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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)

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VAERS ID: 1942396 (history)  
Form: Version 2.0  
Age: 60.0  
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: 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 beyond the manufactures expiration date.


VAERS ID: 1942471 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-11-17
Onset:2021-11-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blepharospasm, Fatigue, Muscle twitching, Pain
SMQs:, Dyskinesia (broad), Dystonia (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Ear infection
Preexisting Conditions: Diabetes
Allergies: Latex, walnuts, scallops, cola flavoring, Zithromax.
Diagnostic Lab Data: I have not been able to get in to see my doctor as he schedule has been booked.
CDC Split Type:

Write-up: 24 hours later my body was aching and i was very fatigued. A little less than a week after my shot my left lower eye lid started to twitch at around 5:00 pm. It has continued on every day. In addition today 12/11/21 now my lips and jaw have started to twitch. This starting at around 3:30ish. It will come and go with about 10-15 minutes between each twitch.


VAERS ID: 1942567 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Chills, Feeding disorder, Gastrointestinal disorder, Myalgia, Pyrexia, Retching
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingles
Other Medications: Hydroxy Urea, Valacyclovir, levothyroxine, baby aspirin, blood pressure medicine, magnesium, Vitamin D, zinc, fish oil
Current Illness: none
Preexisting Conditions: Essential Thrombocytosis, Celiac Disease, Shingles
Allergies: wheat, Fosamax, all bone building injections
Diagnostic Lab Data: none
CDC Split Type:

Write-up: chills, fever, dry heaves, muscle and back aches, weakness, digestive system stopped for 10 days, could not eat, 18 days to recover, no medical doctor seen


VAERS ID: 1943134 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Limb injury, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Arthritis (broad)

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

Write-up: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1943413 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012H21B / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pt had a 102.8 fever and had a headache, chills, weakness and fatigue


VAERS ID: 1943600 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: NA


VAERS ID: 1943608 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: NA


VAERS ID: 1943612 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: NA


VAERS ID: 1943664 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: NA


VAERS ID: 1943699 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: NA


VAERS ID: 1943762 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-17
Onset:2021-11-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cardiac stress test, Chest X-ray, Computerised tomogram thorax, Dyspnoea, Electrocardiogram, Scan with contrast, Urine analysis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine 225mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Tramadol, darvocet, naproxen- hives, itching, swelling
Diagnostic Lab Data: 11/28/2021- urgent treatment center- chest X-rays, EKG 11/29/2021- Emergency Department- chest CT with contrast, EKG, stress test, urine tests, full panel blood work 11/30/2021/12/07/2021 - PCP office- stress test, nebulizer treatment, oral steroids, oral antibiotics, nebulizer, steroid inhaler, stress test, blood work, physical exam
CDC Split Type:

Write-up: Shortness of breath, trouble breathing


VAERS ID: 1943855 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067F21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, C-reactive protein increased, Chest X-ray normal, Chest discomfort, Chest pain, Cough, Decreased appetite, Dizziness, Dyspnoea, Electrocardiogram normal, Fatigue, Feeling abnormal, Fibrin D dimer increased, Full blood count, Headache, Hypersomnia, Hypertension, Nightmare, Oedema, Palpitations, Red blood cell sedimentation rate normal, Troponin, Weight increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: spironolactone 100mg, montelukast 10 mg, esomeprazole 40mg, estrogen 2 mg, progesterone 100 mg, fish oil 1000mg Also on Naproxen 220mg q12h and tylenol 500mg a12h (for a recent sprain)
Current Illness: None. Influenza Vaccination on 11/8/21
Preexisting Conditions: Covid Long Haul, based on clinical signs, since March 9, 2020 (90% resolved, with occasional episodes of fatigue, diarrhea signs. Feeling great at the time x 30-60 days)
Allergies: sulfa drugs, methotrexate (intolerance), green bell peppers (suspected)
Diagnostic Lab Data: Weds 11/24: CBC, Chem, Creactive Proteins (hi), BNP - high, chest rads - normal, 12 lead ECG - normal Sat 11/27 Weds 11/24: CBC, Chem, Creactive Proteins (hi), BNP - high, chest rads - normal, 12 lead ECG - normal, troponin, d-dimer (high), sed rate - normal Since then - 2 weeks of fatigue and intense cough, occasional chest heaviness, tightness and difficulty breathing, all getting better. Almost back to previous health on 12 /14/21. Weigh back to normal, Zero edema. Might try exercising today, but haven''t felt well enough to consider doing so prior to today (very unusual for me)
CDC Split Type:

Write-up: This was a Booster/3rd shot. I had Pfizer 4/14/21 and 5/5/21. I was on NSAID''s everyday except one (noted below) = no fever, but could be masked Monday 11/22 Moderna covid booster left arm Normal Exercise tolerance ? weight lift and elliptical and walk Weight ~156 Tuesday 11/23 3-4+ pound weight gain - Weight 160 Normal Exercise tolerance ? weight lift and elliptical and walk Wednesday 11/24 3-4+ pound weight gain - Weight 163 Pitting Edema in legs 1-2+ Heart palpitations General Fatigue Went to Doctor and DXTCs done Normal Exercise tolerance ? weight lift Increased sleep - three +hours Evening Difficulty breathing Mild chest tightness/pain Shortness of breath Change in cough quality - harder Heart palpitations - bedtime Thursday 11/25 Difficulty rousing in AM Increased pitting Edema 2-3+ -above my knees, arms and face Exercise intolerance ? Pretty much normal work out am wt lift, afternoon: got on elliptical - slow pace, felt better, reduced headache &BP, evening - walk Heart palpitations - bedtime Friday 11/26 Trippy nightmares Difficulty rousing in AM Dizziness/Floaty all day Felt BAD all day Edema easing - 1-2+ Lost 3 pound water weight Hi blood pressure episodes (160-140?s/upper 80-90?s) with Moderate to Severe headache Extreme fatigue - <2K steps all day, Exercise intolerance +++ - No exercise at all! Inappetence Excessive sleep ? 12 hours at night plus 3 hour nap = 15+ hours Mild chest tightness Mild chest soreness Heart palpitations - bedtime, increased mildly Saturday 11/27 Continued headaches with shorter episodes of high blood pressure chest tightness Increased chest soreness - like a band around my chest radiate into my back and left neck 1+ Edema - Lost 3 pound water weight - wt 160 Elliptical ? chest pain moves, doesn?t feel good Moderate headache Heart palpitations - bedtime Inappetance Went to ER Sunday 11/28 Reduced edema 1+ - Lost 3 # - Weight 157 Chest non-painful, not tight, Reduced fatigue but still present Mild in appetence Mild to moderate headache Temp 99.0 - Had stopped NSAID''s temporarily Monday 11/29 Barely discernable edema Most signs reduce low end Weight 158 Headache with higher BP''s BP lower - but high for me (130?s-120?s)


VAERS ID: 1944137 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-11-18
Onset:2021-11-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Rash, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt diagnosed skin rash as urticaria 5 days post vaccination.


VAERS ID: 1944441 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-11-23
   Days after vaccination:238
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Hospitalized patient with confirmed COVID-19 infection post vaccination


VAERS ID: 1944445 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-08
Onset:2021-11-23
   Days after vaccination:288
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Hospitalized patient with confirmed COVID-19 infection post vaccination


VAERS ID: 1944458 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-11-23
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Hospitalized patient with confirmed COVID-19 infection post vaccination


VAERS ID: 1944887 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-09
Onset:2021-11-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-12-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / UNK LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Abdominal pain upper, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: none (occasional use of vitamin D3, but not regular)
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Stomach pain from apple juice, contact dermatitis from lotions
Diagnostic Lab Data:
CDC Split Type:

Write-up: Beginning November 23, I began breaking out in itchy hives on various parts of my body (neck, ankles, back, torso, legs, pelvic area. On November 24, I experienced dull stomach pain strong enough to make walking around in normal activities difficult, which continued until Nov 25. After a medical visit to a nurse practitioner on November 29, I was told to take a 24-hour antihistamine. I took Cetirizine hydrochloride (10 mg) for a week, with a single dose of Benadryl on the first night (as instructed). The Cetirizine hydorchloride was effective, but the hives returned within 36 hours after discontinuing, and intensified after an additional without medication. They responded to a new dose of Cetirizine hydrochloride. The hives continue throughout the day, but individual areas of hives come and go. I am not aware of being allergic to anything, other than the contact dermatitis I get from lotions, which presents very differently (in a rash and blisters).


VAERS ID: 1947100 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8757 / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Dental discomfort, Ear discomfort, Headache, Immunisation, Limb discomfort, Loss of personal independence in daily activities, Movement disorder, Neck pain, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101654100

Write-up: Excruciating pain; booster; woken up in the night with extreme pain in all her joints, in her head, in her neck, her arms and legs and feet, to the point where she is agonizing in pain; woken up in the night with extreme pain in all her joints, in her head, in her neck, her arms and legs and feet, to the point where she is agonizing in pain; woken up in the night with extreme pain in all her joints, in her head, in her neck, her arms and legs and feet, to the point where she is agonizing in pain; woken up in the night with extreme pain in all her joints, in her head, in her neck, her arms and legs and feet, to the point where she is agonizing in pain; I can not even sit up on my own; Shoulders hurts; Neck is sore, I can not move it/I can''t even move without help.; Legs hurts/Feet hurts; I feel something from my feet; Feel something in my teeth.; My body feels like it is on fire; I feel my ear canals; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP) from medical information team. The reporter is the patient. Other Case identifier(s): US-PFIZER INC-202101655441 (Pfizer). A 30 year-old female patient received bnt162b2 (BNT162B2), administration date 23Nov2021 13:15 (Lot number: FJ8757) at the age of 30 years as dose 3 (booster), single for covid-19 immunisation. The patient''s relevant medical history was not reported. There were no concomitant medications. Vaccination history included: Bnt162b2 (Dose 1), for Covid-19 immunization; Bnt162b2 (Dose 2), for Covid-19 immunization. The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021, outcome "unknown", described as "booster"; ARTHRALGIA (non-serious), HEADACHE (non-serious), NECK PAIN (non-serious), PAIN IN EXTREMITY (non-serious) all with onset 23Nov2021, outcome "unknown" and all described as "woken up in the night with extreme pain in all her joints, in her head, in her neck, her arms and legs and feet, to the point where she is agonizing in pain"; LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (non-serious) with onset 23Nov2021, outcome "unknown", described as "I can not even sit up on my own"; ARTHRALGIA (non-serious) with onset 23Nov2021, outcome "unknown", described as "Shoulders hurts"; MOVEMENT DISORDER (non-serious) with onset 23Nov2021, outcome "unknown", described as "Neck is sore, I can not move it/I can''t even move without help."; PAIN IN EXTREMITY (non-serious) with onset 23Nov2021, outcome "unknown", described as "Legs hurts/Feet hurts"; LIMB DISCOMFORT (non-serious) with onset 23Nov2021, outcome "unknown", described as "I feel something from my feet"; DENTAL DISCOMFORT (non-serious) with onset 23Nov2021, outcome "unknown", described as "Feel something in my teeth."; BURNING SENSATION (non-serious) with onset 23Nov2021, outcome "unknown", described as "My body feels like it is on fire"; EAR DISCOMFORT (non-serious) with onset 23Nov2021, outcome "unknown", described as "I feel my ear canals"; PAIN (non-serious) with onset 23Nov2021 15:00, outcome "unknown", described as "Excruciating pain". Therapeutic measures were taken as a result of arthralgia, headache, neck pain, pain in extremity, loss of personal independence in daily activities, arthralgia, movement disorder, pain in extremity, limb discomfort, dental discomfort, burning sensation, ear discomfort, pain. Additional information: Treatment was reported as "Tylenol, 2 extra strength Tylenol." Follow-up attempts are completed. No further information is expected.


VAERS ID: 1947114 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / OT

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Discomfort, Immunisation, Loss of personal independence in daily activities, Myelitis, Pain, Sacral pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Drug allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101677301

Write-up: Booster; Severe coccyx / sacroiliac joint pain (tailbone area and hip) with second dose and third dose; Severe coccyx / sacroiliac joint pain (tailbone area and hip) with second dose and third dose; the pain / discomfort with vaccine 2+3 was significant enough to derail all my activities for multiple days; the pain / discomfort with vaccine 2+3 was significant enough to derail all my activities for multiple days; the pain / discomfort with vaccine 2+3 was significant enough to derail all my activities for multiple days; I had the sensation that my whole body was swollen; my spinal cord was inflamed; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 34 year-old female patient received bnt162b2 (BNT162B2), intramuscular, administered in arm right, administration date 23Nov2021 14:00 (Batch/Lot number: unknown) at the age of 34 years as dose 3 (booster), single for covid-19 immunisation. Relevant medical history included: "cephalosporins" (unspecified if ongoing). The patient''s concomitant medications were not reported. Vaccination history included: Bnt162b2 (Dose Number: 1, Batch/Lot No: Unknown. Unable to locate or read the details, Location of injection: Arm Right, Route of Administration: Intramuscular), administration date: 09Apr2021, when the patient was 34 years old, for COVID-19 immunization; Bnt162b2 (Dose Number: 2, Batch/Lot No: Unknown. Unable to locate or read the details, Location of injection: Arm Right, Route of Administration: Intramuscular), administration date: 30Apr2021, when the patient was 34 years old, for COVID-19 immunization, reaction(s): "Severe coccyx / sacroiliac joint pain (tailbone area and hip) with second dose and third dose", "Severe coccyx / sacroiliac joint pain (tailbone area and hip) with second dose and third dose", "the pain / discomfort with vaccine 2+3 was significant enough to derail all my activities for multiple days", "the pain / discomfort with vaccine 2+3 was significant enough to derail all my activities for multiple days", "the pain / discomfort with vaccine 2+3 was significant enough to derail all my activities for multiple days". The following information was reported: Myelitis (medically significant) with onset 23Nov2021, outcome "recovering", described as "my spinal cord was inflamed"; IMMUNISATION (non-serious) with onset 23Nov2021 14:00, outcome "unknown", described as "Booster"; ARTHRALGIA (non-serious), SACRAL PAIN (non-serious) all with onset 23Nov2021, outcome "recovering" and all described as "Severe coccyx / sacroiliac joint pain (tailbone area and hip) with second dose and third dose"; PAIN (non-serious), DISCOMFORT (non-serious), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (non-serious) all with onset 23Nov2021, outcome "recovering" and all described as "the pain / discomfort with vaccine 2+3 was significant enough to derail all my activities for multiple days"; SWELLING (non-serious) with onset 23Nov2021, outcome "recovering", described as "I had the sensation that my whole body was swollen". Therapeutic measures were not taken as a result of spinal cord disorder, discomfort, loss of personal independence in daily activities, swelling. Therapeutic measures were taken as a result of arthralgia, sacral pain, pain. Prior to vaccination, patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. The lot number for bnt162b2 was not provided and will be requested during follow up.; Sender''s Comments: Based on the information currently available, a possible contributory role of the suspect vaccine BNT162B2 or Comirnaty in triggering the onset of Myelitis, booster, arthralgia, sacral pain ,pain, discomfort, loss of personal independence in daily activity , swelling cannot be excluded. But also consider medical history of pyrexia and wheezing associated with influenza vaccine.


VAERS ID: 1947191 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-11-19
Onset:2021-11-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8757 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VALTREX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101758878

Write-up: Significant veryigo; This is a spontaneous report from a contactable reporter (consumer or other non HCP). The reporter is the patient. A 44-year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in left arm, administration date 19Nov2021 at 16:00 (Lot number: FJ8757) at the age of 44 years as dose 1, single for COVID-19 immunisation. Relevant medical history included: "Penicillin allergy" (unspecified if ongoing). Concomitant medication included: VALTREX. The following information was reported: VERTIGO (non-serious) with onset 23Nov2021, outcome "recovered with sequelae" (an unknown date in 2021), described as "Significant veryigo". Therapeutic measures were not taken as a result of vertigo. Additional Information: The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The event did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care.


VAERS ID: 1947729 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 069F21A / 2 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: 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: Can only verify that the patient has had their 1st dose of Moderna on 2/8/21, and then received only a half dose/booster for their 2nd dose.


VAERS ID: 1947769 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-10-29
Onset:2021-11-23
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Acoustic stimulation tests, Ear discomfort, Tinnitus
SMQs:, Hearing impairment (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: Amlodipine Besylate 10MG
Current Illness: None
Preexisting Conditions: None
Allergies: none
Diagnostic Lab Data: 12/13/2021 - Audio sound test and doctors visit following the audio test
CDC Split Type:

Write-up: Ringing in my left ear primarily and now ringing in both ears. Both ears are clogged and may be causing hearing loss.


VAERS ID: 1947907 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-02
Onset:2021-11-23
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Condition aggravated, Constipation, Musculoskeletal stiffness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Risedronate Sodium 150mg Levothyroxine 25mg Chia Seed Opti Fiber D3 50mg Multivitamin Omega 3 Fish Oil Vitamin E 180mg Turmeric 1000mg 2xday Bioastin 12mg Krill Oil Meta Mucil powder
Current Illness: Chronic constipation
Preexisting Conditions: Chronic Constipation Hyperparathyroidism
Allergies: Sinus
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: After I got home I didn''t feel sore. The next morning I developed a fever so I took a Tylenol. About 4 or 5 hours later I felt fine since then. I felt a little stiffness in my left arm, but after 3rd day I was fine. I started feeling uncomfortable with my tummy. I had chronic constipation on December 7th. On December 9th I took a laxative for it, and I started to feel better.


VAERS ID: 1948133 (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: 2021-12-14
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-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: 1948380 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: patient felt dizzy, sweaty, and complained of foggy-like vision. Blood pressure taken 100/60, heartrate 72, RR 16, oxygen saturation 99%. Patient lying down until blood pressure rises. Pt states she is feeling better and signed patient release form.


VAERS ID: 1948387 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: patient started feeling lightheaded when approaching the charting table post-vaccine. Pt went forward and sat on floor, but did not remember it happening. Patient was remembering the injection of Pfizer booster and felt nervous. Vitals taken blood pressure 130/80, heart rate 87, pulse ox 97%. After lying down vitals were retaken and lowered to 118/80. Heart rate was 91 and pulse ox was 97%. Patient left with her brother.


VAERS ID: 1950595 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 12H21B / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Body temperature, Chills, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D [VITAMIN D NOS]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211123; Test Name: Body temperature; Result Unstructured Data: High fever 103 degree F temperature
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: weak; she had high fever 103 degree F temperature; headache; chills; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (weak), PYREXIA (she had high fever 103 degree F temperature), HEADACHE (headache) and CHILLS (chills) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 12H21B) for COVID-19 vaccination. Concomitant products included VITAMIN D [VITAMIN D NOS] for an unknown indication. On 22-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Nov-2021, the patient experienced ASTHENIA (weak), PYREXIA (she had high fever 103 degree F temperature), HEADACHE (headache) and CHILLS (chills). The patient was treated with PARACETAMOL (TYLENOL [PARACETAMOL]) for Fever, at a dose of 325 mg, 1 tablet. At the time of the report, ASTHENIA (weak), PYREXIA (she had high fever 103 degree F temperature), HEADACHE (headache) and CHILLS (chills) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Nov-2021, Body temperature: 103 (High) High fever 103 degree F temperature. Patient reported that after 1st and 2nd dose, she already reported to Medical information that she was sick for 3 days, had high fever, headache and was weak.


VAERS ID: 1950652 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Immunisation, Interchange of vaccine products, Lymphadenopathy, Off label use
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101662530

Write-up: Lymph nodes swollen on left side of body; same arm where vaccine was received.; Dose Number: 3; offlabel use; Dose 1, brand: Moderna/ Dose 2, brand: Moderna / Dose 3, brand: Comirnaty; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). A 44 year-old female patient (not pregnant) received bnt162b2 (COMIRNATY), intramuscular, administered in arm left, administration date 23Nov2021 11:30 (Batch/Lot number: unknown) 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: Moderna (Dose Number: 2, Batch/Lot No: Unknown. Not available/provided to reporter at the time of report completion, Route of Administration: Intramuscular), for COVID-19 Immunization; Moderna (Dose Number: 1, Batch/Lot No: Unknown. Not available/provided to reporter at the time of report completion, Route of Administration: Intramuscular), for COVID-19 Immunization. The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021, outcome "unknown", described as "Dose Number: 3"; OFF LABEL USE (non-serious) with onset 23Nov2021, outcome "unknown", described as "offlabel use"; INTERCHANGE OF VACCINE PRODUCTS (non-serious) with onset 23Nov2021, outcome "unknown", described as "Dose 1, brand: Moderna/ Dose 2, brand: Moderna / Dose 3, brand: Comirnaty"; LYMPHADENOPATHY (non-serious) with onset 24Nov2021, outcome "not recovered", described as "Lymph nodes swollen on left side of body; same arm where vaccine was received.". Therapeutic measures were not taken as a result of lymphadenopathy. Additional information: It was reported that the patient had no known allergies. The patient had no covid prior vaccination and not tested for covid post vaccination. The lot number for bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 1950653 (history)  
Form: Version 2.0  
Age: 100.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 4 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CARVEDILOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Heart rate
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101670924

Write-up: a little bit more tired yesterday; came in and they kinda forced the Pfizer booster on her couple of days ago.; came in and they kinda forced the Pfizer booster on her couple of days ago.; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from medical information team. A 100 year-old female patient received bnt162b2 (COMIRNATY), administered in arm left, administration date 23Nov2021 (Batch/Lot number: unknown) at the age of 100 years as dose 4 (initial pfizer booster), single for covid-19 immunisation; influenza vaccine (INFLUENZA VACCINE), administration date Sep2021 (Batch/Lot number: unknown). Relevant medical history included: "Rapid Heart Rate" (unspecified if ongoing). Concomitant medication(s) included: CARVEDILOL taken for heart rate. Vaccination history included: Moderna covid-19 vaccine (Dose 1, Lot: 013L20A), administration date: 22Jan2021, when the patient was 99 years old, for Covid-19 immunization; Moderna covid-19 vaccine (Dose 2, Lot: 028L20A), administration date: 18Feb2021, when the patient was 99 years old, for Covid-19 immunization; Moderna covid-19 vaccine (Dose 3, Lot: 058F21A), administration date: 28Oct2021, when the patient was 100 years old, for Covid-19 immunization. The following information was reported: IMMUNISATION (non-serious), INCORRECT DOSE ADMINISTERED (non-serious) all with onset 23Nov2021, outcome "unknown" and all described as "came in and they kinda forced the Pfizer booster on her couple of days ago."; FATIGUE (non-serious) with onset 25Nov2021, outcome "unknown", described as "a little bit more tired yesterday". Additional information: the reporter mentioned that the patient has been taking Carvedilol for many decades. The lot number for bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 1950708 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Nausea, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: feeling uneasy; a little pain when being injected; feel a little bit uneasy; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (feeling uneasy), VACCINATION SITE PAIN (a little pain when being injected) and NAUSEA (feel a little bit uneasy) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Previously administered products included for COVID -19 Vaccination: Janssen. On 23-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Nov-2021, the patient experienced FEELING ABNORMAL (feeling uneasy), VACCINATION SITE PAIN (a little pain when being injected) and NAUSEA (feel a little bit uneasy). On 23-Nov-2021, FEELING ABNORMAL (feeling uneasy), VACCINATION SITE PAIN (a little pain when being injected) and NAUSEA (feel a little bit uneasy) had resolved. Concomitant medication was not reported. Treatment information was not reported. Reporter did not allow further contact


VAERS ID: 1950742 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Connecticut  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Immunisation, Insomnia, Interchange of vaccine products, Muscular weakness, Off label use, Oropharyngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101699551

Write-up: sore throat; tiredness in her legs; insomnia; prev_dose_product=COVID 19, prev_dose_brand=Johnson & Johnson, prev_dose_dose number=1/product=COVID 19, brand=Pfizer, dose number=2; prev_dose_product=COVID 19, prev_dose_brand=Johnson & Johnson, prev_dose_dose number=1/product=COVID 19, brand=Pfizer, dose number=2; Booster; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non-HCP). An adult female patient (not pregnant) received bnt162b2 (BNT162B2), administration date 23Nov2021 (Batch/Lot number: unknown) as dose 2 (booster), single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. Vaccination history included: Johnson &Johnson (Dose Number: 1), for COVID-19 immunization. The following information was reported: OFF LABEL USE (non-serious), INTERCHANGE OF VACCINE PRODUCTS (non-serious) all with onset 23Nov2021, outcome "unknown" and all described as "prev_dose_product=COVID 19, prev_dose_brand=Johnson & Johnson, prev_dose_dose number=1/product=COVID 19, brand=Pfizer, dose number=2"; IMMUNISATION (non-serious) with onset 23Nov2021, outcome "unknown", described as "Booster"; OROPHARYNGEAL PAIN (non-serious) with onset 24Nov2021, outcome "recovered" (27Nov2021), described as "sore throat"; MUSCULAR WEAKNESS (non-serious) with onset 23Nov2021, outcome "recovered" (27Nov2021), described as "tiredness in her legs"; INSOMNIA (non-serious) with onset 23Nov2021, outcome "recovered" (27Nov2021), described as "insomnia". Therapeutic measures were not taken as a result of oropharyngeal pain, muscular weakness, insomnia. Additional information: The patient did not experience any fever. Patient not diagnosed with covid-19 prior to vaccination and since vaccination patient not tested for covid-19. The lot number for bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 1950757 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-01
Onset:2021-11-23
   Days after vaccination:267
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20211130; Test Name: PCR; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101710849

Write-up: I have a breakthrough COVID; I have a breakthrough COVID; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from product quality group. The reporter is the patient. A 33 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), intramuscular, administered in arm left, administration date 01Mar2021 (Lot number: EL3247) at the age of 32 years as dose 2, single and intramuscular, administered in arm left, administration date 08Feb2021 (Lot number: EL3247) as dose 1, single for covid-19 immunisation. The patient had no relevant medical history. There were no concomitant medications. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 23Nov2021, outcome "recovering" and all described as "I have a breakthrough COVID". The event "i have a breakthrough covid" and "i have a breakthrough covid" was evaluated at the emergency room visit. The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (30Nov2021) positive, notes: Nasal Swab. Therapeutic measures were not taken as a result of vaccination failure, covid-19. Clinical course: The patient did not had covid prior vaccination and any known allergies. The patient did not receive other vaccine in four weeks.


VAERS ID: 1951219 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Patient presents cutaneous elevation of the puncture area with a slight red mark that appears to be scratching the patient. He does not report pain in the area, only mild itching. 10:46 patient withdraws stable vital signs. He does not refer itching, no cutaneous elevation is observed


VAERS ID: 1951258 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 LA / IM

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

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

Write-up: External inflammation in the upper right area near the puncture.


VAERS ID: 1951400 (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: 2021-12-15
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-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: 1951466 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celecoxib, Duloxetine, Tizanidine, Gabapentin, Cetirizine
Current Illness: None
Preexisting Conditions: Fibromyalgia, neuromuscular disorder, tendonitis, seasonal allergies, ADHD
Allergies: Latex, bees/wasps/hornets, royal jelly, fentanyl
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme dizziness/ lightheadedness, started approx. 15 min after injection and lasted for 1 hour at which time I could stand and walk, then symptoms slowly decreased over the next 12 hrs until gone. Racing heart and chest tightness, started approx. 20 min after injection and lasted about 40 min.


VAERS ID: 1951471 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-11-21
Onset:2021-11-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Decreased appetite, Dyspnoea, Electrocardiogram normal, Pain in extremity, Paraesthesia, SARS-CoV-2 test negative, Troponin normal, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No home medications
Current Illness: None
Preexisting Conditions: Smoker (1/4 pack per day), other than that - no medical history.
Allergies: No known allergies
Diagnostic Lab Data: Chest X-ray 11/23: No acute cardiopulmonary disease. EKG 11/23: Negative. COVID-19 test was negative, Troponin was <0.030 Vital signs are within normal limits
CDC Split Type:

Write-up: Patient arrived to the emergency department with shortness of breath. Symptoms started Monday (11/22) with decreased appetite and then shortness of breath later in the day. Noted some pain in his left arm and tingling in his hand. He was diagnosed by the doctor with "Adverse reaction to COVID-19 vaccine." Patient was discharged home in stable condition.


VAERS ID: 1951861 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 331308A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Audiogram, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Audiogram 12/7/2021
CDC Split Type:

Write-up: increase in tinnitus in both ears within an hour of each dose. an audiogram indicated no loss of hearing.


VAERS ID: 1951873 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-10-22
Onset:2021-11-23
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / 3 RA / IM

Administered by: Public       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: Pristiq 100mg one tablet daily Sudafed prn Allegra daily Multivitamin - prn
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies: NKA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe hives to include her whole body. She has hives from the bottom of her feet to in her eyes and in rectum. PCP seen one round of prednisone x 7 days, but has restarted another round of Prednisone 20mg 3 pills daily for 4 days, then 2 tabs daily for 4 days, and then 1 tab daily x 4 days. Referred to allergy specialist


VAERS ID: 1952020 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-05-01
Onset:2021-11-23
   Days after vaccination:206
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 UN / UN

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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Urticaria


VAERS ID: 1952024 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-03-22
Onset:2021-11-23
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 - / IM

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

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

Write-up: Developed Covid infection Delta variant


VAERS ID: 1952211 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event
SMQs:

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

Write-up: PATIENT DID NOT EXPERIENCE ANY ADVERSE EVENTS POST-VACCINE.


VAERS ID: 1952682 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-10
Onset:2021-11-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033F21A / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, vitamin d, vitamin b12, iron
Current Illness: None
Preexisting Conditions: Interstitial cystitis
Allergies: None
Diagnostic Lab Data: urgent care gave me prednisone on 12/3. they did not believe it was due to the booster but what do they know lol
CDC Split Type:

Write-up: 13 days post moderna booster got random hives all over my body. they have been happening daily in random spots ever since. went to urgent care on 12/3 put me on prednisone zyrtec pepcid and benadryl for a week. that seemed to help but the symptoms returned once prednisone was stopped and are still ongoing


VAERS ID: 1954384 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 077C21B / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Heart rate decreased, Hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Unknown.
CDC Split Type:

Write-up: The next day upon applying lotion, patient experienced what she felt were allergy symptoms: itching and difficulty breathing. Husband took her to EMS. Heart rate also dropped very low.


VAERS ID: 1954749 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-11-23
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 2 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test normal, Deep vein thrombosis, Pain in extremity, Peripheral swelling, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ULTRA SOUND IMAGES OF LEG THAT REVEAL HUGE CLOT. MNAY BLOOD TEST THAT INDCATED VERY HEALTHY BLOOD. HEMOTOLOGY ALSO REVEAL NOTHING REMARKABLE.
CDC Split Type:

Write-up: I DEVELOPED A MASSIVE BLOOD CLOT (DVT) IN MY LEFT LEG. SYMPTOMS BEGAN WITH SWELLING AND B=NOTICBLE SHARP PAIN IN THE CALVE OF ME LEFT LEG. AN ULTRSOUND IMAGE FROM MY GROIN DOWN TO MY ANKLE OF MY LEG REVEALED A MASSIVE 18 INCH LONG BLOOD CLOT!!!! I WAS HOSPITALIZED FOR SEVERAL DAYS ON A HEPARIN IV DRIP, DISCHARGED AND NOW BEING TREATED AS OUTPATIENT FOR NEXT SEVERAL MONTHS ON EILIQUIS BLOOD THINNER MEDICATION. THERE HAS NEVER BEEN BLOOD CLOT HISTORY IN MY FAMILY. I''M AN ACTIVE HEALTHY MALE, NON SMOKER, VERY LIGHT ALCOHOL CONSUMPTION AND BIKE 10-40 MILEEVERY DAY. I''VE HAD NO ACCIDENTS OR INJURIES THAT COULD HAVE RESULTED IN POSSIBLE CLOTTING. THIS CAME TOTALLY OUT OF THE BLUE .


VAERS ID: 1954789 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-16
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-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: 1954824 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Headache, Neck pain, Pain, Pain in extremity, Painful respiration
SMQs:, Arthritis (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: atenolol, lovastatin, metformin, omeprazole, turmeric, chinese herbs, glucosamine chondoirtin
Current Illness: none
Preexisting Conditions: chronic conditions: hypertension, hyperlipemia, controlled type 2 diabetes, GERD, history of shoulder arthritis
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient received third dose Moderna half dose booster 0.25mL in LD on 11/22/2021. The following day 11/23/21 she developed excruciating right shoulder and right neck pain, described as bone breaking pain, on the side opposite the injection site (left arm) . Very painful to move head, arm , twist, or take deep breaths. Headache also present on right side. Pain escalated the next day and was treated with ibuprofen 400mg every 6 hours. Pain persisted intensely for about 5 days and then she had gradual decreased over two. She was feeling better 12/14/2021. She has remote history of inflammatory vs rheumatoid arthritis 3 decades ago which involved right shoulder.


VAERS ID: 1955043 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 1 RA / IM

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

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

Write-up: No adverse reactions have occurred yet; 16 YO employee was given Moderna vaccine


VAERS ID: 1955048 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-11
Onset:2021-11-23
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939903 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Sinus tachycardia
SMQs:, Supraventricular tachyarrhythmias (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None, patient has IUD in place
Current Illness: none
Preexisting Conditions: Patient has a history of SVT s/p ablation complicated by complete heart block and a permanent pacemaker for the last 10 year
Allergies: none
Diagnostic Lab Data: Pacemaker interrogation showing very elevated sinus rates
CDC Split Type:

Write-up: Patient developed an inappropriate sinus tachycardia, marked decline in her functional capacity one day after receiving the vaccine. We see similar complaints in young patients with long haul covid symptoms


VAERS ID: 1955054 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Virgin Islands  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Headache, Migraine, Pain, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: headache for one week; migraine for 72 hours; vomit for one day and diarhea; unable to bend fingers because of pain. Denied chills.


VAERS ID: 1955195 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-11-16
Onset:2021-11-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram abnormal, Extrasystoles, Interchange of vaccine products, Oesophageal spasm, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Dystonia (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Medication errors (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After 2nd Dose Pfizer, inflammation, lime disease factor; went to doctor.
Other Medications: Cyclobenzaprine 10mg as needed for back issues.
Current Illness: No
Preexisting Conditions: Lime disease
Allergies: No
Diagnostic Lab Data: No blood work but a resting EKG that showed the PVC, based on family history, vaccination and issues with PVC he is requesting the stress test. Through a specialist referral.
CDC Split Type: vsafe

Write-up: 11/23/2021 esophageal spasms, with front of chest feeling like it is being squeezed 12/09/2021 check heart rate and noticed it was skipping and saw primary provider on 12/10/2021. Doctor said new condition setting off spasms and PVC continuous and not stopping. Referred to heart clinic based on family history. Participant states that she had evaluation 8 years ago and did not have any issues. No blood work but a resting EKG that showed the PVC, based on family history, vaccination and issues with PVC he is requesting the stress test, through specialist referral. Going issue.


VAERS ID: 1955305 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2020-11-23
Onset:2021-11-23
   Days after vaccination:365
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 LA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Additional Details: ems called out of caution patient fainted patient declined further treatment


VAERS ID: 1955336 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-18
Onset:2021-11-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1620 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electroencephalogram abnormal, Magnetic resonance imaging normal, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Swelling/redness at injection site on thigh for some previous vaccines (do not know specific ones as it doesn''t always happen)
Other Medications: Fiber gummy Multivitamin gummy
Current Illness: None
Preexisting Conditions: None
Allergies: treenuts, penicillin
Diagnostic Lab Data: EEG - 11/29/21 MRI - 12/9/21
CDC Split Type:

Write-up: Seizure on 11/23/21 and seizure on 11/29/21, each lasting approximately 2 minutes. EEG found abnormal results. MRI, no significant findings. Started medication for seizures on 12/1/21 (prescribed b neurologist)


VAERS ID: 1955370 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-30
Onset:2021-11-23
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed and hospitalized with COVID while fully vaccinated


VAERS ID: 1955387 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

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

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

Write-up: There were no averse events and no treatment required. Patient however was 11 at the time of the vaccine and was given a vaccine for 12 years and over. He returned to clinc for second dose and that is when it was realized that he had been given in error on 11/23/2021 the adolescent and adult dose for Pfizer vaccine. Second dose was not given when he returned.


VAERS ID: 1955450 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-16
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-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: 1955456 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-16
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-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: 1955645 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-03
Onset:2021-11-23
   Days after vaccination:265
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 admitted to Hospital on 11/23/2021 for COVID related symptoms. This is considered a breakthrough case.


VAERS ID: 1955678 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Blood creatine phosphokinase, C-reactive protein normal, Fatigue, Full blood count, Headache, Myalgia, Pain in extremity, Platelet count increased, Pyrexia, Red blood cell sedimentation rate increased, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: seasonal allergies
Diagnostic Lab Data: Labs from 12/15/21 ESR 13 CPK 222 CRP 0.56 CBC WBC 7.06, H/H 12.9/39, platelets 455,
CDC Split Type:

Write-up: Received first dose of Pfizer Covid vaccine on 11/22, and has had persistent complaints since then. She felt fatigue and headache the next day, and had a fever. Since that time, she has felt like her stomach is "squeezing" off and on throughout the day. Feels like "constriction." No nausea/vomiting. Also stating that legs are sore - everywhere on her legs except her anterior lower legs. Able to walk ok, but soreness comes and goes during the day. Having headaches on and off as well since then, which is unusual for her. She then had a fever about two weeks after vaccination, which resolved in one day. At time of last evaluation, about 4 weeks since vaccination, has had persistent lower leg myalgias and fatigue. Headaches and abdominal pain have improved.


VAERS ID: 1955800 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-02-21
Onset:2021-11-23
   Days after vaccination:275
Submitted: 0000-00-00
Entered: 2021-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Oxygen saturation decreased, SARS-CoV-2 test positive, Sleep apnoea syndrome
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin, cabozantinib, enoxaparin, D2, zetia, metrmon, metoprolol, mVI, zofran, oxycodone, senna
Current Illness: unk
Preexisting Conditions: MI, CHF, CAD, DM, hyperlipidemia, Hypertension, stroke
Allergies: ace inhibitors
Diagnostic Lab Data: 11/29/21 = Covid +
CDC Split Type:

Write-up: Incidentally diagnosed. He has no symptoms and is not on oxygen. He is high-risk given heart disease and new cancer, which made him a good candidate for MAbs, which he received during admission. He has had transient desaturations overnight, which appears to be related to undiagnosed OSA with possible COPD. Remained in quarantine (no walks in the hall) for at least 10 days post first positive test.


VAERS ID: 1957979 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast enlargement, Breast pain, Chest pain, Immunisation, Lymphoedema
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Lipodystrophy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101689801

Write-up: lymphdemia; enlarged chest/breast with burning and sensitivity; enlarged chest/breast with burning and sensitivity; enlarged chest/breast with burning and sensitivity; Dose Number 3/ 3rd shot; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 35 year-old male patient received bnt162b2 (BNT162B2), administered in arm left, administration date 23Nov2021 10:00 (Batch/Lot number: unknown) at the age of 35 years as dose 3 (booster), single for covid-19 immunisation. Relevant medical history included: "Known allergies: Penicillin" (unspecified if ongoing). There were no concomitant medications. Vaccination history included: Bnt162b2 (Dose Number: 2, Batch/Lot No: EP7533, Location of injection: Arm Right, Administration Time: 02:00 PM), administration date: 02Apr2021, when the patient was 34 years old, for COVID-19 immunization, reaction(s): "enlarged chest/breast with burning and sensitivity", "lymphdemia", "enlarged chest/breast with burning and sensitivity", "enlarged chest/breast with burning and sensitivity"; Bnt162b2 (Dose Number: 1, Batch/Lot No: EN6207, Location of injection: Arm Right, Administration Time: 02:00 PM), for COVID-19 immunization. The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021 10:00, outcome "unknown", described as "Dose Number 3/ 3rd shot"; LYMPHOEDEMA (non-serious) with onset 26Nov2021 20:45, outcome "recovering", described as "lymphdemia"; BREAST PAIN (non-serious), BREAST ENLARGEMENT (non-serious), CHEST PAIN (non-serious) all with onset 26Nov2021 20:45, outcome "recovering" and all described as "enlarged chest/breast with burning and sensitivity". The events "lymphdemia", "enlarged chest/breast with burning and sensitivity", "enlarged chest/breast with burning and sensitivity" and "enlarged chest/breast with burning and sensitivity" were evaluated at the physician office visit and emergency room visit. Therapeutic measures were not taken as a result of lymphoedema, breast pain, breast enlargement, chest pain. Additional information: Prior to vaccination, the patient was not diagnosed with covid-19 and post vaccination, the patient had not been tested for covid-19. It was reported that 3rd shot resulted in lymphdemia and enlarged chest/breast with burning and sensitivity. The lot number for bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 1958065 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Immunisation, Skin discolouration, Vaccination site erythema, Vaccination site pain, Vaccination site reaction, Vaccination site warmth
SMQs:, Hypotonic-hyporesponsive episode (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: XGEVA; ALEVE; LETROZOL; CLARITIN [LORATADINE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Breast cancer metastatic (Breast Cancer metastasized to the bone)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101778069

Write-up: Large injection site welt; Large injection site welt, very red; Large injection site welt, very red with heat and pain.; Large injection site welt, very red with heat; Small slight discoloration on arm.; Dose received: 3; This is a spontaneous report received from contactable reporter (consumer or other non-HCP). The reporter is the patient. A 55-year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in right arm, administration date 23Nov2021 at 09:30 (Lot number: FH8020) at the age of 55 years as dose 3 (booster), single for COVID-19 immunisation. Relevant medical history included: "Breast cancer metastatic" (unspecified if ongoing), notes: Breast Cancer metastasized to the bone. Concomitant medications included: XGEVA, start date: 12Nov2021, stop date: 12Nov2021; ALEVE; LETROZOL and CLARITIN. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE, Lot Number: EN6205, Route of Administration: Unspecified, Anatomical Location: Right arm, Time of Administration: 14:00), administration date: 02Mar2021, when the patient was 54 years old, for COVID-19 immunisation and Bnt162b2 (DOSE 1, SINGLE, Lot Number: EN8733, Route of Administration: Unspecified, Anatomical Location: Right arm, Time of Administration: 14:00), administration date: 23Mar2021, when the patient was 54 years old, for COVID-19 immunisation. The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021 at 09:30, outcome "unknown", described as "Dose received: 3"; VACCINATION SITE REACTION (non-serious) with onset 23Nov2021 at 16:00, outcome "recovering", described as "Large injection site welt"; VACCINATION SITE ERYTHEMA (non-serious) with onset 23Nov2021 at 16:00, outcome "recovering", described as "Large injection site welt, very red"; VACCINATION SITE PAIN (non-serious) with onset 23Nov2021 at 16:00, outcome "recovered" (an unknown date in Dec2021), described as "Large injection site welt, very red with heat and pain"; VACCINATION SITE WARMTH (non-serious) with onset 23Nov2021 at 16:00, outcome "recovered" (an unknown date in Dec2021), described as "Large injection site welt, very red with heat"; SKIN DISCOLOURATION (non-serious) with onset 23Nov2021 at 16:00, outcome "recovering", described as "Small slight discoloration on arm". Therapeutic measures were not taken as a result of vaccination site reaction, vaccination site pain, vaccination site warmth, vaccination site erythema and skin discolouration. Additional Information: The patient did not have any physical allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The large injection site welt, very red with heat and pain expanded to 3 inch diameter. Three weeks later, the heat and pain went away. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care.


VAERS ID: 1958169 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H2A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Pityriasis rosea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: The patient had a herald patch which was a precursor to developing Pityriasis Rosea; fever; chills; headaches; This spontaneous case was reported by a consumer and describes the occurrence of PITYRIASIS ROSEA (The patient had a herald patch which was a precursor to developing Pityriasis Rosea), PYREXIA (fever), CHILLS (chills) and HEADACHE (headaches) in a 30-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031H2A) for COVID-19 vaccination. Previously administered products included for Product used for unknown indication: pfizer (2nd dose) and pfizer (1st dose). Past adverse reactions to the above products included No adverse reaction with pfizer and pfizer. On 23-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Nov-2021, the patient experienced PYREXIA (fever), CHILLS (chills) and HEADACHE (headaches). On 30-Nov-2021, the patient experienced PITYRIASIS ROSEA (The patient had a herald patch which was a precursor to developing Pityriasis Rosea). The patient was treated with PARACETAMOL (TYLENOL [PARACETAMOL]) at an unspecified dose and frequency. On 24-Nov-2021, PYREXIA (fever), CHILLS (chills) and HEADACHE (headaches) had resolved. At the time of the report, PITYRIASIS ROSEA (The patient had a herald patch which was a precursor to developing Pityriasis Rosea) had not resolved. Concomitant medications were not reported. Patient noticed dry patches on back and patches had gotten bigger. On 13-DEC-2021, he went to dermatologist. The doctor indicated that he had a herald patch which was a precursor to developing Pityriasis Rosea. It was look like he was in between stages and once he had Pityriasis Rosea it could last 2 to 6 months before clearing.


VAERS ID: 1958184 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-01-06
Onset:2021-11-23
   Days after vaccination:321
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: None- vaccine given 17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046C21A and 011J20A) for COVID-19 vaccination. No Medical History information was reported. On 06-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Nov-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication information was not provided by the reporter. Treatment information was not provided by the reporter. This case was linked to MOD-2021-395985 (Patient Link).


VAERS ID: 1958278 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-01-14
Onset:2021-11-23
   Days after vaccination:313
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: None- vaccine given 17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046C21A and 041L20A) for COVID-19 vaccination. No Medical History information was reported. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-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 EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medication were reported. No treatment medication were reported. This case was linked to MOD-2021-395985 (Patient Link).


VAERS ID: 1958304 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-01-06
Onset:2021-11-23
   Days after vaccination:321
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: vaccine given 17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (vaccine given 17 days post expiry) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046C21A and 011J20A) for COVID-19 vaccination. No Medical History information was reported. On 06-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-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, the patient experienced EXPIRED PRODUCT ADMINISTERED (vaccine given 17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (vaccine given 17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medications were reported. No Treatment information was reported. This case was linked to MOD-2021-395985 (Patient Link).


VAERS ID: 1958317 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 3 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: None- vaccine given 17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) in a 28-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. Previously administered products included for Product used for unknown indication: Pfizer (batch number- ER8732) on 29-Apr-2021. Past adverse reactions to the above products included No adverse event with Pfizer. On 23-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment information was provided. This case was linked to MOD-2021-395985 (Patient Link).


VAERS ID: 1958812 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-11-17
Onset:2021-11-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939903 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Dyspnoea, Electrocardiogram, Fatigue, Injection site erythema, Injection site pain, Myocarditis, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3
Current Illness:
Preexisting Conditions:
Allergies: Allergic to honey bees
Diagnostic Lab Data: EKG and bloodwork 12/7/2021 ECG 12/10/2021
CDC Split Type:

Write-up: Swollen red and painful at injection site two weeks following the shot. November 23rd -Chest pain, shortness of breath, tire easily. Diagnosed with myocarditis


VAERS ID: 1959028 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Contusion, Headache, Injection site rash, Pain, Pain in extremity, Photophobia, Pyrexia, Skin warm
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Accidents and injuries (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Got my booster around 12:30pm on 11/23 - also got my flu shot in the same arm (right) By 10-11pm, I had chills, fever, body aches and lasted until the morning. Also woke up with a massive headache on the right side - sharp strong pain, made it hard to see in the sun/bright lit areas Fever went away around 1-2pm but still had really bad headache. Took an Advil around 4pm. Went away around 6pm. Arm was still sore then 2-3 days later started to get a rash close to where I was poked. The rash was warm and lasted for about a week. Then arm bruised for 5-7 days. Bruise is getting smaller but still visible until today.


VAERS ID: 1959040 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-11-16
Onset:2021-11-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065152M / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Too many to list.
Current Illness: none
Preexisting Conditions: heart
Allergies: nothing
Diagnostic Lab Data: Dr. tested me for gout and none was found.
CDC Split Type:

Write-up: Hands started getting very painful in joints. As the days went on, my left hand got much worse. It was hurting so bad that I could not use my left hand at all and in great pain. ( Left arm is where i received the booster shot. ) My right hand was hurting but not nearly as much as my left hand. Went to Dr. and he prescribed some prednisone. The prednisone relieved the pain and I could use my left hand again. Its been a few days since I took my last prednisone and my left hand is starting to get bad again. Right now, I can not move my 2 fingers next to my thumb and is in quite a bit of pain. I just e-mailed Dr. asking him what I should do.


VAERS ID: 1959529 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Parosmia
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol-chlothalidone 50 mg.-25 mg., 1/2 tablet daily at bedtime Atrovastatin 80 mg. daily Metformin Hcl ER 1000 mg. twice a day Rybelsus 7 mg. daily Farxiga 10 mg. daily Glimepiride 4 mg. twice a day Losartan Potassium 75 mg. daily
Current Illness: None
Preexisting Conditions: Diabetes, Type II HTN Hyperlipidemia
Allergies: A blood pressure pill
Diagnostic Lab Data:
CDC Split Type:

Write-up: Metallic smell in nose 15 minutes after injection. Since then, the smell of odors are intense, and overwhelming at times.


VAERS ID: 1959590 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-02
Onset:2021-11-23
   Days after vaccination:294
Submitted: 0000-00-00
Entered: 2021-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, COVID-19, COVID-19 pneumonia, Cough, Dyspnoea, Intensive care, Positive airway pressure therapy, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Carvedilol, furosemide, metformin, omeprazole, potassium, pravastatin, warfarin
Current Illness:
Preexisting Conditions: He has a past medical history of Adenoma of cecum, CAD (coronary artery disease), Colon polyp, DJD (degenerative joint disease), Factor V Leiden (HCC), GERD (gastroesophageal reflux disease), History of prostate cancer, History of pulmonary embolus (PE), Hyperlipidemia, Hypertension, Malignant melanoma of skin of chest (HCC), Melanoma (HCC), Metabolic syndrome, Microalbuminuria, Mitral insufficiency, Non-insulin dependent type 2 diabetes mellitus (HCC), Osteoarthritis, Prostate cancer (HCC), Protein C deficiency (HCC), Pyloric erosion, acute, Spinal stenosis, and Tricuspid insufficiency.
Allergies: Demerol
Diagnostic Lab Data: 11/30/21 COVID 19- positive; 11/30/21 CTA chest: Findings compatible with COVID pneumonia.
CDC Split Type:

Write-up: Presented to ER on 11/30 with worsening shortness of breath, cough for 7 days. Oxygen saturation was 88% was placed on nasal cannula oxygen. Vaccinated for COVID in February 2021. COVID tested positive 11/30/2021. Admitted on 11/30/21. Placed on azithromycin, ceftriaxone, dexamethasone, and remdesivir. O2 requirements increased to 5L NC, ID and pulmonary consulted. O2 requirements increased again overnight 12/1/12/2, transferred to ICU. o2 requirements continued to increase, placed on Opti flow and then CPAP. Patient decided 12/4 am that he wanted to pursue comfort measures. Patient only required 2 L oxygen now and comfortable with oral and IV morphine, Ativan. Discharged on 12/9/21.


VAERS ID: 1961181 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-01-14
Onset:2021-11-23
   Days after vaccination:313
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: None- vaccine given 17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046C21A and 041L20A) for COVID-19 vaccination. No Medical History information was reported. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-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 EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication information was provided. The patient was given vaccine 17 days post expiry date. No treatment medication information was provided. This case was linked to MOD-2021-395985 (Patient Link).


VAERS ID: 1961187 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: None- vaccine given 17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) in a 22-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. No Medical History information was reported. On 23-Nov-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medicines were reported No treatment medicines were reported This case was linked to MOD-2021-395985 (Patient Link).


VAERS ID: 1961211 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-01-12
Onset:2021-11-23
   Days after vaccination:315
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: None- vaccine given17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (None- vaccine given17 days post expiry) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046C21A and 011L20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-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, the patient experienced EXPIRED PRODUCT ADMINISTERED (None- vaccine given17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (None- vaccine given17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The patient received vaccine 17 days post expiry dose of the Moderna. No concomitant medications was reported. No treatment drug details was reported. This case was linked to MOD-2021-395985 (Patient Link).


VAERS ID: 1961227 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: None- vaccine given 17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. No Medical History information was reported. On 23-Nov-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was provided. No treatment information was provided. This case was linked to MOD-2021-395985 (Patient Link).


VAERS ID: 1961238 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-02-18
Onset:2021-11-23
   Days after vaccination:278
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Vaccine given 17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Vaccine given 17 days post expiry) in a 31-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046C21A and 041L20A) for COVID-19 vaccination. No Medical History information was reported. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-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 EXPIRED PRODUCT ADMINISTERED (Vaccine given 17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (Vaccine given 17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medication were reported. No treatment medication were reported. This case was linked to MOD-2021-395985 (Patient Link).


VAERS ID: 1961267 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-01-12
Onset:2021-11-23
   Days after vaccination:315
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Vaccine given 17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Vaccine given 17 days post expiry) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046C21A and 011L20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-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 EXPIRED PRODUCT ADMINISTERED (Vaccine given 17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (Vaccine given 17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication information was provided. No treatment medication were provided This case was linked to MOD-2021-395985.


VAERS ID: 1961317 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-01-29
Onset:2021-11-23
   Days after vaccination:298
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: None- vaccine given 17 days post expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. No Medical History information was reported. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-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 EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (None- vaccine given 17 days post expiry) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications and no treatment medications were reported This case was linked to (Patient Link).


VAERS ID: 1961330 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 3 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: This spontaneous case reported by a pharmacist, describes the occurrence of administered expired product (vaccine given 17 days post expiry) in a 73-year-old male patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch/lot# 046C21A and 041L20A) for COVID-19 immunization. No medical history reported. On Jan 13, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Nov 23, 2021, patient received the third dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Nov 23, 2021, patient administered expired product (vaccine given 17 days post expiry). On Nov 23, 2021, administered expired product (vaccine given 17 days post expiry) resolved. The reporter did not provide any causality assessments, concomitant medication or treatment information. Patient did not experience any other adverse reactions. This case linked to MOD-2021-395985 (patient link).


VAERS ID: 1961497 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Antibody test; Test Result: Inconclusive ; Result Unstructured Data: Antibody numbers were in the 800-900 range
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Administered this vaccine to patients after this 30-day mark; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administered this vaccine to patients after this 30-day mark) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037C21A) for COVID-19 vaccination. No Medical History information was reported. On 23-Nov-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administered this vaccine to patients after this 30-day mark). On 23-Nov-2021, EXPIRED PRODUCT ADMINISTERED (Administered this vaccine to patients after this 30-day mark) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Antibody test: 800-900 (Inconclusive) Antibody numbers were in the 800-900 range. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication of the patient was not reported. No treatment information was provided by the reporter. The patient did not report any adverse events or symptoms post 24 hours after vaccination.


VAERS ID: 1961696 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Injection site pain, Limb injury, Mobility decreased
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Site: Pain at Injection Site-Severe, Systemic: Joint Pain-Severe, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-, Additional Details: numbness, unable to move her arm


VAERS ID: 1961825 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-12
Onset:2021-11-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dermatitis contact, Erythema, Eye pruritus, Insomnia, Mechanical urticaria, Pruritus, Rash, Scratch, Skin irritation, Throat irritation, Urticaria, Urticaria contact, Vaccination site reaction
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (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: Volnea birth control pill. VitaFusion multivitamin gummies Digestive Advantage daily probiotic Sambucus Elderberry gummies
Current Illness: None
Preexisting Conditions: Occasional seborrheic dermatitis on face.
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed as contact urticaria/dermatitis. Began the night of Nov 22, itchy eyes and throat, skin. Eyes and throat issues quickly went away, but itchy/irritating feeling on scalp, ears, neck, and shoulders continued. Bright red welts would form wherever skin was scratched, appeared to look like dermatographia. Symptoms are now from the waste up, including hands. Sought treatment after being unable to sleep due to symptoms. On December 7th, doctor suggested I take Allegra and Pepcid, which helped symptoms tremendously. Symptoms still return towards the end of 24 hr Allegra dose. Doctor then prescribed Prednisone on December 15th, I am currently on the second day of a five day treatment. Skin irritation still breaks through occasionally. I did have "COVID Arm" rash appear about a week after Moderna dose this spring, but no other skin issues until after this booster shot.


VAERS ID: 1961908 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 1 LA / IM

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

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

Write-up: Patient was given Pfizer (12+ years old) instead of what they thought we had which was Pfizer (5-11 yo). There were no adverse symptoms to the vaccine itself. Just wrong vaccine for age group was given.


VAERS ID: 1963370 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site pain, Myalgia, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Similar, but more minor versions of the described side effects after my second dose of the Pfizer shot. After the first dose, I
Other Medications: Sertraline 25mg
Current Illness: N/A
Preexisting Conditions: Acid reflux
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Adverse side effects included low-grade fever, muscle aches, pain at the injection site and severe shakes. The primary adverse reaction was the shaking. It felt almost like a compulsion and I was unable to stop it. I added an extra blanket to the bed and turned up the heat in the house to 72�F. I shook from about 10 pm to 3 am that night. The fever continued into the morning when I took one tablet of ibuprofen. Tenderness at the injection site lasted for 48 hours after the first onset of the symptoms (around 9 pm on 11/23/2021).


VAERS ID: 1963959 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: syncopal episode after J&J vaccine 12 hrs after.
Other Medications: finasteride, flonase, vit B supplement
Current Illness: unknown
Preexisting Conditions: acne, anxiety
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Syncopal episode 12 hrs after administration.


VAERS ID: 1967757 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 3 RA / IM
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS UKNOWN / N/A LA / IM

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

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

Write-up: Patient stated she had received the Covid booster and flu vaccines in opposite arms and that the shots were given too high. She has experienced arm/shoulder pain since, the vaccines were administered 4 weeks ago. The pain did require a doctor''s visit but no other treatment other than over the counter ibuprofen.


VAERS ID: 1968087 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 Pfizer 30mcg COVID-19 first dose on 11/10/2021. She inadvertently received the second dose of Pfizer 30mcg COVID-19 on 11/23/2021 instead of 21 days after the 1st dose. The error was discovered. The patient was notified on 12/3/2021. There were no adverse outcomes reported. The physician recommended she repeat the 2nd dose 21 days after the dose on 11/23/2021. She received the additional dose on 12/14/2021 to complete the series.


VAERS ID: 1968141 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dizziness, Palpitations, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D Multivitamin gummy
Current Illness: Bronchitis
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Had to call 911 and they checked vitals
CDC Split Type:

Write-up: Heart palpitations Chest pain Throwing up three times Felt faint


VAERS ID: 1968231 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0347F21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ambien, oaxypam
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 12/21/2021 Exam by dermatologist - only solution was a steroid creme and to report it.
CDC Split Type:

Write-up: Sore arm for 14 days, joint pain in shoulder for 3 weeks, rash starting 48 hours after injection. Rash is continuing to spread down both legs, from top of thigh to knees, inside and outside of legs. rash on neck and arms. I am so concerned about the rash that I saw a dermatologist and she said this is a known problem with Moderna


VAERS ID: 1968645 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-17
Onset:2021-11-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Eye pain, Intraocular pressure test normal, Pain, Photophobia, Scleral oedema, Scleritis, Sleep disorder, Ultrasound eye abnormal, Uveitis, Visual acuity tests normal
SMQs:, Angioedema (narrow), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Scleral disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithium, venlafaxine, vyvanse, levothyroxine, l-methyl folate, metformin, azelastine, melatonin, multi vitamin, iron, vitamin D, omeprazole, dulera
Current Illness: None
Preexisting Conditions: Asthma, poly cystic ovarian syndrome, bipolar disorder
Allergies: None known
Diagnostic Lab Data: Probably best to consult Dr.
CDC Split Type:

Write-up: Approximately one week post vaccination I began to feel a dull pain behind both eyes but primarily behind my left eye. This pain very slowly increased over the course of a week and one week in to symptoms I began feeling a sharp pain with eye movement. This lead me to see my ophthalmologist (now three weeks after vaccine) After normal visual acuity and ocular pressure tests, and also noting my sensitivity to lights, he said I either had uveitis or scleritis and knowing that my symptoms had not improved with regular NSAIDS he prescribed oral prednisone. I saw him again one week later (4 weeks post vaccine) and my symptoms had not notably improved and the pain was even waking me from sleep. With an ultrasound imaging machine he documented fluid/inflammation in my posterior sclera bilaterally and prescribed continued prednisone. Over the next week pain on movement resolved but there is still severe pain behind my eyes and I still have intense light sensitivity. I am awaiting my next follow up (five weeks post vaccine).


VAERS ID: 1970368 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-11-23
Submitted: 0000-00-00
Entered: 2021-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 182811 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram, Pain in extremity, Paralysis, Pneumonia, Pulmonary thrombosis, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211123; Test Name: CAT; Result Unstructured Data: blood clot in one of the legs; Comments: unsure which side; Test Date: 20211123; Test Name: CAT; Result Unstructured Data: Blood clot in the lung; Comments: unsure which side
CDC Split Type: USJNJFOC20211225184

Write-up: THE LEFT SIDE OF HER BODY WAS PARALYZED FROM THE ARM, TORSO AND LEG ON THE LEFT SIDE.; BLOOD CLOT IN THE LEG; PNEUMONIA; CHEST PAIN; PAIN IN BOTH LEGS; BLOOD CLOT IN THE LUNG; This spontaneous report received from a patient concerned a 53 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 182811, and expiry: UNKNOWN) dose was not reported, 1 total (dose number in series: 1) administered on 19-OCT-2021 to right deltoid for prophylactic vaccination. No concomitant medications were reported. On 23-NOV-2021, the patient experienced blood clot in the leg, pneumonia, blood clot in the lung, chest pain and pain in both legs, and was hospitalized. The patient went to the emergency room for the chest pain and was diagnosed with pneumonia and 2 blood clots, one in her lung and one in her leg but. She was unsure that which side of the lung and leg in which had the blood clot. Laboratory data included: CAT (computerized tomography) (NR: not provided) Blood clot in the lung, blood clot in one of the legs. The patient was admitted in the hospital 23-Nov-2021 and was discharged on 27-Nov-2021. On 05-DEC-2021, the patient admitted in hospital due to the left side of her body was paralyzed from the arm, torso and leg on the left side and chest pain, which she described as the same chest pain as before that never went away and was currently admitted in hospital. They gave antibiotics for the pneumonia and something else for the blood clots. The patient recieved physical therapy in order to treat the paralysis and to regain strength in the left leg. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from pneumonia, and had not recovered from blood clot in the leg, blood clot in the lung, chest pain, pain in both legs, and the left side of her body was paralyzed from the arm, torso and leg on the left side. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender''s Comments: V0:20211225184-COVID-19 VACCINE AD26.COV2.S-Blood clot in the leg,Pneumonia,The left side of her body was paralyzed from the arm,torso and leg on the left side,Blood clot in the lung,Chest pain. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20211225184-COVID-19 VACCINE AD26.COV2.S-Pain in both legs. This event(s) is labeled per RA and is therefore considered potentially related.


VAERS ID: 1970417 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-11-18
Onset:2021-11-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Angina pectoris, Arthralgia, Blood test, Chest X-ray, Chest pain, Dyspnoea, Echocardiogram abnormal, Electrocardiogram, Exercise tolerance decreased, Headache, Inflammatory marker increased, Loss of personal independence in daily activities, Pericarditis, Pulmonary pain
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Chronic kidney disease (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 12/11/21 echocardiogram ekg blood panel tests 2 chest xrays
CDC Split Type:

Write-up: Started 5 days after 1st vaccine with headaches then severe joint pain that lasted for 5 days then the heart and chest pain started and has been going on now for 4 weeks. We went to urgent care the er and pediatrician. He had high levels of inflammatory marker and after a echocardiogram the ER doctor said most likely pericarditis. Pain in chest and lungs worse when laying down. My 9 you cannot walk long distances or at a fast pace cannot play and had been taking ibuprofen on and off for almost 4 weeks now. It is NOT heart burn because antacids do not help his shortness of breath and chest pain.


VAERS ID: 1970636 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1620 / 3 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Headache, Immunisation, Pain in extremity, Pain in jaw, Paranasal sinus discomfort
SMQs:, Osteonecrosis (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: FLONASE [FLUTICASONE PROPIONATE]; CLARITIN [CLARITHROMYCIN]; ZOLOFT; ABILIFY
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101654777

Write-up: Booster dose; jaw pain; Sore arm; headache; sinus pressure; earache; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 60 year-old male patient received bnt162b2 (BNT162B2), administered in arm left, administration date 24May2021 11:15 (Batch/Lot number: unknown) at the age of 60 years as dose 2, single for covid-19 immunisation. Relevant medical history included: "known allergies: Oral anti Inflammatorys" (unspecified if ongoing); "if covid prior vaccination: Yes" (unspecified if ongoing). Concomitant medication(s) included: THYROXINE. Vaccination history included: Bnt162b2 ((product=COVID 19, brand=Pfizer, lot unknown=True, lot unknown reason=Unable to locate or read the details, administration date=23Mar2021, administration time=11:15 AM, dose number=1,, vaccine location=Left arm)), administration date: 23Mar2021, when the patient was 60 years old, for COVID-19 immunisation. The following information was reported: INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (non-serious), outcome "unknown", described as "administration date=23Mar2021/administration date=24May2021"; TREMOR (non-serious) with onset 24May2021 23:00, outcome "recovering", described as "Severe shaking after 12hrs.Elevated heart rate during rest Severe drenching night sweat 60 hrs later."; HEART RATE INCREASED (non-serious), NIGHT SWEATS (non-serious) all with onset 24May2021 23:00, outcome "recovering" and all described as "Severe shaking after 12hrs.Elevated heart rate during restSevere drenching night sweat 60 hrs later.". Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were not taken as a result of inappropriate schedule of product administration, tremor, heart rate increased, night sweats. Additional information: Patient had not received any other vaccine with in four weeks, No prior vaccination patient has not been taken. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1970642 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 3 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: EFFEXOR; CONCERTA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Breast cancer; Shingles (I had shingles before that was mild like this about seven years prior); Total mastectomy (Total mastectomy due to breast cancer)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101673758

Write-up: a very itchy rash on my neck lasted all day; woke up the next morning the rash was over my; diagnosed it with shingles; dose number=3; This is a spontaneous report received from contactable reporter(s) (Other HCP). The reporter is the patient. A 51 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm left, administration date 23Nov2021 02:00 (Lot number: FH8027) at the age of 51 years as dose 3 (booster), single for covid-19 immunisation. Relevant medical history included: "Total mastectomy due to breast cancer" (unspecified if ongoing), notes: Total mastectomy due to breast cancer; "Shingles" (unspecified if ongoing), notes: I had shingles before that was mild like this about seven years prior; "breast cancer" (unspecified if ongoing). Concomitant medication(s) included: EFFEXOR; CONCERTA. Vaccination history included: Bnt162b2 (Prev dose product=COVID 19, Prev dose brand=Pfizer, Prev dose lot number= ER8729, Prev dose dose number=2, Prev dose vaccine location=Left arm), administration date: 10Apr2021, when the patient was 50 years old, for Covid-19 immunization; Bnt162b2 (Prev dose product=COVID 19, Prev dose brand=Pfizer, Prev dose lot number= ER8727, Prev dose dose number=1, Prev dose vaccine location=Left arm), administration date: 20Mar2021, when the patient was 50 years old, for Covid-19 immunization. The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021 02:00, outcome "unknown", described as "dose number=3"; RASH PRURITIC (non-serious) with onset 24Nov2021, outcome "recovering", described as "a very itchy rash on my neck lasted all day"; RASH (non-serious) with onset 24Nov2021, outcome "recovering", described as "woke up the next morning the rash was over my"; HERPES ZOSTER (non-serious) with onset 24Nov2021, outcome "recovering", described as "diagnosed it with shingles". The events "a very itchy rash on my neck lasted all day", "woke up the next morning the rash was over my" and "diagnosed it with shingles" were evaluated at the physician office visit and emergency room visit. Therapeutic measures were taken as a result of rash pruritic, rash, herpes zoster. Additional information: There were no other vaccine taken in four weeks. The patient took the antiviral Valtrex as the treatment. There were no allergies. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1970686 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 3 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Ageusia, Anosmia, Immunisation, SARS-CoV-2 test
SMQs:, Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211129; Test Name: PCR; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101705450

Write-up: Loss of smell and taste; Loss of smell and taste; dose number=3; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from product quality group. The reporter is the patient. A 20 year-old female patient (not pregnant) received bnt162b2 (BNT162B2, solution for injection), administered in arm left, administration date 23Nov2021 (Lot number: EW0217) at the age of 20 years as dose 3 (booster), single for covid-19 immunisation. The patient''s relevant medical history was not reported. There were no concomitant medications. Past drug history included: Bactrum, reaction(s): "known allergies: Bactrum". Vaccination history included: Bnt162b2 (prev dose lot number=ER8729, prev dose dose number=1, prev dose vaccine location=Left arm), administration date: 15Apr2021, when the patient was 20 years old, for COVID-19 immunization, reaction(s): "29Nov2021 covid test result=Positive", "29Nov2021 covid test result=Positive"; Bnt162b2 (prev dose lot number=ER8736, prev dose dose number=2, prev dose vaccine location=Left arm), administration date: 07May2021, when the patient was 20 years old, for COVID-19 immunization, reaction(s): "29Nov2021 covid test result=Positive", "29Nov2021 covid test result=Positive". The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021, outcome "unknown", described as "dose number=3"; ANOSMIA (non-serious), AGEUSIA (non-serious) all with onset 29Nov2021, outcome "recovering" and all described as "Loss of smell and taste". Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were not taken as a result of anosmia, ageusia. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1971993 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-11-11
Onset:2021-11-23
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039F21A / N/A LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Small pox
Other Medications: Cinnamon turmeric cayenne pepper
Current Illness: Bad cold that lasted two weeks. Had a covid test, was simply a bad cold.
Preexisting Conditions: Eczema
Allergies: Dairy Codeine Bee stings Hay Horses cats
Diagnostic Lab Data: I haven''t called the doctor. Hives seems something I ought to be to handle.
CDC Split Type:

Write-up: I am breaking out in hives !!! I was a little bit earlier this year, but never associated it with possible Janssen shot connection. After the Moderna booster, seems hives are not going away. I''ve rules out foods high in histamine, yet this morning, such a mess!!! I also have stopped wine.


VAERS ID: 1973803 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33030817 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunisation, Vaccination site mass
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: PRISTIQ; CLIMARA PRO; VITAMIN D [VITAMIN D NOS]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Depression
Allergies:
Diagnostic Lab Data:
CDC Split Type: PRPFIZER INC202101664749

Write-up: Lump under the armpit of the vaccinated arm (left); Booster; This is a spontaneous report received from a contactable reporter(s) (Other HCP). The reporter is the patient. A 45 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm left, administration date 23Nov2021 02:30 (Lot number: 33030817) at the age of 45 years as dose 3 (booster), single for covid-19 immunisation. Relevant medical history included: "Depression" (unspecified if ongoing). Concomitant medication(s) included: PRISTIQ; CLIMARA PRO; VITAMIN D [VITAMIN D NOS]. Vaccination history included: Bnt162b2 (Dose Number: 2, Batch/Lot No: EW0151, Location of injection: Arm Left, Vaccine Administration Time: 11:15 AM), administration date: 28Mar2021, when the patient was 44 years old, for COVID-19 immunization; Bnt162b2 (Dose Number: 1, Batch/Lot No: EP6955, Location of injection: Arm Left, Vaccine Administration Time: 03:30 PM), administration date: 18Mar2021, when the patient was 44 years old, for Covid-19 Immunization. The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021, outcome "unknown", described as "Booster"; VACCINATION SITE MASS (non-serious) with onset 23Nov2021 20:30, outcome "not recovered", described as "Lump under the armpit of the vaccinated arm (left)". Therapeutic measures were not taken as a result of vaccination site mass. Additional Information: Prior vaccination within 4 weeks was reported as none. The patient had no known allergies. Prior to vaccination patient was not diagnosed with COVID-19 and since the vaccination, the patient had not been tested for COVID-19. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1974192 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1620 / 3 LA / -

Administered by: Military       Purchased by: ?
Symptoms: Body temperature, Headache, Hyperhidrosis, Immunisation, Loss of personal independence in daily activities, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20211124; Test Name: Fever; Result Unstructured Data: Test Result:100.8; Test Date: 20211124; Test Name: Fever; Result Unstructured Data: Test Result:98.1
CDC Split Type: USPFIZER INC202101664014

Write-up: Aches and pains all over; Fever; hands and feet keep locking up; sweated it out; Headache; booster; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). A 73 year-old female patient received bnt162b2 (BNT162B2), administered in arm left, administration date 23Nov2021 10:30 (Lot number: FJ1620) at the age of 73 years as dose 3 (booster), single for covid-19 immunisation. The patient had no relevant medical history. Concomitant medication(s) included: FLU VACCINE VII. Vaccination history included: Bnt162b2 (1st dose, Lot: EP7533, Expiry: Unknown, didn''t have any issue with the 1st 2 doses, just a sore arm and was a little bit tired.), administration date: 23Apr2021, when the patient was 72 years old, for COVID-19 immunization, reaction(s): "sore arm"; Bnt162b2 (1st dose, Lot: EP7533, Expiry: Unknown, didn''t have any issue with the 1st 2 doses, just a sore arm and was a little bit tired.), administration date: 23Apr2021, for COVID-19 immunization, reaction(s): "was a little bit tired."; Bnt162b2 (2nd dose, Lot: EW0158, Expiry: Unknown, didn''t have any issue with the 1st 2 doses, just a sore arm and was a little bit tired.), administration date: 14May2021, when the patient was 72 years old, for COVID-19 immunization, reaction(s): "was a little bit tired.", "sore arm". The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021, outcome "unknown", described as "booster"; PAIN (non-serious) with onset 24Nov2021, outcome "not recovered", described as "Aches and pains all over"; HEADACHE (non-serious) with onset 23Nov2021, outcome "not recovered", described as "Headache"; PYREXIA (non-serious) with onset 24Nov2021, outcome "recovering", described as "Fever"; LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (non-serious) with onset 24Nov2021, outcome "unknown", described as "hands and feet keep locking up"; HYPERHIDROSIS (non-serious) with onset 24Nov2021, outcome "unknown", described as "sweated it out". Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were taken as a result of pain, headache, pyrexia, loss of personal independence in daily activities, hyperhidrosis. Additional information: Caller states that patient was calling her best friend who went to the hospital yesterday and got the Pfizer booster for Covid 19 vaccine, the adult dose. Ever since this morning her friend has just been laying around in bed, and experienced aches and pains all over, a headache, a fever of 100.8 which just broke and is now 98.1, and her hands and feet keep locking up, Caller states that patient has been giving her friend 2 Tylenol 500mg every 4 hours because she is not supposed to take Ibuprofen, but the patient already called her pharmacy and they told her that it was a side effect so she just wants to report it. She didn''t have any issue with the 1st 2 doses, just a sore arm and was a little bit tired. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1974193 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Ear pain, Headache, Immunisation, Lethargy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TELMISARTAN; AMLODIPINE BESILATE; LIPITOR; FAMOTIDINE; NORETHINDRONE ACETATE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetes; Heart disease, unspecified
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101664341

Write-up: Terrible headache; I got body aches; Chills; I have absolutely no energy; At one point today my ears hurt as well; Very lethargic no energy; Low grade fever; Booster; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 52 year-old female patient received bnt162b2 (BNT162B2), administered in arm left, administration date 23Nov2021 16:45 (Lot number: FH8030) at the age of 52 years as dose 3 (booster), single for covid-19 immunisation. Family history included: "diabetes" (unspecified if ongoing); "heart disease" (unspecified if ongoing). Concomitant medication(s) included: TELMISARTAN (ongoing); AMLODIPINE BESILATE; LIPITOR; FAMOTIDINE; NORETHINDRONE ACETATE. Vaccination history included: Bnt162b2 (Dose:1, Date: 01Mar2021, Time: 11:00, Anatomical site of injection: Left arm, Route of administration: Intramuscular, Batch/Lot Number: EL3247), administration date: 01Mar2021, when the patient was 52 years old, for COVID-19 immunization; Bnt162b2 (Dose: 2, Date: 01Apr2021, Anatomical site of injection: Left arm, Route of administration: Intramuscular, Batch/Lot Number: EP6955), administration date: 01Apr2021, when the patient was 52 years old, for COVID-19 immunization. The following information was reported: IMMUNISATION (non-serious) with onset 23Nov2021 16:45, outcome "unknown", described as "Booster"; HEADACHE (non-serious) with onset 24Nov2021, outcome "unknown", described as "Terrible headache"; PAIN (non-serious) with onset 24Nov2021, outcome "unknown", described as "I got body aches"; CHILLS (non-serious) with onset 24Nov2021, outcome "unknown", described as "Chills"; ASTHENIA (non-serious) with onset 24Nov2021, outcome "unknown", described as "I have absolutely no energy"; EAR PAIN (non-serious) with onset 24Nov2021, outcome "unknown", described as "At one point today my ears hurt as well"; LETHARGY (non-serious) with onset 24Nov2021, outcome "unknown", described as "Very lethargic no energy"; PYREXIA (non-serious) with onset 24Nov2021, outcome "unknown", described as "Low grade fever". Therapeutic measures were taken as a result of headache, pain, chills, asthenia, ear pain, lethargy. No follow-up attempts are possible. No further information is expected.


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