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From the 7/23/2021 release of VAERS data:

Found 506,830 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 52 out of 5,069

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VAERS ID: 1482881 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antibody test positive, Anxiety, Blood pressure increased, Cognitive disorder, Communication disorder, Decreased appetite, Electrocardiogram abnormal, Heart rate increased, Hypoaesthesia, Insomnia, Memory impairment, Myocarditis, Neurological symptom, Palpitations, Seizure, Sensory loss
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vasculitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: There were no previously existing conditions and not medications, dietary supplements or herbal remedies were being taken at the time of this vaccination.
Current Illness: No illnesses at the time of vaccination.
Preexisting Conditions: No chronic or long-standing health conditions, besides a BMI of overweight (which discounts muscle tissue).
Allergies: No allergies to medications, food or any other consumable products.
Diagnostic Lab Data: Blood Pressure 150/90. Abnormal Activity from an electrocardiogram. Myocarditis Diagnoses. Positive Antibody Test for Spike Protein (Low Levels).
CDC Split Type:

Write-up: Increased heartbeat, heart palpitations, significant increase in blood pressure at 150/90, for a healthy young 23 year old who would usually receive a blood pressure test of 120/70 during normal circumstances. Inability to sleep or stay asleep since the vaccination, every time I attempt to fall asleep, heart rate increases, convulsion occurs followed loss of feeling in extremities. Cognitive decline, inability to remember certain events, and communication skills have greatly diminished. Reduced Appetite. Neurological Symptoms (Numbness throughout body, Entire body is numb). Anxiety Attacks.


VAERS ID: 1483584 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Poor quality product administered, Product preparation error, Product temperature excursion issue
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: USPFIZER INC2021853623

Write-up: a patient received a dose of the Pfizer Covid-19 vaccine after it was diluted and left in the syringe in the fridge for 4 days; a patient received a dose of the Pfizer Covid-19 vaccine after it was diluted and left in the syringe in the fridge for 4 days; Received Vaccine that was punctured more than the time of 6 hours.; This is a spontaneous report from a contactable other hcp via Pfizer sponsored program. A male patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: EW0179, Expiration Date: 31Aug2021), via an unspecified route of administration on 06Jul2021 as first dose, single for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient received vaccine that was punctured more than the time of 6 hours on 06Jul2021 and received a dose of the Pfizer Covid-19 vaccine after it was diluted and left in the syringe in the fridge for 4 days. The reporter wanted to know if the patient needed to receive another Pfizer Covid 19 Vaccine immediately or if the Pfizer Covid 19 dose already administered was okay. The outcome of the events was unknown.; Sender''s Comments: Based on the information provided, the association between the event production preparation error and the vaccination cannot be completely ruled out.


VAERS ID: 1483632 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-07-06
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Drug ineffective, Dyspnoea, Fatigue, Headache, Inappropriate schedule of product administration, Nasal congestion, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210707; Test Name: Covid-19; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC2021880761

Write-up: Sars-cov-2 test positive: positive on 07Jul2021; sars-cov-2 test positive: positive on 07Jul2021; Cough; Fever; Congestion; Headache; SOB; Fatigue / tired; Dose 1 08Apr2021 / Dose 2 08Apr2021; This is a spontaneous report from a contactable other Health Care Professional. A 44-years-old female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: ER8736 and Expiry date: Unknown) via an unspecified route of administration on 08Apr2021 (age at the time of vaccination was 50-year-old) as single, first dose via an unspecified route of administration on 08Apr2021, (Lot Number: GN6204 and Expiry date: Unknown) as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient was not diagnosed COVID prior to the vaccination. On 06Jul2021, the patient experienced cough, fever, congestion, headache, fatigue, tired and SOB (shortness of breath). On 07Jul2021, the patient underwent COVID-19 test and resulted positive. The adverse events resulted in doctor or other healthcare professional office/clinic and Emergency room/department or urgent care visit. The patient received unspecified antibiotics and steroids as treatment medication for the events.; Sender''s Comments: Based on Plausible association, there is a casual relationship between the suspected drug BNT162b2 and the reported events COVID-19 along with Drug Ineffective.


VAERS ID: 1483749 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Allergic to penicillin, almonds, walnuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: No immediate allergic reaction, however that evening (and continuing through to today - now almost 2 weeks later) my hands have been covered in red hives and have been extremely itchy. It burns under water and when heat is applied. The hives started on the back of my hand and now have spread to the tips of my fingers. As I am breastfeeding an 8 -month old, I have not taken Antihistamines nor NSAIDS for relief. I have had no fever nor pain in my arm since the vaccine, however these hives have become severely debilitating.


VAERS ID: 1483940 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Angiogram pulmonary normal, Blood corticotrophin normal, C-reactive protein normal, Colonoscopy normal, Computerised tomogram abdomen, Cortisol normal, Dizziness, Echocardiogram normal, Fatigue, Full blood count normal, Gastrointestinal pathogen panel, Heart rate increased, Hepatic steatosis, Impaired work ability, Metabolic function test, Metabolic function test normal, Nausea, Oesophagogastroduodenoscopy normal, Palpitations, Parasite stool test negative, Respiratory viral panel, Ultrasound liver abnormal, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (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? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Adult Multi-vitamin
Current Illness: acute pharyngitis 5/19/2021 (covid negative at that visit)
Preexisting Conditions: obesity
Allergies: Adhesive-hives, iodine-hives, lamictal-hives, shellfish-hives, wellbutrin-rash
Diagnostic Lab Data: ECHO on 7/14 normal. CTA of the thorax on 7/13, negative for pneumonia or PE. CT abdomen and pelvis showing "possible early, mild colitis" on 7/15. GI consulted negative EGD and Colonoscopy on 7/17. CMP, CBC unremarkable on 7/13, 7/14, 7/15. CRP normal on 7/14, ACTH and cortisol normal on 7/16, Respiratory viral panel negative on 7/14, enteric pathogens negative on 7/14, O&P negative on 7/14. RUQ US showing hepatic steatosis.
CDC Split Type:

Write-up: Patient presented with severe fatigue, nausea, lightheadedness, and palpitations. Started 1 day after 2nd dose of vaccine. Called off work day after 2nd vaccine. Went to ER with palpitations and lightheadedness 3 days after her 2nd dose. Was given fluids and nausea medication and sent home. 8 days after her 2nd dose, she was admitted to the hospital with worsening nausea, fatigue, lightheaded, and palpitations. Her heart rate would elevate into the 140''s with minimal exertion. She works as a nurse at night, normally does not have any medical problems or fatigue or palpitations. Very fatigued and painful with abdominal pain, nauseated and vomiting. Required IV narcotics and IV benzos for pain control and nausea control. Palpitations uncontrolled with lopressor, fatigue and nausea difficult to control. palpitations did not improve with improvement of oral intake or with fluid resuscitation.


VAERS ID: 1484488 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-07-06
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acoustic stimulation tests normal, 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: Vit D, Oral Birth Control Lexapro
Current Illness: No
Preexisting Conditions: No
Allergies: Sulfa, Amoxicillin
Diagnostic Lab Data: Hearing test, Structure of ear(bone inclusion)
CDC Split Type: vsafe

Write-up: On July 6 I woke up with ringing in both ears especially louder in right ear. I went to audiologist stated that I had no hearing loss. The doctor informed me she has several patients that have came in since vaccine withe the same symptoms. My husband experienced the same exact adverse events after Dose 2 as well.


VAERS ID: 1484519 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA / 2 LA / IM

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

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

Write-up: Pt came today 7/19/21 at 9am complaining of patch liked rash around her body that''s itching. Noticed ones on her leg , one on the left arm, and pt said one just formed on the side of the forehead. She stated that it started the day after the vaccine and that it keeps popping up. I recommended pt to see the doctor as soon as possible. Pt states they do not have insurance and cannot afford to go. I recommended a clinic near by that could help with uninsured pts. I offered to make an appt for them. They said they would call me if they need help.


VAERS ID: 1484813 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / IM

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

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

Write-up: 14 years old female vaccinated with Moderna COVID vaccine, current minimum age approved is 18 years. Both Flow Monitor and Vaccinator reported error in providing the vaccine at the request of patient''s mother who was the registered homebound patient to receive the vaccine. Per Vaccinator/nurse he received communication from the stating ages 12 years and older can now receive their COVID-19 vaccine at home! link for nyc.gov/homevaccine was provided in the text communication which is why he thought it was ok per the mother''s request. Patient showed not adverse effect during 30 minutes post vaccine observation period. No adverse response noted or reported on NP home visit on 7/7/2021 . No Adverse effect reported by mother on follow call by writer on 7/8.21.


VAERS ID: 1484852 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-19
Onset:2021-07-06
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 UN / UN
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Exposure to SARS-CoV-2, Fatigue, Sick relative
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 74 years-old female with pmhx significant for ESRD on HD, COPD, HTN, HLD, OSA (BiPAP at home) presents 07/06/21 to after completing full HD treatment with worsening SOB/fatigue x 4 days, family members at home tested positive for COVID, she states they have been isolating at home. Required 3-4L of O2 on presentation. Patient received a 5 day course of Remdesivir and 10 day course of Decadron.


VAERS ID: 1484864 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-07
Onset:2021-07-06
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose: 01/10/2021 ,pfizer,Lot#012L20A 2nd dose: 02/07/21,Pfizer,Lot# 012M20A Diagnosed covid positive:07/09/21 Exposure:unknown Symptoms:Fatigue, bodyaches,runny nose,headache.


VAERS ID: 1484878 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-16
Onset:2021-07-06
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Anosmia, COVID-19, Chest discomfort, Cough, Headache, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 03/27/21,pfizer,Lot#ER8733 2nd dose: 04/16/21,Pfizer,Lot# EW0162 Diagnosed covid positive:07/07/21 Exposure:Home exposure Symptoms:Fever,cough,loss of smell,abd pain. sore throat,runny nose,headache,chest pressure.


VAERS ID: 1486795 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-19
Onset:2021-07-06
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 2 LA / IM

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

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

Write-up: Tested positive for Covid-19


VAERS ID: 1486854 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-07-06
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

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

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

Write-up: I caught the COVID virus after being fully vaccinated. Two weeks and still testing positive for the virus.


VAERS ID: 1486862 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram, Palpitations, Rash pruritic, Troponin I
SMQs:, Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fludrocortisone (FLORINEF) 0.1 mg Oral Tab 90 tablet 0/0 6/28/2021 6/28/2022 Sig - Route: Take 1 tablet by mouth daily - Oral Ivabradine (CORLANOR) 5 mg Oral Tab 180 tablet 0/0 6/28/2021 6/28/2022 Sig - Route: Take 1 tablet by mouth 2 times
Current Illness: ANEMIA 1/3/2019 - Present GERD (GASTROESOPHAGEAL REFLUX DISEASE) (Chronic) 1/3/2019 - Present FHX OF BREAST CANCER (Chronic) 4/29/2019 - Present FHX OF COLON CANCER (Chronic) 4/29/2019 - Present ADENOMATOUS POLYP, COLON 5/24/2019 - Present HX OF GESTATIONAL DM (Chronic) 6/21/2019 - Present GRIEF REACTION 1/21/2020 - Present MIGRAINE (Chronic) 1/21/2020 - Present ANXIETY 1/21/2020 - Present MODERATE PERSISTENT ASTHMA (Chronic) 10/13/2020 - Present ASTHMA, UNSPECIFIED (Chronic) 4/15/2021 - Present
Preexisting Conditions: see above
Allergies: aspirin bactrim bee venom ciprofloxacin ibuprofen metoclopramide nitrofurantoin NSAIDS sulfa phenergan shellfish doxycycline
Diagnostic Lab Data: ? Troponin i ? Methylprednisolone sod suc(pf) 125 mg/2 ml inj recon soln ? Non-system (see admin instr) ? Sodium chloride 0.9 % iv solp soln ? Ekg 12 or more leads w int & rpt
CDC Split Type:

Write-up: presents with itchy rash and palpitations after getting her 1stnd COVID-19 vaccine today. Patient reports that she has a history of 16 different allergies and has had anaphylaxis before so she carries an EpiPen with her. She denies any difficulty breathing for "throat closing up". She states that she did feel some palpitations and chest tightness earlier but this has improved. She states that her skin feels itchy. She states that her heart rate feels high.


VAERS ID: 1486912 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-20
Onset:2021-07-06
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abnormal uterine bleeding, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

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

Write-up: Abnormal uterine and vaginal bleeding, unspecified


VAERS ID: 1486931 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-07-06
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Appendiceal abscess, Appendicitis, Appendicitis perforated, Blood test, Computerised tomogram abdomen abnormal, Gastrointestinal pain, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal perforation (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Xulane birth control patch; calcium supplement; daily multi-vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 7/12 - 7/14: CT scan showed enlarged appendix with abscess. They took blood and urine samples. I spent 2 days in the hospital on IV antibiotics.
CDC Split Type:

Write-up: 12 days after my J&J vaccine I began to experience intestinal pains. It turned out to be appendicitis. It actually ruptured and I''m now on antibiotics and will have to have it removed in about 6 weeks.


VAERS ID: 1487110 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Circumstance or information capable of leading to medication error, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: the patient/parent was dishonest while filling out the consent form. and the patient is actually only 11 years old and not the approved 12 years old for the pfizer vaccination.


VAERS ID: 1487293 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Probiotic Iron Multivitamin Vitamin C Vyvanse
Current Illness: Cold a month before
Preexisting Conditions: Adhd
Allergies: None
Diagnostic Lab Data: Physical exam
CDC Split Type: vsafe

Write-up: She developed a rash within 24 hours of the vaccination. Itchiness. This continued for about 5 days. It was sporadic from chin and neck area to buttocks. Still some remaining patches and red welts on top of the skin.


VAERS ID: 1487349 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: Numbness in hands/face immediately following vaccine. Constant numbness in right thumb that continues to this day; numbness/tingling in hands/fingers that comes and goes


VAERS ID: 1487379 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Appetite disorder, Dyspepsia, Feeling hot, Head discomfort, Heart rate increased, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 500mg chewable vit c
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: no
CDC Split Type:

Write-up: After receiving the vaccine her head was feeling heavy, a little tingling in pinky. After laying down when she got up her body felt like it was on fire, that went on for about a week. Couldn''t drink orange juice. She had a rapid heart rate, she took ibuprofen which helped for a couple of hours also took some Benadryl. Also had heartburn and felt nausea.


VAERS ID: 1487447 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-14
Onset:2021-07-06
   Days after vaccination:53
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion spontaneous, Anembryonic gestation, Exposure during pregnancy, Ultrasound antenatal screen abnormal, Uterine dilation and curettage
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (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: Prenatal daily pill
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received first dose of Pfizer vaccine on 4/12/2021 and second dose of Pfizer vaccine on 5/14/2021. At the time of first dose, I was not pregnant but we were actively trying to become pregnant. At time of second vaccine, I was pregnant (possibly 1-2 weeks along). I did not know I was pregnant. At my regular first check up on July 6, 2021, I went in to confirm pregnancy with my OGBYN. An ultrasound confirmed I had a blighted ovum, which is a type of miscarriage that the body does not recognize on its own. I did have a surgery to end to miscarriage since my body did not do it naturally. I wanted to report this happening in case it was significant since the timeframes of receiving vaccine and pregnancy were very close together. I know tests on the safety of this vaccine have been very limited and wanted to offer my experience in case it is relevant. Thank you,


VAERS ID: 1487514 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-21
Onset:2021-07-06
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Sprintec birth control pills
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: Ultrasound was given to locate clot
CDC Split Type:

Write-up: Blood clot in left leg


VAERS ID: 1487734 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-05-12
Onset:2021-07-06
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Mass, Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (broad)

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

Write-up: palpable spherical subcutaneous facial mass, 7mm diameter, discolored no treatment


VAERS ID: 1489564 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-07-06
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Erythema, Fatigue, Injection site erythema, Injection site pain, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (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:
Current Illness: Abstains from alcohol; Hypertension; Non-smoker; Penicillin allergy; Type II diabetes mellitus
Preexisting Conditions: Comments: The patient had no history of drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210739135

Write-up: SEVERE ITCHING; RED WHELPS ON LEGS,THIGH AND STOMACH; FATIGUE; INJECTION SITE SORENESS; INJECTION SITE RED; INJECTION SITE SWOLLEN; LIGHTHEADNESS; This spontaneous report received from a patient concerned a 51 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hypertension, diabetes type 2, penicillin allergy, non alcoholic, and non smoker, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug usage. The patient experienced drug allergy when treated with amoxicillin, sulfamethoxazole/trimethoprim, ciprofloxacin, erythromycin, and pravastatin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 06-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 06-JUL-2021, the subject experienced lightheadness. On 06-JUL-2021, the subject experienced fatigue. On 06-JUL-2021, the subject experienced injection site soreness. On 06-JUL-2021, the subject experienced injection site red. On 06-JUL-2021, the subject experienced injection site swollen. On 15-JUL-2021, the subject experienced severe itching. On 15-JUL-2021, the subject experienced red whelps on legs, thigh and stomach. Treatment medications included: calamine, and cortisone. On 17-JUL-2021, treatment medications included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from lightheadness, and fatigue on 07-JUL-2021, severe itching, and red whelps on legs,thigh and stomach on 16-JUL-2021, and injection site soreness, injection site red, and injection site swollen on 10-JUL-2021. This report was non-serious.


VAERS ID: 1489609 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-24
Onset:2021-07-06
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anal incontinence, Confusional state, Lethargy, Pruritus, Somnolence
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (broad), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: VALSARTAN; METFORMIN; ASPIRIN [ACETYLSALICYLIC ACID]; ATORVASTATIN; PRILOSEC [OMEPRAZOLE]; METOPROLOL
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Not having control of their bowels; Completely confused; Constant itching; Very lethargic; Never slept past 9am but after receiving the second dose they could not get up before 11am; This spontaneous case was reported by a consumer and describes the occurrence of BOWEL INCONTINENCE (Not having control of their bowels) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included VALSARTAN, METFORMIN, ASPIRIN [ACETYLSALICYLIC ACID], ATORVASTATIN, OMEPRAZOLE (PRILOSEC [OMEPRAZOLE]) and METOPROLOL for an unknown indication. On 24-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 06-Jul-2021, the patient experienced BOWEL INCONTINENCE (Not having control of their bowels) (seriousness criterion hospitalization) and CONFUSIONAL STATE (Completely confused) (seriousness criterion hospitalization) . On an unknown date, the patient experienced PRURITUS (Constant itching), LETHARGY (Very lethargic) and SOMNOLENCE (Never slept past 9am but after receiving the second dose they could not get up before 11am). At the time of the report, BOWEL INCONTINENCE (Not having control of their bowels), CONFUSIONAL STATE (Completely confused), and SOMNOLENCE (Never slept past 9am but after receiving the second dose they could not get up before 11am) outcome was unknown, and the events of PRURITUS (Constant itching), LETHARGY (Very lethargic) was not resolved. On 06July2021, the caller could not get a hold of the patient. The caller called 911 to check on the patient. The caller found the patient at home completely confused (not knowing themselves or recognizing any family members), the patient was in their underwear. The patient was admitted to the hospital and stayed for about 10 days. The health care providers have done every test possible according to the caller and tests have come back negative and the HCPs stating "the patient is 100% healthy. No treatment drug details was reported.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1489771 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-04
Onset:2021-07-06
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036CZ1H / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040CZ1H / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding, Oligomenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: No
CDC Split Type:

Write-up: Long heavy menstrual cycle. Cycle started June 24 and ended July 3. Then I started spotted for a few days (5days). Cycle became heavy July 19 and hasn?t stopped as of today July 21


VAERS ID: 1489795 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Poor quality product administered
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: USPFIZER INC2021846459

Write-up: Received vaccine after point; This is a spontaneous report from a contactable pharmacist. A 54-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in left arm on 06Jul2021 at 10:30(Batch/Lot Number: EW0198; Expiration Date: Sep2021) as dose number unknown, 0.3ml single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient was given a Pfizer''s COVID-19 vaccine "beyond its appropriate time of use". Yesterday vaccine was diluted and put in a syringe in the fridge by 07:30pm, today patient received it by 10:30am. After dilution, store vials between 2?C to 25?C (35?F to 77?F) and use within 6 hours from the time of dilution. Any vaccine remaining in vials must be discarded after 6 hours. There is no additional excursion time for diluted vaccine in syringes. They drew the covid vaccine up in syringes and put them in the refrigerator, but the syringe was given to a patient beyond it''s use time, so they are wanting to know what Pfizer recommends. Caller states this occurred around 1030 this morning and reports the vaccine was probably drawn up yesterday around or after 1900, and it was left overnight. Caller states, she guesses when the person came in to get their shot, the technician thought it was a new vaccine that had been drawn up, and they gave that one. Caller confirms the syringe had been drawn up and left in the refrigerator overnight. It was medically significant. Outcome was unknown.; Sender''s Comments: Based on the narrative and the known safety profile of the suspect drug, the reported Poor quality product administered was considered possible. its role in the reported event could not be excluded


VAERS ID: 1489810 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Chills, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021848367

Write-up: vomiting multiple times; Nausea; Chills; Fever; Body aches; Chest pain; This is a spontaneous report from a non-contactable consumer (patient). A 22-years-old female patient received bnt162b2 (Pfizer-BioNTech Covid-19 Vaccine) at the age of 22-years-old, dose 2 via an unspecified route of administration, administered in Arm Left on 05Jul2021 15:45 (Batch/Lot Number: EW0198) as DOSE 2, SINGLE for covid-19 immunisation. The patient medical history was not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient was not pregnant. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient''s concomitant medications were not reported. Historical Vaccine included BNT162B2 for COVID-19 Immunization on 14Jun2021 at the age of 22-years-old (1st Dose, Batch/lot number: EW0196, Anatomical Location: Arm left, Administration time: 11:00 AM). Reported Adverse Events: Nausea, vomiting multiple times, chills, fever, body aches and chest pain since 06Jul2021 05:00AM. No treatment received. The event outcome was recovering. Since the vaccination, the patient has not been tested for COVID-19. Case received as non-serious. No follow-up attempts possible. No further information expected. Information about batch number has been obtained.


VAERS ID: 1489816 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-27
Onset:2021-07-06
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021853339

Write-up: she wanted to pass out; Sweating; she felt weak; middle of her stomach it hurts/Stomach ache; This is a spontaneous report from a non-contactable consumer. This consumer reported for a female patient (daughter). A female patient of an unspecified age received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 27Jun2021 (As reported: lot number: ''E06180'', or 00180; Expiry Date of Covid-19 Vaccine: Unknown) as single dose for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced she wanted to pass out (syncope) on 06Jul2021 with outcome of unknown , sweating (hyperhidrosis) (non-serious) on 06Jul2021 with outcome of unknown , she felt weak (asthenia) (non-serious) on 06Jul2021 with outcome of unknown , middle of her stomach it hurts/stomach ache (abdominal pain upper) (non-serious) on 06Jul2021 with outcome of unknown. No follow up attempts are possible. information about lot/batch number cannot be obtained.


VAERS ID: 1490343 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphonia, Dyspnoea, Fatigue, Feeling abnormal, Hypersensitivity, Hypoaesthesia, Paraesthesia, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Willcall Benadryl
Current Illness: None
Preexisting Conditions: Degenerative Disc Disease Spinal Stenosis Ulcer
Allergies: Multiple
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Forty five minutes after vaccine brain started feeling like it was speeding, felt buzzy, face started swelling, numbness and tingling in right arm, tiredness, fatigue, unable to stand noise, loss of voice, out of breath when taking long walks


VAERS ID: 1490393 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

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

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

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490410 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

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

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

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490423 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

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

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

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490443 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / IM

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

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

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490484 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-03
Onset:2021-07-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Hypertension (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin, Lantis, Losartan, Synthroid, Sertrinle
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I was hospitalized on July 7th with 2 strokes was released from hospital July 9th and back on July 10th less than 24 hours later with another stroke.
CDC Split Type:

Write-up: From Juy 3rd to July 10th I had 3 strokes, very high blood pressure.


VAERS ID: 1490554 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

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

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

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490578 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / IM

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

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

Write-up: ?Describe the adverse events, treatment, and outcomes?: enter: ?Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.?


VAERS ID: 1490619 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

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

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

Write-up: ?Describe the adverse events, treatment, and outcomes?: enter: ?Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.?


VAERS ID: 1490629 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

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

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

Write-up: ?Describe the adverse events, treatment, and outcomes?: enter: ?Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.?


VAERS ID: 1490633 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

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

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

Write-up: ?Describe the adverse events, treatment, and outcomes?: enter: ?Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.?


VAERS ID: 1490701 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / IM

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

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

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 06/17/2021. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490722 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

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

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

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 06/17/2021. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490746 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

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

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

Write-up: Patient received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 06/17/2021. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the patient will need to be re-vaccinated.


VAERS ID: 1490822 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / IM

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

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

Write-up: Patient received improperly stored vaccine. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, the patient will need revaccination


VAERS ID: 1490838 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

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

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

Write-up: Patient received improperly stored vaccine. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, the patient will need revaccination


VAERS ID: 1490849 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

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

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

Write-up: Patient received improperly stored vaccine. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, the patient will need revaccination


VAERS ID: 1490860 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

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

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

Write-up: Patient received improperly stored vaccine. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, the patient will need revaccination


VAERS ID: 1490870 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Low weight gain, short stature
Allergies: NONE
Diagnostic Lab Data: none; clinic and ER evaluations only
CDC Split Type:

Write-up: truncal and upper thigh rash - appears c/w pityriasis rosea; small focus, slightly itchy at first after first dose, resolved/improved and then spread rapidly after second dose


VAERS ID: 1490877 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

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

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

Write-up: Patient received improperly stored vaccine. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to guidance from Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, the patient will need revaccination


VAERS ID: 1491234 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-20
Onset:2021-07-06
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER0568 / 2 RA / IM

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

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

Write-up: I got shingles. I got a Toradol shot for the pain and was given an antiviral medication, Ibuprofen, and Tylenol 3 with Codeine.


VAERS ID: 1493148 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chromaturia, Dysuria, Fatigue, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (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: TYLENOL; IBUPROFEN; CYMBALTA; TRAZODONE; HYDROXYZINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; Depression; Post-traumatic stress disorder; Scoliosis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021846656

Write-up: Dark and painful urination; dark and painful urination; Pain in back of left thigh; Fatigue; This is a spontaneous report from a contactable consumer. A 33-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left at age of 33-years-old on 05Jul2021 10:45 (Batch/Lot number was not reported) as DOSE 2, SINGLE for covid-19 immunisation. Medical history included depression, anxiety, post-traumatic stress disorder, scoliosis. Pregnant: No. The patient previously received first dose of bnt162b2 at age of 33 years old on 14Jun2021 for COVID-19 immunization. Concomitant medications included paracetamol (TYLENOL); ibuprofen; duloxetine hydrochloride (CYMBALTA); trazodone; hydroxyzine taken for an unspecified indication, start and stop date were not reported. Prior to vaccination the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient experienced dark and painful urination, pain in back of left thigh, fatigue on 06Jul2021 15:30. No treatment was received for the events. Outcome of events was not recovered. The patient was not tested covid post vaccination. Information on the lot/ batch number has been requested.


VAERS ID: 1493153 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 INC2021846700

Write-up: Presented dizziness; tight chest; blurry vision; This is a spontaneous report received from a non-contactable consumer. An 18-year-old female patient (unknown if pregnant at time of vaccination) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 06Jul2021 at 12:00 PM (Lot number: EW0172) as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 immunization. The patient''s medical history and concomitant medications were not provided. Unknown if covid prior vaccination; unknown if covid tested post vaccination. On 06Jul2021 at 12:00 PM, patient presented dizziness, tight chest, blurry vision; refused EMS. Treatment received for events including first aid, vitals. Outcome of events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1493185 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO198 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Headache, Myocarditis, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (If covid prior vaccination: Yes); Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210707; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Unknown result
CDC Split Type: USPFIZER INC2021862035

Write-up: I believe these symptoms are consistent with the reports of myocarditis; Headache; Shortness of breath; Chest tightness all sustained between 12-24 hours after receiving 2nd dose; This is a spontaneous report from a non-contactable consumer, the patient. A 24-years-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot Number: EWO198), via an unspecified route of administration, administered in Arm Left on 05Jul2021 at 20:15 (at the age of 24-years-old) as single dose for covid-19 immunization. Facility type vaccine was Pharmacy or Drug Store. Medical history included known allergies to Penicillin from an unknown date and unknown if ongoing, covid-19 from an unknown date and unknown if ongoing (If covid prior vaccination: Yes). There were no concomitant medications. Historical vaccine included previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection), via an unspecified route of administration, administered in Arm Left on 14Jun2021 at 20:15 (at the age of 24-years-old) (Batch/Lot Number: EWO181) as single dose for covid-19 immunization and did not experience any adverse reaction. No other vaccine administered in four weeks. Adverse event description stated by patient as on 06Jul2021 at 08:00 was headache, shortness of breath, and chest tightness all sustained between 12-24 hours after receiving 2nd dose. Took 2 Tylenol 24hrs after 2nd dose, symptoms dissipated, reappeared next morning, albeit reduced severity. I believe these symptoms are consistent with the reports of myocarditis (though the symptoms are admittedly nondescript) experienced by others in my demographic group following the 2nd dose. Patient was tested covid post vaccination. The patient underwent lab tests and procedures which included Nasal Swab test on 07Jul2021 with unknown result. The patient received treatment for the events. The outcome of the events was recovering. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1493200 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-30
Onset:2021-07-06
   Days after vaccination:98
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CR8727 / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma
Allergies:
Diagnostic Lab Data: Test Date: 20210622; Test Name: Nasal Swab; Test Result: Negative ; Test Date: 20210707; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC2021864466

Write-up: I contracted Covid-19 again. Was diagnosed positive on July 7th, 2021; I contracted Covid-19 again. Was diagnosed positive on July 7th, 2021; This is a spontaneous report from a contactable consumer (patient). A 55-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: CR8727) via an unspecified route of administration, administered in left arm on 30Mar2021 at 12:00 (at the age of 55-years-old) as dose number unknown, single for covid-19 immunisation. Medical history included asthma. Patient had no known allergies. The patient''s concomitant medications were not reported. Patient had not received any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, patient was not diagnosed with COVID-19. On 06Jul2021 at 07:00, the patient contracted covid-19 again, was diagnosed positive on 07Jul2021. Since the vaccination, the patient was tested for COVID-19. The patient underwent lab tests and procedures which included rapid test nasal swab: negative on 22Jun2021, positive on 07Jul2021. Events resulted in emergency room/department or urgent care. No treatment received for the events. The clinical outcome of events was recovered on unspecified date in Jul2021. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1493218 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-07-06
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210706; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC2021868950

Write-up: Tested positive for COVID-19; Tested positive for COVID-19; This is a spontaneous report from a non-contactable consumer (patient) or other non HCP. An adult non-pregnant female patient of unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: not reported), via an unspecified route of administration on 26Mar2021 as dose 2, single for COVID-19 immunisation was in doctor''s office/urgent care. The patient medical history and concomitant medications were not reported. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: not reported), administered on an unknown date as dose 1 single for COVID-19 immunisation. Prior to the vaccination, the patient was not diagnosed with COVID. The patient did not receive other vaccine in four weeks. On 06Jul2021, the patient tested positive for COVID-19. The event resulted in doctor or other healthcare professional office/clinic visit. The patient underwent lab tests and procedures which included nasal swab: positive on 06Jul2021.Therapeutic measures were taken as a result of tested positive for COVID-19. Outcome of the events was resolving. No follow up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1493366 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-07-06
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Discomfort, Headache, Injection site erythema, Injection site swelling, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: HYQVIA
Current Illness: Immunocompromised; Immunoglobulin G decreased
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (The patient tested positive for COVID on 02/2021); Stroke
Allergies:
Diagnostic Lab Data: Test Date: 202102; Test Name: COVID-19 virus test positive; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210730588

Write-up: DISCOMFORT; ACHY HERE AND THERE; FEVER; SWOLLEN ARM AT THE AREA OF VACCINATION; REDNESS AT THE SITE OF THE INJECTION; HEADACHE HERE AND THERE; This spontaneous report received from a parent concerned a 30 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included stroke, and covid-19, and concurrent conditions included immunocompromised, and low immunoglobulin g (igg). The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and expiry: 07-AUG-2021) dose was not reported, administered on 06-JUL-2021 for prophylactic vaccination. Concomitant medications included immunoglobulin human normal for low igg. On FEB-2021, Laboratory data included COVID-19 virus test positive (NR: not provided) Positive. On 06-JUL-2021, the subject experienced discomfort. On 06-JUL-2021, the subject experienced achy here and there. On 06-JUL-2021, the subject experienced fever. On 06-JUL-2021, the subject experienced swollen arm at the area of vaccination. On 06-JUL-2021, the subject experienced redness at the site of the injection. On 06-JUL-2021, the subject experienced headache here and there. On 14-JUL-2021, treatment medications included paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, swollen arm at the area of vaccination, discomfort, redness at the site of the injection, headache here and there, and achy here and there. This report was non-serious.


VAERS ID: 1493391 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-15
Onset:2021-07-06
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Skin irritation
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Additional Details: Patient came in to the pharmacy on 7/21/2021 to report that she had left her band-aid on (applied after vaccine on 6/15/2021) for several weeks after receiving the vaccine, stating she forgot to take it off. She showed her arm, which showed mild skin irritation in the shape of a band-aid. Referred patient to see a physician at urgent care or a dermatologist. She went to urgent care and had a topical remedy prescribed.


VAERS ID: 1493876 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-07-03
Onset:2021-07-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Ear pain, Fatigue, Headache, Injection site pain, Myalgia, Nausea, Oropharyngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Lisinipril, Lipitor, Vyvanse, Vitamin B12, Vitamin D
Current Illness: None
Preexisting Conditions: Type-2 Diabetes
Allergies: Gluten
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: The First vaccination was received on Saturday, July 3 at 1pm. Patient experienced common injection site soreness that lasted approximately 48 hours with no other symptoms. New symptoms appeared approximately 80 hours post-injection (approximately 8pm on July 6), including left ear ache, fatigue, sore throat and muscle aches. By the following morning additional symptoms appeared including nausea, chills, and headache. Symptoms persisted up to bed on July 18 and by the morning of July 19 all symptoms were gone. Temperature readings were normal throughout symptom period.


VAERS ID: 1494380 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, 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: No
Current Illness: No illness reported by patient
Preexisting Conditions: Patient had kidney transplant (immune compromised)
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received a dose of Moderna vaccine on 07/06/2021. He completed both Pfizer doses (03/15/21 and 04/05/2021). Mistake was found after accessing MIIC on 07/19. Patient indicated that he did not experience any adverse events and is advised to follow up with his doctor and contact us if he experiences any adverse events.


VAERS ID: 1497438 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Head discomfort, Headache, Hyperhidrosis, Hypersensitivity, Oropharyngeal pain, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BENADRYL; SINGULAIR MINI
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (Both parents have allergies); Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021861990

Write-up: diarrhea 2 times today; sore throat; About 1 hour after receiving her COVID-19 vaccine shot, she had a reaction; she felt like her head was swimming; Rashes/ rash on her stomach; headache; stomach ache; sweating all night/ sweaty on her stomach area; This is a spontaneous report from a contactable consumer (patient) via Medical Information Team. A 58-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EW0178) dose 1, via an unspecified route of administration in arm left on 06Jul2021 at 14:00 (at the age of 58-years-old) as single dose for COVID-19 immunisation. The family medical history included both parents have allergies. The patient''s medical history included mild asthma, stated that she had asthma all her life. The patient''s concomitant medications included diphenhydramine hydrochloride (BENADRYL, Lot number: P122740, Expiration date: on an unspecified date in Nov2023), 25 mg (every 6 hours, as needed), taken for mild asthma and montelukast sodium (SINGULAIR MINI), 10 mg, as needed, taken for an unspecified indication. The history of all previous immunization with the Pfizer vaccine considered as suspect was reported as none. Additional vaccines administered on same date of the pfizer suspect was reported as none. Prior vaccinations (within 4 weeks) were reported as none. The caller had the 1st dose of the Pfizer COVID 19 vaccine last on 06Jul2021 and experienced some reactions - rashes, headache, stomach ache, sweating all night, diarrhea 2 times today on 08Jul2021. Stated that, she does not want to get the 2nd dose due to the symptoms she has been experiencing. The patient was taking Benadryl, asked for the efficacy of the single dose. Response included was referred to healthcare professional. It was reported that, she was called about the COVID-19 Vaccine. Stated that, she had mild asthma and thought she had an allergic reaction to the COVID-19 Vaccine. She clarified that, she got her first COVID-19 Vaccine shot on 06Jul2021 and about 1 hour after she took the vaccine shot, she had a reaction. Stated that, the reaction got worse, but now she felt a little better. Stated that, she felt sweaty on her stomach area. She lifted up her shirt and she had a rash on her stomach. She started to get a headache and sore throat. Stated that, she thought she was having a reaction (to the vaccine) and she thought she would have something happened after she got the COVID-19 Vaccine. Stated that, she never had the COVID-19 Vaccine before and just tried the COVID-19 Vaccine for the first time. Stated that, she thought her allergic reaction would get worse if she didn''t take Benadryl. Stated that, she was sweating last night and had a headache and she took Tylenol for the headache. Stated that, she had diarrhea 2 times this morning on 08Jul2021 and the Benadryl was helping her. Stated that, she took Benadryl and allergy medicine, clarified as generic Diphenhydramine 25mg capsule and prescription Singulair prescribed from the doctor at urgent care. Stated that, Equate Brand Allergy Relief Diphenhydramine 25mg capsule (she took 2 capsules after symptoms started on 06Jul2021), NDC number: 49035-901-12, Lot number: P122740, Expiry date: on an unspecified date in Nov2023. The patient stated that, the Equate Brand Allergy Relief Diphenhydramine 25mg capsule product NDC number was really, really, small type and she had to turn a light on to read the NDC number because of the really small print. Singulair 10mg (dispensed in prescription bottle and did not have the NDC, Lot and Expiry date). Stated that, she took the Singulair 10mg, as needed. She took one Singulair 10mg on 06Jul2021. Stated that, her allergic reaction got worse and then better after she took the Equate Brand Allergy Relief Diphenhydramine 25mg capsule. Stated that, she took Benadryl (Diphenhydramine 25mg) every day for her mild asthma, clarifying she took one Benadryl (Diphenhydramine 25mg) every 6 hours, as needed for her mild asthma. She clarified she had been taking Benadryl (Diphenhydramine 25mg) every day since her allergic reaction started on 06Jul2021. Stated that, she got the Generic Tylenol and did not have the NDC, Lot and Expiry date. Stated that, Generic Tylenol helped her headache and she felt like her head was swimming. She felt like she had an allergic reaction (to the COVID-19 Vaccine). Stated that, the allergic reaction was not severe and the allergic reaction was not what she normally gets. Stated that, she was not going to get the second COVID-19 Vaccine and asked whether she was somewhat protected from only having one COVID-19 Vaccine dose. The description of product complaint included Equate Brand Allergy Relief Diphenhydramine. The patient stated that, the Equate Brand Allergy Relief Diphenhydramine 25mg capsule product NDC number was really, really, small type and she had to turn a light on to read the NDC number because of the really small print. Treatment was received for the events about 1 hour after receiving her COVID-19 vaccine shot, she had a reaction, rashes/ rash on her stomach and headache. The investigation assessment was not reported. The outcome of the events for about 1 hour after receiving her COVID-19 vaccine shot, she had a reaction and stomach ache was unknown while for the other events was recovering.


VAERS ID: 1497581 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-29
Onset:2021-07-06
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210706; Test Name: Covid; Test Result: Positive ; Comments: got the Covid vaccine and tested positive
CDC Split Type: USPFIZER INC2021894617

Write-up: Several colleagues got the Covid vaccine and tested positive; Several colleagues got the Covid vaccine and tested positive; This is a spontaneous report from a non-contactable consumer (patient). A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot Number: GN6204 and Expiry date were not reported), via an unspecified route of administration, on 08Apr2021 as dose1, single and BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: ER8736; Expiration Date: 31Jul2021), via an unspecified route of administration, on 29Apr2021 as dose2, single for COVID-19 immunization. The patient medical history was not reported. The patient''s concomitant medications were not reported. Stated that she received the first dose on 08Apr2021.and received the second dose on 29Apr2021. She tested positive after the second dose. Stated that she developed Covid on 06Jul2021. Stated that she has to call colleagues when they get Covid. Stated that in the past several days several colleagues got the Covid vaccine and tested positive. Stated that website will not accept Pfizer her Pfizer email. Stated that she reported two yesterday without a problem. Does not have reference numbers from the website from reports yesterday. Stated that the colleagues call in to report this and she follows up. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 06Jul2021 got the Covid vaccine and tested positive. QA Review and Rationale: The complaint and its classification have been reviewed. No immediate containment action is required. The complaint, its priority, and its classification have been reviewed and determined to be appropriate. A full investigation will be performed. This is a complaint for lack of effect of lot ER8736 of the PFIZER-BIONTECH COVID-19 VACCINE INJECTABLE. The initial scope of this investigation is limited to the reported finished goods lot ER8736, fill lot EP8688, and the bulk formulated drug product lot EP8585. The investigation will include a review of the returned complaint sample (if received) and reserve samples, if necessary. Conclusion: The complaint for lack of effect of the PFIZER-BIONTECH COVID-19 VACCINE INJECTABLE lot ER8736 was investigated. The investigation included reviewing manufacturing and packaging batch records, deviation investigations, analytical release test results, and an analysis of complaint history for the reported lot. The final scope was determined to be the reported finished goods lot ER8736, fill lot EP8688, and the formulated drug product lot EP8585. A complaint sample was not returned. No related quality issues were identified during the investigation. There is no impact on product quality. No root cause or CAPA were identified as the complaint was not confirmed. All release testing performed prior to the release of the reported batch was within specifications. The outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1450938 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Large red swollen area on my left arm around the injection site. Didn''t show up until the next day.


VAERS ID: 1466866 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-01
Onset:2021-07-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3004222 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, 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: NAC, Vitamin D (1000IU), Vitamin C
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Shellfish, NSAIDs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen neck lymph node


VAERS ID: 1468660 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-02
Onset:2021-07-06
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002621 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chills, Headache, Myalgia, Myocarditis, Pain, Pyrexia, SARS-CoV-2 test, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: CYCLIZINE; TRAMADOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Myocarditis; Suspected COVID-19 (Unsure when symptoms stopped)
Allergies:
Diagnostic Lab Data: Test Date: 20210101; Test Name: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: Yes - Positive COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: tenderness; pain; muscle aches; fevers; Did have headcahe; fevers; Myocarditis; chest tightness; This regulatory authority case was reported by an other health care professional and describes the occurrence of MYOCARDITIS (Myocarditis), CHEST DISCOMFORT (chest tightness), TENDERNESS (tenderness), PAIN (pain), MYALGIA (muscle aches), CHILLS (fevers), HEADACHE (Did have headcahe) and PYREXIA (fevers) in an 18-year-old male patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3002621) for COVID-19 vaccination. The patient''s past medical history included Myocarditis and Suspected COVID-19 (Unsure when symptoms stopped) on 01-Jan-2021. Concomitant products included CYCLIZINE and TRAMADOL for an unknown indication. On 02-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 06-Jul-2021, the patient experienced MYOCARDITIS (Myocarditis) (seriousness criteria hospitalization and medically significant). 06-Jul-2021, the patient experienced CHEST DISCOMFORT (chest tightness) (seriousness criterion hospitalization). On an unknown date, the patient experienced TENDERNESS (tenderness) (seriousness criterion hospitalization), PAIN (pain) (seriousness criterion hospitalization), MYALGIA (muscle aches) (seriousness criterion hospitalization), CHILLS (fevers) (seriousness criterion hospitalization), HEADACHE (Did have headcahe) (seriousness criterion hospitalization) and PYREXIA (fevers) (seriousness criterion hospitalization). The patient was treated with PARACETAMOL at an unspecified dose and frequency; IBUPROFEN at an unspecified dose and frequency and COLCHICINE at an unspecified dose and frequency. At the time of the report, MYOCARDITIS (Myocarditis) had not resolved, CHEST DISCOMFORT (chest tightness), TENDERNESS (tenderness), PAIN (pain), MYALGIA (muscle aches) and CHILLS (fevers) outcome was unknown and HEADACHE (Did have headcahe) and PYREXIA (fevers) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Jan-2021, SARS-CoV-2 test: positive (Positive) Yes - Positive COVID-19 test. 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. Patient now under CCU care. Central radiating around sides into back. Worse on both deep breath in and out. No rash. No calf swelling. No muscle weakness. Never experienced this before. Sharp pain at top and bottom of breath, worsens on leaning forward or backwards. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1476415 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Unknown  
Location: Foreign  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002621 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Diarrhoea, Headache, Illness, SARS-CoV-2 test
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LIZINNA
Current Illness:
Preexisting Conditions: Comments: No medical history was reported.
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: Negative COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Cold sweat; Sickness; Diarrhoea; Headache; This regulatory authority case was reported by a consumer and describes the occurrence of COLD SWEAT (Cold sweat), ILLNESS (Sickness), DIARRHOEA (Diarrhoea) and HEADACHE (Headache) in an 18-year-old patient of an unknown gender who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3002621) for COVID-19 vaccination. No medical history was reported. Concomitant products included ETHINYLESTRADIOL, NORGESTIMATE (LIZINNA) for Contraception. On 05-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 06-Jul-2021, the patient experienced HEADACHE (Headache) (seriousness criterion medically significant). On 07-Jul-2021, the patient experienced COLD SWEAT (Cold sweat) (seriousness criterion medically significant), ILLNESS (Sickness) (seriousness criterion medically significant) and DIARRHOEA (Diarrhoea) (seriousness criterion medically significant). At the time of the report, COLD SWEAT (Cold sweat) and HEADACHE (Headache) had not resolved and ILLNESS (Sickness) and DIARRHOEA (Diarrhoea) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, SARS-CoV-2 test: no - negative covid-19 test (Negative) Negative COVID-19 test. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Patient has not tested positive for COVID-19 since having the vaccine. No treatment information was provided. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1485519 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Depressed mood, Fatigue, Iron deficiency anaemia, Limb discomfort, Migraine, Nausea, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), 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: FERROUS FUMARATE; MEFENAMIC ACID; TRANEXAMIC ACID
Current Illness: Blood loss anaemia; Iron deficiency anaemia; Period pains
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased; Suspected COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20200406; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: No - Negative COVID-19 test.
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Iron deficiency anaemia; Migraine; Depressed mood; Arm discomfort; Nausea; Fatigue; This regulatory authority case was reported by a consumer and describes the occurrence of IRON DEFICIENCY ANAEMIA (Iron deficiency anaemia), MIGRAINE (Migraine), DEPRESSED MOOD (Depressed mood), LIMB DISCOMFORT (Arm discomfort), NAUSEA (Nausea) and FATIGUE (Fatigue) in an 18-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased and Suspected COVID-19 from 04-Apr-2020 to 15-Apr-2020. Concurrent medical conditions included Iron deficiency anaemia, Period pains and Blood loss anaemia. Concomitant products included FERROUS FUMARATE from 05-Jul-2021 to an unknown date for Anemia iron deficiency, TRANEXAMIC ACID from 01-Jul-2021 to an unknown date for Blood loss anaemia, MEFENAMIC ACID from 01-Jul-2021 to an unknown date for Period pains. On 06-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 06-Jul-2021, the patient experienced MIGRAINE (Migraine) (seriousness criterion medically significant), DEPRESSED MOOD (Depressed mood) (seriousness criterion medically significant), LIMB DISCOMFORT (Arm discomfort) (seriousness criterion medically significant), NAUSEA (Nausea) (seriousness criterion medically significant) and FATIGUE (Fatigue) (seriousness criterion medically significant). On an unknown date, the patient experienced IRON DEFICIENCY ANAEMIA (Iron deficiency anaemia) (seriousness criterion medically significant). On 08-Jul-2021, NAUSEA (Nausea) had resolved. On 10-Jul-2021, MIGRAINE (Migraine) and LIMB DISCOMFORT (Arm discomfort) had resolved. At the time of the report, IRON DEFICIENCY ANAEMIA (Iron deficiency anaemia) outcome was unknown, DEPRESSED MOOD (Depressed mood) had not resolved and FATIGUE (Fatigue) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 06-Apr-2020, SARS-CoV-2 test: negative (Negative) No - Negative COVID-19 test.. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Treatment information was not provided. The patient was not tested positive for COVID-19 since having the vaccine. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1488269 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-02
Onset:2021-07-06
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cystic lymphangioma; Shoulder fracture
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRMODERNATX, INC.MOD20212

Write-up: Myocarditis; This regulatory authority case was reported by a physician and describes the occurrence of MYOCARDITIS (Myocarditis) in an 18-year-old male patient who received mRNA-1273 (COVID 19 Vaccine Moderna) for COVID-19 vaccination. The patient''s past medical history included Shoulder fracture and Cystic lymphangioma. On 02-Jul-2021, the patient received dose of mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 06-Jul-2021, after starting mRNA-1273 (COVID 19 Vaccine Moderna), the patient experienced MYOCARDITIS (Myocarditis) (seriousness criteria hospitalization and medically significant). At the time of the report, MYOCARDITIS (Myocarditis) was resolving. For mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. No treatment information was provided. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Sender''s (Case) Safety Report Unique Identifier: FR-AFSSAPS-BR20212660; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1490512 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Migraine
SMQs:, Anaphylactic reaction (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Migraine with sharp pain occasionally on the left top and back of the head 3-5 days after 2nd shot and still occurring occasionally until now (more than 2 weeks). Occasionally I feel uncomfortable and pain in the chest since second day after 2nd shot.


VAERS ID: 1492654 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-07-06
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Hyperpyrexia, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 20210709; Test Name: Hyperpyrexia; Result Unstructured Data: Fever 40.5 up to and including 42 degrees Celsius
CDC Split Type: NLJNJFOC20210739118

Write-up: JOINT PAIN; NAUSEA; HEADACHE; FATIGUE; FEVER 40.5 TO 42 DEGREES CELSIUS; This spontaneous report received from a consumer via a Regulatory Authority (NL-LRB-00620834) concerned an 18 year old female of unknown race and ethnicity. The patient''s weight was 59 kilograms, and height was 165 centimeters. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) frequency 1 total, 0.5ml, 1 dosage forms, administered on 06-JUL-2021 for covid-19 immunisation. Drug start period was 6 hours. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 06-JUL-2021, the patient experienced fever 40.5 to 42 degrees Celsius, fatigue and headache. On 08-JUL-2021, the patient experienced nausea. On 09-JUL-2021, Laboratory data included: Hyperpyrexia (not provided) Fever 40.5 up to and including 42 degrees Celsius. On 11-JUL-2021, the patient experienced joint pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever 40.5 to 42 degrees celsius on 10-JUL-2021, nausea, and headache on 08-JUL-2021, and had not recovered from fatigue, and joint pain. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210739118-COVID-19 VACCINE AD26.COV2.S-Fever 40.5 to 42 degree. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1446779 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: New York  
Vaccinated:2020-12-22
Onset:2021-07-05
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Memory impairment
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: joint pain, fatigue lost of vigor
Current Illness: none
Preexisting Conditions: hypertension, hypercholesterolemia
Allergies: no known drug or fodd allergy
Diagnostic Lab Data: none
CDC Split Type:

Write-up: persistent fatigue, joint pain and short term memory deficit


VAERS ID: 1446782 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-02
Onset:2021-07-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Deafness unilateral, Pain, Pain in extremity
SMQs:, Hearing impairment (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, Losartan/HCTZ, Duloxetine, Gabapentin
Current Illness: None
Preexisting Conditions: High blood pressure, high Cholesterol and Fibromyalgia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received vaccine on 07/02/2021 at 9:00am. Woke up on 07/05/2021 with hearing loss in right ear. Arm soreness starting 07/04/2021. Chills and full body aches started 07/02/2021 in the evening and again 07/03/2021 in the evening but only in the evenings.


VAERS ID: 1446794 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Injection site pain
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad)

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

Write-up: Patient presents with dizziness and pain in inoculation area after vaccine.


VAERS ID: 1446797 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: PCOS
Allergies: Neomycin, Aleve, apples, strawberries, medrol
Diagnostic Lab Data: O2 sat 98%
CDC Split Type:

Write-up: 5-10 minutes post injection, pt complains of itching to face. Pt not scratching face. No hives, rash or redness noted. No mouth swelling. Pt denies difficulty breathing or swallowing. Pt instructed to remain in clinic an additional 15 minutes.


VAERS ID: 1446799 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Fall, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Patient developed dizziness and fell face first approximately 10 minutes after receiving vaccine. EMS called. Blood pressure normal. Heart rate 54. Blood sugar normal. Patient stated loss of consciousness. Patient refused to go to the hospital.


VAERS ID: 1446800 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: influenza vaccine, other information unknow
Other Medications: escitalopram 10mg, montelukast 10mg
Current Illness:
Preexisting Conditions:
Allergies: azithromycin, cefdinir, cetirizine, clindamycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted while seated on immunization bench after receiving vaccination, approximately 30 second after while talking with her. She slouched to her side and lost unconsciousness for about 10 seconds. Patient and parent noted that patient has previously fainted after receiving vaccinations (she mentioned influenza vaccine), and even while seeing injections given on tv. They did not appear to be very concerned about situation. Patient was given water, was observed, and rested for another 15 minutes before she was ready to leave.


VAERS ID: 1446830 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-03
Onset:2021-07-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: no known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient woke up on 7/5/2021 with a swollen left hand (same arm as injection). She stated it is red and hot to the touch. She is also feeling a throbbing pain. Pharmacist advised her to take some ibuprofen and put ice on the hand to see if it resolved the problem. Pharmacist advised her to seek medication treatment if medication and ice did not help. Patient was also notified to let primary care physician know the next business day of reaction.


VAERS ID: 1446836 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: patient''s mom states any needle stick or vaccine causes this reaction
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: pt started feeling cold and clammy with numbness in left arm and legs; mom states that this is a normal reaction after blood draws or any injections; patient didn''t reveal this when screening questions were asked. gave pt water and wash cloth to use and checked bp; BP was 107/75 with a pulse of 57; observed pt for 30 minutes and pt expressed no more symptoms and feeling much better, refused EMS and Mom stated she was a trauma nurse and didn''t feel need for further intervention; pt left pharmacy after 40 minutes post immunization


VAERS ID: 1446837 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia oral, Paraesthesia oral, Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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: PATIENT ON LOVENOX, BAB Y ASPIRIN AND FOLIC ACID. AND ZYRTEC
Current Illness: NO ILLNESS
Preexisting Conditions: NO HEALTH CONDITIONS. AND HAD BABY 05/17/21
Allergies: ALLERGIC TO PEANUTS, PEANUT BUTTER, AND ALL TREE NUTS. ALLERGIC TO PCN, CEFTIN, AND CEPHALEXIN
Diagnostic Lab Data: NONE SHE WILL CALL PRIMARY MD
CDC Split Type:

Write-up: PATIENT MOUTH NUMB, AND LIPS TINGLING, THROAT SCRATCHY. GAVE 50MG DIPHENHYDRAMINE WATCHED FOR 30 MINUTES. PATIENT GOT SOMEONE TO PICK UP. SHE WAS MUCH BETTER WHEN SHE LEFT.


VAERS ID: 1446845 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Malaise, Nausea, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: no known illnesses
Preexisting Conditions: Hypertension
Allergies: no known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortly after receiving the vaccine during the observation period, patient complained she was not feeling well. Symptoms include dizziness, shaking, nausea, and feeling hot. Patient was provided bottled water. Patient requested EMS response who arrived within 5 to 10 minutes. EMS checked on patient and carried her to emergency room.


VAERS ID: 1446872 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension; Thyroid (hypothyroidism).
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt received vaccine from Pfizer on 6/14/21 and came in at 3 weeks for her second dose, but MODERNA was given by mistake. Pt 30 minutes after the vaccine was given she felt fine.


VAERS ID: 1446876 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: PATIENT WAS GIVEN COVID VACCINE AT 9:13AM. Patient was slightly nervous, covid vaccine was adminstered as normal routine. Patient was tense, slight blood at adminstration site. Left arm was wiped with pad, and given band-aid. After 30 seconds patient passed out on chair with faint response. I IMMEDIATELTY called 911 and ambulance came to observe patient. Ptaient became response, mother assured she had "Anxiety" and she left pharmacy.


VAERS ID: 1446881 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Skin discolouration
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: unknown
Current Illness: nka
Preexisting Conditions: no health conditions
Allergies:
Diagnostic Lab Data: unkown
CDC Split Type:

Write-up: patient got very dizzy, with an almost "grey" color to skin. She had not eaten anything before vaccine. Given a coke to drink by dad and monitored for 15 minutes. Patient had full color back when she left and felt so much better


VAERS ID: 1446890 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Dizziness, Feeling hot
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)

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

Write-up: Patient complained of lightheadedness, slight vision loss, and feeling overheated. This lasted for maybe a few minutes; laying down on his back helped relieve the symptoms.


VAERS ID: 1446897 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip pruritus, Lip swelling, Oral pruritus, Paraesthesia oral, Swollen tongue, Tongue pruritus
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient began experiencing tingling and itching of the tongue and mouth roughly 15 minutes following 2nd Moderna vaccine. No issues with 1st dose aside from fatigue and arm soreness. Reported the tingling began on the tip of her tongue, migrating to the base. No throat involvement, full breath was drawn with no issues. Benadryl 25 mg was given orally and patient waited an additional 20 minutes. Swelling and itching of lips as well as tongue began to subside and pt left with intent for husband to drive her home; instructed to seek emergent medical attention if s/sx worsened or returned.


VAERS ID: 1446920 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-02
Onset:2021-07-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Dizziness, Headache, Nausea, Pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient called to let us know that about 12 hours after receiving the Moderna vaccine she had stomach upset and felt like vomiting. As she was walking to the bathroom she became very dizzy and fainted . Her husband was home and was able to bring her to . She is okay except for body pain from the fall and a headache. She is going to go to the doctor to get checked just to be on the safe side.


VAERS ID: 1446926 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt felt dizzy but did not lose consciousness and lasted less than 1 min. Pt was 19 yo with Moderna covid 19 vaccine
Other Medications: NA
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: NKDA
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt was administered Pfizer instead of Moderna which is what she was supposed to get for her second dose. Pt had no reactions while she was waiting in pharmacy


VAERS ID: 1446944 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH WE0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dyspnoea, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: pt described swelling of tongue and difficulty breathing administered 25mg liquid Benadryl and 0.3mg EpiPen emergency services was called, emt check out pt, advised likely anxiety related reaction


VAERS ID: 1446956 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 fainted


VAERS ID: 1446963 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Eye movement disorder, Fall, Respiratory rate increased
SMQs:, Anaphylactic reaction (broad), Accidents and injuries (narrow), Ocular motility disorders (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: patient was admitted to the hospital (ER)
CDC Split Type:

Write-up: Patient was given a Janssen Covid 19 shot on 7/5/21 around noon. After the shot we talked about different side affects and he had a few questions about adverse reactions. I had him sit down for 15 minutes while I finished his paperwork. As i was walking back from the immunization room toward the pharmacy I saw him drop his phone and he fell to the ground. I tried to reach for him but was not close enough to break his fall. I saw his eye roll back and his face turn very red. He was breathing very fast and loud. He regained consciousness and I told him 911 way on the way and to please try to relax his breathing. His brother was with me the whole time talking to him and reassuring that everything was ok. The paramedics came and hooked up a monitor. They were asking all sorts of questions to everyone in the area. I went back into the pharmacy and he walked out to the ambulance with his family and was taken to the hospital.


VAERS ID: 1446980 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Patient reported history of fainting after vaccination after questioning, said no history of fainting on VAR form
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Roughly 10 minutes after vaccination patient had fainted in their chair, patient''s mother helped daughter remain in char. Patient was given water and an ice pack and felt fully recovered after about 15 more minutes. Patient did not want 911 called and was ready to leave.


VAERS ID: 1447004 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / IM

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

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

Write-up: Fainting after administration, within minutes of receiving vaccine. Short episode, only fainted for a second.


VAERS ID: 1447017 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21 / N/A RA / IM

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

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

Write-up: Patient fainted about 15 minutes after receiving Janssen Covid-19 vaccine. She lost consciousness for about 3-5 minutes. She continued to breath and was not cyanotic. After 3-5 minutes she regained consciousness. She reported that she had experienced this before with injections. I had her remain in the pharmacy for an additional 30 minutes and checked her blood pressure twice. The second BP check was at 2:05pm and her BP was 108/68. The patient left the pharmacy at 2:05pm.


VAERS ID: 1447026 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Chills, Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: the patient soon after receiving the vaccine started to sweat profusely and felt extremely light headed. we had him sit for a few minutes and drink some water and took his blood glucose to see if it might by hypoglycemia--results were normal (148)-- the patient started to shiver and experience chills but after about 10 minutes the patient started to feel better and in an additional 10 minutes was back to normal. his issues resolved on their own.


VAERS ID: 1447028 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 RA / IM

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

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

Write-up: Immediately afterwards she passed out and peed her pants. Her mom was sitting next to her and was able to catch her and support her.


VAERS ID: 1447034 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

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

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

Write-up: PT wasn''t feeling good and appeared pale white after administration of the vaccine. pt fell unconsisious after 5 mins and emt was called. pt refused to go to hospital with them


VAERS ID: 1447041 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient was not currently taking any prescriptions, over-the-counter medications, dietary supplements, or herbal remedies being taken at the time of vaccination:
Current Illness: Patient did not have any illnesses at the time of vaccination and up to one month prior.
Preexisting Conditions: Patient did not have any chronic or long-standing health conditions
Allergies: Patient stated she did not have any allergies to medications, food, or other products
Diagnostic Lab Data: No medical tests or lab results.
CDC Split Type:

Write-up: Patient was given 1 dose of the Jansen Covid Vaccine in the left deltoid by the administering intern. Within 30 seconds the patient became light headed, dizzy and upon standing up, then fainted. Intern notified the pharmacist on duty immediately. The RPh attempted to communicate with the patient of which she was unresponsive. RPh then informed technician to call 911. Patient was red in the face, arms and very hot upon touch. Patients eyes were open but was not lucid of responsive to questions. RPh then administered 1 dose of an Epi-pen. Patient immediately became responsive upon first Epi-Pen administration and was able to sit-up and communicate with pharmacy staff. Patient declined 911 services upon being informed of 911 being called. Patient was able to sit-up and talk stated that she was fine. Patient called her mother to come and get her from the pharmacy after resting for roughly 20min in the immunization room. Pharmacist on duty followed-up with patient about 4 hours later to check-in with how patient was doing. Patient stated she was a little jittery from the epi-pen but otherwise feeling fine. Due to the holiday, RPh told patient she would follow up with the patient and the patients primary care the following day (07/06/21), along with informing patient to also follow up with her Primary Care.


VAERS ID: 1447050 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Seasonal allergies, DDD lumbar spine
Allergies: Wellbutrin, Bactrim
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received vaccine and went to wait in the waiting room, she then notified staff that she had a metal taste in her mouth. She waited thirty minutes in the clinic. She stated that the metal taste went away quickly. She guessed around the fifteen minute mark. She walked out of the clinic with no assistance needed.


VAERS ID: 1447077 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW173 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose, Dizziness, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: Blood Glucose Test and assessment of the following Skin Vitals, BP, Pulse Rate, Oxygen Saturation, Respiratory Rate/ Quality, pupils
CDC Split Type:

Write-up: Patient received vaccine in right Deltoid, immediately following administration pt stated to nurse ?I feel like everything is going dark and I''m going to pass out. Nurses then escorted the vehicle the pt was in to observation where they assisted the ambulatory pt from the passenger side of the vehicle to the observation tent. Pt was placed on the stretcher in a very mild trendelenburg position. Skin Vitals, BP, Pulse Rate, Oxygen Saturation, Respiratory Rate/ Quality, pupils were all assessed with unremarkable findings. A BG test was performed with a reading of 110. Water was provided to pt and supportive care was continued for 15 minutes. At which point the pt stated ?I feel much better. Pt was encouraged to stay another 15 minutes for further observation. Pt did remain in observation for an additional 15 minutes but she stayed in her brother vehicle with her brother. Upon completion of the 15mins pt stated I feel fine. Providers then felt comfortable with her leaving the site as she was with her brother and would be with family all day.


VAERS ID: 1447086 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-05
Onset:2021-07-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Seizure like phenomena, Vomiting
SMQs:, Acute pancreatitis (broad), Convulsions (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient has adverse reaction" seizure "like response. She was awake but not reacting when question was asked. She vomited and she said she was filling better afterwards. 911 was called and she was taken to the hospital. This was her second shot and she had no reaction with first one.


VAERS ID: 1447087 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-05
Onset:2021-07-05
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: SWOLLEN LYMPH NODES IN COLLARBONE AREA OF INJECTION SIDE THAT WERE GROSSLY PRESENT FOR 3 WEEKS, UP UNTIL RECEIVING SECOND DOSE


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