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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: 1920817 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-05
Onset:2021-11-20
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angioplasty, Asthenia, COVID-19, Cough, Dyspnoea, Exposure to SARS-CoV-2, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH/Chronic conditions include dyslipidemia, spinal stenosis, squamous cell carcinoma.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This case meets criteria for vaccine breakthrough review. SxS include fever, cough, SOB, weakness for 1 week PTA after exposure. Tested positive 11/20.


VAERS ID: 1920985 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-11-16
Onset:2021-11-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Chills, Computerised tomogram normal, Laboratory test normal, Pain, Vertigo
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: phenergan
Diagnostic Lab Data: CT scan done on first day and labs to r/o any other illness. All test were negative and one of my co worker has started with the same issue today on her third day of vaccination.
CDC Split Type:

Write-up: I had body ache and chills for three days and started with vertigo on 4th day morning. It was really bad and still continuing but slightly improved.


VAERS ID: 1921098 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-17
Onset:2021-11-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Chlamydia test negative, Headache, Herpes simplex test negative, Pyrexia, Sexually transmitted disease test, Vulval ulceration, Vulvovaginal discomfort, Vulvovaginal swelling
SMQs:, Severe cutaneous adverse reactions (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (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: Usually have strong reaction to all vaccines including flu and previous COVID vaccines (fever, chills, headaches)
Other Medications: Spironalactone 50mg
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin, Grass Seed, Flowering trees
Diagnostic Lab Data: Swabbed ulcer to test for Herpes simplex (1 +2) [NEGATIVE], Chlamydia + Gonorrhea [NEGATIVE].
CDC Split Type:

Write-up: Thursday 11/18 - Friday 11/19 had very normal reaction including chills, low fever, headache. On Saturday 11/20 Developed vaginal swelling/ discomfort and an ulcer on right labial area. On Sunday 11/21 visited urgent care to get the ulcer looked at. Swabbed ulcer to test for Herpes simplex (1 +2) [NEGATIVE], Chlamydia + Gonorrhea [NEGATIVE]. Doctor recommended 5 days of Acyclovir (400mg) orally while waiting for Herpes results. Discontinued the Acyclovir once the results came back negative. Ulcer went away without additional treatment on 11/25.


VAERS ID: 1921269 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Pruritus, 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? Yes
Hospitalized? No
Previous Vaccinations: 2nd dose of Pfizer i had fever and Chills the same night but that subsided quickly
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: No Allergies that I am aware of
Diagnostic Lab Data: I went to my local urgent care. No tests were done other than vitals. They did mention my blood pressure was somewhat high, which is abnormal for me as my blood pressure is almost always in the ideal range when checked.
CDC Split Type:

Write-up: Hives and itching under arms, on upper and lower arms, hands, on back and buttocks, starting roughly 24 hours after. Has mostly subsided by 12/3/2021, but slight symptoms have continued to this point . Hives have mostly faded but are still slightly present but itching is more infrequent.


VAERS ID: 1921857 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Eye irritation, Feeling hot, Hypoaesthesia, Hypoaesthesia oral, Injection site pain, Lacrimation increased, Malaise, Pain in extremity, Pyrexia, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Corneal disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acyclovir, calcium, daily vitamin
Current Illness: none
Preexisting Conditions: mitro-valve prolapse (MVP)
Allergies: none known
Diagnostic Lab Data: none. she referred me to a neurologist to order these tests.
CDC Split Type:

Write-up: I received the shot in the pharmacy, It was extremely painful. I waited a few minutes there and then left. As soon as I started driving, I felt a wave of warmth and numbness come over my face and ears and neck. My chest became red. I drove home and hoped it would go away. a few hours later, my eyes began to burn so badly, that I lay in bed keeping them closed. they were watering. my face, tongue, ears and so on were still numb. i ran a fever of 101.9. I felt ill and lay in bed. the next day I went to work. my arm was somewhat sore. My eyes were still burning, but much improved. my chest was still red and my face and such still numb. I went to the immediate care center and reported the symptoms to the nurse practitioner. By then, i was also having some mild congestion. she prescribed an antibiotic and referred me to a neurologist. while some symptoms have went away, the numbness in my face, tongue, ears, etc is still there. I am very scared that this may be permanent neurological damage. i plan to see a neurologist as soon as possible.


VAERS ID: 1922986 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-16
Onset:2021-11-20
   Days after vaccination:249
Submitted: 0000-00-00
Entered: 2021-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211118; Test Name: Nasal Swab; Test Result: Positive ; Comments: Nasal Swab; Test Date: 20211118; Test Name: PCR; Test Result: Positive ; Comments: PCR
CDC Split Type: USPFIZER INC202101631517

Write-up: Positive Covid 19 Test; Positive Covid 19 Test; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non-HCP). The reporter is the patient. A 53-year-old female patient (not pregnant) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection), intramuscular, administered in arm left, administration date 16Mar2021 (Batch/Lot number: unknown) as dose 2, single and intramuscular, administered in arm left, administration date 23Feb2021 (Batch/Lot number: unknown) as dose 1, single for COVID-19 immunization. The patient relevant medical history was not reported. There were no concomitant medications. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 20Nov2021, outcome "not recovered" and all described as "Positive COVID-19 Test". The patient underwent the following laboratory tests and procedures: Nasal Swab: (18Nov2021) positive, notes: Nasal Swab; PCR: (18Nov2021) positive, notes: PCR. Therapeutic measures were not taken as a result of vaccination failure, COVID-19. Clinical course: It was reported that, patient did not receive any other vaccine in four weeks and no other medications in two weeks. She was not diagnosed with COVID-19, prior to vaccination. She was tested for COVID-19, after the vaccination. She did not receive any other vaccines within 4 weeks prior to the COVID vaccine and any other medications the patient received within 2 weeks of vaccination. No follow-up attempts are possible, information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1922996 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33030BD / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal dreams, Chills, Dyspnoea, Fatigue, Heart rate increased, Hyperhidrosis, Impaired work ability, Migraine, Pulse abnormal, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLU
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101635350

Write-up: high heart rate at rest (approx 150; Chills; fatigue; migraine; pulse ox; shortness of breath; very vivid dreams; sweats like a fever; sweats like a fever; could not function; This is a spontaneous report received from a non-contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. An adult female patient received bnt162b2 (BNT162B2), administration date 19Nov2021 (Lot number: 33030BD) as dose 3 (booster), single for covid-19 immunisation. The patient''s relevant medical history was not reported. Concomitant medication(s) included: FLU. Vaccination history included: Bnt162b2 (Dose Number: 2, Batch/Lot No: Er8735), administration date: 07May2021, for COVID-19 immunisation; Bnt162b2 (Dose Number: 1, Batch/Lot No: Ew0150), administration date: 16Apr2021, for COVID-19 immunisation. The following information was reported: HEART RATE INCREASED (non-serious) with onset 20Nov2021, outcome "recovering", described as "high heart rate at rest (approx 150"; CHILLS (non-serious) with onset 20Nov2021, outcome "recovering", described as "Chills"; FATIGUE (non-serious) with onset 20Nov2021, outcome "recovering", described as "fatigue"; MIGRAINE (non-serious) with onset 20Nov2021, outcome "recovering", described as "migraine"; PULSE ABNORMAL (non-serious) with onset 20Nov2021, outcome "recovering", described as "pulse ox"; DYSPNOEA (non-serious) with onset 20Nov2021, outcome "recovering", described as "shortness of breath"; ABNORMAL DREAMS (non-serious) with onset 20Nov2021, outcome "recovering", described as "very vivid dreams"; HYPERHIDROSIS (non-serious), PYREXIA (non-serious) all with onset 20Nov2021, outcome "recovering" and all described as "sweats like a fever"; IMPAIRED WORK ABILITY (non-serious) with onset 20Nov2021, outcome "recovering", described as "could not function". Therapeutic measures were not taken as a result of heart rate increased, chills, fatigue, migraine, pulse abnormal, dyspnoea, abnormal dreams, hyperhidrosis, pyrexia, impaired work ability. Additional Information: It was reported that name of drug as reported was no with reaction: allergy. Seriousness criteria was reported as no for death, life threatening, caused/prolonged hospitalization, disabling/Incapacitating, congenital anomaly/birth defect. Facility where the most recent COVID-19 vaccine was administered: Pharmacy or Drug Store. Reporter stated that I had only minimal reactions with the first two shots. I won''t be getting a fourth shot! Prior to vaccination, the patient was not diagnosed with COVID-19. 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: 1923291 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8757 / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Dizziness, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Early 20?s in age, after flu shot in 2013. The hours after I had sweats and intense tremors. Slept them off.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sudden onset nausea, followed by immediate dizziness and feeling faint. Chills and complete body covered in sweat. All symptoms resolved within 5 minutes


VAERS ID: 1923343 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Cognitive disorder, Confusional state
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: When she received second dose of Moderna she had some confusion
Other Medications: Mirtazapine
Current Illness: No acute illnesses
Preexisting Conditions: Dementia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient developed confusion and weakness that last longer than one week. Weakness improved but she remained with a decline in her cognitive function


VAERS ID: 1923559 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 2 LA / IM

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

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

Write-up: A member called today to inform us that she thinks she had a side effect of Pfizer Covid-19 2nd shot received on Nov 20th. She felt dizzy and had congested nose, so she went to urgent care on Dec 1st as she does not have a Primary Care Physician. The urgent care doctor told her that if she thinks it is related to the vaccine, she should contact the pharmacy so they can report it.


VAERS ID: 1923634 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-11-18
Onset:2021-11-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Lymphadenopathy, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol, metformin, Meloxicam,metoprolol,duloxetine(30&60mg),simvastatin, keppra, baclofen, multivitamin,basenglar, otc ibuprofen, potassium
Current Illness: Yeast infection
Preexisting Conditions: Sinusitis,gout, fibromyalgia,Type 2 diabetes, hypertension, diabetic neuropathy, osteoarthritis, scoliosis, enlarged thyroid,high cholesterol
Allergies: Amoxicillin,aclendamyacine,bactrum, Lisinopril, watermelon,banana,Tide detergent,mango
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lump on collarbone appeared 2 days after and is still currently there causing right arm and chest pain


VAERS ID: 1923751 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-12
Onset:2021-11-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Anaphylactic reaction, Angiotensin converting enzyme, Antinuclear antibody negative, Aphasia, Balance disorder, Blood potassium decreased, Blood test, Blood thyroid stimulating hormone normal, Borrelia test negative, C-reactive protein normal, Choking, Computerised tomogram head normal, Condition aggravated, Disorganised speech, Dysphagia, Feeling abnormal, Full blood count normal, Magnetic resonance imaging head normal, Mental impairment, Metabolic function test, Metabolic function test normal, Muscle contracture, Muscular weakness, Neurological symptom, Paraesthesia, Paraesthesia oral, Pharyngeal paraesthesia, Presyncope, Red blood cell sedimentation rate normal, Retching, Thyroxine free normal, Vertigo, Vomiting, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: Moderna 2nd shot, 2/4/21- vomiting vertigo
Other Medications: spironolactone 100 mg bid metformin 500 mg bid broad spectrum CBD gummy 10mg at bed time as needed for sleep
Current Illness: head cold- covid testing negative started 4 weeks prior to booster and was left with nasal congestion at time of booster.
Preexisting Conditions: PCOS- polycystic ovarian syndrome over weight
Allergies: eggplant- itchy mouth silk tape- blisters
Diagnostic Lab Data: MRI and CT scan of brain normal Blood work showed potassium 3.4,. WBC 12.1 resolved nest day. TSH 7.8 resolved to normal after 4 days. normal: CMP, CBC, ESR, CRP, ACE, ANA, TSH, Free T4 Thyroid antibodies, lyme''s titer
CDC Split Type:

Write-up: vertigo, vomiting, mental fog, muscle weakness, paresthesia that started in legs and went to hands and arms then throat mouth. felt loss of control over my tongue and swallowing called for help, had presyncope. Then had expressive aphasia, knew what I wanted to say but per husband and health care reports words came out as garbled non words for 4 hours. muscle contractions. choked/gagged on tongue if was placed on my back. EMT and emergency room treated as an anaphylactic reaction but felt neurological/stroke like. 15 days later and paresthesia to hands and feet continue with flares up into bottom of face and neck and up to mid torso. mild vertigo/balance issues, some continued mental recall and verbal pausing issues. In process of following up with neurology.


VAERS ID: 1924099 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-18
Onset:2021-11-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Lymphadenopathy, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Cardizem, Aspirin, Crestor, Albuterol, Vitamin C, D, Zinc & potassium
Current Illness: none
Preexisting Conditions: Alpha-Gal, CVD, Asthma
Allergies: All mammal food and products, wheat
Diagnostic Lab Data: None a present.
CDC Split Type:

Write-up: Right supraclavicular adenopathy and right axillary adenopathy continues. Contacted PCP and Allergist and was told to take Benadryl and watch for 2 weeks. Also experienced chills, body aches, nausea & diarrhea that have resolved.


VAERS ID: 1924780 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-15
Onset:2021-11-20
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Electrocardiogram normal, Palpitations, Troponin normal
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Kawasaki''s disease as a child, no residual problems
Allergies: none
Diagnostic Lab Data: normal EKG and negative troponin and chest xray on 12/6/21
CDC Split Type:

Write-up: patient started having chest pain and heart palpitations 5 days after second vaccine dose. seen in the ER 3 weeks later still complaining of same symptoms


VAERS ID: 1924850 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-02
Onset:2021-11-20
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, COVID-19, Computerised tomogram head normal, Femur fracture, Hip arthroplasty, Mental status changes, Pneumonia, Subdural haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteoporosis/osteopenia (broad), Osteonecrosis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 77 year old female presented with altered mental status. Pt is normally alert X4 as baseline but has been having a decline in her mental status. Daughter reports that pt was recently hospitalized from 11/8/2021-11/12/2021 with right femur fracture and traumatic subdural hemorrhage. Pt underwent right hip hemiarthroplasty on 11/9/2021. Pt was diagnosed with COVID19 11/17/2021 POA. At arrival, CT brain with no acute finding. CTA chest with early pneumonia but no PE. Pt initially on oxygen. She was started on dexamethasone and remdesivir. Pt symptoms improved quickly and she has been on room air for the past couple day . Pt is now being discharge back to the HCF to complete the course of dexamethasone. remdesivir has been completed


VAERS ID: 1924904 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

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


VAERS ID: 1924968 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1924978 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-18
Onset:2021-11-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1925001 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 2 LA / IM

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

Write-up: Patient reported to clinic to receive 2nd dose of Pfizer Covid vaccine but had completed the consent form for the Pediatric Pfizer covid vaccine. We didn''t verify the age as being too old to receive the pediatric dose until after the fact.


VAERS ID: 1925041 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-11-17
Onset:2021-11-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH 8020 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Bursitis, Pain, Pain in extremity
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: Hydrochlorothiazide, Atenolol, Bupropion, Allegra, Vitamin D, Centrum Silver for Women
Current Illness:
Preexisting Conditions: Asthma
Allergies: Allergic to nuts
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Beginning Friday night, pain in arm, shoulder only. Saturday used arm as normal, but in the evening became increasingly painful - 6 out of 10. Sunday morning unable to lift arm without severe pain - 8 or 9 out of 10. No known injury, only event was booster shot. Pain lasted two more days, then eased up on wednesday. Doctor said it was likely bursitis. I''ve never had these symptoms before.


VAERS ID: 1925052 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Dizziness, Dyspnoea, Fatigue, Feeding disorder, Nausea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), 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: minor, covid 2 (pfizer), flu shot one time ill
Other Medications: Bystolic, Valsartan/HCTZ, Simvastatin, Pantaprazole, 81 mg aspirin, Hydrocortisone 2.5%, Potassium Chloride, Omega-3 acid ethyl esters, Calcium, One-a-day 65+, Vit D3, celexa, Metformin, probiotic
Current Illness: NA
Preexisting Conditions: High blood pressure, diabetes
Allergies: Amlodipine Besylate, Sulfamethoxazole-Trimethoprim, Pseudoephedrine Hcl, Erythromycin, Clindamycin Hcl, Acyclovir, Meomycin-Bacitracnzn-Polymyxnb
Diagnostic Lab Data: NA
CDC Split Type: ?

Write-up: shortness breath, nausea, diarrhea, fatigue. duration 5 days. right arm sore, weak days 4-5, and continuing. Weakness, lightheaded. Not eat 5 days.


VAERS ID: 1925063 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec; pantoprazole; Flovent HFA
Current Illness: Thyroid
Preexisting Conditions: Thyroid
Allergies: Penicillin
Diagnostic Lab Data: N/A
CDC Split Type: vsafe

Write-up: Fever, swollen at injection site, itching.


VAERS ID: 1925166 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administration 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: During a routine count of vaccine amounts administered, it was noted that a vial of Moderna had been punctured over the recommended 20 times, and all 8 "over-puncture" doses had been administered. No health concerns noted from any clients during the clinic day related to this med error. We are uncertain of which 8 people on our vaccinated list would have received those 8 doses, so the birthdate given is a best guess of one of those 8 people. Moderna has been notified.


VAERS ID: 1925251 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-26
Onset:2021-11-20
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 - / IM

Administered by: Military       Purchased by: ?
Symptoms: Angiogram pulmonary normal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Hypoxia, Intensive care, Laboratory test, Malaise, Pneumonia, Respiratory symptom, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None known
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data: CXR showing multilobar pneumonia CT-angio showing no evidence PE. Standard labs for inpatient intensive care.
CDC Split Type:

Write-up: Patient received COVID vaccination with his employer in March 2021. Patient was reported to be vaccine-hesitant and his vaccine records were inconsistent. Nonetheless, his unit confirmed Janssen vaccine info provided on this report. Patient became ill with respiratory symptoms on/about 20 Nov2021, tested positive for COVID on 26 Nov 2021, and was admitted to hospital on 30 Nov 2021 for COVID pneumonia. ID consultant dxd ''severe COVID pneumonia'' based on imaging and hypoxia. Treated with dexamethasone, remdesivir, and baricitinib. Required facemask O@ support but not intubated. Remained stable in hospital as of the time of this report (06 Dec 2021).


VAERS ID: 1925352 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3302680 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyskinesia, Eye movement disorder, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: HE WAS TAKEN BY AMBULANCE TO THE HOSPITAL EMERGENCY ROOM
CDC Split Type:

Write-up: ABOUT 5 MINUTES AFTER VACCINE PATIENT WAS SITTING IN WAITING ROOM., AND EXPERIENCED FOLLOWING: JERKING MOTIONS, PERFUSELY SWEATING, EYES ROLLED BACK AND OUT OF IT. I CHECKED PATIENT, HE WAS BREATHING AND THROAT WAS NOT SWOLLEN. WE CALLED EMS


VAERS ID: 1927780 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012H21B / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Accidental overdose, Myalgia, Nasopharyngitis, Oropharyngeal pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug abuse and dependence (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: patients received the 0.5ml dose; symptoms of a sore throat; Cold Symptoms; mild fever; body aches; This spontaneous case was reported by a nurse and describes the occurrence of OROPHARYNGEAL PAIN (symptoms of a sore throat), NASOPHARYNGITIS (Cold Symptoms), ACCIDENTAL OVERDOSE (patients received the 0.5ml dose), PYREXIA (mild fever) and MYALGIA (body aches) in a 28-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012H21B) for COVID-19 vaccination. No Medical History information was reported. On 19-Nov-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Nov-2021, the patient experienced PYREXIA (mild fever) and MYALGIA (body aches). On 23-Nov-2021, the patient experienced OROPHARYNGEAL PAIN (symptoms of a sore throat) and NASOPHARYNGITIS (Cold Symptoms). On an unknown date, the patient experienced ACCIDENTAL OVERDOSE (patients received the 0.5ml dose). At the time of the report, OROPHARYNGEAL PAIN (symptoms of a sore throat), NASOPHARYNGITIS (Cold Symptoms), PYREXIA (mild fever) and MYALGIA (body aches) outcome was unknown and ACCIDENTAL OVERDOSE (patients received the 0.5ml dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were reported. This case was linked to MOD-2021-396492, MOD-2021-403159 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 03-Dec-2021: Secondary reporter added


VAERS ID: 1928023 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-06-01
Onset:2021-11-20
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Obesity
Allergies:
Diagnostic Lab Data: Test Date: 20211105; Test Name: PCR; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20211120; Test Name: PCR; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101639353

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from product quality group. A 30-year-old male patient received BNT162B2 9 PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection), intramuscular, administered in arm left, administration date 22Jun2021 (Lot number: ew0181) as dose 2, single (at the age of 30 years old) and intramuscular, administered in arm left, administration date 01Jun2021 (Lot number: ew0185) as dose 1, single for COVID-19 immunisation. Relevant medical history included: "Obesity" (unspecified if ongoing). The patient''s concomitant medications were not reported. The following information was reported: VACCINATION FAILURE (medically significant) with onset 20Nov2021, outcome "unknown", COVID-19 (medically significant) with onset 20Nov2021, outcome "not recovered" and all described as "COVID-19 confirmed by positive COVID-19 test". The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (05Nov2021) negative, notes: Nasal Swab; (20Nov2021) positive, notes: Nasal Swab. Therapeutic measures were not taken as a result of covid-19. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1928029 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Fatigue, Immunisation, Insomnia, Lymphadenopathy, Malaise, Myalgia, Nasal congestion, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: LEVOTHYROXIN; VITAMIN D NOS; MELOXICAM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to molds; Asthma; Food allergy
Allergies:
Diagnostic Lab Data: Test Date: 20211101; Test Name: Covid-19; Result Unstructured Data: Test Result:Pending; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101640685

Write-up: difficulty breathing which requires inhaler; dose received: 3; cough which makes sleeping difficult; cough which makes sleeping difficult; some congestion; swollen glands; extreme fatigue; fever; chills; muscle aches; still not well, three days later; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 61 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm left, administration date 19Nov2021 15:00 (Batch/Lot number: unknown) at the age of 61 years as dose 3 (booster), single for covid-19 immunisation. Relevant medical history included: "Asthma" (unspecified if ongoing); "various foods" (unspecified if ongoing); "molds" (unspecified if ongoing). Concomitant medication(s) included: LEVOTHYROXIN; VITAMIN D NOS; MELOXICAM. Past drug history included: Aspirin, reaction(s): "Drug allergy"; Thimerosal, reaction(s): "Drug allergy"; Prednisone, reaction(s): "Drug allergy". Vaccination history included: Bnt162b2 (Dose Number: 2, Location of injection: Right Arm, Vaccine Administration Time: 03:15 PM), administration date: 20Mar2021, when the patient was 61 years old, for Covid-19 Immunization; Bnt162b2 (Dose Number: 1, Location of injection: Right Arm, Vaccine Administration Time: 09:30 AM), administration date: 27Feb2021, for Covid-19 Immunization. The following information was reported: DYSPNOEA (non-serious) with onset 20Nov2021, outcome "not recovered", described as "difficulty breathing which requires inhaler"; IMMUNISATION (non-serious) with onset 20Nov2021, outcome "unknown", described as "dose received: 3"; COUGH (non-serious), INSOMNIA (non-serious) all with onset 20Nov2021, outcome "not recovered" and all described as "cough which makes sleeping difficult"; NASAL CONGESTION (non-serious) with onset 20Nov2021, outcome "not recovered", described as "some congestion"; LYMPHADENOPATHY (non-serious) with onset 20Nov2021, outcome "not recovered", described as "swollen glands"; FATIGUE (non-serious) with onset 20Nov2021, outcome "not recovered", described as "extreme fatigue"; PYREXIA (non-serious) with onset 20Nov2021, outcome "not recovered", described as "fever"; CHILLS (non-serious) with onset 20Nov2021, outcome "not recovered", described as "chills"; MYALGIA (non-serious) with onset 20Nov2021, outcome "not recovered", described as "muscle aches"; MALAISE (non-serious) with onset 20Nov2021, outcome "not recovered", described as "still not well, three days later". The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (01Nov2021) pending, notes: Nasal Swab. Therapeutic measures were not taken as a result of dyspnoea, cough, nasal congestion, lymphadenopathy, fatigue, pyrexia, chills, myalgia, malaise, insomnia. The lot number for bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 1928296 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Decreased appetite, Dizziness, Illness, Influenza, Pain in extremity, Peripheral swelling, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (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: Type 2 diabetes mellitus
Preexisting Conditions: Medical History/Concurrent Conditions: Type 2 diabetes mellitus; blood clot.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: This spontaneous case reported by a consumer, describes the occurrence of illness (started getting really sick/feeling sick), influenza (flu-like), pain in extremity (left foot still hurts), peripheral swelling (left leg swelled up) and decreased appetite (appetite is off) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch/lot# 051F21A) for COVID-19 vaccination. The occurrence of additional events detailed below. The patient''s past medical history included blood clot. Concurrent medical conditions included type 2 diabetes mellitus. On Nov 20, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Nov 20, 2021, patient had pain in extremity (left foot still hurts), peripheral swelling (left leg swelled up) and pain in extremity (left arm was sore for 3 days). On Nov 28, 2021, patient experienced illness (started getting really sick/feeling sick), influenza (flu-like), decreased appetite (appetite is off), dizziness (dizzy) and vomiting (throwing up for 3 days). Patient treated with acetylsalicylic acid (baby aspirin) for swelling of legs, at an unspecified dose and frequency. On Nov 22, 2021, pain in extremity (left arm was sore for 3 days) resolved. On Dec 1, 2021, vomiting (throwing up for 3 days) resolved. At the time of the report, illness (started getting really sick/feeling sick), pain in extremity (left foot still hurts) and dizziness (dizzy): not resolved. Influenza (flu-like) and decreased appetite (appetite is off) outcome unknown. Peripheral swelling (left leg swelled up): resolving. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. Concomitant medications not provided.


VAERS ID: 1928372 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-18
Onset:2021-11-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain lower, Appendicitis, Imaging procedure abnormal
SMQs:, Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: nkda
Diagnostic Lab Data: Image studies showed positive acute pendicitis, confirmed at hospital.
CDC Split Type:

Write-up: Pt was complaining about RLQ pain x 3 days post vaccine. Pt had positive rebound test, was taken to Pediatrics. The MD exam concerning for Appendicitis.


VAERS ID: 1928380 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-13
Onset:2021-11-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058F21A / 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: Fever, 29, 4/14/2021, Moderna second vaccine (lot 032B21A)
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives all over body


VAERS ID: 1928544 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1928878 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-23
Onset:2021-11-20
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Dyspnoea, Dyspnoea exertional, Lethargy, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, hypothyroidism, CVA, hx prostate cancer, chronic kidney disease stage 3
Allergies:
Diagnostic Lab Data: COVID +
CDC Split Type:

Write-up: hospitalized 11/20/21-11/23/21, increased weakness, lethargy, increase work of breathing with activity, and vomiting


VAERS ID: 1928935 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1928937 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Immunisation, No adverse event, Wrong technique in product usage process
SMQs:, Medication errors (narrow)

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

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


VAERS ID: 1928941 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1928945 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1928948 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-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: 1929119 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-11
Onset:2021-11-20
   Days after vaccination:254
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Polymerase chain reaction
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, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cycle threshold 18.8 on 11/18/21
CDC Split Type:

Write-up: Hospitalization due to COVID-19 Reported per Moderna COVID-19 Vaccine EUA


VAERS ID: 1929121 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1929126 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Immunisation, No adverse event, Wrong technique in product usage process
SMQs:, Medication errors (narrow)

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

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


VAERS ID: 1929132 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1929150 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1929159 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-05
Onset:2021-11-20
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Headache, Nephrolithiasis, Pain in extremity, Urine analysis
SMQs:, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL, IRON PILLS
Current Illness: NO
Preexisting Conditions: NO
Allergies: STERIODS
Diagnostic Lab Data: in er they did a cat scan and a urine test. they told me i had kidney stones
CDC Split Type: vsafe

Write-up: After the shot i had the normal headache and sore arms. The kidney stones came about 2-3 weeks ago. I went to the ER and they sent me to the urologist. i have a urologist appointment this monday.


VAERS ID: 1929197 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939939 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Patient was 17 years of age at the time of the vaccination. Moderna boost doses are for those 18 years of age and older. Patient previously received Pfizer for shot #1 and #2.


VAERS ID: 1929239 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1929261 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1929277 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1929280 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1929352 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 2 LA / IM

Administered by: Other       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: Vaccine administered at half dose.


VAERS ID: 1929361 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-09
Onset:2021-11-20
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 3 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Discomfort, Erythema, Feeling hot, Papule, Peripheral swelling, Pruritus, Rash, Sleep disorder, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: omeprazole 40mg daily junell (OC)
Current Illness: n/a
Preexisting Conditions: eosinophilic esophagitis GERD
Allergies: kiwi molds
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: dose 2 - mild rash with small red papules that developed 6 days after the injection. Was very itchy and uncomfortable. treated with benadryl PRN and slowly it went away within a week and a half. dose 3 - 11 days after the dose, I noticed I was very itchy particularly on my underarms and back. I took a long acting antihistamine to try to go back to bed (the itching woke me up at midnight even though I initially noticed it around 10pm). The next day, my neck, legs, and arms were itchy, but i had a 6 hour drive and took another long acting antihistamine to get through my day. On the night of the 21st, my right foot was incredibly swollen and my legs were very itchy. I documented the rash with pictures on my phone, but the rash was on my arms, lets, lower back, and the tops of my feet. I took a benadryl and went to sleep. On the 22nd, I woke up at 2pm (I am typically up by 9am) and my face was so swollen that i was not able to put contacts in. The rash was all over my face, neck, chest, arms, palms of my hands, back, legs, and the tops and bottoms of my feet. I had another 6 hour drive ahead of my and was only able to take another long acting antihistamine. Anywhere i touched on my body instantly god red, swollen, hot, and itchy. Today is december 7th and still, anywhere i touch, within 60 seconds is swollen, red, hot, and itchy. after the 6 hour drive on the 22nd, I started on prednisone after learning that that is the course of action taken by the infectious disease doctor at the hospital i work at. The steroid did not help. Neither did the long acting antihistamine. I have not been taking anything else (except my prescribed omeprazole).


VAERS ID: 1929364 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 2 LA / IM

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

Write-up: Vaccine administered at half dose.


VAERS ID: 1929366 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 3 LA / IM

Administered by: Other       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: Vaccine administered at half dose.


VAERS ID: 1929378 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 3 LA / IM

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

Write-up: Vaccine administered at half dose.


VAERS ID: 1929425 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Blood test, Computerised tomogram, Headache, Lethargy, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Was admitted to hospital on 11/22. Had CT scan, blood work
CDC Split Type:

Write-up: Appendicitis resulting in appendectomy. Patient had nonstop vomiting for 2 days, nausea, lethargy, headache that started hours after the 2nd dose. She was feeling great and healthy prior to the shot.


VAERS ID: 1929435 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Unknown  
Location: Minnesota  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 RA / IM

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

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

Write-up: Needle malfunction, vaccine leaked out-was revaccinated


VAERS ID: 1929451 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-16
Onset:2021-11-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855/94 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Laboratory test, Ocular hyperaemia, Oedema peripheral, Pruritus, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: flu vaccine
Other Medications: citalopram 10mg vitamin D-3 5,000IU x2 DHEA 50mg levothyroxine150mcg
Current Illness:
Preexisting Conditions:
Allergies: suprax, doxycycline, noroxin, bactrim, augmenten, excedrin migraine, flu shot
Diagnostic Lab Data: 12-5-2021 lab work
CDC Split Type:

Write-up: under arms were like sun burnt itchy sore to touch swollen and red ring around areas. moved down to lower left arm. moved to right arm and left eye. all over my waist and inside upper legs.


VAERS ID: 1929482 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram normal, Electrocardiogram normal, Extra dose administered, Hypoaesthesia, Inflammation, Magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Pruritus, Skin irritation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mutivitamin, flaxseed
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I had to get a cat scan and mri to rule out neuro concerns as well as EKG. All normal results.
CDC Split Type:

Write-up: 24 hours after booster my left arm started going numb and tingling and my pinkie and ring finger were numb. 48 hours after booster my jawline was numb. That jaw numbness turned into inflammation feeling of itchy and irritation. No visible rash. The numbness lasted on and off for 2 weeks and turned into left arm pain from Shot location down my arm.


VAERS ID: 1929517 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site rash, Lymphadenopathy, Mobility decreased, Musculoskeletal chest pain, Nausea, Pain, Paraesthesia, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine, HCL (20mg), Levothyroxine (112 micrograms), Estratiol (1mg), Esomeprazole, MAG (20mg)
Current Illness: None
Preexisting Conditions: Hashimoto disease
Allergies: Food: Dairy Medication: Sulptha
Diagnostic Lab Data: None
CDC Split Type:

Write-up: When I woke up I had a rash on my left arm going from where I got the shot towards my armpits and my gland under my armpit was swollen and I had to keep my arm up. I felt sick to my stomach I had tingling down to my left arm, my joints, and upper body were really painful and I had a pain that started on the left side of my rib cage it was an awful pain. 1 week later after the shot I had rash underneath my left breast and stomach and it was very itchy and reddish. Then I contacted the doctor and they gave me Valacyclovir and was advised to take it 3x a day. It helped a lot with the rash and the side effects.


VAERS ID: 1930015 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-11-02
Onset:2021-11-20
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA D51F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mechanical urticaria
SMQs:, Hypersensitivity (broad)

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

Write-up: Dermatographism


VAERS ID: 1931590 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-16
Onset:2021-11-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Drug allergy; Gluten intolerance
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101689908

Write-up: Bloody noses, one required trip to ER because I was unable to stop the bleeding after 40 minutes. I have had multiple episodes since; This is a spontaneous report received from contactable reporter(s) (Other HCP). The reporter is the patient. A 45 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm right, administration date 16Nov2021 17:30 (Lot number: FH8028) at the age of 45 years as dose 3 (booster), single for covid-19 immunisation. Relevant medical history included: "Gluten sensitivity" (unspecified if ongoing); "Known allergies: Tetracycline" (unspecified if ongoing). Concomitant medication(s) included: FLU VACCINE VII, administration date 26Oct2021. Vaccination history included: Bnt162b2 (Dose 2, Batch/Lot No: EN5318, Location of injection: Arm Right, Vaccine Administration Time: 12:30 PM), administration date: 02Feb2021, for COVID-19 Immunization; Bnt162b2 (Dose 1, Batch/Lot No: EL3302, Location of injection: Arm Right, Vaccine Administration Time: 12:30 PM), administration date: 12Jan2021, for COVID-19 Immunization. The following information was reported: EPISTAXIS (non-serious) with onset 20Nov2021 05:00, outcome "recovering", described as "Bloody noses, one required trip to ER because I was unable to stop the bleeding after 40 minutes. I have had multiple episodes since". The event "bloody noses, one required trip to er because i was unable to stop the bleeding after 40 minutes. i have had multiple episodes since" was evaluated at the physician office visit and emergency room visit. Therapeutic measures were not taken as a result of epistaxis. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1932106 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Antinuclear antibody, Condition aggravated, Full blood count, Gastrooesophageal reflux disease, Hepatitis viral test, Lipase, Metabolic function test, Nausea, Serum ferritin, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Esomeprazole 40mg
Current Illness: GERD
Preexisting Conditions: GERD, Hepatic Steatosis
Allergies: Tylenol; Oxycodone
Diagnostic Lab Data: 11/30/21: Metabolic panel, lipase, hepatitis panel, ANA, Ferritin, CBC 12/2/21: CBC, Lipase, metabolic panel
CDC Split Type:

Write-up: Patient reports he has always had GERD, however the day after receiving his covid vaccine his symptoms intensified, nausea, vomiting, stomach pains, not relieved with his PPI or OTC medications.


VAERS ID: 1932139 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-18
Onset:2021-11-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8757 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Chest Pains, left side, 41 years, 03/02/2021 & 04/01/2021, Moderna COVID 19 series.
Other Medications: Fish Oil, Vitaman E & D.
Current Illness: Minor allergies/hay fever
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No tests have been conducted in relation to my current chest pains. Previous cardiology and medical exams after encountering similar chest pains following COVID-19 vaccine injection revealed no abnormalities.
CDC Split Type:

Write-up: A couple days after receiving my booster shot, I began having mild chest pains. These chest pains were similar to those I had after having COVID-19 and then receiving my first and second COVID-19 vaccinations using Moderna. The chest pains do not increase with exercise and are located specifically near the upper-left side of my chest. Certain arm movements can cause a twinge or increase in pain that then quickly clear with a little rest. I had a full cardiological examination after my initial bout with chest pain and was cleared of any heart related issues. The chest pain eventually completely cleared after approximately 4 months.


VAERS ID: 1932151 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1932221 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1932232 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1932339 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1932425 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-12
Onset:2021-11-20
   Days after vaccination:312
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/20/21 SARS-CoV-2 (COVID-19) by test detected
CDC Split Type:

Write-up: 11/20/21 presents to EC ED for "SOB and cough". PMHx of "COPD, HTN".


VAERS ID: 1932449 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-09
Onset:2021-11-20
   Days after vaccination:284
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Confusional state, Cough, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/20/21 SARS-CoV-2 (COVID-19) by nucleic acid amplification detected
CDC Split Type:

Write-up: 11/20/21 presents to ED for "cough, fever and confusion". PMHx of "bell palsy, Dm, HTN".


VAERS ID: 1932450 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-11-20
   Days after vaccination:233
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / UNK - / -

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

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

Write-up: 11/20/21 presents to local ED for "worsening dyspnea". PMHx of "Lambert Eaton, hypothyroidism"


VAERS ID: 1932451 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-18
Onset:2021-11-20
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3592671001 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 5926710001 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/20/21 SARS-CoV-2 (COVID-19) by detected
CDC Split Type:

Write-up: 11/20/21 presents to ED for "worsening dyspnea and cough". PMHx of "CAP, aflutter on Eliquis, CAD, cirrhosis s/p transplant COPD".


VAERS ID: 1932453 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-11
Onset:2021-11-20
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / UNK - / -

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

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

Write-up: 11/20/21 presents to ED with "worsening sob and cough with sputum". PMHx of "asthma, Hepatic steatosis, ADHD, obesity"


VAERS ID: 1932542 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1932612 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-10
Onset:2021-11-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR
FLUC4: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT) / SEQIRUS, INC. - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lo Loestrin Fe
Current Illness: None
Preexisting Conditions: None
Allergies: German cockroaches and dust mites. No other known allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the Moderna Booster on 11/10/2021, and on 11/20/2021, I began experiencing spontaneous urticaria (hives) throughout the day and night. The hives appear on my neck, back of my lower head, chest, stomach, head, wrists, palm of my hands, inner thighs, and bottom of my feet. The hives appear randomly over my body and last about 20 - 30 minutes, with an itching/burning sensation. I have not had any prior allergic reactions similar to this and there has been no change in my diet or environment. I began taking Allegra 24 Hour Tablets on 12/04/2021 and have seen a reduction in the hive flare ups, but I do have some still break through.


VAERS ID: 1932711 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Breast tenderness, Tenderness
SMQs:, Lipodystrophy (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: Multi-vitamin
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Gluten Intolerant
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I had pain/tenderness under right arm pit and into the right side of my right breast for 2 days. I did receive my vaccination in the right arm.


VAERS ID: 1932796 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1932934 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-11-17
Onset:2021-11-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Creatinine urine, Glucose urine absent, Haemoglobin urine absent, Malaise, Nitrite urine absent, Protein urine absent, Specific gravity urine normal, Urine ketone body absent, Urine leukocyte esterase, Urobilinogen urine, pH urine normal
SMQs:

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: Don''t know the details. I have only had the flu twice in my life. This was two years in a row (1991 & 1992) after getting a fl
Other Medications: hydrochlorothiazide-triamterene 25mg-37.5mg for high blood pressure
Current Illness: none
Preexisting Conditions: none
Allergies: acetaminophen
Diagnostic Lab Data: November 27th was when I eventually went to the doctor. POC BIL - Negative POC NIT - Negative POC PRO - Negative POC URO - Normal Urine Glucose - Normal Urine Hemoglobin - Negative Urine Ketones - Negative Urine Leukocyte Esterase - Negative Unire pH - 7.0 Urine Specific Gravity - 1.005 Est. Creatinine CL - 115.31 mL/min
CDC Split Type:

Write-up: Had symptoms of a urinary tract infection for several days. I eventually went to an urgent care and was prescribed an antibiotic (Amoxicilin-clavulanate) even though they tested a urine sample and it showed no sign of an infection. Basically I had symptoms of a UTI without an UTI.


VAERS ID: 1932940 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-17
Onset:2021-11-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012F214 / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Full blood count, International normalised ratio, Laboratory test, Metabolic function test, Paraesthesia, Prothrombin time, Vitamin B12
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Lab 12/7/21 CBC, BMP, B12, PTT/PT/INR
CDC Split Type:

Write-up: Numbness and tingling in hands/fingers BILAT


VAERS ID: 1933086 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939904 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Headache, Muscle spasms, Palpitations, Pyrexia, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, Extreme dizziness, vertigo, loss of balance, headache, calf muscle cramping, racing heart, palpitations


VAERS ID: 1933089 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blister, Condition aggravated, Neuralgia, Swelling face, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderal Prozac
Current Illness: None
Preexisting Conditions: Amputee
Allergies: Benadryl Shellfish
Diagnostic Lab Data: I had to start back on pain and nerve meds. My hives aren?t going away even after a week of oral steroids prescribed.
CDC Split Type:

Write-up: As an amputee all my nerves started firing after the vaccine. My face swelled up as if I?d been beaten. My residual limb has had hives and blisters and nerve pain since the vaccine. Pain I haven?t had in 3 years since losing my leg.


VAERS ID: 1933099 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Cold sweat, Dizziness postural, Extra dose administered, Hyperhidrosis, Irregular breathing, Loss of consciousness, Musculoskeletal chest pain, Nausea, Pain in extremity, Peripheral swelling, Seizure, Sleep disorder, Visual impairment, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: I received my second Covid-19 Moderna vaccine(Lot 036B21A) in my left arm.
Other Medications: Levothyroxine; Symbicort (inhaler); Amphetamine Salt Comvo.
Current Illness: None.
Preexisting Conditions: Mild asthma
Allergies: Aspirin; Penicillin.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had the Moderna booster in my left arm at your office on Friday, Nov. 19th at about 2:30pm. Around 2:45am (Sat.), I noticed my feet were hurting when standing or walking. I noticed the left foot had some swelling and took an antihistamine (10mg Zyrtec allergy tab). The bottoms also must have been swollen at that time because it felt like I was walking on balloons. Several minutes later, my rib cage area felt as if it was icy and churning. The sensation felt as if my entire below-the-shoulder to the bottom of the rib cage area was actually physically thrashing about. My lower rib bones felt painful and broken. This sensation lasted about half an hour to 45 minutes. Simultaneously, I experienced intense stomach.


VAERS ID: 1933804 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-19
Onset:2021-11-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 185519 / 1 LA / IM

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

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

Write-up: Parasthesia- numbness and tingling bilateral upper and lower extremities with most symptoms primarily on right lower extremity


VAERS ID: 1935109 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Arizona  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Immunisation, 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: USPFIZER INC202101631137

Write-up: I got the Pfizer booster; he is having a very bad fever; I have high fever really bad; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non-HCP) for a Pfizer sponsored program (159558). The reporter is the patient. A male patient received bnt162b2 (BNT162B2), administration date 20Nov2021 (Batch/Lot number: unknown) as dose number unknown (booster), single for covid-19 immunization. The patient''s relevant medical history and concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (Dose 1 (Primary Immunization series complete but unknown manufacturer)), for COVID-19 immunization; Covid-19 vaccine (Dose 2 (Primary Immunization series complete but unknown manufacturer)), for COVID-19 immunization. The following information was reported: IMMUNISATION (non-serious) with onset 20Nov2021, outcome "unknown", described as "I got the Pfizer booster"; PYREXIA (non-serious) with onset 20Nov2021, outcome "unknown", described as "he is having a very bad fever; I have high fever really bad". Additional information:Transferring agent stated, I have a caller on the other line. He said he got the booster shot (Captured as unspecified shot) and he is having a very bad fever. So, he also wanted to know if he can take allergy tablets (Unspecified medications). So, I already provided him the number of Pfizer Medical Information department as well." Call was transferred. Consumer stated, Yesterday I got the Pfizer booster. I have high fever bad. The guy who gave it to me said I could not get an allergy shot. I just need to know if I can take allergy pills (unspecified medications), you know, like Benadryl or any of them. Is there any problem there?". Proprietary medicinal product name: Benadryl. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1935114 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 3 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Chills, Immunisation, Mouth swelling, Pain, Pyrexia, Tenderness, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dermal filler injection
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101642613

Write-up: booster dose; slight fever; body aches; chills; Tenderness; very little swelling around the mouth where she received dermal fillers; she gets reactions after every vaccine given to her; This is a spontaneous report received from a contactable reporter(s) (Physician). A 48 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), intramuscular, administered in arm left, administration date 20Nov2021 (Lot number: EW0175) at the age of 48 years as dose 3 (booster), single for covid-19 immunisation. Relevant medical history included: "received dermal fillers", start date: May2021 (unspecified if ongoing). The patient''s concomitant medications were not reported. Vaccination history included: Bnt162b2 (Dose Number: 1, Batch/Lot No: ER8733), administration date: 30Mar2021, when the patient was 47 years old, for COVID-19 immunization, reaction(s): "she gets reactions after every vaccine given to her"; Bnt162b2 (Dose Number: 2, Batch/Lot No: ER8735), administration date: 24Apr2021, when the patient was 47 years old, for COVID-19 immunization, reaction(s): "she gets reactions after every vaccine given to her". The following information was reported: IMMUNISATION (non-serious) with onset 20Nov2021, outcome "unknown", described as "booster dose"; PYREXIA (non-serious) with onset 20Nov2021, outcome "recovered", described as "slight fever"; PAIN (non-serious) with onset 20Nov2021, outcome "recovered", described as "body aches"; CHILLS (non-serious) with onset 20Nov2021, outcome "recovered", described as "chills"; TENDERNESS (non-serious) with onset 20Nov2021, outcome "recovered", described as "Tenderness"; MOUTH SWELLING (non-serious) with onset 20Nov2021, outcome "recovered", described as "very little swelling around the mouth where she received dermal fillers"; VACCINATION COMPLICATION (non-serious) with onset 20Nov2021, outcome "recovered", described as "she gets reactions after every vaccine given to her". Therapeutic measures were taken as a result of pyrexia, pain. Therapeutic measures were not taken as a result of chills, tenderness, vaccination complication. Additional information: patient reported tenderness and very little swelling around the mouth where she received dermal fillers on May2021. the swelling and tenderness resolved in less than 24 hours. she mentioned that she gets reactions after every vaccine given to her. No treatment received. Facility where the most recent COVID-19 vaccine was administered was Doctor''s office/urgent care. The patient did not received any other vaccines within 4 weeks prior to the COVID vaccine. She mentioned that she gets reactions after every vaccine given to her. she ran a slight fever and had body aches and chills. motrin helped with the pain and fever. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. Follow-Up (29Nov2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1935161 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Immunisation, Myopia, Visual acuity reduced, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADVIL [IBUPROFEN]; VIT E; VIT C; MAGNESIUM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (known allergies: Penicillin); Pre-diabetic
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101722196

Write-up: Vision significantly impacted; Both distance and reading vision affected.; Both distance and reading vision affected; Dose received 3/ dose number=3; This is a spontaneous report received from a contactable reporter (consumer or other non HCP). The reporter is the patient. A 52 year-old male patient received bnt162b2 (BNT162b2), administered in left arm, administration date 20Nov2021 at 14:00 (Lot number: FG3527) at the age of 52 years as dose 3 (booster), single for COVID-19 immunisation. Relevant medical history included: "Pre-diabetic" (unspecified if ongoing) and "Penicillin allergy" (unspecified if ongoing) notes: known allergies: Penicillin. Concomitant medications included: ADVIL; VIT E; VIT C, MULTI-VIT and MAGNESIUM. Vaccination history included: bnt162b2 (DOSE 1, SINGLE; Lot number: EW0153; Anatomical site: Right arm; Administration time: 16:00), administration date: 12Apr2021, when the patient was 52 years old, for COVID-19 immunisation and bnt162b2 (DOSE 2, SINGLE; Lot number: ER8735; Anatomical site: Left arm; Administration time: 14:00), administration date: 13May2021, when the patient was 52 years old, for COVID-19 immunisation. The following information was reported: IMMUNISATION (non-serious) with onset 20Nov2021 at 14:00, outcome "unknown", described as "Dose received 3/ dose number=3"; VISUAL IMPAIRMENT (non-serious) with onset 22Nov2021 at 09:00, outcome "recovered with sequelae" (an unknown date in 2021), described as "Vision significantly impacted"; VISUAL ACUITY REDUCED (non-serious) with onset 22Nov2021 at 09:00, outcome "recovered with sequelae" (an unknown date in 2021), described as "Both distance and reading vision affected"; MYOPIA (non-serious) with onset 22Nov2021 at 09:00, outcome "recovered with sequelae" (an unknown date in 2021), described as "Both distance and reading vision affected". The events "Vision significantly impacted" and "Both distance and reading vision affected'''' were evaluated at the physician office visit. Therapeutic measures were not taken as a result of visual impairment, visual acuity reduced and myopia. 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. It was reported that patient needed reading glasses now everyday glasses and stronger new glasses needed for reading.


VAERS ID: 1935603 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1935698 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-19 Vaccine 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: 1935730 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1935756 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-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: 1935767 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1935886 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-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: 1935900 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1935923 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received a dose of Pfizer COVID-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: 1936072 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

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


VAERS ID: 1936271 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-25
Onset:2021-11-20
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Fatigue, Feeling abnormal, Headache, Insomnia, Oropharyngeal pain, Pain, SARS-CoV-2 test negative
SMQs:, Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot- arm was very sore. (2020)
Other Medications: Oxycodone 15mg Rosuvastatin 5mg Bupropion SR 150mg 2xday Amitriptyline 50mg 1xday Gabapentin 300mg 10xday
Current Illness: none
Preexisting Conditions: Chronic Pain
Allergies: Morphine
Diagnostic Lab Data: Test were all did on 12/6/2021: chest x-ray- normal blood work- normal covid test- negative
CDC Split Type: vsafe

Write-up: The first day I started with a sore throat, and I felt a little achy. I didn''t sleep that night because of a massive headache I had. In the middle of night two I took Excedrin. In the last couple of weeks I have had on and off headaches. 11/29/2021 I called my doctor because I was feeling poorly. I was prescribed amoxicillin and 1 other medication. I wasn''t getting any better so I called again. I went to see my doctor on 12/6/2021. They did many test. I was prescribed methylprednisolone and have been on that for about 4 days now. Anytime I do anything I am tired. I feel exhausted, but I''m starting to feel a little bit better.


VAERS ID: 1936298 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-11-02
Onset:2021-11-20
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3203080 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: fish oil, glucosamine, turmeric, advil, apple cider vinegar
Current Illness: N/A
Preexisting Conditions: regular headaches, moderate (significant) osteoarthritic, history of depression
Allergies: histamine response to dairy
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: increasingly severe tinnitus, mostly in the left ear, but often loud enough that both seem to be ringing. It''s getting louder and does not go away.


VAERS ID: 1937224 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: A 13-year-old boy was scheduled for his first COVID-19 vaccine at one of our COVID-19 clinics aimed at 5-11 years old. Even though we had a plan to identify anyone who showed up $g11 years old and vaccinate them appropriately, our catches missed this patient. He was immunized with a 10mcg dose instead of a 30mcg dose. This was not caught until a few days later during an audit. We contacted his family and explained that it is recommended he not repeat dose 1 but make sure he gets 30mcg of dose 2. Our team met internally to do a quality improvement causal analysis and put additional safe guards in to make sure appropriate doses are delivered to patients.


VAERS ID: 1937226 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-11-20
Onset:2021-11-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Private       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: Pt was a 14yo girl who was scheduled for her first COVID19 vaccine at one of our COVID19 clinics aimed at 5-11yo. Even though we had a plan to identify anyone who showed up $g11yo and vaccinate them appropriately, our catches missed this patient and she was immunized with a 10mcg dose instead of a 30 mcg dose. This was not caught until a few days later during an audit. We contacted her family and explained that the CDC recommend he not repeat dose 1 but make sure he gets 30mcg of dose 2. Our team met internally to do a quality improvement causal analysis and have put additional safe guards in to make sure appropriate doses are delivered to patients.


VAERS ID: 1938331 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-11-20
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Hypersomnia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211150318

Write-up: SLEEPING ALL DAY; CHILLS; FEVER; HEADACHE; This spontaneous report received from a patient via social media (Twitter) through company representative concerned a patient of unspecified age, sex, race and ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient was previously treated with covid-19 vaccine ad26. cov2. s ( manufacturer not specified) (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, frequency 1 total for prophylactic vaccination (dose series 1). The patient received additional covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, frequency 1 total administered on 19-Nov-2021 for prophylactic vaccination (dose series 2). The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 20-Nov-2021, patient experienced fever, chills, headache and sleeping all day (dose series 2). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever, chills, headache and sleeping all day was not reported. This report was non-serious.


VAERS ID: 1938377 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-11-20
Submitted: 0000-00-00
Entered: 2021-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Off label use, Overdose
SMQs:, Drug abuse and dependence (broad), 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: USJNJFOC20211220177

Write-up: RECEIVING 2.5ML OF THE JANSSEN COVID-19 VACCINE; OFF LABEL USE; This spontaneous report received from a health care professional concerned a 44 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: 1822809 expiry: 07-MAR-2022) 2.5 ml, administered on 20-NOV-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-NOV-2021, the patient experienced receiving 2.5ml of the janssen covid-19 vaccine. On 20-NOV-2021, the patient experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the receiving 2.5ml of the janssen covid-19 vaccine and off label use was not reported. This report was non-serious.


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