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From the 7/16/2021 release of VAERS data:

Found 479,813 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 78 out of 4,799

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VAERS ID: 1446681 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-18
Onset:2021-06-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Culture positive, Herpes virus infection, Infection, Rash, Swelling face
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: Blistering rash on side of face. Resulted in infection and swelling on right side of face and under eye. Blister was swabbed and cultured by attending physician and came back as Herpes. Patient was put on antibiotics immediately and Valtrex after culture diagnosis was returned.


VAERS ID: 1446808 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 3 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
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: UNK
Current Illness: UNK
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: NURSING HOME WAS NOT INFORMED THE RESIDENT HAD A PREVIOUS VACCINE BEFORE ENTERING FACILITY. THEREFORE THE RESIDENT RECIEVED #2 DOSES OF MODERNA VACCINE AND PREVIOUS DOSE OF PFIZER. PHARMACY FOUND OUT WHILE ENTERING IT INTO THE VACCINE SYSTEM. INFORMED HOME BUT PATIENT WAS DOING FINE.


VAERS ID: 1446810 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cold sweat, Fatigue, Hot flush, Impaired work ability, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Woke up with cold sweats on 6/22/2021. By late morning spiked a fever (100.4) and was very tired. Switched between cold chills and hot flashes. Sent home from work and slept for about 3 hours in mid afternoon. Once awake, felt much better. Symptoms gone by dinner time. Took Ibuprofin.


VAERS ID: 1446813 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Disorientation, Fatigue, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: The next afternoon around 1pm, became tired, achy, disoriented, low grade fever (99.8), headache. Took ibuprofen about 4pm. Felt this way for a couple of days. About 2 days after the 2nd vaccine for COVID my right armpit began to ache and continued to do so for about a week. All symptoms were gone within a week.


VAERS ID: 1446826 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-18
Onset:2021-06-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident
SMQs:, 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)

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

Write-up: patient suffered a stroke and was hospitalized on june 22 2021 week long stay in hospital facility


VAERS ID: 1446882 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient fainted and seized for approximately 30 seconds and regained consciousness about a minute after. Patient felt dizzy and lightheaded.


VAERS ID: 1446992 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-22
Onset:2021-06-22
   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 ER8735 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Cardiac discomfort, Chest discomfort, Fear
SMQs:, Anaphylactic reaction (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: Gemfibrozil, Omeprazole, Trazodone, multivitamin, ginko biloba, fish oil
Current Illness: none
Preexisting Conditions: high LDL cholesterol
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: I''ve been experiencing intermittent sensations in my upper and lower chest [lung and heart] area since I received my 2nd Pfizer vaccination shot on June 22, 2021. It?s been happening for two weeks, today but I?m only now reporting it because I?m getting concerned. Each time it?s happened, it lasts for a couple of hours and it''s scaring me. I feel pressure in there like something?s not right. I?m not paranoid but I am concerned and want to report it.


VAERS ID: 1447131 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Fatigue, Menstruation irregular, Oligomenorrhoea, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: I do not have so I send the mail because I want to know what to do
CDC Split Type:

Write-up: I work in public security. On June 22, they gave me the Johnson vaccine, at 11:15 a.m., that day I get off at night and to this day I continue to menstruate a lot and many clots I went to the gynecologist and he gave me contraceptives to cut the period but I am still menstruating a lot and I feel weak and would like information or what can I do? I do not omit that days before the Johnson vaccine I had my menstruation which was June 17, 18, 19 and on the 20th it stopped, (which was my normal period without any anomaly), on Tuesday June 22 when I got the vaccine for the Tomorrow night I started to menstruate, it is already 14 days menstruating a lot, which is not normal, I feel my body weak and tired. I hope news soon I would appreciate it very much!


VAERS ID: 1447336 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Chest pain, Chills, Dizziness, Dyspnoea, Electrocardiogram, Fatigue, Gait disturbance, Headache, Nausea, Pain, Pain in extremity, Palpitations, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, Jardiance, Viibryd, Rexulti, Atorvastatin, Levocetirizine, Advil
Current Illness: None
Preexisting Conditions: Diabetes, Fibro myalgia
Allergies: Naproxen
Diagnostic Lab Data: EKG done on June 29th, 2021
CDC Split Type:

Write-up: At 2:30am on June 22nd, 2021, i woke up with a terrible headache. I took some Advil and went back to sleep. At 5:30am I woke up and had body aches, chills, nausea, a 99.9 degree fever, and my arm was terribly sore. When i woke again at 7:30am i felt like had been hit by a truck. Extremely tired and weak. By mid afternoon i realized my chest was pounding and i had very frequent chest pain. After a few days passed with no improvement, i went to my Dr. to see if there was anything i could do because i was so dizzy and light headed that i was having trouble walking across the room without falling over or losing my breath. He ordered an EKG which was done at the Hospital. The results came back normal. By I''m still having trouble with catching my breath after doing very minor tasks. I still have chest pain and palpitations. Whereas I did not have these problems prior to receiving the second dose of the Moderna vaccine.


VAERS ID: 1447339 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-26
Onset:2021-06-22
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Blood albumin increased, Blood glucose normal, Blood sodium decreased, Laboratory test, SARS-CoV-2 test negative, Vertigo, Vitamin D
SMQs:, Liver related investigations, signs and symptoms (narrow), Hyponatraemia/SIADH (narrow), Vestibular disorders (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: glipizide; Trulicity; Metformin; Irbesartan; Atorvastatin
Current Illness: Slight cough
Preexisting Conditions: Type II Diabetes Sleep Apnea
Allergies: None known
Diagnostic Lab Data: 6/22/2021 - COVID-19 - Negative 6/28/2021 - Blood Test - Sodium 134 mEq/L; Glucose 141 mg/dL (non fasting; meal 1 hour before test); Albumin 5.1 g/dL; SGPT (ALT) - 58 U/L; Vitamin D 26.0 ng/mL
CDC Split Type:

Write-up: Experienced a bad case of vertigo. Urgent Care doctor prescribed Meclizine. Meclizine had no affect so I discontinued use,


VAERS ID: 1449725 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination complication
SMQs:

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

Write-up: Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Additional Details: Patient is still experiencing severe pain on injection site area. "COVID ARM" symptoms.


VAERS ID: 1449764 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Head injury, Joint injury, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Additional Details: Patient fainted after several minutes of the vaccine administration. She hit her head and twisted her ankle when she fainted according to witnesses/mother.


VAERS ID: 1450045 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-24
Onset:2021-06-22
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: R56.9 - Unspecified convulsions


VAERS ID: 1450328 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-12
Onset:2021-06-22
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Bell's palsy, Blood test normal, Ear pain, Facial paralysis, Nasopharyngitis
SMQs:, Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

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

Write-up: Received COVID #2 on 6/12 and developed cold symptoms with ear pain and loss of taste. On 6/22/2021, developed right facial droop and was seen in the ER - diag with Bell''s palsy and placed on Abx, Prednisone, and acyclovir. Lyme came back negative. Was seen in f/u 6/25 in clinic with improved but still apparent right facial droop. Abx discontinued at that point. He is doing much better now (7/6) with some residual facial droop.


VAERS ID: 1450349 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-24
Onset:2021-06-22
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaemia, Decreased appetite, Fatigue, Haemoglobin decreased, Somnolence
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No Medications
Current Illness: Stomach issues prior to this
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Continual tests for anemia.
CDC Split Type:

Write-up: Became Anemic, with hemoglobin going to 7, became very tired, sleepy, loss of appetite.


VAERS ID: 1450411 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-17
Onset:2021-06-22
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

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

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

Write-up: 3-4 days later I broke out into hives and red patches on my body. They seem to come and go, it''s been almost 3 weeks. It goes from arm to arm, my body, my eye, finger, hands and feet. I have been taken Reactine, but not all the time. I''m using cream to help with the itching.


VAERS ID: 1450522 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-05-22
Onset:2021-06-22
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Nodule
SMQs:, Guillain-Barre 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: blue relief exract
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 days after the vaccine was given knot appeared on shoulder. after a week the knot moved to neck . went to doctor and was given antibiotics. a week later problem persist. was given steroids . Had no strength in left arm. problem has gotten better.


VAERS ID: 1451994 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-19
Onset:2021-06-22
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test abnormal, Chills, Fatigue, Pain, Pyrexia, Vitamin D decreased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Severe Airborne allergies
Allergies: None
Diagnostic Lab Data: The only thing detected in blood work was low vitamin D.
CDC Split Type:

Write-up: At time of vaccine, developed fever, body aches, chills. Have been experiencing extreme fatigue now. It sure of it''s related to the vaccine, or the virus which I had I. January or something else .


VAERS ID: 1452592 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-08
Onset:2021-06-22
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 RA / 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness:
Preexisting Conditions:
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT REPORTED 2 WEEKS AFTER VACCINATION SHE HAD AN ITCHY RASH. NEEDED TO GET OINTMENT FROM PRIMARY CARE DOCTOR . THE RASH ALSO SPREAD TO HER ABDOMEN. TOOK ABOUT 1 WEEK TO RESOLVE


VAERS ID: 1453765 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-08
Onset:2021-06-22
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Inappropriate schedule of product administration
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (Known Allergies: Penicillin)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021758775

Write-up: female patient received the first dose on 08May2021 and second dose on 08May2021 for covid-19 immunisation; fatigue; hard time of breathing; This is a spontaneous report from contactable consumer. A 44-years-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for Injection, Batch/Lot number: EW0176) via an unspecified route of administration, administered in Arm Left on 08May2021 at 13:00 and second dose via an unspecified route of administration, administered in Arm Left on 08May2021 (Batch/Lot Number: EW0185) as single dose for covid-19 immunisation. The patient''s relevant medical history included drug hypersensitivity from penicillin. The patient''s concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 22Jun2021 at 12:30 PM, patient experienced fatigue and had a momentary hard time of breathing. Patient ended up laying down for about 15 minutes and was able to continue the day. AE resulted in congenital anomaly or birth defect. Patient did not received any treatment. The outcome of the events fatigue and hard time of breathing was recovered on 22Jun2021 and another event was unknown. Information on Lot/Batch number was available. Additional information has been requested


VAERS ID: 1453901 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-01
Onset:2021-06-22
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: No symptoms or reactions were developed by client


VAERS ID: 1453902 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-11
Onset:2021-06-22
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: No symptoms or adverse reactions were reported by client


VAERS ID: 1453903 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-10
Onset:2021-06-22
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: No symptoms or adverse reactions were reported by client


VAERS ID: 1453904 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-27
Onset:2021-06-22
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: No symptoms or adverse reactions reported by client


VAERS ID: 1454086 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-29
Onset:2021-06-22
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Fatigue, Lymphadenopathy, Oropharyngeal pain, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot- swollen, sore arm
Other Medications: cetirizine, Vitamins: Multiple vitamin, B complex,C,D3, E, Lutein, calcium, zinc, CoQ10, tumeric
Current Illness: none
Preexisting Conditions: allergies, vertigo
Allergies: sulfa drugs, all raw fruit with pits, jicama, blossom end of raw peas and beans, hazelnuts, hot pepper seeds if near them
Diagnostic Lab Data: Covid-19 test -6/28/21 negative Strep test -6/28/21 negative
CDC Split Type:

Write-up: Cough, sore throat, swollen glands, weakness, tiredness After about two weeks the symptoms lessoned substantially. I was given a Covid-19 test and a strep test. Both were negative. The PA prescribed lots of liquids and lots of rest.. That is what I have been doing and the symptoms have gradually lessened.


VAERS ID: 1454094 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-08
Onset:2021-06-22
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Antinuclear antibody negative, Bleeding time prolonged, Contusion, Full blood count abnormal, Immune thrombocytopenia, Platelet count decreased, SARS-CoV-2 antibody test, SARS-CoV-2 antibody test positive, Thrombocytopenia
SMQs:, Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (narrow), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: The patient presented on 6/22/2021 with bruising to the lower extremities and longer than usual bleeding from a cut he had on his right leg. The patient had a CBC done and showed he had thrombocytopenia with a platelet count of 15,000. He was evaluated by hematology and the CBC repeated and showed platelet count was indeed very low at 13,000. He was diagnosed with immune thrombocytopenic purpura. No treatment was given, observation only. Patient had Covid antibodies performed and on 7/1/2021 he had a positive IgM antibody to COVID-19 and a negative IgG antibody to COVID-19. He was ANA negative. His platelet antibodies were positive confirming the diagnosis of autoimmune thrombocytopenia.
CDC Split Type:

Write-up: The patient presented on 6/22/2021 with bruising to the lower extremities and longer than usual bleeding from a cut he had on his right leg. The patient had a CBC done and showed he had thrombocytopenia with a platelet count of 15,000. He was evaluated by hematology and the CBC repeated and showed platelet count was indeed very low at 13,000. He was diagnosed with immune thrombocytopenic purpura. No treatment was given, observation only. Patient had Covid antibodies performed and on 7/1/2021 he had a positive IgM antibody to COVID-19 and a negative IgG antibody to COVID-19. He was ANA negative. His platelet antibodies were positive confirming the diagnosis of autoimmune thrombocytopenia.


VAERS ID: 1454130 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-02
Onset:2021-06-22
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pain in extremity, SARS-CoV-2 test
SMQs:, Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lasartin Asprin Vitamin C
Current Illness: None
Preexisting Conditions: Asthma
Allergies: penicillin Vacoymimcin
Diagnostic Lab Data: covid test
CDC Split Type: vsafe

Write-up: I had a headache and pain in my arm.


VAERS ID: 1454279 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache
SMQs:

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

Write-up: headache for 5 days straight took tylenol


VAERS ID: 1454491 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: Site: Pain at Injection Site-Mild


VAERS ID: 1454789 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient reported taking cough syrup and Mucovibrol C
Current Illness: Patient reported consistent coughing and similar vomiting episode the week before.
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data: None
CDC Split Type:

Write-up: At approximately 1039, lead nurse saw patient with her hands around her throat. Patient immediately ran out the room with mother. Lead nurse followed patient outside. Patient vomited outside. Patient''s mother reported that her daughter has been coughing for the past week and had a similar vomiting episode last week. Patient''s mother reported they did not report this to the patient''s vaccinator. Patient''s mother reported seeing a doctor for her daughter last week. Their doctor prescribed Mucovibrol C and patient reported taking the medication in the morning. Patient denied difficulty swallowing, difficulty breathing, itchiness, rashes, and hives. At approximately 1045, EMT offered to take patient''s vital signs. Patient refused vital signs. Patient and mother given water and sat outside for further observation, accompanied by EMT . At 1104, EMT offered to take patient''s vital signs. Patient refused vital signs. At 1107, patient reported she felt good. Lead nurse educated patient and mother on signs/symptoms of when to seek emergency care, to sign up on v-safe, and to follow up with primary care provider. At approximately 1108, patient left facility with unlabored respirations and steady gait.


VAERS ID: 1455749 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Headache, Laboratory test, Pain, Visual impairment, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbrurin Blood pressure med Allegra Flomax Zantac Zoloft
Current Illness: None
Preexisting Conditions: Head injury 17 years ago Neck surgery 2 times
Allergies: Penncillin Zrytec Nuts
Diagnostic Lab Data: Just immune response done
CDC Split Type:

Write-up: Heqdache severe throwing up fatigue and outvof breathe alot having vision Horroble headache Chest pain Shortness of breathe Pain all over body


VAERS ID: 1456688 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Maternal exposure during pregnancy, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021775942

Write-up: Severe diarrhea for 48 hours; fever; muscle aches; chills; Is_pregnant: Yes; This is a spontaneous report from a non-contactable consumer (patient). This is a (maternal or fetus/baby) report. A 29-year-old pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: Ew0180), via an unspecified route of administration, administered in arm left on 22Jun2021 at 12:15 (29-year-old at the time of vaccination) as single dose for COVID-19 immunisation. Medical history was none. The patient''s concomitant medications were not reported. Previously patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: Ew0186), via an unspecified route of administration, administered in arm left on 01Jun2021 (29-year-old at the time of vaccination) as single dose for COVID-19 immunisation and resulted maternal exposure during pregnancy. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient did not receive any other medications within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. On 22Jun2021 patient was pregnant and on the same day at 01:00, she experienced severe diarrhea for 48 hours, fever, muscle aches and chills. The adverse event resulted in doctor or other healthcare professional office/clinic visit. The mother reported she became pregnant while taking bnt162b2. She was 19 weeks pregnant at the onset of the event. Her LMP was on 08Feb2021. The mother was due to deliver on 15Nov2021. Patient did not receive any treatment for the events. Outcome of the event maternal exposure during pregnancy was unknown and was resolving for all other events. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1456771 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-06-16
Onset:2021-06-22
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, Fertility 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: Nexplanon implant
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I received my first dose of the Pfizer vaccine on June 16th, the day after I started menstruating. My period did not end until July 3rd resulting in 19 days of bleeding.


VAERS ID: 1457396 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

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

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

Write-up: Moderna was given to patient 1 day after expiration day on vial. Called manufacture and they recommended no need to revaccinate patient.


VAERS ID: 1457422 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

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

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

Write-up: Moderna was given to patient 1 day after expiration day on vial. Called manufacture and they recommended no need to revaccinate patient.


VAERS ID: 1457453 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

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

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

Write-up: Moderna was given to patient 1 day after expiration day on vial. Called manufacture and they recommended no need to revaccinate patient.


VAERS ID: 1457484 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Maple trees
Diagnostic Lab Data: Blood drawn (7/8/2021)
CDC Split Type:

Write-up: On and off headaches every day for the past two weeks. On 7/6/2021 and 7/7/2021 had severe nose bleeds. Had headache on 7/8/2021


VAERS ID: 1457504 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

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

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

Write-up: Moderna was given to patient 1 day after expiration day on vial. Called manufacture and they recommended no need to revaccinate patient.


VAERS ID: 1457515 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-02
Onset:2021-06-22
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: N93.9 - Abnormal uterine and vaginal bleeding, unspecified


VAERS ID: 1457591 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-18
Onset:2021-06-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Blood test normal, Cardiac flutter, Cardiac stress test normal, Chest discomfort, Chest pain, Decreased appetite, Dysphagia, Electrocardiogram normal, Heart rate irregular, Palpitations, Sensation of foreign body, Ultrasound scan normal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Tachyarrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderal and Testosterone Replacement Therapy
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: ER visit on 6/23/2021 with EKG reading and multiple blood tests done through tour the 3-1/2 hours I was there. Then I finally got into a cardiologist appointment on 7/6/2021 went through an ultrasound, then a treadmill stress test and an ultrasound again. But by that time my heart flutters and what not were gone. So I don?t know if anything was missed.
CDC Split Type:

Write-up: 4 days after my second vaccine of Pfizer COVID vaccine. I felt chest pain. Day 5 I went to ER for chest pains along with what felt like heart flutters, irregular heartbeat and excessive pounding. I had one of those 3 constantly happened for 10 days but ER read nothing wrong. As chest pains started to ease up I noticed I am getting constant bloating feeling, swollowing is not difficult but not easy either. Like something is lodged in my throat. Not really hungry do to all of this either. Now my heart went back to normal. After 10 days and ran through a series of test from the cardiologist. It all came back good. I?m happy about that, I still have minimal chest pressure and bloating excessive bloating that goes with mid section of the body being achy/painful. I have been a super healthy person all my life and as I get older I change things to better my health. I hope all this goes away but hopefully others are reporting more like this so I can get some answers sooner rather than later before it?s bad news. Thank you for your time.


VAERS ID: 1457689 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-14
Onset:2021-06-22
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenopathy, Pain in extremity, Peripheral swelling, Post-acute COVID-19 syndrome, Pruritus, Rash, Skin discolouration, 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), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Cosentyx, Dulera, Lexapro, Daily multivitamin, Biotin, Vitamin D3.
Current Illness: None
Preexisting Conditions: Ankylosing Spondylitis, Asthma, IBS, GERD
Allergies: Demerol and Penicillin
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: "Covid arm" 8 days after shot. I got a dark spot first, then a rash developed. My arm swelled, got hot, and started itching and hurting. I called my PCP, and he told me to go to urgent care right away. The urgent care doc said it was a localized delayed allergic reaction to the vaccine and the lymph nodes in my left armpit were swollen. I had a regular dr. appt 3 days later, and the doc said the lymph nodes in my neck were also swollen. Everything healed in about 10 days.


VAERS ID: 1460018 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-08
Onset:2021-06-22
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Chills, Computerised tomogram head, Computerised tomogram normal, Dyspnoea, Electrocardiogram normal, Fatigue, Headache, Laboratory test normal, Nodule, Pyrexia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Ibuprofen at childhood
Diagnostic Lab Data: Urgent care 7/6/21- CT of head normal, labs normal, EKG normal
CDC Split Type:

Write-up: Fatigue, chills, slight fever headache- within first 24 hours Nodule felt on right temple area- 8 days after vaccine Headaches on both temples- 8 days after vaccine Slight blurry vision left eye- 1-2 weeks after vaccine Headaches left temple- 2-4 weeks after vaccine Left sided chest pain with difficulty taking deep breath lasting 2-3 days- 3 weeks after vaccine


VAERS ID: 1460391 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-15
Onset:2021-06-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Musculoskeletal stiffness, Neck pain
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (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: Rizatriptan (Maxalt)
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely stiff neck and upper back with pain


VAERS ID: 1461720 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: Chest pain for 2 days


VAERS ID: 1461877 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Diarrhoea, Heart rate irregular, Hyperhidrosis, Nausea, Palpitations
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metagenix pro-multi vitamin
Current Illness: None
Preexisting Conditions: Slight mitral valve prolapse
Allergies: Sulfa allergy
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Woke up next morning around 6a to racing and irregular heart beat, sweating, nausea and diarrhea. Those symptoms persisted for about 24 hours. Intermittent chest pains have been present ever since, lessening in frequency though.


VAERS ID: 1462041 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-25
Onset:2021-06-22
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

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

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

Write-up: Pt with history of COVID illness (January 2021) and fully vaccinated now inpatient with positive COVID PCR test


VAERS ID: 1463391 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-28
Onset:2021-06-22
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Shingles


VAERS ID: 1463620 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-19
Onset:2021-06-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / UNK LA / IM

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

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

Write-up: starting 4 to 5 days following the vaccine, she developed a bilateral rash with hives from the top of her hands to above the elbows.


VAERS ID: 1464211 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-01-16
Onset:2021-06-22
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR UJ552AA / 1 LA / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH M79320 / 1 RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS U6518AA / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure increased, Mental status changes, Nausea, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (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: REFER TO ADDITIONAL INFORMATION FOR ITEM 9ACCU-CHECK AVIVA PLUIS TEST STRIP, ACETAMINOPHEN 500MG, ALCOHOL SWABS, ASPIRIN 81MG, BRINZOLAMIDE 1% OPHTHALMIC SUSPENSION, CALCIUM CARB-CHOLECALCIFEROL, CRANBERRY 400MG, DICYCLOMINE 10MG, FLUTICASO
Current Illness: REFER TO ADDITIONAL INFORMATION FOR ITEM 9DIABETES CHRONIC ULCERS TO BILATERAL TOE
Preexisting Conditions: DIABETES, RLS, OSTEOPOROSIS, IBS, HTN
Allergies: PENICILLINS
Diagnostic Lab Data:
CDC Split Type:

Write-up: ALTERED MENTAL STATUS, SHAKING, NAUSEA, ELEVATED BP


VAERS ID: 1464229 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-19
Onset:2021-06-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000-01 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Limb discomfort, Muscular weakness, Neuralgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Amlod/benazepril 5/20
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: In office exam with primary care physician 7/12/2021.
CDC Split Type:

Write-up: Nerve pain in both upper arms, heavy pressure in both upper arms, nerve pain in neck and noticable weakness in both arms.


VAERS ID: 1464502 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Eczema, Erythema, Eye swelling, Feeling hot, Headache, Ocular hyperaemia, Pruritus, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (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: Dupixient
Other Medications: paxil cr, singulair, asthmanex twist inahler, melatonin.
Current Illness: none
Preexisting Conditions: asthma and eczema
Allergies: Sulfa, Nickel, Gluten and normal indoor/outdoor allergens to dust, pollen.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After 4 hours of 1st injection started to feel heat and swelling of face. In the morning woke up to red swollen cheeks and eyes. Itching sporadic over entire body. Eczema that was dormant flared on legs and upper arms. Severe headache which did not respond to Tylenol.


VAERS ID: 1464680 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: Denies
Preexisting Conditions: Unknown
Allergies: NKDA
Diagnostic Lab Data: None, no health problems reported.
CDC Split Type:

Write-up: Patient was transferred from a county jail to Corrections facility. He requested a COVID Vaccine. He did not tell us he was previously vaccinated at his county jail. He was given a Moderna vaccine on 6/10/2021 by the Health Department. On 6/22/2021 he received a Janssen (J&J) vaccine from us, 12 days later. Health Department was notified. Our instructions were to repeat the vaccine in 28 days from his last dose, and that the Janssen on 6/22 is invalid due to it being given to soon from the initial Moderna dose on 6/10.


VAERS ID: 1466070 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-18
Onset:2021-06-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oral herpes
SMQs:, Oropharyngeal infections (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE
Current Illness: Cold sores (Verbatim: cold sores Patient Medical continuing: Yes); Hypothyroidism (Verbatim: Hypothyroidism Patient Medical continuing : Yes)
Preexisting Conditions: Medical History/Concurrent Conditions: Botulinum toxin injection; Shingles (Verbatim: shingles Patient Medical continuing : No)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021753926

Write-up: breaking out with a fever blister, cold sore just outside above her lip; This is a spontaneous report from a contactable consumer (patient). A 44-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot Number: EW0196), dose 1 via an unspecified route of administration, administered in Arm Right on 18Jun2021 11:10 (at the age of 44-years-old) as dose 1, single for covid-19 immunization (for health and safety, as reported). Medical history included hypothyroidism from 2008 and ongoing (Verbatim: Hypothyroidism Patient Medical continuing: Yes), shingles from an unknown date and unknown if ongoing (Verbatim: shingles Patient Medical continuing: No), cold sores from 1993 and ongoing (Verbatim: cold sores Patient Medical continuing: Yes) since she was 16 years old, botulinum toxin injection (Botox injection) from 29May2021 to 29May2021. Reportedly, additional Information for Other Conditions was this past fall. the fall of maybe 2020. it has been within the past 2 years. anywhere between fall of 2019 to fall of 2020. Concomitant medications included levothyroxine (Manufacturer of levothyro amneal) taken for hypothyroidism from 2008 to ongoing. Caller reports she received the dtap it was greater than 30 days, received tetanus shot on 23 Apr 2021. Caller states while we are documenting everything, she does receive Botox injections in my forehead. She is wondering if that should be noted. She reports she received a Botox injection 29 May 2021. On 22Jun2021 07:00, the patient experienced breaking out with a fever blister, cold sore just outside above her lip. Reporter seriousness for breaking out with a fever blister, cold sore just outside above her lip was unspecified. Event breaking out with a fever blister, cold sore just outside above her lip was reported as worsened. She received first dose of the vaccine last Friday. She is reporting breaking out with a fever blister, cold sore just outside above her lip, states that it is progressively getting worse. Suspect product: Lot number: EW0196, She thinks it is a 9 or a 4. She thinks it could be a 9, 7 or 4. Caller confirms she received vaccination on 18 Jun 2021. No Emergency Room and Physician Office visit. Outcome of the event was not recovered. Description of complaint: Levothyroxine: Caller states the NDC, Lot number, and expiration date are probably on the paper work they print out but it is not on the bottle. Product strength and count size dispensed: 125mcg Follow-up attempts are needed. Additional information been requested.


VAERS ID: 1466091 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Heart disorder; Thyroid disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021770729

Write-up: I have hives on my legs and I haven''t ever had that before until I took the shot.; This is a spontaneous report from a contactable consumer (patient). A 46-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EW0185), dose 1 via an unspecified route of administration on 21Jun2021, as single dose for COVID-19 immunisation. Medical history included heart problems, thyroid problems and asthma. The patient''s concomitant medications were not reported. After took first COVID shot on 22Jun2021, the patient noticed had hives on legs and she had not ever had that before until she took the shot and went to her doctor in few minutes. Patient stated this must be a side effect. The last night (22Jun2021) and took a very cold shower and iced the area with a bunch of ice and she called her doctor, doctor told to go and get over the counter medicine at any pharmacy and got Benadryl 25 mg. Therapeutic measures were taken as a result of event and treatment with Benadryl 25 mg. Outcome of the event was unknown. Follow-up attempts are needed;further information is expected.; Sender''s Comments: Linked Report(s):PFIZER INC-2021770789 Same reporter/product/event, different patients


VAERS ID: 1466529 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Soon after receiving the shot, I had soreness in my arm but also began experiencing numbness from the area where I received the shot all the way down to my wrist. That soreness and numbness are still there and it has been three weeks since receiving the first shot so I am concerned that this numbness is permanent. As such I do not intend to receive the next shot for fear of my arm becoming even more numb or even losing all sensation in my left arm.


VAERS ID: 1466553 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arteriogram normal, Blood test, Chest discomfort, Chest pain, Chills, Dyspnoea, Echocardiogram, Electrocardiogram, Hyperhidrosis, Injection site pain, Magnetic resonance imaging, Myocarditis, Pain, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: 06/25/2021 - Blood work, EKG, echocardiogram, arteriogram 06/26/2021- Blood work, EKG 06/30/2021- Blood work, EKG, Echocardiogram 07/06/2021- MRI
CDC Split Type:

Write-up: Woke up the next morning feeling sore at shot site and as the day progressed my body started to ache all over. For the next 2 days after this, I will alternate between having the chills and having intense sweats. On Friday 06/25/2021, I woke up to my chest hurting , I could not catch my breath, it felt like I had a very heavy weight on my chest . I went to the emergency room which is a part of the Hospital. After the initial tests the physician told me with 99% certainty that I had had a heart attack. Soon after this they rushed me by ambulance from hospital to hospital which is about 20 miles or so. They rushed me in and completed an arteriogram within minutes of arriving at the hospital. They confirmed with this test that is was not a heart attack and after several more test, the doctor that I had developed Myocarditis due to the vaccine shot. The admitted me into the hospital on 06/25/2021 for observation and to run more test until I was stable enough to go home. I stayed in the hospital for 1 evening and was discharged on 06/26/2021 at about 1:00 or 2:00 that afternoon. The doctor prescribed several medications for me to take for my heart for the next foreseeable future. On 06/30/2021 I had a visit to my new cardiologist in which he ran several test and stating that I was looking better, but he had ordered an MRI to take place on 07/06/2021 at Hospital. I have a follow up visit for my cardiologist slated for 07/19/2021 in which I will find out more information.


VAERS ID: 1466616 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-29
Onset:2021-06-22
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Impaired work ability, Pain, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Approximately three weeks after the 2nd Moderna vaccination on 6/22/2021 I noticed that when reclined in my chair watching television both my feet began to tingle and go numb. I had to stand up and walk around for about 10 minutes for the numb feeling to lessen. When I sat down again it started over again. Over the next several days the numbness continued and began to progress. The next day on 6/23/2021 when sitting at my desk working on my computer my entire leg began to feel numb starting around my calves and especially my left leg. My toes felt about 80% numb and my leg below the knee felt 20 to 50% numb. This numb feeling progressed to a burning throbbing pain in left foot. I had to stop working and stand


VAERS ID: 1466664 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Virginia  
Vaccinated:2020-12-18
Onset:2021-06-22
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Foetal death, Foetal heart rate abnormal, Twin 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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pregnancy and miscarriage. Hx: one living child born 4/19/19. No hx of miscarriage. Attempted to get pregnant ~3 months post vaccination. Taking prenatal for 3 months prior to attempt to get pregnant. Date of LMP was 3/29/2021. Found out I was pregnant was twins via vaginal US at 8 weeks. Normal growth, heartbeats present. Second OB appointment at 11 weeks 5 days. No heartbeat present with either child on US. One twin measured 9 wks 5 day, other twin measured 10 weeks. D&C completed 6/22/21. No complications.


VAERS ID: 1466695 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Headache, Oropharyngeal pain
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad)

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

Write-up: headache, sore throat, lightheadedness


VAERS ID: 1466844 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-18
Onset:2021-06-22
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient doctor stated this could be related carpel tunnel according to patient.
CDC Split Type:

Write-up: Patient is reporting tingling in right fingers and on right side of body that appeared after vaccine administration.


VAERS ID: 1466873 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 LA / IM

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

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

Write-up: Error: Patient Too Young for Vaccine Administered-


VAERS ID: 1466996 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 - / -

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

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

Write-up: After needle was retracted following vaccination, the needle broke away from the hub and a drop of vaccine fell on the patient. It was determined that a sufficient dose was given and the patient was released to home.


VAERS ID: 1467066 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lymphadenopathy, Pain
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph node/armpit, pain.


VAERS ID: 1469624 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-22
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Diarrhoea, Hyperhidrosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: IVERMECTIN
Current Illness: Immune thrombocytopenic purpura; Nervous system disorder
Preexisting Conditions: Comments: .
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210720240

Write-up: SOME LOSE BOWELS; SEVERE CHILLS; FEVER/HOT; SWEATS; This spontaneous report received from a patient concerned a 70 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included immune thrombocytopenic purpura, and multiple neurological issues, and other pre-existing medical conditions included .The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A expiry: UNKNOWN) dose was not reported, administered on 22-JUN-2021 13:15 for prophylactic vaccination. Concomitant medications included ivermectin. On 22-JUN-2021, the subject experienced sweats. On 22-JUN-2021, the subject experienced severe chills. On 22-JUN-2021, the subject experienced fever/hot. On 23-JUN-2021, the subject experienced some lose bowels. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fever/hot, severe chills, and sweats, and the outcome of some lose bowels was not reported. This report was non-serious.


VAERS ID: 1470117 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear discomfort, Feeling abnormal, Head discomfort, Headache, Insomnia, Tinnitus
SMQs:, Dementia (broad), Hearing impairment (narrow)

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

Write-up: Ringing in ears, ears popping. Brain fog , headache, pressure in head. Trouble sleeping


VAERS ID: 1470439 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-22
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

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

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

Write-up: Patient received the vaccine 21 days apart instead of the recommended 28 days.


VAERS ID: 1470855 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Fine motor skill dysfunction, Hypoaesthesia, Loss of personal independence in daily activities, Movement disorder, Muscular weakness, Orthosis user
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Low Estrogen Birth Control pill Adderall XR Bupropion XL Unithroid Liothyronine
Current Illness:
Preexisting Conditions: Hashimotos (Thyroid) Herniated disc Migraines Rashes without a known cause
Allergies: none that have been diagnosed
Diagnostic Lab Data:
CDC Split Type:

Write-up: May not be related but I''m not a fan of "coincidence". 8-10 hours after 2nd shot, right pinky & ring finger started feeling numb and not moving normally. The next morning, those 2 fingers were completely numb and I could not type or write. The following day, I could feel those 2 fingers but they would not move normally. There was also a loss of strength such that I was unable to expand my fingers -- such as what you do when opening a pair of closed scissors. I had to move those 2 fingers with my other hand if I wanted to expand them. During the following week, the symptoms improved slowly. By week #2, I could type again but still had some weakness and my hand, wrist, arm tired easily. At the 3 week mark, I saw an Orthopedic specialist (because I made the appointment the day I couldn''t move my fingers) and he had no real explanation. He said the symptoms I described normally progress the opposite way...starting subtle and progressing to loss of hand/finger function. Starting with loss of hand/finger function and then it getting better slowly was not something he had seen. No real treatment or known cause of the problem. The Orthopedic specialist told me to wear a brace and call if it happens again.


VAERS ID: 1471006 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Nausea, Palpitations
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), 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: Albuterol inhaler
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: During observation period, patient displayed at the time syncope type symptoms (nausea, dizzy, clammy skin). Patient said she should be fine and left after 30 minutes. On 7/13/21 patient was in the store and said when she went home her heart felt racey. She said her doctor thought she may have had an allergic reaction to the moderna vaccine. Therefore I''m filing the VAERS.


VAERS ID: 1471263 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-09
Onset:2021-06-22
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Dizziness, Fatigue, Nerve injury, Pain in extremity, Paraesthesia, Peripheral swelling, Spinal X-ray, Thrombosis, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspar, Pantoprazole, Duloxetine, Vitamin D, Amlodipine, Losartan, Lamotrigine, Vitamin B-1, Folic Acid
Current Illness: Barrett''s Esophagus
Preexisting Conditions: Barrett''s Esophagus, Prostate Cancer, High Blood Pressure
Allergies: None
Diagnostic Lab Data: Ultrasound-June 21, 2021-legs diagnosed with blood clots. June 25, 2021-appointment with primary care physician concerning tingling, burning and pain in arms and legs. CT Scan-June 27, 2021 to rule out blood clots in lungs. Ultrasound-July 1, 2021-on arms to rule out blood clots. X-ray-July 13, 2021of lower spine to rule out pinched nerve. Appointment scheduled with Neurologist on September 2, 2021 for nerve issues.
CDC Split Type:

Write-up: June 17-swelling of hands and arms, pain, tingling, burning sensations in arms and legs. Dizziness and fatigue.


VAERS ID: 1471655 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Diarrhoea, Dizziness, Dyspnoea, Feeling hot, Headache, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

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

Write-up: client alerted that she developed a headache and dizziness about 1 hour after she received the first dose of COVID vaccine Pfizer. The client stated the headache and dizziness lasted 1.5 days. The client did not seek formal medical care for the headache or dizziness. The client stated she did take Advil for symptomatic relief. The client stated she did eat prior to her first COVID vaccine and did eat today. The client noted approximately one week after receiving the COVID vaccine she developed chest pressure, mild shortness of breath, and felt "hot." The client stated these symptoms lasted for a few days. She also stated she developed diarrhea about 7 days after receiving the first COVID vaccine, which lasted about 2 weeks. The client stated she received negative COVID test results on 07/01/21. The client did not seek formal medical care for these symptoms. The client denies any chronic conditions. She takes oral birth control pills. The client has a history of dust allergies which cause her to "sneeze." The client was provided a water and Pringles snack, she started drinking the water. The client received 2nd COVID vaccine Pfizer Lot#EW0187 at 5:01PM. The client ambulated to the observation area and sat in the anti-gravity chair upon arrival. At 5:20 EMT Bustamante inquired how the client was feeling and the client reported feeling nausea. RN Withers responded. The client denied any s/s of anaphylaxis. Vitals obtained at 5:21 PM were as follows: BP 130/70 and HR 76. The client was provided an emesis bag. The client stated she last ate around 12:00PM. The client continued to drink water. Vitals obtained at 5:31 were as follows: BP 126/70 and HR 68. The client stated the "water is helping" with nausea. The client denied any dizziness, SOB, or headache. RN Withers reinforced education regarding s/s of anaphylaxis, when to seek EMS, V-safe, recommendation to follow up with PCP, common side effects following COVID vaccination, and to continue drinking water. The client voiced understanding of this. RN Withers escorted the client to the parking lot at 5:42. The client ambulated unassisted with a steady gait and was observed entering a personal vehicle at 5:42 PM.


VAERS ID: 1474161 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-15
Onset:2021-06-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB, Chest pain, Electrocardiogram normal, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Mild, intermittent asthma (not acutely exacerbated)
Allergies: None
Diagnostic Lab Data: Normal EKG, Troponin, CK-MB on July 15, 2021.
CDC Split Type:

Write-up: Intermittent substernal chest pain, daily, started 1 week after receiving vaccine. Otherwise asymptomatic.


VAERS ID: 1474227 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Latex, pcn
Diagnostic Lab Data:
CDC Split Type:

Write-up: Period started day after shot. 14 days early.


VAERS ID: 1474249 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017CZIA / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024CZIA / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Anion gap decreased, Aspartate aminotransferase normal, Asthenia, Back pain, Basophil percentage, Bilirubin urine, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatine phosphokinase normal, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea normal, C-reactive protein normal, Carbon dioxide normal, Chromaturia, Complement factor C3, Complement factor C4, Decreased appetite, Eosinophil percentage decreased, Flank pain, Glomerular filtration rate decreased, Glucose urine absent, Granulocyte percentage, Haematocrit decreased, Haemoglobin decreased, Haemolysis, Lymphocyte count, Lymphocyte percentage, Malaise, Mean cell haemoglobin concentration normal, Mean cell haemoglobin decreased, Mean cell volume decreased, Mean platelet volume normal, Micturition urgency, Monocyte percentage increased, Nausea, Neutrophil count, Nitrite urine absent, Platelet count normal, Protein total increased, Protein urine present, Pyrexia, Red blood cell count normal, Red blood cell sedimentation rate increased, Red cell distribution width normal, Specific gravity urine, Ultrasound kidney normal, Urinary retention, Urine ketone body present, Urine leukocyte esterase, Urobilinogen urine, Vomiting, White blood cell count decreased, pH urine
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haemolytic disorders (narrow), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram
Current Illness: None known
Preexisting Conditions: History of VUR, Deflux, and urinary tract infections
Allergies: None
Diagnostic Lab Data: Diagnostic Results (07/08/2021 12:19 EDT US Renal Complete) RENAL ULTRASOUND IMPRESSION: Normal ultrasound of the kidneys. (07/08/21) Urinalysis U Glucose: NEGATIVE U Blood: NEGATIVE U Nitrite: NEGATIVE U Protein: TRACE U Ketones: 15 mg/dL U Color: YELLOW U Leuk Est: NEGATIVE U Bilirubin: NEGATIVE U pH: 6.5 U Spec Gravity: 1.025 Albumin: 4.9 gm/dL (07/08/21) Alkaline Phos: 60 unit/liter (07/08/21) ALT (SGPT): 13 unit/liter (07/08/21) ANC: 2862 /microliter (07/08/21) Anion Gap: 11 mmol/liter (07/08/21) AST (SGOT): 24 unit/liter (07/08/21) Baso%: 0.7 % (07/08/21) Bilirubin Total: 0.4 mg/dL (07/08/21) BUN: 10 mg/dL (07/08/21) Calcium: 9.8 mg/dL (07/08/21) Chloride: 105 mmol/liter (07/08/21) CO2: 23 mmol/liter (07/08/21) Complement 3: 110 mg/dL (07/08/21) Complement 4: 22.0 mg/dL (07/08/21) CPK: 53 unit/liter (07/08/21) Creatinine: 0.6 mg/dL (07/08/21) CRP: <0.5 mg/dL (07/08/21) eGFR: 71 mL/min/1.73m? (07/08/21) Eos%: 0.2 % (07/08/21) Glucose Lvl: 94 mg/dL (07/08/21) Gran%: 60.9 % (07/08/21) Hematocrit: 33.9 % (07/08/21) Hemoglobin: 11.1 gm/dL (07/08/21) Hemolysis Interpretation: No Hemolysis (07/08/21) Lymph Absolute auto: 1410 /microliter (07/08/21) Lymph%: 30.0 % (07/08/21) MCH: 24.7 pg (07/08/21) MCHC: 32.7 % (07/08/21) MCV: 75.7 Femtoliters (07/08/21) Mono%: 8.2 % (07/08/21) MPV: 9.1 Femtoliters (07/08/21) Platelet Count: 203 10e3/microliter (07/08/21) Potassium: 4.3 mmol/liter (07/08/21) Protein Total: 8.9 gm/dL (07/08/21) RBC: 4.48 10e6/microliter (07/08/21) RDW: 14.0 % (07/08/21) Sed Rate-West: 29 mm/hr (07/08/21) Sodium: 139 mmol/liter (07/08/21) U Appear: CLEAR (07/08/21) U Uro: 1.0 EU/dL (07/08/21) WBC: 4.7 10e3/microliter (07/08/21)
CDC Split Type:

Write-up: Patient received her second COVID vaccine (Moderna) on 06/21/21. She says 12 hours after her vaccine she developed nausea, vomiting, and low grade fever. The vomiting became persistent and patient developed severe flank pain. She was taken to an ER. 24 hours post vaccine. Patient says she was given IV boluses and Zofran which helped resolve the vomiting, she was discharged later the same day. Her fever lasted 4-5 days, t-max 100.0 with intermittent Tylenol dosing. Since discharge she says she continues to have consistent nausea but denies vomiting. She admits she has little appetite and has not felt hungry. She denies diarrhea. Her flank pain is "constant" and she felt it was starting to effect her bladder. Patient denies burning and stinging; however, describes back pain prior to voiding. She says she does not feel she can fully empty her bladder despite having urgency to do so. She denies gross hematuria. She says she does not feel well in general and has no energy. She feels her flank pain is becoming worse and Tylenol is no longer giving her relief. Her brother says the family wanted to ensure there was no complications involving her kidneys considering her history. The renal team did not feel patients symptoms were related to a kidney/bladder issue but rather a reaction to her second COVID vaccine. Her case was discussed with rheumatology and infectious disease. She received ondansetron for nausea, Naproxen for pain, and encouraged her to remain well hydrated. She was prescribed a short course of prednisone.


VAERS ID: 1474465 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Urgent care visit on Wed. 7/14; referred to neurology and orthopedic specialists
CDC Split Type:

Write-up: Left forearm and finger tingling, slight numbness akin to a "dead arm" when one falls asleep; Every 15-30 min. the first 4-5 days after injection; has become less intense and less frequent over the last 3 weeks; still occurs 5-7 times a day and is more localized to the left pointer finger (most intense) and left hand


VAERS ID: 1474586 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-17
Onset:2021-06-22
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Nodule
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported a red lump on her arm which appeared about 5 days after her first dose and lasted for 1 to 2 weeks.


VAERS ID: 1474822 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Electrocardiogram, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: Sever''s apophysitis
Preexisting Conditions: Joint hypermobility, Still''s murmur, recurrent tonsillitis, history of MRSA infection (remote), frequent headaches
Allergies: Bactrim-hives Omnicef-rash
Diagnostic Lab Data: CXR, EKG--6/22/2021
CDC Split Type:

Write-up: Patient developed shortness of breath and wheezing within 12 hours of receiving dose #2 Pfizer. These side effects were not noted with her initial vaccine. She required ER visit for this. Received Benadryl, Ibuprofen, Duoneb, CXR, EKG. She required continued albuterol over the next few days. She also required outpatient MD visit on 6/23/2021 and was placed on Flovent as well.


VAERS ID: 1474969 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Fatigue, Hypoaesthesia, Hypoaesthesia oral, Malaise, Speech disorder developmental
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: eceived 2nd dose at 1350, stated to staff at 1605 that she was "not feeling well". Pt now c/o numbness of the lips, left arm, and left leg, feeling dizzy and tired. 1605 VS: 177/118, 104 HR, 96% O2 EMS alerted at 1616. 1620 VS: 168/104, 89 HR, 98% O2, POCT Glucose 82mg/dL. Pt sitting upright on a chair talking with staff, speech delayed. EMS arrived at 1622. Pt left with EMS via gurney at 1630 to ED for further assessment.


VAERS ID: 1419944 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-15
Onset:2021-06-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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: lomexin spray
Current Illness: tinea versicolor
Preexisting Conditions: no
Allergies: not that I know of
Diagnostic Lab Data:
CDC Split Type:

Write-up: red rush, swelling, itchiness


VAERS ID: 1421251 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003188 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Redness area around the site of injection. Painful arm


VAERS ID: 1445154 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NOT KNOWN / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, Chest discomfort, Drooling, Hypotension, Pharyngeal oedema, Seizure, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Clinical trial participant; Lactation decreased; Comments: Patient has not had symptoms associated with COVID-19 Not had a COVID-19 test Patient is not pregnant,Patient is not currently breastfeeding
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: seizure; anaphylaxis; throat tightness; drooling; chest tightness; Hypotension; Throat edema; This regulatory authority case was reported by a physician and describes the occurrence of SEIZURE (seizure) and ANAPHYLACTIC REACTION (anaphylaxis) in an 18-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. Not known) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Patient has not had symptoms associated with COVID-19 Not had a COVID-19 test Patient is not pregnant,Patient is not currently breastfeeding. The patient''s past medical history included Lactation decreased and Clinical trial participant. On 22-Jun-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Jun-2021, the patient experienced HYPOTENSION (Hypotension) and PHARYNGEAL OEDEMA (Throat edema). On an unknown date, the patient experienced SEIZURE (seizure) (seriousness criterion medically significant), ANAPHYLACTIC REACTION (anaphylaxis) (seriousness criterion medically significant), THROAT TIGHTNESS (throat tightness), DROOLING (drooling) and CHEST DISCOMFORT (chest tightness). The patient was treated with ADRENALINE 22-Jun-2021 for Anaphylactic reaction, at an unspecified dose and frequency. On 22-Jun-2021, HYPOTENSION (Hypotension) and PHARYNGEAL OEDEMA (Throat edema) had resolved. At the time of the report, SEIZURE (seizure), ANAPHYLACTIC REACTION (anaphylaxis), THROAT TIGHTNESS (throat tightness), DROOLING (drooling) and CHEST DISCOMFORT (chest tightness) outcome was unknown. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication information was provided by the reporter. 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: 1449675 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002539 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Circulatory collapse, Pallor
SMQs:, Anaphylactic reaction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: JPTAKEDA2021TJP046998

Write-up: Circulatory collapse; Pallor facial; This spontaneous case was reported by a pharmacist and describes the occurrence of CIRCULATORY COLLAPSE (Circulatory collapse) in an 18-year-old female patient who received mRNA-1273 (COVID 19 Vaccine Moderna) (batch no. 3002539) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 22-Jun-2021, the patient received first dose of mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 22-Jun-2021, the patient experienced CIRCULATORY COLLAPSE (Circulatory collapse) (seriousness criterion medically significant) and PALLOR (Pallor facial). On 22-Jun-2021, CIRCULATORY COLLAPSE (Circulatory collapse) and PALLOR (Pallor facial) had resolved. For mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular), the reporter considered CIRCULATORY COLLAPSE (Circulatory collapse) and PALLOR (Pallor facial) to be possibly related. Concomitant product use was not provided by the reporter. No treatment information was provided. On 22-Jun-2021, at 11:48, the patient received the 1st dose of the vaccine. At 12:05, the patient experienced pallor facial and collapse. The symptoms resolved after follow-up. Collapse was assessed as serious by the Authority. The outcome of pallor facial and collapse was reported as recovered. The events developed after the administration of COVID-19 vaccine mRNA (mRNA 1273) and there is temporal relationship. 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.; Reporter''s Comments: The events developed after the administration of COVID-19 vaccine mRNA (mRNA 1273) and there is temporal relationship.; 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: 1450843 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Anaphylactic shock
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (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: DEPFIZER INC2021759377

Write-up: anaphylactic reaction; anaphylactic shock; This is a spontaneous report from a contactable physician and consumer based on information received by Pfizer from Biontech [manufacturer control number: 66975, license party for Comirnaty]. An 18-years-old female patient received bnt162b2 (COMIRNATY), dose 1 via an unspecified route of administration on 22Jun2021 11:30 at age of 18-years-old as dose 1, single for COVID -19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced anaphylactic reaction on 22Jun2021 11:35. The patient suffered anaphylactic shock at approx.11.30 am 5 to 10min after the vaccination with COMIRNATY. This was the first time for the patient. The outcome of the event was unknown. Lot/batch number has been requested.; Sender''s Comments: Based on the information available and close temporal association, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported event of Anaphylactic reaction. The case will be reassessed once new information is available.


VAERS ID: 1450850 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic shock
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (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: DEPFIZER INC2021770758

Write-up: anaphylactic shock; This is a spontaneous report based on information received by Pfizer from Biontech [manufacturer control number: 67003, license party for Comirnaty]. A contactable physician reported that an 18-years-old female patient received first dose of BNT162B2 (COMIRNATY) at the age of 18-years, via an unspecified route of administration on 22Jun2021 at 11:20 at single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient suffered an anaphylactic shock at approx.11.30 AM 5-10 min after the vaccination today. This was the first time for the patient. Outcome of the event was unknown. Lot/batch number has been requested.; Sender''s Comments: as per the information provided in the case, the causal association between the anaphylactic shock and the suspect drug cannot be excluded.


VAERS ID: 1452718 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY5456 / 1 - / -

Administered by: Other       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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021765083

Write-up: Fainting; This is a spontaneous report from a contactable other hcp received from the Regulatory Agency. The regulatory authority report number is GB-MHRA-WEBCOVID-202106221648446520-VGDTV, Safety Report Unique Identifier GB-MHRA-ADR 25521058. An 18-year-old female patient received first dose of bnt162b2 (Pfizer BioNTech covid-19 vaccine), via an unspecified route of administration on 22Jun2021 (lot number: EY5456) as dose 1, single for covid-19 immunization. Patient has not had symptoms associated with covid-19, not had a covid-19 test Patient is not enrolled in clinical trial. The patient''s medical history and concomitant medications were not reported. Patient has not had symptoms associated with covid-19, not had a covid-19 test. Patient was not enrolled in clinical trial. Patient has not tested positive for covid-19 since having the vaccine. On 22Jun2021 patient experienced fainting. Outcome of event was resolved on 22Jun2021. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1452741 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA1027 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Comments: No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC2021765641

Write-up: Stomach cramps; This is a spontaneous report from a contactable consumer received from the Regulatory Agency. The regulatory authority report number is GB-MHRA-WEBCOVID-202106222311186910-NWC4X, Safety Report Unique Identifier is GB-MHRA-ADR 25521935. An 18-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: FA1027), via an unspecified route of administration on 22Jun2021 (at the age of 18 years old) as dose 1, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Patient has not had symptoms associated with COVID-19. Patient is not enrolled in clinical trial. The patient experienced stomach cramps on 22Jun2021. The reporter assessed the event as serious (medically significant). Patient has not tested positive for COVID-19 since having the vaccine. The patient underwent lab tests and procedures which included COVID-19 virus test: negative (no - negative COVID-19 test) on an unspecified date. The outcome of the event was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1455888 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-05-14
Onset:2021-06-22
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ST8885 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Abortion spontaneous, SARS-CoV-2 test, Scan
SMQs:, Termination of pregnancy and risk of abortion (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FOLIC ACID
Current Illness: Pregnancy
Preexisting Conditions: Medical History/Concurrent Conditions: Normal delivery; Polycystic ovarian syndrome; Pregnancy
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:No - Negative COVID-19 test; Test Date: 20210622; Test Name: pregnancy scan; Result Unstructured Data: Test Result:small for gestational age foetus and no heartbeat; Comments: No foetal heart rate detected on dating scan at 12 weeks. Foetus small for dates. Waiting to miscarry.
CDC Split Type: GBPFIZER INC2021766058

Write-up: Early miscarriage; This is a spontaneous report from a contactable consumer. This is a report received from the Regulatory Agency. The regulatory authority report number is GB-MHRA-WEBCOVID-202106230747037180-LWUXA and Safety Report Unique Identifier is GB-MHRA-ADR 25523039. The consumer reported both for the mother and the fetus This is the mother case. A 40-year-old female patient received 1st dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 14May2021 (Batch/Lot Number: ST8885) as dose 1, single for covid-19 immunization. Medical history included Polycystic Ovarian Syndrome, ongoing pregnancy and one previous pregnancy 10 years ago, normal pregnancy and delivery (2011). Patient has not had symptoms associated with COVID-19. Patient is not enrolled in clinical trial. Patient is not currently breastfeeding. Concomitant medication included folic acid taken for folic acid supplementation. On 22Jun2021, the patient experienced early miscarriage. The clinical course was reported as follows: LMP 28.03.21. Vaccine on 14May2021. First pregnancy scan at 12 weeks (22.06.21) revealed: a small for gestational age foetus and no heartbeat. Previous pregnancy normal. Patient has not tested positive for COVID-19 since having the vaccine. Details of previous pregnancies: One previous pregnancy 10 years ago. Normal pregnancy and delivery. Patient was exposed to the medicine first-trimester (1-12 weeks). Details of scans or investigations: No foetal heart rate detected on dating scan at 12 weeks. Foetus small for dates. Waiting to miscarry. The case is serious (medically significant). The outcome for early miscarriage was miscarriage. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1458340 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA1027 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Vaccination site pain
SMQs:, 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: Contraception (taken for over 4 months)
Allergies:
Diagnostic Lab Data: Test Date: 20210621; Test Name: COVID-19 virus test; Test Result: Negative ; Comments: no - negative COVID-19 test
CDC Split Type: GBPFIZER INC2021766061

Write-up: Injection site muscle pain; This is a solicited report from a contactable consumer. This report is received from Regulatory Authority. Regulatory authority''s case report number GB-MHRA-YCVM-202106210924218650-ZH4WA, Safety Report Unique Identifier GB-MHRA-ADR 25521246. An 18-year-old female patient received BNT162B2 (COVID-19 MRNA VACCINE BIONTECH), via an unspecified route of administration on 22Jun2021 (Lot Number: FA1027) as DOSE NUMBER UNKNOWN, single for COVID-19 vaccination. The patient medical history included contraceptive pill Yazmine (taken for over 4 months) and concomitant medications were not reported. Patient has not had symptoms associated with COVID-19 Patient is not enrolled in clinical trial Patient is not pregnant, Patient is not currently breastfeeding. The patient experienced injection site muscle pain (medically significant) on 22Jun2021 with outcome of not recovered. The patient underwent lab tests and procedures which included no - negative COVID-19 test on 21Jun2021. The reporter''s assessment of the causal relationship of the events with the suspect product BNT162B2 was not provided at the time of this report. Since no determination has been received, the case is managed based the company causality assessment. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on available information, a possible contributory role of subject product, BNT162B2 vaccine cannot be excluded for the reported event of injection site muscle pain, based on temporal relationship and the known product safety profile. There is limited information provided in this report. This case will be reassessed upon receipt of follow-up information. Based on the information provided in the case, this individual report would not seem to modify the risk-benefit profile of the subject product.


VAERS ID: 1459542 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0221 / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Abortion spontaneous, Foetal death, Gynaecological examination, Inappropriate schedule of product administration, Ultrasound abdomen
SMQs:, Termination of pregnancy and risk of abortion (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: no
Allergies:
Diagnostic Lab Data: Test Date: 20210623; Test Name: pelvic exam; Result Unstructured Data: Test Result:confirm miscarriage; Test Date: 20210623; Test Name: ultrasound; Result Unstructured Data: Test Result:confirm miscarriage
CDC Split Type: CAPFIZER INC2021782766

Write-up: The day after the vaccine my embryo died and I had an spontaneous miscarriage.; The day after the vaccine my embryo died and I had an spontaneous miscarriage.; first dose of bnt162b2 on 06Apr2021 10:00 AM, second dose on 22Jun2021 10:00 AM; This is a spontaneous report from a contactable pharmacist. A 31-years-old female patient received bnt162b2 (PFIZER MRNA BNT162B2), dose 2 via an unspecified route of administration, administered in arm left on 22Jun2021 10:00 AM (at age of 31-years-old) (Batch/Lot Number: EW0221) as single dose for covid-19 immunisation. There was no medical history. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included hpv vaccine taken for immunisation on 03Jun2021. The patient previously took the first dose of bnt162b2 on 06Apr2021 10:00 AM as single dose on arm left (Batch/lot number ER1742) for covid-19 immunisation. On 23Jun2021 04:00, the day after the vaccine her embryo died and she had an spontaneous miscarriage. The events were considered as serious per disability, medically significant, congenital anomaly. The mother reported she became pregnant while taking bnt162b2. The mother was 7 weeks pregnant at the onset of the event. The mother was pregnant with 1 baby. The mother was due to deliver on 06Feb2022. The pregnancy resulted in spontaneous abortion. Confirm miscarriage ultrasound and pelvic exam on 23Jun2021. The treatment was received for the events. Since the vaccination, the patient had not been tested for COVID-19. The events result in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. The outcome of fetal death was not recovered, of other events was unknown.; Sender''s Comments: Based on the close temporal relationship, the association between the event "her embryo died and she had a spontaneous abortion" with BNT162b2 can not be fully excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1461757 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-19
Onset:2021-06-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Lymph node pain, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ipsilateral supraclavicular lymphadenopathy. Enlarged supraclavicular lymph nodes, right side same as vaccine, highly movable nodes and soft, somewhat painful for the first couple of days


VAERS ID: 1462670 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue
SMQs:

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: GBPFIZER INC2021814294

Write-up: Tiredness; Regulatory Authority This is a solicited report from the Regulatory Authority program from a contactable consumer. This is a report received from the Regulatory Authority. Regulatory authority report number GB-MHRA-YCVM-202106292007510660-MRWRX, Safety Report Unique Identifier GB-MHRA-ADR 25564347. An 18-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number was not reported) dose 1 via an unspecified route of administration on 22Jun2021 at the age of 18-year-old as dose 1, single for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. Patient has not had symptoms associated with COVID-19. Not had a COVID-19 test. Patient is not enrolled in clinical trial. Patient is not pregnant. Patient is not currently breastfeeding. The patient experienced tiredness on 22Jun2021 with outcome of recovered on 28Jun2021. The event was serious per medically significant. The reporter''s assessment of the causal relationship of the event with the suspect product was not provided at the time of this report. Since no determination has been received, the case is managed based on the company causality assessment. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Sender''s Comments: Based on temporal association and known safety profile, a causal association between BNT162B2 and the reported fatigue cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1465028 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA1G27 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Gait disturbance, Maternal exposure timing unspecified, Pain, SARS-CoV-2 test
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Arthritis (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PARACETAMOL
Current Illness: Pregnancy; Suspected COVID-19
Preexisting Conditions: Medical History/Concurrent Conditions: Pain
Allergies:
Diagnostic Lab Data: Test Date: 20201025; Test Name: COVID-19 virus test; Test Result: Positive ; Comments: COVID-19 tested positive.
CDC Split Type: GBPFIZER INC2021786683

Write-up: became pregnant while taking BNT162B2; walking with difficulty; pain; Aching in knees; Fatigue; This is a spontaneous report from a contactable consumer received from the Regulatory Agency. The regulatory authority report number is GB-MHRA-WEBCOVID-202106252219384960-WCJAR. A 48-year-old pregnant female (also reported as male) patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; solution for injection; Lot Number: FA1G27) via an unspecified route of administration on 22Jun2021 (at the age of 48-years-old) as a single dose for COVID-19 immunization. Medical history included suspected COVID-19 from 26Oct2020 and ongoing, pregnancy from an unknown date and ongoing and pain from an unknown date and unspecified if ongoing. The patient was not enrolled in clinical trial. Concomitant medications included paracetamol taken for pain from 22Jun2021 to an unspecified stop date. The patient experienced fatigue on 22Jun2021, aching in knees on 23Jun2021, walking with difficult and pain on unspecified dates. The patient stated that she felt tired a lot and just wanted to sleep. She stated that she never had problems with her knees and suddenly, she was getting pain, especially in her left knee. If she was sitting down and were to get up, the pain made her scream and she found that she was walking with difficulty. The mother reported that she became pregnant while taking BNT162B2. It was reported that the adverse reaction did not occur as a result of an exposure during pregnancy.The patient underwent lab tests and procedures which included sars-cov-2 test: positive (COVID-19 tested positive) on 25Oct2020. The clinical outcomes of the events fatigue and aching in knees were not recovered/not resolved while the clinical outcomes of the events walking with difficulty and pain were unknown. The patient had not tested positive for COVID-19 since having the vaccine. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1465400 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA/027 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Laboratory test, Maternal exposure during pregnancy
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregnancy (Estimated due date: 23Sep2021)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: scans or investigations; Result Unstructured Data: Test Result:All fine
CDC Split Type: GBPFIZER INC2021786746

Write-up: Felt faint; Maternal exposure during pregnancy; This is a solicited report from a contactable consumer (patient) received from the Regulatory Agency. The regulatory authority report number is GB-MHRA-YCVM-202106252229178220-IRRT7, Safety Report Unique Identifier: GB-MHRA-ADR 25547620. A 26-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot# FA/027), via an unspecified route of administration on 22Jun2021 at age of 26-year-old at dose 1, single for COVID-19 immunization. The patient''s medical history included ongoing pregnancy, Estimated due date: 23Sep2021. Patient has not had symptoms associated with COVID-19. Not had a COVID-19 test. Patient is not enrolled in clinical trial. Patient is not currently breastfeeding. The patient''s concomitant medications were not reported. The patient experienced maternal exposure during pregnancy, felt faint on 22Jun2021 with outcome of recovered on 23Jun2021. The event was serious as medically significant. The mother reported she became pregnant while taking BNT162B2. The mother was due to deliver on 23Sep2021. The patient underwent lab tests and procedures which included scans or investigations: all fine. Clinical course: Had not had breakfast, and was prone to feeling a bit faint in the morning now that she was pregnant, but not nearly as badly as after the vaccine. Faintness started 10 minutes after the shot. Patient did not take folic acid supplement during pregnancy. The reporter''s assessment of the causal relationship of the events with the suspect product was not provided at the time of this report. Since no determination has been received, the case is managed based on the company causality assessment. No follow-up attempts are possible; No information is expected.; Sender''s Comments: The reported faintness started 10 minutes after the shot was related to vaccination with BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE). The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics committees and Investigators, as appropriate.


VAERS ID: 1466204 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Loss of consciousness, Physical deconditioning, Stomatitis
SMQs:, Torsade de pointes/QT prolongation (broad), Severe cutaneous adverse reactions (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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? 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: JPTAKEDA2021TJP048207AA

Write-up: Oral inflammation (erosion in the gum); Loss of consciousness; Sick feeling; This spontaneous case was reported by a consumer and describes the occurrence of LOSS OF CONSCIOUSNESS (Loss of consciousness) in an 18-year-old male patient who received mRNA-1273 (COVID 19 Vaccine Moderna) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 22-Jun-2021, the patient received first dose of mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 22-Jun-2021, the patient experienced LOSS OF CONSCIOUSNESS (Loss of consciousness) (seriousness criterion medically significant) and PHYSICAL DECONDITIONING (Sick feeling). On 24-Jun-2021, the patient experienced STOMATITIS (Oral inflammation (erosion in the gum)). On 22-Jun-2021, LOSS OF CONSCIOUSNESS (Loss of consciousness) and PHYSICAL DECONDITIONING (Sick feeling) had resolved. At the time of the report, STOMATITIS (Oral inflammation (erosion in the gum)) had not resolved. No concomitant medications are reported by the reporter. No treatment information is provided. 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: 1471870 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-15
Onset:2021-06-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time ratio, Foetal death, Glomerular filtration rate, Haemoglobin, International normalised ratio, Platelet count, Polymerase chain reaction, Prothrombin time, Ultrasound scan
SMQs:, Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LEVOCETIRIZINE DIHYDROCHLORIDE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Foetal death (Premature Rupture of Membranes at 22 weeks + 2 days); Gastroesophageal reflux disease; Pregnancy; Psoriasis (without treatment); Rash
Allergies:
Diagnostic Lab Data: Test Date: 20210622; Test Name: Activated partial thromboplastin time ratio; Result Unstructured Data: Test Result:1; Test Date: 20210622; Test Name: glomerular filtration; Result Unstructured Data: Test Result:5.1; Test Date: 20210622; Test Name: Haemoglobin; Result Unstructured Data: Test Result:12.6; Test Date: 20210622; Test Name: International normalised ratio; Result Unstructured Data: Test Result:1; Test Date: 20210622; Test Name: Platelets; Result Unstructured Data: Test Result:187; Test Date: 20210622; Test Name: polymerase chain reaction test; Test Result: Negative ; Test Date: 20210622; Test Name: Prothrombin time; Result Unstructured Data: Test Result:100; Test Date: 20210408; Test Name: ultrasound; Result Unstructured Data: Test Result:healthy foetus without malformation; Comments: 51st percentile eutrophic foetus
CDC Split Type: FRPFIZER INC2021804261

Write-up: Foetal death in utero; This is a spontaneous report from a contactable other healthcare professional downloaded from the regulatory authority-WEB FR-AFSSAPS-CF20211723, Safety Report Unique Identifier FR-AFSSAPS-2021082473. A 33-year-old pregnant female patient received the second dose of BNT162B2 (COMIRNATY; Lot Number: Unknown), intramuscular on 15Jun2021 as a single dose for COVID-19 immunisation. Medical history included rash from an unknown date and unknown if ongoing , gastrooesophageal reflux disease with pregnancy from an unknown date and unknown if ongoing , psoriasis from an unknown date and unknown if ongoing without treatment , foetal death from 2020 to an unknown date (Premature Rupture of Membranes at 22 weeks + 2 days), pregnancy from an unknown date and unknown if ongoing. Concomitant medication included levocetirizine dihydrochloride for an unspecified indication, start and stop date were not reported. The patient previously received the first dose of BNT162b2 on 15May2021 (Lot Number: unknown) via an unspecified route of administration for COVID-19 immunisation. The patient experienced foetal death in utero (hospitalization) on 22Jun2021. A 2nd trimester ultrasound performed on 08Apr2021 found a healthy foetus without malformation. 51st percentile eutrophic foetus. On 15Jun2021, 33-year-old patient received the second intramuscular injection of COMIRNATY Covid-19 Vaccine. The 1st injection of the COMIRNATY vaccine took place 15May2021. On 22Jun2021, the patient did not feel any foetal movements. Maternity Obstetrics and hospitalisation consultation: Diagnosis of Fetal Death In Utero (MFIU) at 33 weeks + 4 days. Negative polymerase chain reaction test on 22Jun2021 at 9:30 pm. On 22Jun2021: Haemoglobin: 12.6, Platelets: 187, Prothrombin time: 100, International normalised ratio: 1, Activated partial thromboplastin time ratio: 1, glomerular filtration: 5.1, glomerular filtration: 5.1. On 23Jun2021: Vaginal birth and foetal death in utero childbirth. Examinations to be performed: placental anatomical pathology. Foetal autopsy was pending. The patient recovered from the event, foetal death in utero on an unknown date. No follow-up attempts are possible, information on batch number cannot be obtained.


VAERS ID: 1472434 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Off label use, Peripheral swelling, Product use issue, Pruritus
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), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: KETOTIFEN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021776574

Write-up: Itching/ terrible itching all over body; Itching ears; Itching back of throat; Swelling of hands/Starburst feeling under skin; Age at time of onset of reaction/event: 11 year; Age at time of onset of reaction/event: 11 year; This is a spontaneous report from a contactable consumer received from the Regulatory ARA). Regulatory authority report number (GB-MHRA-WEBCOVID-202106231142008620-ZBQ0K), Safety Report Unique Identifier (GB-MHRA-ADR 25524984). A 11-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), on 22Jun2021 (Lot number was not reported) at single dose for COVID-19 immunisation (11-year-old at vaccination). The patient medical history was not reported. Concomitant medication(s) included ketotifen (KETOTIFEN) taken for an unspecified indication, start and stop date were not reported. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: not reported) at single dose for COVID-19 immunisation. Patient has not had symptoms associated with COVID-19. Not had a COVID-19 test. Patient was not enrolled in clinical trial. The patient experienced itching (pruritus) (medically significant) on 22Jun2021 with outcome of not recovered, swelling of hands/starburst feeling under skin (peripheral swelling) (medically significant) on 22Jun2021 with outcome of not recovered, age at time of onset of reaction/event: 11 year (off label use) on an unspecified date with outcome of unknown. The patient stated starburst feeling under skin then terrible itching all over body; Itching ears; Itching back of throat. Pharmacist would not give her anti histamine. Patient has not tested positive for COVID-19 since having the vaccine. No follow-up attempts are possible. Information about lot/batch number cannot be obtained.


VAERS ID: 1472458 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-05
Onset:2021-06-22
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Abortion spontaneous, Haemorrhage, SARS-CoV-2 test
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Termination of pregnancy and risk of abortion (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Comments: No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC2021776318

Write-up: bleeding; Early miscarriage; This is a spontaneous report from a contactable consumer. This is a report received from the Regulatory Agency (RA). Regulatory authority report number GB-MHRA-WEBCOVID-202106231504379760-XNJKWT4T. Safety Report Unique Identifier GB-MHRA-ADR 25526648. A female patient of an unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 05Jun2021 as dose 1, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. Patient has not had symptoms associated with COVID-19. Patient is not enrolled in clinical trial. The patient experienced bleeding on an unspecified date, early miscarriage on 22Jun2021. The mother was 5 Weeks pregnant at the onset of the event. The patient had bleeding and then a miscarriage 18 days after her vaccination (as reported). Seriousness criteria reported as other medically important condition. She was been 5 weeks 3 days pregnant. Patient has not tested positive for COVID-19 since having the vaccine. The patient underwent lab tests and procedures which included COVID-19 virus test: No - Negative COVID-19 test on an unspecified date. The outcome of event bleeding was unknown, of event Early miscarriage was recovering. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1472467 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-22
Onset:2021-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC9001 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021775879

Write-up: dizziness; aches & pains in legs; This is a spontaneous report from a contactable consumer received from a regulatory authority. The regulatory authority report number is GB-MHRA-WEBCOVID-202106231545212490-CQU5S. An 18-year-old female non-pregnant patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via unspecified route of administration on 22Jun2021 (batch/lot number FC9001 and expiry date unknown) at 18 years of age as dose 1, single for covid-19 immunization. Medical history included lactation decreased. The patient has not had symptoms associated with COVID-19, not had a COVID-19 test, was not enrolled in clinical trial, was not currently breastfeeding. The patient''s concomitant medications were not reported. On 22Jun2021, the patient experienced dizziness, aches & pains in legs. The events were reported serious as other medically important condition. The patient has not tested positive for COVID-19 since having the vaccine. The outcome of the events was not recovered. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1413852 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA. Headache, dizzieness, nausea. Headache of varying degrees has not ended yet. The other symptoms stopped after a few days.


VAERS ID: 1414001 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-20
Onset:2021-06-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Chills, Dizziness, Dyspnoea, Headache, Myalgia, Nausea, Restlessness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Chills, Restlessness, Nausea, Headaches, Shortness of breath, Dizziness, Muscle and joint pain, chest pain


VAERS ID: 1414078 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-06-18
Onset:2021-06-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Electrocardiogram abnormal
SMQs:, Arrhythmia related investigations, signs and symptoms (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: abnormal EKG


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