxiety, left breast cancer"


VAERS ID: 1935572 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1935576 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1935581 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1935583 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-11-23
   Days after vaccination:251
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Caesarean section, Gestational hypertension, Maternal exposure before pregnancy, SARS-CoV-2 test positive
SMQs:, Hypertension (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/24/21 SARS-CoV-2 (COVID-19) detected
CDC Split Type:

Write-up: 11/23/21 presents to FBC triage for "scheduled repeat C-section and gestational hypertension". PMHx of "anxiety disorder, depression, GERD"


VAERS ID: 1935584 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-10
Onset:2021-11-23
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Myalgia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/23/21 SARS-CoV-2 (COVID-19) by NAA detected
CDC Split Type:

Write-up: 11/23/21 presents to ED for "coronavirus concern, tested positive today at nursing facility" "some congestion and muscle aches, especially in his shoulders". PMHx of "aortic stenosis, CKD, Diabetes mellitus, type II, DVT"


VAERS ID: 1935585 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-23
Onset:2021-11-23
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Maternal exposure before pregnancy, Morning sickness, Obesity
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 11/23/21 presents to L&D triage for "CC of nausea and vomiting". PMHx of "PTD @ 25w2d, COVID during pregnancy, Obesity, Hx of gastric bypass, Rh neg, HSV2, GBS bacteruria, AMA, hx PPD"


VAERS ID: 1935596 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1935610 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1935841 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Incorrect dose administered, Product administered to patient of inappropriate age
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: 17 yr old patient received a 10 ug booster dose. Booster dose is not even approved in this age group Staff re-educated on booster eligibility and proper dosage for patients 12-17 who require a 3rd dose for immunocompromising conditions.


VAERS ID: 1936047 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-12
Onset:2021-11-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Influenza virus test negative, Mechanical urticaria, Muscular weakness, Musculoskeletal pain, Musculoskeletal stiffness, Pain, Pain in extremity, Pruritus, SARS-CoV-2 test negative, Skin swelling, Skin warm, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin, progestin-only birth control pill, fish oil, probiotic, vitamin D
Current Illness: mild sore throat
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 11/26 - negative COVID PCR test, negative influenza test
CDC Split Type:

Write-up: Hives and dermatographia began 11/23. Full body, including scalp, feet, hands, and upper lip. Hives were extremely itchy and painful and skin seemed swollen and was hot to the touch. Fingers felt very stiff and hands weak. By 11/25, left arm (NOT the arm that received the injection) and wrist felt very sore. After sitting for Thanksgiving dinner, buttocks also felt painfully sore. Was fatigued that day. On 11/26, conditions began to improve. As of today (12/9), still experiencing some itchniess, hives, and dermatographia, but much more manageable. Treatments: 11/23 - none 11/24-25 - Spray Benadryl, Eucerin Calming Cream, Colloidal Oatmeal bath 11/26-27 - Spray Hydrocortisone, 1 Claritin/day, Colloidal Oatmeal bath 11/28+ - occasional spray hydrocortisone


VAERS ID: 1936256 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19 Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL, 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1936276 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Peripheral swelling, Pruritus, Rash, Rash erythematous, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Sulfa Erythromycin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Started out as red bump/rash on arm. The next day it had grown and looked more like huge mosquito bites. Grew for a few days. It was warm to touch and itchy. At times it felt like a sunburn. Used over the counter itch medication. Tried Benadryl the second night. Finally reduced but can still tell where some of the rash appeared (maybe because of how pale I am?). Didn''t have any kind of reaction like this the first two doses.


VAERS ID: 1936277 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Condition aggravated, Electrocardiogram, Injection site reaction, Nausea, Panic attack, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone 10mg tablet Fluoxetine 20mg capsule LamoTrLgine 200mg tablet
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: ekg
CDC Split Type:

Write-up: PT received Pfizer booster on 11/22/21 within 24 hours developed a red painful non raised non pruritic ring around the injection site; nausea; anxiety with panic attacks PT states he tolerated the first two injection without the above sxs PMHx significant for MDD and GAD, however states prior anxiety was controlled and no panic attacks meds: lamotrigine, fluoetine, buspiron, tylenol


VAERS ID: 1936371 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-12
Onset:2021-11-23
   Days after vaccination:256
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, COVID-19, Pneumonia, SARS-CoV-2 test positive
SMQs:, Interstitial lung disease (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: 2019 Novel Coronavirus RNA detected 11/26/2021 Hospitalized 12/3/2021 DX Pneumonia and ARDS


VAERS ID: 1936408 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Cerebrovascular accident, Computerised tomogram, Confusional state, Encephalopathy, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Excedrin tension headache
Current Illness: None
Preexisting Conditions: Migraines
Allergies: Nickel, lactose
Diagnostic Lab Data: MRA, CT scan, hospital admission, 11/23/21
CDC Split Type:

Write-up: Headache, confusion, stroke, encephalopathy


VAERS ID: 1936441 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-10
Onset:2021-11-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No tests completed. Dr. said its an auto immune response and it could be from the vaccine. For some reason my body is releasing histamine and causing hives throughout my body.
CDC Split Type:

Write-up: Rash/Hives all over the body (face, chest,arms, legs, stomach, and back). Trouble breathing. Rash/hives response started on 11/23/21 when menstrual cycle started and is continuing to present day.


VAERS ID: 1936603 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Electrocardiogram, Laboratory test, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: history of muscle aches after 1st and 2nd dose of moderna covid vaccinations
Other Medications: losartan, rouvastatin
Current Illness: none known
Preexisting Conditions: dyslipidemia, hypertension, history of hepatitis b
Allergies: lisinopril, simvastatin, trazodone
Diagnostic Lab Data: presented for evaluation 12/9/2021. labs, EKG and chest xray ordered
CDC Split Type:

Write-up: patient reports having muscle aches. also with left-sided chest pain.


VAERS ID: 1937039 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Tinnitus
SMQs:, Hearing impairment (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Second Moderna COVID19 shot
Other Medications: A, B Complex, Bio-identical HRT (sublingual Bi-estrogen, sublingual Testosterone, sublingual Progesterone)
Current Illness: None
Preexisting Conditions: migraines, menopause
Allergies: Eggs, Amoxicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Tinnitus, both ears, worse in right ear. This reaction also occurred after my second Moderna Vaccine on 04/29/2021. Tinnitus is severe for at least 6 months. The booster shot immediately triggered it again. Low, pitch, high pitch, and "tambourine" clanging has persisted rather in the same fashion as my second shot. - My insurance will not cover a visit to the ENT without a referral from a primary, which my insurance will also not pay for... I haven''t made an appointment yet, but plan to do so in January.


VAERS ID: 1938339 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-11-23
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Myalgia, Sluggishness
SMQs:, Rhabdomyolysis/myopathy (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211159539

Write-up: JUST A LITTLE BIT SLUGGISH; CHILLS; MUSCLE ACHES; This spontaneous report received from a patient via social media through company representative concerned a male of unspecified age of unknown race and ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient was previously treated on unspecified dates with the first dose of bnt 162 for prophylactic vaccination (manufacturer: Pfizer) and the second dose of bnt 162 for prophylactic vaccination (manufacturer: Pfizer). (Dose number series 1). On 23-NOV-2021, the patient reported getting the covid-19 vaccine (dose number in series 2) (reported by patient as Johnson and Johnson booster) on campus yesterday (suspension for injection, route of administration not reported, batch/lot number not reported) dose was not reported, 1 total administration for prophylactic vaccination. The company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. The patient experience chills and muscle aches all last night (dose number in series 2). At the time of reporting (24-NOV-2021) patient was feeling much better, just a little bit sluggish (dose number in series 2). Overall, much better than the second shot of Pfizer. The action taken with covid-19 vaccine was not applicable. The the time of the report, the outcome of chills, muscle aches, and just a little bit sluggish was unknown. This report was non-serious.


VAERS ID: 1938723 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New York  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Immunisation, Pain, Vaccination site pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101656483

Write-up: Booster; body aches; soreness at the injection site; fatigue; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A patient (no qualifiers provided) received bnt162b2 (BNT162B2), administration date 23Nov2021 (Batch/Lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (dose 1, Primary Immunization series complete but unknown manufacturer), for Covid-19 immunization; Covid-19 vaccine (dose 2, Primary Immunization series complete but unknown manufacturer), for Covid-19 immunization. The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021, outcome "unknown", described as "Booster"; PAIN (non-serious) with onset 23Nov2021, outcome "recovering", described as "body aches"; VACCINATION SITE PAIN (non-serious) with onset 23Nov2021, outcome "recovering", described as "soreness at the injection site"; FATIGUE (non-serious) with onset 23Nov2021, outcome "recovering", described as "fatigue". The lot number for bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 1938748 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1620 / 3 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101665883

Write-up: booster; sore arm; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non-HCP). A 44-year-old male patient received bnt162b2 (BNT162B2), intramuscular, administered in arm left, administration date 23Nov2021 (Lot number: FJ1620) at the age of 44 years as dose 3 (booster), single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. Vaccination history included Bnt162b2 (Dose Number: 1, Batch/Lot No: EP6955, Location of injection: Arm Left, Route of Administration: Intramuscular), administration date: 17Mar2021, when the patient was 43 years old, for Covid-19 immunization; Bnt162b2 (Dose Number: 2, Batch/Lot No: EP6955, Location of injection: Arm Left, Route of Administration: Intramuscular), administration date: 07Apr2021, when the patient was 43 years old, for Covid-19 immunization. The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021, outcome unknown; PAIN IN EXTREMITY (non-serious) with onset 23Nov2021, outcome recoverin. Therapeutic measures were not taken as a result of pain in extremity. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient not diagnosed with covid-19 prior to vaccination and since vaccination patient not tested for covid-19. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1938764 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Body temperature, Bone pain, Chills, Headache, Immunisation, Pain in extremity, Peripheral swelling, Pruritus, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Hypersensitivity (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergic asthma
Allergies:
Diagnostic Lab Data: Test Date: 20211123; Test Name: Fever; Result Unstructured Data: Test Result: 102 Fahrenheit.
CDC Split Type: USPFIZER INC202101676359

Write-up: Fever 102 f; Extreme chill; Pain in joints and bones; Pain in joints and bones; Headache; Swollen, itchy, painful arm and armpit; Swollen, itchy, painful arm and armpit; painful arm and armpit; Dose Number: 3; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 48-year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm right, administration date 23Nov2021 10:45 (Batch/Lot number: unknown) at the age of 48 years as dose 3 (booster), single for covid-19 immunisation. Relevant medical history included Allergic Asthma (unspecified if ongoing). The patient''s concomitant medications were not reported. Vaccination history included Bnt162b2 (Dose Number: 2, Location of injection: Arm Left, Vaccine Administration Time: 10:00 AM, prev dose product=COVID 19,, prev dose brand=Pfizer), administration date: 22Mar2021, when the patient was 47 years old, for COVID-19 Immunization; Bnt162b2 (Dose Number: 1, Location of injection: Arm Left, Vaccine Administration Time: 10:45 AM, prev dose product=COVID 19,, prev dose brand=Pfizer), administration date: 01Mar2021, when the patient was 47 years old, for COVID-19 Immunization. The following information was reported IMMUNISATION (non-serious) with onset 23Nov2021 10:45, outcome unknown; PYREXIA (non-serious) with onset 23Nov2021 16:00, outcome not recovered; CHILLS (non-serious) with onset 23Nov2021 16:00, outcome recovering; ARTHRALGIA (non-serious), BONE PAIN (non-serious) all with onset 23Nov2021 16:00, outcome not recovered; HEADACHE (non-serious) with onset 23Nov2021 16:00, outcome not recovered; PERIPHERAL SWELLING (non-serious), PRURITUS (non-serious) all with onset 23Nov2021 16:00, outcome recovering; PAIN IN EXTREMITY (non-serious) with onset 23Nov2021 16:00, outcome not recovered. Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were taken as a result of pyrexia, arthralgia, bone pain, headache, and pain in extremity. Therapeutic measures were not taken as a result of chills, peripheral swelling, and pruritus. On 23Nov2021 the patient''s fever was 102F. The lot number for bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 1939338 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-29
Onset:2021-11-23
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Chest pain, Computerised tomogram thorax abnormal, Pericardial effusion, Pericarditis, White blood cell count increased
SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol, Cardura, Flovent, Remeron, MVI, Procera AVH, Therawirx, Cialis, Unithroid, Vit B12, Zinc, ASA
Current Illness: None
Preexisting Conditions: Asthma, mild OSA, secondary hypothyroidism
Allergies: Morphine
Diagnostic Lab Data: elevated WBC, elevated BNP, CT chest showing small pericardial effusion 11/23.
CDC Split Type:

Write-up: On 11/23/21 developed chest pain and diagnosed with pericarditis. He returned to the hospital 12/4/21 with a pericardial effusion.


VAERS ID: 1939450 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-11-18
Onset:2021-11-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012F21A / 2 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Feeling abnormal, Gingival swelling, Headache, Lymphadenitis, Menstruation irregular, Pain in jaw, Pyrexia, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Osteonecrosis (broad), Fertility disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Moderna vaccine (dose one)
Other Medications: Moderna IUD, multi-vitamin, collagen gummy.
Current Illness: A cold two weeks prior to second vaccination.
Preexisting Conditions: None.
Allergies: Amoxicillin
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: AFTER I had completed my VAERS report to disclose my unexpected and unusual reaction (a period), approximately two days later, additional symptoms appeared. The VAERS system does not allow updates electronically, so I am documenting them now and will then recap dose two reactions. This is also why I waited longer to disclose side effects following the second shot because I wanted ample time to observe effects before jumping to report. Additional side effects after dose one included: inflammed lymph nodes all over my entire body - the neck was particulary swollen, which potentially then caused a neck rash, swollen gums, jaw pain and headache. There was also an odd ''pulsing'' feeling in my limbs (arms and legs). After dose two, I immediantly had a fever the next day. Highest peak was 102.6 - I took a tylenol and stayed hydrated all day and by the next day, no fever (I did not have a fever after the first shot). I still had the unexpected period (again, I have an IUD and do not have periods) although this one was more ''fluid'' than the previous ''sticky/thick'' period the month prior. Less severe lmph node swelling this time (all over body), still had a very itchy rash on neck that lasted a couple of weeks and then went away. And finally, my left eye has developed a small twitch that has not stopped and occurs throughout the day.


VAERS ID: 1939578 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1939601 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1939614 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1939616 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1939618 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1939624 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19Vaccine Peds formulation (5-11yr) that may have been reconstituted with a single use vial of 0.9%NS that was entered into multiple times to reconstitute other vials of Pfizer vaccine. Staff did not realize the 10mL vial was for single use only (to take out 1.3mL then discard). Each time the vial was used it was swabbed with alcohol and a new syringe was used to enter the vial then to add the diluent to the Pfizer vaccine for reconstitution. The 10mL , 0.9%NS vial was disposed of at the end of each day. The patient did not experience any adverse reaction. At the recommendation of Pfizer and the CDC, due to lack of stability data, it was advised to revaccinate the patient.


VAERS ID: 1939902 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: I have a similar reaction after the second dose of the COVID Pfizer vaccine on 4/14/21. I was 35 at the time.
Other Medications: Birth control
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Allergies to tree nuts and peanuts; diary and acidic foods are triggers for eczema
Diagnostic Lab Data:
CDC Split Type:

Write-up: The evening of the vaccine, I experienced extreme fatigue, weakness, and chills. This continued into the following day and I developed a fever. I slept on and off for 16 hours and eventually took Children''s Tylenol for the fever.


VAERS ID: 1939930 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-11-21
Onset:2021-11-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
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: Lexapro Klonopin Lipitor
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Moderna 02272021 WAG19209 Moderna 03272021 WAG19209 Moderna 11212021 Booster Drug Emp Flue Shot 12212021 same day as booster both in left arm


VAERS ID: 1941726 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 3 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLUZONE [INFLUENZA VACCINE]
Current Illness: Hyperlipidemia; Prediabetes; Schizoaffective disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Administration of booster shot from vial punctured past 12 hours; This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administration of booster shot from vial punctured past 12 hours) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021C21A) for COVID-19 vaccination. Concurrent medical conditions included Hyperlipidemia, Prediabetes and Schizoaffective disorder. Concomitant products included INFLUENZA VACCINE (FLUZONE [INFLUENZA VACCINE]) for an unknown indication. On 23-Nov-2021 at 10:35 AM, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .25 ml. On 23-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administration of booster shot from vial punctured past 12 hours). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (Administration of booster shot from vial punctured past 12 hours) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment medications were reported. HCP stated the vial was received and put in freezer on 5 Nov 2021 then was pulled out of freezer to thaw the day of being punctured at 11:30 AM on 22 Nov 2021. Total amount of time the vial was exposed to room temperature range is from 11:30AM 22 Nov 2021 then overnight and was administered 23 Nov 2021. Patient had no side effects since the day of vaccination. Most recent FOLLOW-UP information incorporated above includes: On 23-Nov-2021: Follow-up received which contains primary source, patient demographics On 09-Dec-2021: Follow-up received on 09-DEC-2021 Updated Patient information, and Medical History and concomitant medication.


VAERS ID: 1941816 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-02
Onset:2021-11-23
   Days after vaccination:294
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Delayed chronic hives; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (Delayed chronic hives) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004F21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Nov-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced URTICARIA (Delayed chronic hives). At the time of the report, URTICARIA (Delayed chronic hives) outcome was unknown. The patient stated that she was on concomitant medications for years. Treatment medications reported were Anti-Histamines. This case was linked to MOD-2021-407240, MOD-2021-407115 (Patient Link).


VAERS ID: 1941897 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Breast enlargement, Chest pain, Immunisation, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Lipodystrophy (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: IBUPROFEN; LARISSIA; LEVOCETIRIZINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (if covid prior vaccination: Yes); Seasonal allergy (other medical history: Seasonal allergies)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101676333

Write-up: noticed the large difference in the size of my left breast.Again, there are no lumps or signs of lymph node swelling but my entire breast is larger; experiencing left sided chest pain; felt muscular in nature; Booster; This is a spontaneous report received from a contactable reporter(s) (Other HCP). The reporter is the patient. A 30 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm left, administration date 23Nov2021 15:30 (Lot number: FH8028) at the age of 30 years as dose 3 (booster), single for covid-19 immunisation. Relevant medical history included: "Seasonal allergies" (unspecified if ongoing), notes: other medical history: Seasonal allergies; "if covid prior vaccination: Yes" (unspecified if ongoing), notes: if covid prior vaccination: Yes. Concomitant medication(s) included: IBUPROFEN; LARISSIA; LEVOCETIRIZINE. Vaccination history included: Bnt162b2 (Dose Number: 2, Batch/Lot No: EW0169, Location of injection: Arm Left), administration date: 21Apr2021, when the patient was 29 years old, for COVID-19 immunization, reaction(s): "left breast increased in size by 1 cup size. There are no lumps and no signs of lymph node swelling"; Bnt162b2 (Dose Number: 1, Batch/Lot No: ER8730, Location of injection: Arm Right), administration date: 31Mar2021, when the patient was 29 years old, for COVID-19 immunization, reaction(s): "left breast increased in size by 1 cup size. There are no lumps and no signs of lymph node swelling". The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021 15:30, outcome "unknown", described as "Booster"; CHEST PAIN (non-serious) with onset 24Nov2021 06:00, outcome "recovered" (25Nov2021 18:00), described as "experiencing left sided chest pain"; MYALGIA (non-serious) with onset 24Nov2021 06:00, outcome "recovered" (Nov2021), described as "felt muscular in nature"; BREAST ENLARGEMENT (non-serious) with onset 25Nov2021, outcome "not recovered", described as "noticed the large difference in the size of my left breast.Again, there are no lumps or signs of lymph node swelling but my entire breast is larger". Therapeutic measures were not taken as a result of chest pain, myalgia, breast enlargement. Follow-Up (30Nov2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1941911 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Headache, Lethargy
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LOSARTAN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Aneurysm cerebral (unruptured); Angioid streaks; Atrial septal defect repair; Connective tissue disorder NOS; COVID-19; Ventricular septal defect repair
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101678637

Write-up: became very lethargic; developed an intense headache; kept taking deep breaths while holding her chest, saying it felt tight.; having a hard time getting a good breath; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP). The reporter is the parent. A 10 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm right, administration date 23Nov2021 09:30 (Lot number: FK5127) at the age of 10 years as dose 1, single for covid-19 immunisation. Relevant medical history included: "Connective tissue disease" (unspecified if ongoing); "repaired heart VSD/ASD" (unspecified if ongoing); "repaired heart VSD/ASD" (unspecified if ongoing); "Unruptured brain aneurysm" (unspecified if ongoing); "angioid streaks in right eye" (unspecified if ongoing); "Covid-19" (unspecified if ongoing). Concomitant medication(s) included: LOSARTAN; FLUARIX QUADRIVALENT, administration date 10Nov2021. The following information was reported: DYSPNOEA (medically significant) with onset 23Nov2021, outcome "recovered" (Nov2021), described as "having a hard time getting a good breath"; LETHARGY (medically significant) with onset 23Nov2021 10:00, outcome "recovered" (Nov2021), described as "became very lethargic"; HEADACHE (medically significant) with onset 23Nov2021 10:00, outcome "recovered" (Nov2021), described as "developed an intense headache"; CHEST DISCOMFORT (medically significant) with onset 23Nov2021 10:00, outcome "recovered" (Nov2021), described as "kept taking deep breaths while holding her chest, saying it felt tight.". The events "having a hard time getting a good breath", "became very lethargic", "developed an intense headache" and "kept taking deep breaths while holding her chest, saying it felt tight" were evaluated at the emergency room visit. Therapeutic measures were taken as a result of dyspnoea, lethargy, headache, chest discomfort and included diphenhydramine hcl (BENADRYL). The clinical course was described as follows: The patient waited the 15 minutes required at the hospital after receiving the COVID vaccine. Then left to go shopping at a store within a close distance and within 10 minutes she was having a hard time getting a good breath. She became very lethargic and developed an intense headache. She kept taking deep breaths while holding her chest, saying it felt tight.


VAERS ID: 1941997 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-19
Onset:2021-11-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Itch Generalized-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Additional Details: hives on trunk and arms 4 days after vaccine, no other changes in daily life, very itchy and classic hives presentation


VAERS ID: 1942279 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC33183 / 3 LA / IM

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

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

Write-up: The patient received a vaccine that had been stored in the freezer too long and was expired . Patient has not suffered any side effects to this date


VAERS ID: 1942323 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC33183 / 1 RA / IM

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

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

Write-up: There was no adverse reaction. Patient was given a vaccine that was left in the freezer too long and was expired.


VAERS ID: 1942334 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC33183 / 3 LA / IM

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

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

Write-up: The patient was given a vaccine that had been stored in the freezer too long and was expired


VAERS ID: 1942360 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

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

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

Write-up: The patient was given a vaccine that was left in the freezer too long and was expired. There has been no adverse reactions reported .


VAERS ID: 1942365 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

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

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

Write-up: The patient was given a vaccine that was left in the freezer too long and was expired.


VAERS ID: 1942373 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

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

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

Write-up: Patient was given an expired vaccine that had been left in the freezer beyond the recommended date.


VAERS ID: 1942378 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

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

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

Write-up: The patient was given a vaccine that was expired . The vaccine had been left in the freezer longer than what the manufacture recommended .


VAERS ID: 1942383 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 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: The patient received a vaccine that was left in the freezer longer then the recommended manufacturer suggested.


VAERS ID: 1942389 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-13
Onset:2021-11-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Pruritus, SARS-CoV-2 test negative, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil; probiotic
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid test (negative) 12/10/21 Routine bloodwork (pending results)
CDC Split Type:

Write-up: Moderate Facial swelling, Full body hives and itchy skin starting 10 days after injection. Treated with benadryl, pepcid, steroids with little relief. Symptoms still ongoing 2.5 weeks later slightly milder than when initially observed with ongoing medication.


VAERS ID: 1942393 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 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: Patient was given a vaccine that had been left in the freezer longer then the recommended manufacturer date.


Result pages: prev   380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=479&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166