National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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 84 out of 4,799

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183   next


VAERS ID: 1462125 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-25
Onset:2021-06-21
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Foreign body sensation in eyes, Muscle twitching, Ocular discomfort, Ocular hyperaemia, Ophthalmological examination
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dyskinesia (broad), Dystonia (broad), Glaucoma (broad), Corneal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ATENOLOL, GABAPENTIN, CITALOPRAM HYDROBROMIDE, SUMATRIPTAN, CYCLOBENZAPRINE HYDROCHLORIDE, GNC MULTIVITAMIN, SIX STAR CREATINE X3, SIX STAR NITRIC OXIDE MATRIX, MUSCLETECH HMB FREE ACID
Current Illness: none
Preexisting Conditions: head, neck and shoulder soft tissue damage from military deployment. Also suffer from Migraine and Hay Fever and Sinus infections. Diagnosed and treated for Crohn''s disease in 1982
Allergies: ALMONDS, CHERRIES, BEE STINGS, LAMASIL, TEA TREE OIL
Diagnostic Lab Data: Initial inspection by confirmed swelling and redness with slight twitch. I have follow on consult with Board Certified Ophthalmologist on July 19th.
CDC Split Type:

Write-up: Patient has staring to develop a twitching in the left eye followed by pressure and a gritty feeling with redness.


VAERS ID: 1463065 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-01
Onset:2021-06-21
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Severe hives (that lasted weeks). I have taken Benadryl and Medrol, but they still have not gone away. Waiting on appointment with allergist.


VAERS ID: 1463019 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-21
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210621; Test Name: COVID-19 virus test; Result Unstructured Data: Positive; Comments: Type of covid-19 test performed was not specified.
CDC Split Type: USJNJFOC20210713582

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 4 decade old male of unspecified ethnicity. The patient''s weight, height, and medical history were not reported. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose,1 total, start therapy date was in either April or May for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 21-JUN-2021, the patient experienced suspected covid-19 infection. The patient had experienced symptoms additional to testing positive and had contacted physician concerning the symptoms. Laboratory data included: COVID-19 virus test (NR: not provided) positive. The type of test performed was unknown. On an unspecified date, the patient experienced suspected clinical vaccination failure. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint:90000185108.; Sender''s Comments: 20210713582-Covid-19 vaccine ad26.cov2.s-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1463268 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-01
Onset:2021-06-21
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, SARS-CoV-2 test, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LAMICTAL; TRINTELLIX
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Name: Blood tests; Result Unstructured Data: Test Result:Unknown; Test Date: 20210622; Test Name: PCR; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021785786

Write-up: I have a blood clot in my left leg that is unprovoked / The clot runs from poplioteal to common iliac.; This is a spontaneous report from a contactable consumer (patient). A 38-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection Batch/Lot number was not reported, Expiration Date was not reported), via an unspecified route of administration, administered in left arm on 01Apr2021 12:00 (at the age of 38-years-old) as dose 2, single for covid-19 immunisation at pharmacy or drug Store. The patient medical history included none. Concomitant medications included lamotrigine (LAMICTAL), vortioxetine hydrobromide (TRINTELLIX). Other medications the patient received within 2 weeks of vaccination included Lamictal, Trintellix. The patient historical vaccine included first dose of BNT162B2 via route of administration, administered in left arm on 08Mar2021 05:00PM (at the age of 38-Years-old) for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient had not been diagnosed with COVID-19 prior to vaccination and had not tested for covid-19 since the vaccination. It was reported that, on 21Jun2021 07:00 the patient had a blood clot in his left leg that is unprovoked and he had no underlying conditions. He is male and 38 years old. Blood tests haven''t shown the underlying cause and I''m being seen by hemotoligists. The clot runs from poplioteal to common iliac. He was having a thrombectomy on Monday. The patient was hospitalized for I have a blood clot in my left leg that is unprovoked/the clot runs from poplioteal to common iliac for 7 days. The patient underwent lab tests and procedures which included blood test: unknown on an unspecified date, sars-cov-2 test: negative on 22Jun2021 (Nasal Swab). Therapeutic measures were taken as a result of I have a blood clot in my left leg that is unprovoked/the clot runs from poplioteal to common iliac. Heparin was received as treatment for the adverse event. Will have to have a thrombectomy. The reporter assessed the seriousness as serious. Seriousness criteria caused hospitalization. The outcome of the event was reported as not resolved. Information about batch/Lot number has been requested.


VAERS ID: 1463443 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-20
Onset:2021-06-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 RA / IM

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

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

Write-up: PT REPORTS FEELING PALPITATIONS AND "HEART BURNING" 24 HOURS AFTER RECEIVING HIS FIRST COVID-19 VACCINE.


VAERS ID: 1463447 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-10
Onset:2021-06-21
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Contusion, Herpes zoster, Myalgia, Neuralgia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: Symptoms started the week of 6/21/2021 with severe muscle ache on the left side of my body; upper back, shoulder, and neck. On Friday 6/25/2021 a red dot showed up on the front of my shoulder and the dots slowly spread all over the front of my shoulder, scapula, trap and into my hair line. Symptoms: burning, nerve pain, severe muscle aches, feeling bruised. On Tuesday, 6/29/2021, I went to the Clinic and was diagnosed with shingles. I am still having burning and bruised feeling, but the rash is slowly going away. After researching side effects of the COVID vaccine, I believe this rash could have been a reaction.


VAERS ID: 1463677 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-17
Onset:2021-06-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO177 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO191 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bedridden, Diarrhoea, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Noninfectious diarrhoea (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: Shingles rash and myeopathy from tetnas, both in 2015
Other Medications: Levothyroxine .88mcg Metropolol 50mg, twice daily Gabepentin 600mg Lunesta 2mg
Current Illness:
Preexisting Conditions: Vestibular migraine. Had not had an attack for a very long time over a year. Controlled by stopping coffee and environmental exposure to pollens. Vaccine from Pfizer caused severe vertigo attacks, stronger and lasting much much longer than usual. L4/5 chronic radiculapthy
Allergies: Dust, mold, pollen, caffeine
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: 1st shot , vertigo started 3 days after. Was able to resolve after 1 day with Omnaris and , tylenol. 2nd shot SEVERE vertigo started the next morning, with nausea, diareaha, bedridden , won''t resolve with Omnaris, Afrin, Tylenol, Mucinex . lasting now 3 days. Never had an attack last this long before ever!


VAERS ID: 1463703 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-21
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 MO / PO

Administered by: Other       Purchased by: ?
Symptoms: Acute myocardial infarction, Angioplasty, Condition aggravated, Coronary arterial stent insertion, Coronary artery occlusion, Depressed mood, Rash
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Depression (excl suicide and self injury) (narrow), Other ischaemic heart disease (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: COPD MI Stroke MI STEMI
Preexisting Conditions: COPD MI TIA Storke STEMI
Allergies: Pen zolfa she''ll fish bee sings fire ants
Diagnostic Lab Data: Angioplasty stent plantad both ateries blooked
CDC Split Type:

Write-up: Rash on arms be legs had to go to the ER MD sad reaction to ,2 shot taken by EMS to hosp STEMI


VAERS ID: 1463969 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Pain
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: oxycontin, hydrocodone, lexapro, baclofen, gabapentin, trazadone, progesterone, fish oil, ds3, zinc, melatonin, l-theanine, complex b vitamin
Current Illness: frozen shoulder (left)
Preexisting Conditions: chronic pain in neck and frozen left shoulder
Allergies: Penicillin, sulfa, codeine, sensitive to ethromycin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Severe pain in my left shoulder that continues one month after second vaccine dose. Constant pain of around 5 - 6 (1 - 10 pain scale) and pain level of 8-9 when moving arm/doing PT exercises. Pain medication and OTC drugs (ibuprofen. Tylenol) have no affect on pain level


VAERS ID: 1464011 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-14
Onset:2021-06-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Oral mucosal eruption, Oral pruritus, Paraesthesia oral, Pharyngeal paraesthesia, Rash erythematous, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: hives from flu shot in 2020
Other Medications: Biotin, Vitamin D, Probiotics & birth control
Current Illness:
Preexisting Conditions:
Allergies: lactose & possibly egg
Diagnostic Lab Data:
CDC Split Type:

Write-up: I experienced itching and tingling in my mouth, throat and ears. A red rash could be seen on the roof of my mouth down my throat. This has happened three times since getting the shot and I have never experienced this before. Symptoms resolved with benadryl.


VAERS ID: 1464056 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-28
Onset:2021-06-21
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, Blood lactic acid, Blood sodium, Chest X-ray, Culture urine, Differential white blood cell count, Echocardiogram, Electrocardiogram, Fatigue, Full blood count, Metabolic function test, Troponin I, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Guillain-Barre syndrome (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atenolol 50 mg Oral DAILY Potassium Chloride Crys ER 10 MEQ 20 mEq Oral 2 TIMES DAILY Rosuvastatin Calcium 20 MG Take 1 tablet by mouth once daily Triamterene-HCTZ 75-50 MG 1 tablet Oral DAILY
Current Illness: None
Preexisting Conditions: Essential hypertension Candidate for statin therapy due to risk of future cardiovascular event Peripheral vascular disease Low serum potassium
Allergies: Penicillins
Diagnostic Lab Data: Urinalysis with Reflex Testing Arrived Comprehensive metabolic panel CBC and differential Whole Blood Lactic Acid Troponin I EKG 12-lead Sodium Chloride 500 mL XR Chest 1 View TTE (Transthoracic Echo) Complete
CDC Split Type:

Write-up: on set ~6/21/21 moderate/sever weakness and fatigue. Went o hospital on 7/10/21 Dx Acute Kidney Injury


VAERS ID: 1464187 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-26
Onset:2021-06-21
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Joint range of motion decreased, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril 5 mg tablet (one daily)
Current Illness: None
Preexisting Conditions: High Blood Pressure, controlled by the lisinopril.
Allergies: None
Diagnostic Lab Data: Exam is scheduled for 07/26/2021.
CDC Split Type:

Write-up: Left arm between shoulder and elbow has become very weak and painful. It is difficult to raise my left arm (or extend it to close a car door for example).


VAERS ID: 1464317 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-19
Onset:2021-06-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Cough, Echocardiogram, Electrocardiogram normal, Hypoaesthesia, Myocarditis, Paraesthesia, Pericarditis, Troponin increased
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None
Preexisting Conditions: Idiopathic scoliosis Congential bilateral flat foot Congenital femoral retroversion
Allergies: None known
Diagnostic Lab Data: 6/22/2021: CXR: PA/L NAD Troponin elevation with rapid peak (3.89) and then decrease ECG: 87 and regular, normal intervals with borderline STEs in inferior leads, ? early repol (no baseline avail) TTE: completely normal, good study
CDC Split Type:

Write-up: Adverse event: acute myocarditis/pericarditis. 2 days after receiving Pfizer #2, dev substernal chest pain, largely positional with positional dry cough. Also had left arm numbness/paresthesia after second vaccine. Treatments: 1 dose enoxaparin, IVF, ondansetron x 1, then placed on/discharged from hospital on colchine Never had fever or tachycardia


VAERS ID: 1464688 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-07
Onset:2021-06-21
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bronchitis, Chest X-ray abnormal, Cough, Drainage, Dysgeusia, Inflammation, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Obesity
Allergies:
Diagnostic Lab Data: Covid-19 Chest x-ray
CDC Split Type: vsafe

Write-up: I got a metallic taste in my mouth. I had drainage in nose, cough and was running a fever. It got so bad; I went to Urgent care. They did a Covid-19 test, which came back negative. They also did a chest X-ray, which showed bronchitis and inflammation. They give me Arborol and Prognose. I also was taking over-the-counter medicine as well. A week later, had a phone appointment because of the symptoms was getting worse. I had legions on my hands and above my lip and at my nose.


VAERS ID: 1464800 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-14
Onset:2021-06-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH YO578 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adalat, Atorvastatin, Premarin, Mylan-Nifedipine, Mint-Furosemide, Sandoz-Candesartan, Solystat, low dose aspirin
Current Illness:
Preexisting Conditions: Type 1 Diabetes
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: I developed Shingles shortly after receiving my second Pfizer vaccination. I had received a vaccination AGINST getting shingles about 6 years ago and thought myself protected. These events could be unrelated but the quick onset of shingles so soon after being vaccinated, makes me consider the possibility that the vaccine triggered this event somehow and needs to be looked into. I still have shingles


VAERS ID: 1465340 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-06-21
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), 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? 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: Heart palpitations Shortness of breath Light headed


VAERS ID: 1465601 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-08
Onset:2021-06-21
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Fibrin D dimer increased, Groin pain, Hyperhidrosis, Loss of consciousness, Pain in extremity, Pulmonary embolism, Pulmonary thrombosis, Thrombosis, Troponin increased, Ultrasound Doppler abnormal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Was diagnosed with DVT, leading to Pulmonary Embolism. Ultrasound on legs revealed blood clots in both legs. CT scan of chest revealed clots in/on lungs. Troponin levels were extremely elevated, but have come down since. D-Dimer tests revealed existence of blood clots. Was given two blood thinner injections in hospital and now taking Eliquis.
CDC Split Type:

Write-up: Received 2nd Moderna COVID-19 dose on 5/8. Experienced sore calf and sore groin around 6/17. Woke up morning of 6/21 with lower left leg pain and ended up passing out twice in 20 minutes (15 minutes unaccounted for). Experienced extreme sweating and shortness of breath. Called 9-1-1 and was treated by paramedics, then taken to ER.


VAERS ID: 1466095 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-21
   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 EW0217 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Dizziness, Dyspnoea exertional, Heart rate, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), 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: NATRUM MURTIATICUM 12X
Current Illness: Anemia
Preexisting Conditions: Medical History/Concurrent Conditions: Heart injury (Damaged heart septum due to radiation treatment); Hodgkin''s disease (No reoccurrence since 1997); Palpitations (have had palpitations on and off throughout life); Penicillin allergy; Radiation therapy; Thyroid function decreased
Allergies:
Diagnostic Lab Data: Test Date: 20210621; Test Name: Heart rate/sinus rhythm; Result Unstructured Data: Test Result:200+; Comments: heart rate was 200+ and it took 12 hours to return to sinus rhythm of 91 after hanging in 190s, 180s and 174 for hours; Test Date: 20210621; Test Name: Heart rate/sinus rhythm; Result Unstructured Data: Test Result:190s; Test Date: 20210621; Test Name: Heart rate/sinus rhythm; Result Unstructured Data: Test Result:180s; Test Date: 20210621; Test Name: Heart rate/sinus rhythm; Result Unstructured Data: Test Result:174; Test Date: 20210621; Test Name: Heart rate/sinus rhythm; Result Unstructured Data: Test Result:91
CDC Split Type: USPFIZER INC2021785172

Write-up: Heart began racing/have had palpitations on and off throughout my life but never for 12 hours/heart rate was 200+/hanging in 190s, 180s and 174 for hours; Felt faint; No appetite; left with breathlessness for the days that followed whenever going up or down stairs; This is a spontaneous report from a contactable consumer (patient). A 63-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the left arm, on 18Jun2021 12:45 (Batch/Lot Number: EW0217), as dose 1, single, at age 63 years old, for COVID-19 immunisation, at a pharmacy/drug store. Medical history included ongoing anaemia from an unspecified date, palpitations (have had palpitations on and off throughout life) from an unknown date not reported if ongoing or not, low thyroid function from an unspecified date not reported if ongoing or not due to Hodgkins disease treatment in 1997 (no reoccurrence since 1997), and damaged heart septum from an unspecified date not reported if ongoing or not due to radiation treatment on an unspecified date, and known allergies: penicillin from an unspecified date not reported if ongoing or not. The patient was not diagnosed with COVID-19 prior to vaccination and was not tested for COVID-19 since the vaccination. Concomitant medication included sodium chloride (NATRUM MURTIATICUM 12X) taken for an unspecified indication, start and stop dates were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. On 21Jun2021 at 10:45, after a brief exercise and bending at the waist, the patient''s heart began racing and she felt faint. Her heat rate was 200+ and it took 12 hours to return to sinus rhythm of 91 after hanging in 190s, 180s and 174 for hours. Normal measures of bearing down, rest, and metoprolol did nothing. Treatment of thyroidinum brought her heart rate down from 174 to 91. On the same day, the patient had no appetite throughout that day, felt faint each time she sat up and was left with breathlessness for the days that followed whenever going up or down stairs. As the patient got further away from the vaccine date, the symptoms lessened and there had been no flare up of palpitations. The events resulted to physician''s office visit. The patient recovered from "heart began racing/have had palpitations on and off throughout my life but never for 12 hours/heart rate was 200+/hanging in 190s, 180s and 174 for hours" on 21Jun2021 22:45, and was recovering from the remaining events. Follow-up attempts are possible. Further information is expected.


VAERS ID: 1466581 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Minnesota  
Vaccinated:1921-06-17
Onset:2021-06-21
   Days after vaccination:36529
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pepcid 20 mg prn, lasix 20 mg twice daily, lopressor 25 mg daily, viagra 50 mg prn
Current Illness: liver disease d/t alcohol Dx 11/17 tobacco abuse
Preexisting Conditions: see above
Allergies: no known drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: platelet count decreased to 30K on 6/21/21, then 7/9/21 15K, 7/12/21 20K, 7/13/21 21K started on dexamethasone on 7/21


VAERS ID: 1466729 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-06-21
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (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: amlodipine 5 mg, fexofenadine 180 mg, quetiapine 50 mg, trazodone 100 mg
Current Illness: chronic illness : HTN, daily smoker, BPH and seasonal allergies
Preexisting Conditions: as above
Allergies: lisinopril - cough
Diagnostic Lab Data: DVT sonogram done 7/13/21
CDC Split Type:

Write-up: 1st COVID dose was 5/14/21 and 2nd COVID dose was6/29/21 he started w/ right calf pain on or about 6/21/21. he came to PCP for appointment on 7/12/21 and a sonogram was ordered to r/o DVT. he was unable to get to hospital until 7/13/21 and the songram revealed right DVT from groin to knee


VAERS ID: 1466939 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-06-21
Onset:2021-06-21
   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 EW0196 / 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient and Parent lied on pharmacy consent form about patient''s age so he could receive the vaccine. First dose was administered to patient at age of 11 years old. This was discovered when Patient''s other parent brought him in for dose two and Parent gave us actual birthdate.


VAERS ID: 1467000 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-19
Onset:2021-06-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pain, Paraesthesia, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness: Covid 19 on 04/02/2021
Preexisting Conditions: None
Allergies: Aleve Zithromax
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme body aches fever, tingling in fingers and arm. 36 hours post vaccine I had hives in multiple areas of my body. Due to my history of delayed onset reaction with Zithromax that was associated with lip and tongue tingling and a trip to the ER, I was told not to get the second shot


VAERS ID: 1467143 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-21
Onset:2021-06-21
   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 EW0180 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dehydration, Headache, Injection site pain, Thirst
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Dehydration (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: Site: Pain at Injection Site-Mild, Systemic: extreme thirst and dehydration-Severe, Systemic: Headache-Mild, Additional Details: extreme thirst for first 48 hours then thirst for 6 days after


VAERS ID: 1467555 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Headache, Hypoaesthesia, Hyporeflexia, Muscular weakness, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Acetaminophen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe chills, fever, muscle numbness, headache, brain fog, aches. Muscle numbness lasted 48 hours; afterwards, brain fog and muscle discoordination lasting since. Slower reflexes, numbness at back of head experienced. Ongoing, minor; but feeling really off since. The muscle issue/random numbness occurs still


VAERS ID: 1467773 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-15
Onset:2021-06-21
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test, Burning sensation, Hypoaesthesia, Magnetic resonance imaging, Muscle spasms, Paralysis, Peripheral coldness, Vibratory sense increased
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tacrolimus 0.1
Current Illness: No
Preexisting Conditions: Lichen Sclerosus
Allergies: No
Diagnostic Lab Data: MRi,Bloodwork 6/28
CDC Split Type:

Write-up: Started with right hand becoming extremely cold and cold objects felt like they were burning. Night time led to numbing upper and lower extremities. Muscle spasms in calfs and lower/upperbody weakness. Sensation of vibration then numbness. At day 11,had to go to the emergency room due to temporary paralysis ..treated with atavan for 5 days.next week,same numb episodes at night and while napping,led to appointment with neurologist after a second trip to the E.R where they took blood and MRI. Neurologist prescribed gabapentin which made matters worse. Waiting currently for EMG test


VAERS ID: 1469911 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-21
Onset:2021-06-21
   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 EW0181 / 2 LA / 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? 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-Medium


VAERS ID: 1470166 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-20
Onset:2021-06-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anaemia, Asthenia, Blood lactic acid increased, Blood potassium, Cardiac failure congestive, Condition aggravated, Culture stool negative, Dialysis, Diarrhoea, Dyspnoea, Hyperkalaemia, Hypervolaemia, Hypoxia, Leukocytosis, Nausea, Pain in extremity, Pneumonia, Pyrexia, Shift to the left, Vascular access malfunction, Vomiting, White blood cell count increased
SMQs:, Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol, Ventolin, Norvase, Catapres, Apresoline, Humalog, Toprolxl, Iron, Oxycodone, Protonlx, Paxil, Viagra
Current Illness: Diabetes, End stage renal disease, Hypertension, Hemodialysis, Congestive Heart Failure
Preexisting Conditions: Chronic Prostatitis, Asthma, Neuropathy, Chronic Pain Syndrome
Allergies: Iodinated Contrast Media
Diagnostic Lab Data: K6.3 (6/22), Lactic Acid 0.9; Leukocytosic with left shift (10.98)
CDC Split Type:

Write-up: Leg pain 24 hours later, fever pneumonia, congestive cardiac failure, dialysis access dysfunction, post vaccine fever, hyperkalemia, anemia, vomiting, weakness, hypoxia, hypervolemia; Pt rcvd J & J and next day seen in ER with leg pain, N, V, diarrhea and shortness of breath. Mult stool antigens neg. Lactic acid and WBC elevated. Initial fever resolved as did hyperkalemia and hypervolemia state after urgent dialysis.


VAERS ID: 1470237 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-21
Onset:2021-06-21
   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 - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood culture, Computerised tomogram, Haemorrhage urinary tract, White blood cell count
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Wellbutrin
Current Illness: No
Preexisting Conditions: Ovarian cysts
Allergies: Penicillin
Diagnostic Lab Data: Blood tests for WBC Blood cultures CAT Scan Done on 6/22/21
CDC Split Type:

Write-up: Sudden onset of heavy amounts of blood and blood clots in urine


VAERS ID: 1470376 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Cough, Malaise, Movement disorder, Pain, Pruritus, Pyrexia, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies: Dixcyclin
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient received her 2nd dose of Moderna vaccine on 06/21/2021 and began feeling ill that evening with body aches and fever on the third day she had hives and went to the ER and was sent home. She progressed into body aches, itching, joint pain and throwing up. By the 7th day she could not move, she felt like she was paralyzed.She was admitted into the Hospital on 07/03/2021 and was released on 07/11/2021. She currently still has a fever, whole body aches , coughing, itching and weakness.


VAERS ID: 1470573 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-18
Onset:2021-06-21
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 UN / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Autoimmune disorder, Laboratory test abnormal, Nail psoriasis
SMQs:, Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metaformin ER, Ezetimibe, Montelukast, Albuterol HFA, Modafinil
Current Illness: None
Preexisting Conditions: Diabetes, Mild Asthma, Cholesterol, Skin issues
Allergies: Statins
Diagnostic Lab Data: Currently Fungus of Toe Nails is been sent to lab which only is exclusive
CDC Split Type:

Write-up: Sometime after receiving the second dose, fingernails have developed what appears to be Nail Psoriasis to the point that on 6/21/2021 the patient ran out of functional fingernails as they had wasted away. This was reported to Moderna and again updated 7/14/2021 after the patient visited a dermatologist who suspects Nail Psoriasis. Samples were takens to see if Fungal issues are also involved. In AAD brochure, Causes of Psoriasis is suspected to be mistakenly activating T cells, triggering inflation. A trigger is often described as setting off the Psoriasis. The patient had never had nail psoriasis but some indicators and family history. In that the COVID 19 Vaccine is described as impacting T Cells/Immune system, the correlation seems possible.


VAERS ID: 1471026 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-19
Onset:2021-06-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Deafness, Influenza, Limb discomfort, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hearing impairment (narrow), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad)

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

Write-up: Lost my hearing, flu symptoms, throat got tight, throbbing in my left leg.


VAERS ID: 1471307 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely heavy, painful, and long period that came 4 days early. I''ve never experienced such bad cramping and bleeding with a period before. I am not coming up on my next period and the terrible cramps have begun again. Prior to the vaccine I rarely had cramps, and if I did they were minor. Now I am having such strong cramps that I can only lay down with a heating pad. The bleeding is heavier and clots.


VAERS ID: 1471313 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-19
Onset:2021-06-21
   Days after vaccination:2
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: Private       Purchased by: ?
Symptoms: Disturbance in attention, Fatigue, Headache, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (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: None
Current Illness: None
Preexisting Conditions: Fibromyalgia, anxiety, acid reflux, IBS
Allergies: NSAIDS
Diagnostic Lab Data: No medical tests. My doctor said it was most likely a post vaccination reaction.
CDC Split Type:

Write-up: Starting 2 days after the vaccination, I had constant tingling in legs and feet and occasional tingling in head and face that would come and go. Three days after vaccination tingling in legs and feet became more intense and felt like pins and needles. Still had waves of tingling in head and face that came and went. Four days after vaccination had less intense tingling in legs and feet but more intense tingling in head. Again it came in waves that lasted a few seconds. Along with it I had trouble concentrating and a mild headache and fatigue. Five days past vaccination all symptoms were less intense and less frequent but still came in waves and included legs and feet, arms and upper body and head. Also had mild headache and fatigue. Six days past vaccination less often and less intense tingling sensation in all affected areas. Seven days past vaccination, again less intense and less frequent tingling sensation in all areas. Eight days past vaccination, tingling mainly in legs and feet and more noticeable when at rest. Nine days past vaccination, 6/28/21 tingling in legs and feet continued and I went to my doctor. The tingling sensation in legs and feet is still there as of today 7/14/21. It varies in intensity and happens mainly when at rest.


VAERS ID: 1474247 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Corrective lens user, Dizziness, Fear, Headache, Immediate post-injection reaction, Nausea, Oropharyngeal pain, Photophobia, SARS-CoV-2 test negative, Vertigo positional, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 75 mcg. Vitamin D3, vitamin C, vitamin E, Ocuvite, L lysine, Sea Buckthorn oil, Hair Skin and Nail vitamin
Current Illness: Day of vaccination, minor sinus and chest congestion. Pharmacist was aware.
Preexisting Conditions: Hypoglycemia and, hypothyroidism, occasional bronchitis
Allergies: Penicillin Bactrim Erythromycin Keflex Doxycycline
Diagnostic Lab Data: Went to urgent Care. Tested negative to covid. Urgent care doctor said it could be sinus issue or just a combination of the sinus issue and the covid vaccine. Or it could have been the covid vaccine, but there was no way to tell.
CDC Split Type:

Write-up: Immediate headache and sore throat, light-headed. 2 Days later experienced vertigo while laying down, some nausea, vision more blurred, for a split second, could not see out of the center of my left eye, when room was dark, no issues with light on. I know sounds weird, but freaked me out. I wear glasses so vision was always a little blurred but it is worse now. I''m nearsighted but now that is a little blurry too. Eyes more sensitive to light to the point of where it hurts if I''m in bright sunlight or a brightly Lit room. Although my left eye doesn''t always hurt, it feels different. Always aware of it. Don''t know how to explain it.


VAERS ID: 1474617 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-07
Onset:2021-06-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Heart rate increased, Pulse abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

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

Write-up: headache like head about to explode, checked my pulse on watch and just plain using the computer and working but pulse is fluctuating between 100-125 for no reason. was like this for the whole week: headache and increased resting heart rate


VAERS ID: 1474697 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-24
Onset:2021-06-21
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Complication of pregnancy, Exposure during pregnancy, Streptococcal infection
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: pregnant at time of vaccination O99.824 - Streptococcus B carrier state complicating childbirth O75.9 - Labor and delivery, indication for care


VAERS ID: 1415062 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-16
Onset:2021-06-21
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Menstruation started 5 days early even though it is usually very regular. It is also a lot heavier than usual.


VAERS ID: 1417760 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Condition aggravated, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dexalant, Fresium, Seraquil, Lametic
Current Illness: Syncope
Preexisting Conditions: Bi-polar
Allergies: Aspirin
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT fainted after long term observation post vaccination. Pt was transported to Hospital by EMS. PT experienced a seizure during transport to Hospital. PT was transported under protocol.


VAERS ID: 1420463 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-20
Onset:2021-06-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysstasia, Feeling abnormal, Gait disturbance, Impaired work ability, Loss of personal independence in daily activities, Muscle spasms, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Muscle spasems in lower back left side extreme pain cant walk or sit can only lie down in cetain positions cant work or drive .woke feeling good arm a little sore started feeling strange within an hr of getting up by lunch time i couldnt hardly walk.


VAERS ID: 1424222 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-11
Onset:2021-06-21
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0195 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Bone pain, Decreased appetite, Hyperhidrosis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Osteonecrosis (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: KETEROLAC
Current Illness: NO
Preexisting Conditions: ASTHMA
Allergies: NO
Diagnostic Lab Data: NO
CDC Split Type: A40-52271644

Write-up: Excessive sweating, excessive bone pain, excessive muscular pain, lack of appetite.


VAERS ID: 1445109 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Illness, Presyncope, SARS-CoV-2 test
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (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:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Date: 20210621; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: Patient has not tested positive for COVID-19 since having the vaccine.
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Near fainting; Sick; This regulatory authority case was reported by a consumer and describes the occurrence of LOSS OF CONSCIOUSNESS (Passed out) in a 21-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Lactation decreased. On 21-Jun-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 21-Jun-2021, the patient experienced PRESYNCOPE (Near fainting) and ILLNESS (Sick). Few hours after my vaccine I stood up and almost passed out and have felt sick ever since.On 21-Jun-2021, PRESYNCOPE (Near fainting) had resolved. At the time of the report, ILLNESS (Sick) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 21-Jun-2021, SARS-CoV-2 test: negative (Negative) Patient has not tested positive for COVID-19 since having the vaccine.. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. No relevant concomitant medication were provided. Few hours after the vaccine patient experienced passed out and felt sick. No treatment information was provided.; 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: 1446743 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-16
Onset:2021-06-21
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ??? / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Fatigue, Nausea, Purpura, Pyrexia, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: water pill/olmetec for hypertension
Current Illness: copd
Preexisting Conditions: copd
Allergies: no
Diagnostic Lab Data: covid test negative
CDC Split Type:

Write-up: abdomen pain ,bloating , purping ,nausea, fatigue, feverish


VAERS ID: 1449138 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002185 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Dyskinesia, Hyperventilation, Seizure, Tetany
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 35.8
CDC Split Type: JPTAKEDA2021TJP046920

Write-up: Convulsion; Hyperventilation syndrome-like symptom; Tetany-like symptom; Involuntary movements of the whole body; This regulatory authority case was reported by a physician and describes the occurrence of SEIZURE (Convulsion), HYPERVENTILATION (Hyperventilation syndrome-like symptom), TETANY (Tetany-like symptom) and DYSKINESIA (Involuntary movements of the whole body) in an 18-year-old female patient who received mRNA-1273 (COVID 19 Vaccine Moderna) (batch no. 3002185) for COVID-19 vaccination. Previously administered products included for Product used for unknown indication: Influenza vaccine. Past adverse reactions to the above products included Pyrexia with Influenza vaccine. On 21-Jun-2021, the patient received first dose of mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 21-Jun-2021 at 1:15 PM, the patient experienced SEIZURE (Convulsion) (seriousness criteria hospitalization and medically significant), HYPERVENTILATION (Hyperventilation syndrome-like symptom) (seriousness criterion hospitalization), TETANY (Tetany-like symptom) (seriousness criterion hospitalization) and DYSKINESIA (Involuntary movements of the whole body) (seriousness criterion hospitalization). The patient was hospitalized from 21-Jun-2021 to 22-Jun-2021 due to DYSKINESIA, HYPERVENTILATION, SEIZURE and TETANY. On 22-Jun-2021, SEIZURE (Convulsion), HYPERVENTILATION (Hyperventilation syndrome-like symptom), TETANY (Tetany-like symptom) and DYSKINESIA (Involuntary movements of the whole body) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 35.8 (normal) 35.8. The action taken with mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) was unknown. For mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular), the reporter did not provide any causality assessments. Patient developed Involuntary movements of the whole body gradually. The patient was emergently transported and admitted to Hospital, because the symptoms did not lessen after about 2-hour observation. No concomitant medication information was reported. No treatment information was reported. 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: 1458341 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   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: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021774250

Write-up: Pain in arm; 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 is GB-MHRA-YCVM-202106211047132870-25LDX, Safety Report Unique Identifier is GB-MHRA-ADR 25514806. A 18-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 21Jun2021 (Lot Number: FA1027) (at the age of 18-year-old) as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 vaccination. The patient''s medical history was not reported. Patient also reported a menstrual period date as 14Jun2021. 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 at the time of reporting. Patient is not currently breastfeeding. The patient''s concomitant medications were not reported. On 21Jun2021, the patient experienced pain in arm, which was provided as serious, seriousness criteria-other medically important condition by the regulatory authority. The outcome of the event was not recovered. 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. No further information is expected.; Sender''s Comments: Based on temporal association, the event pain in arm is considered related to BNT162B2. 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: 1458592 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002185 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, Body temperature
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dermatitis atopic (Atopic dermatitis)
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: Before vaccination.
CDC Split Type: JPTAKEDA2021TJP044865

Write-up: Anaphylaxis; This regulatory authority case was reported by a physician and describes the occurrence of ANAPHYLACTIC REACTION (Anaphylaxis) in an 18-year-old female patient who received mRNA-1273 (COVID 19 Vaccine Moderna) (batch no. 3002185) for COVID-19 vaccination. Concurrent medical conditions included Dermatitis atopic (Atopic dermatitis). On 21-Jun-2021, the patient received first dose of mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 21-Jun-2021 at 2:55 PM, after starting mRNA-1273 (COVID 19 Vaccine Moderna), the patient experienced ANAPHYLACTIC REACTION (Anaphylaxis) (seriousness criteria hospitalization and medically significant). The patient was hospitalized until 22-Jun-2021 due to ANAPHYLACTIC REACTION. The patient was treated with NORADRENALINE [NOREPINEPHRINE] (intramuscular) for Anaphylaxis, at an unspecified dose and frequency. On 22-Jun-2021, ANAPHYLACTIC REACTION (Anaphylaxis) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 35.8 degree Celsius (Low) Before vaccination.. For mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular), the reporter considered ANAPHYLACTIC REACTION (Anaphylaxis) to be possibly related. No concomitants were provided. Body temperature was take with 35.8 cel on an unknown date. The patient experienced anaphylaxis. Hyperventilation syndrome developed with sudden onset of tachypnoea and decreased blood oxygen saturation level to 60%. The patient received an intramuscular injection of noradrenalin and was transported by ambulance. Thereafter, the symptoms abruptly resolved. However, transfer by an ambulance was requested for follow-up. On 22-JUN-2021, the patient was discharged. The outcome of anaphylaxis was reported as recovered. Follow-up investigation will be made. Company Comment ; The event 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 event, a causal relationship cannot be excluded. Most recent FOLLOW-UP information incorporated above includes: On 28-Jun-2021: Follow up added additional document:new info added, updated Anaphylaxis stop date, action take for first dose, narrative; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1462667 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   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 FD5613 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Headache, Maternal exposure during pregnancy, Musculoskeletal stiffness, Nausea, SARS-CoV-2 test, Scan
SMQs:, Acute pancreatitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Arthritis (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: FOLIC ACID; GAVISCON DOUBLE ACTION; LAXIDO; PREGNACARE ORIGINAL [ASCORBIC ACID;BETACAROTENE;BIOTIN;CALCIUM PANTOTHENATE;COLECALCIFEROL;COPPER;CY; VICKS INHALER; VICKS VAPORUB [CAMPHOR;EUCALYPTUS GLOBULUS OIL;LEVOMENTHOL;PINUS PINASTER OIL;T
Current Illness: Hay fever; Irritable bowel syndrome; Pregnancy (Estimated due date: 20211203); Psoriasis
Preexisting Conditions: Medical History/Concurrent Conditions: Abdominal bloating; Constipation; Folic acid supplementation; Sinusitis
Allergies:
Diagnostic Lab Data: Test Date: 20210626; Test Name: COVID-19 virus test; Test Result: Negative ; Comments: No-Negative COVID-19 test; Test Name: Scan; Result Unstructured Data: Test Result:Uncomplicated pregnancy; Comments: Uncomplicated pregnancy, no syndromes detected
CDC Split Type: GBPFIZER INC2021814503

Write-up: Headache; Nausea; Shoulder pain; Neck stiff; Maternal exposure during pregnancy; This is a solicited report from a contactable consumer. This is a report received from the Regulatory Agency (RA). Regulatory authority report number GB-MHRA-YCVM-202106260841092530-YI5AF, Safety Report Unique Identifier GB-MHRA-ADR 25556792. A 34-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: FD5613), dose 1 via an unspecified route of administration on 21Jun2021 at the age of 34-year-old as single dose for covid-19 vaccination. Medical history included ongoing pregnancy (estimated due date: 03Dec2021), ongoing irritable bowel syndrome, ongoing hey fever, ongoing psoriasis, sinusitis, constipation, abdominal distension, and folic acid supplementation. Unsure if patient had symptoms associated with COVID-19. Patient was not enrolled in clinical trial. Patient was not currently breastfeeding. Concomitant medications included folic acid taken for vitamin supplementation; calcium carbonate, sodium alginate, sodium bicarbonate (GAVISCON DOUBLE ACTION) taken for abdominal distension from 09May2021 to an unspecified stop date; macrogol 3350, potassium chloride, sodium bicarbonate, sodium chloride (LAXIDO) taken for constipation from 27May2021 to an unspecified stop date; ascorbic acid, betacarotene, biotin, calcium pantothenate, colecalciferol, copper, cyanocobalamin, folic acid, iodine, iron, magnesium, nicotinamide, phytomenadione, pyridoxine hydrochloride, riboflavin, selenium, thiamine mononitrate, tocopheryl acid succinate, zinc (PREGNACARE ORIGINAL) taken for pregnancy from 06Apr2021 to an unspecified stop date; ascorbic acid, menthol (VICKS INHALER) taken for an unspecified indication from 01Jun2021 to an unspecified stop date; camphor, eucalyptus globulus oil, levomenthol, pinus pinaster oil, thymol (VICKS VAPORUB) taken for sinusitis from 11May2021 to an unspecified stop date. The patient experienced maternal exposure during pregnancy on 21Jun2021, headache (medically significant), nausea (medically significant), shoulder pain (medically significant), neck stiff (medically significant) on 26Jun2021. The patient became pregnant while taking bnt162b2. First pregnancy. The mother was 15 weeks pregnant at the onset of the event. Patient was exposed to the vaccine Second-trimester (13-28 weeks). The mother was due to deliver on 03Dec2021. Patient did not think vaccination had an adverse effect on any aspect of the pregnancy. The patient underwent lab tests and procedures which included COVID-19 virus test: No-Negative COVID-19 test on 26Jun2021, scan: uncomplicated pregnancy, no syndromes detected. The action taken in response to the events for bnt162b2 was not applicable. The outcome of event maternal exposure during pregnancy was unknown, headache was recovering, nausea, neck stiff was recovered on 27Jun2021, shoulder pain was recovered on 28Jun2021. 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 further information is expected.; Sender''s Comments: Based on plausible temporal relationship and known drug profile, a contributory role of the suspect BNT162B2 cannot be excluded in the development of headache, nausea, shoulder pain and neck stiff. 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: 1465522 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002185 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Hyperventilation, Muscle spasms
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Dystonia (broad), Eosinophilic pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Test Result: Inconclusive ; Result Unstructured Data: 35.8 degree Celsius
CDC Split Type: JPTAKEDA2021TJP047831

Write-up: Hyperventilation syndrome; Movements involuntary of the whole body (cramp of limb); This spontaneous case was reported by a physician and describes the occurrence of HYPERVENTILATION (Hyperventilation syndrome) and MUSCLE SPASMS (Movements involuntary of the whole body (cramp of limb)) in an 18-year-old female patient who received mRNA-1273 (COVID 19 Vaccine Moderna) (batch no. 3002185) for COVID-19 vaccination. Previously administered products included for an unreported indication: Influenza vaccine live. Past adverse reactions to the above products included Pyrexia with Influenza vaccine live. On 21-Jun-2021, the patient received first dose of mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 21-Jun-2021 at 1:15 PM, the patient experienced HYPERVENTILATION (Hyperventilation syndrome) (seriousness criterion hospitalization) and MUSCLE SPASMS (Movements involuntary of the whole body (cramp of limb)) (seriousness criterion hospitalization). On 22-Jun-2021, HYPERVENTILATION (Hyperventilation syndrome) and MUSCLE SPASMS (Movements involuntary of the whole body (cramp of limb)) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 35.8 degree Celsius. The action taken with mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular) was unknown. For mRNA-1273 (COVID 19 Vaccine Moderna) (Intramuscular), the reporter considered HYPERVENTILATION (Hyperventilation syndrome) and MUSCLE SPASMS (Movements involuntary of the whole body (cramp of limb)) to be possibly related. No concomitant medication information was provided. No treatment product information was provided. Though the progress was observed for about 2 hours, the motion of limbs was not improved, and the emergency transport request was carried out. On 22-Jun-2021, the patient was discharged. 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. Further information is expected.; Reporter''s Comments: Not reported.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information is expected.


VAERS ID: 1468718 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   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 EW3143 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Maternal exposure during pregnancy
SMQs:, 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: FOLIC ACID
Current Illness: Pregnancy (Estimated due date: 17Jul2021)
Preexisting Conditions: Medical History/Concurrent Conditions: Folic acid supplementation
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021821897

Write-up: Fatigue; Maternal exposure during pregnancy; This is a solicited report from a monitor program from a contactable consumer. This is a report received from a regulatory authority. Regulatory authority report number YCVM-202106300844237350-FHBZC. Safety Report Unique Identifier is GB-MHRA-ADR 25566218. A 32-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW3143), dose 2 via an unspecified route of administration on 21Jun2021 at the age of 32-year-old as single dose for COVID-19 immunisation. Medical history included ongoing pregnancy (Estimated due date: 17Jul2021), folic acid supplementation. Patient did not have symptoms associated with COVID-19. Not had a COVID-19 test. Patient was not enrolled in clinical trial. Patient was not currently breastfeeding. Concomitant medications included folic acid taken for folic acid supplementation. The patient experienced maternal exposure during pregnancy on 21Jun2021, fatigue on 23Jun2021. The mother reported she became pregnant while taking bnt162b2. The mother was due to deliver on 17Jul2021. This case was reported as serious, medically significant. The outcome of event maternal exposure during pregnancy was unknown, fatigue was recovered on 26Jun2021. The reporter''s assessment of the causal relationship of the event fatigue 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 further information is expected.; Sender''s Comments: Considering a drug-event temporal association and the consistency of this event with the known safety profile of the suspect product, there is a reasonable possibility that the reported fatigue is related to BNT162B2. 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: 1468927 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   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 FD4555 / 1 RA / OT

Administered by: Other       Purchased by: ?
Symptoms: Amnesia, Epilepsy
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalopathy/delirium (broad), Generalised convulsive seizures following immunisation (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: ITPFIZER INC2021794501

Write-up: An episode of presumed epileptic nature, of the absence type, lasting about 5 seconds. After the end of the episode, amnesia of the event present.; An episode of presumed epileptic nature, of the absence type, lasting about 5 seconds. After the end of the episode, amnesia of the event present.; This is a spontaneous report from a contactable physician downloaded from a regulatory authority-WEB, regulatory authority number IT-MINISAL02-748266. A 16-year-old male patient received on 21Jun2021 at the age of 16-years first dose of BNT162B2 (COMIRNATY, lot FD4555, expiration date 31Oct2021) intramuscular in the right arm at 0.3 ml single for Covid-19 immunization. Medical history and concomitant medications were not reported. On 21Jun2021, the patient had an episode of presumed epileptic nature, of the absence type, lasting about 5 seconds. After the end of the episode, amnesia of the event present. Outcome was recovered on 21Jun2021. Senders comment: 25Jun2021 Severity changed on the basis of the ime list from not severe to severe - other clinically relevant condition. No follow up attempts are needed. No further information is expected.


VAERS ID: 1471999 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   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 - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Illness
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PROGESTERON
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Contraception; Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021784397

Write-up: severe stomach cramping; Diarrhea; Sickness/unable to keep food down; This is a spontaneous report from a contactable consumer received from the regulatory authority. The regulatory authority report number is GB-MHRA-APPCOVID-202106232230039760-L7DT0, Safety Report Unique Identifier GB-MHRA-ADR 25535460. A 18-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration (at the age of 18-year-old) on 21Jun2021 (Batch/Lot number: Not Known) as single dose for COVID-19 immunisation. Medical history included Lactation decreased, contraception. Unsure if patient has had symptoms associated with COVID-19. Not had a COVID-19 test. Patient was not enrolled in clinical trial. Patient was not pregnant. Patient was not currently breastfeeding. Concomitant medication included progesterone (PROGESTERON) taken for contraception. The patient experienced severe stomach cramping on an unspecified date, diarrhea and sickness/unable to keep food down on 21Jun2021; all medically significant. Patient has not tested positive for COVID-19 since having the vaccine. The outcome of the event Stomach cramps was unknown, others was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1472036 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-20
Onset:2021-06-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Fatigue, Lymphadenopathy, Pain, SARS-CoV-2 test, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Test Date: 20210702; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: No - Negative COVID-19 test.
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Swelling in underarm glands; Chronic pain; Tiredness; Bruising; Swollen glands; Swelling; This regulatory authority case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (Swelling in underarm glands), CONTUSION (Bruising), LYMPHADENOPATHY (Swollen glands), SWELLING (Swelling), PAIN (Chronic pain) and FATIGUE (Tiredness) in an 18-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 20-Jun-2021, the patient received dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Jun-2021, the patient experienced CONTUSION (Bruising) (seriousness criterion medically significant), LYMPHADENOPATHY (Swollen glands) (seriousness criterion medically significant), SWELLING (Swelling) (seriousness criterion medically significant) and FATIGUE (Tiredness) (seriousness criterion medically significant). On an unknown date, the patient experienced LYMPHADENOPATHY (Swelling in underarm glands) (seriousness criterion medically significant) and PAIN (Chronic pain) (seriousness criterion medically significant). At the time of the report, LYMPHADENOPATHY (Swelling in underarm glands) and PAIN (Chronic pain) outcome was unknown and CONTUSION (Bruising), LYMPHADENOPATHY (Swollen glands), SWELLING (Swelling) and FATIGUE (Tiredness) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 02-Jul-2021, SARS-CoV-2 test: no - negative covid-19 test (Negative) No - Negative COVID-19 test.. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was provided. 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. 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: 1472399 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-02
Onset:2021-06-21
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW3143 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Abortion spontaneous, Heavy menstrual bleeding, Maternal exposure during pregnancy, Off label use, Pain, Pregnancy test, Product use issue
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Medication errors (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: Miscarriage; Comments: Patient has not had symptoms associated with COVID-19 Not had a COVID-19 test Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data: Test Name: pregnancy test; Test Result: Negative ; Comments: I talked to the GP and she asked me to do pregnancy test just in case if it is a miscarriage. The pregnancy test is negative.
CDC Split Type: GBPFIZER INC2021776147

Write-up: miscarriage/Her last period started on 25May2021; Exposure during breastfeeding; Exposure during breastfeeding; miscarriage; pain; Heavy periods; This is a spontaneous report from a contactable consumer received from the Regulatory Agency (RA). The regulatory authority report number is GB-MHRA-WEBCOVID-202106230818279150-7GQRL. Safety Report Unique Identifier (GB-MHRA-ADR 25523302). This consumer reported information for both mother and baby. This is the maternal report. A 34-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration on 02Jun2021 (Lot Number: EW3143) as single dose for covid-19 immunization. Medical history included miscarriage. The patient''s concomitant medications were not reported. The patient experienced miscarriage and pain on an unspecified date, heavy periods on 21Jun2021 and exposure during breastfeeding. She was a healthy woman aged 34. She had a 2 and half year-old baby whom she still breastfeed. On 02Jun2021 she had the first dose of Pfizer. She did not get any side effects at that time. She always had a normal menstruation cycle and periods never ever got late till now in her life and she had never missed any cycle (apart from being pregnant) and the flow was always normal. Her last period started on 25May2021. On 20Jun2021 the period started for this month. On 21Jun2021 since morning, she had heavy bleeding flow with large amounts of jelly like lumps started coming out at each visit to the washroom and later turned into excessive blood lumps/clots coming out back to back. It had never happened to her ever before. The lumps were extremely dark reddish and still came on 22Jun2021. Today was 23Jun2021 and they were still there. She didn''t have any pain. They were so big that she can feel it moving from top to bottom of the vagina and coming out. She talked to the GP and she asked her to do pregnancy test just in case if it was a miscarriage. The pregnancy test was negative and she did not even plan for a baby. She was pretty sure it was due to the side effect of the Pfizer. She didn''t have any other disease or infection. Case was reported as serious, medically significant. Patient has not tested positive for COVID-19 since having the vaccine. Outcome of event heavy periods was not recovered and the other events were recovering. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : GB-PFIZER INC-2021813728 Baby case


VAERS ID: 1477273 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-21
Onset:2021-06-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY3860 / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Body temperature, Erythema, Lip erythema, Lip swelling, Oxygen saturation, Oxygen saturation decreased, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Alcohol allergy; Food allergy; Seafood allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210621; Test Name: Body temperature; Result Unstructured Data: Test Result:36.8 Centigrade; Comments: before vaccination; Test Name: Oxygen saturation; Result Unstructured Data: Test Result:improved; Test Date: 20210621; Test Name: Oxygen saturation; Result Unstructured Data: Test Result:decreased; Comments: After the vaccination,Oxygen saturation decreased; Test Date: 20210621; Test Name: COVID-19 PCR test; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: JPPFIZER INC2021815543

Write-up: Anaphylaxis; Lip swelling; Oxygen saturation decreased; lip redness; Redness generalised; This is a spontaneous report from a contactable nurse received via System and from a contactable physician received from the regulatory authority. Regulatory authority report number is v21117129. The patient was a non-pregnant 18 -year-old female. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any other medications within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient had allergy to crustacean, pineapples, raw eggs and alcohol. On 01Jun2021 at 01:30am (the day of vaccination), the patient previously received the first single dose of BNT162B2 (COMIRNATY, Solution for injection, Lot number EY4834, Expiration date 31Aug2021) intramuscular in the left arm for COVID-19 immunization. Body temperature before the vaccinations was 36.8 degrees Centigrade on 21Jun2021. On 21Jun2021 at 13:30 (the day of vaccination), the patient received the second single dose of BNT162B2 (COMIRNATY, Solution for injection, Lot number EY3860, Expiration date 31Aug2021) intramuscular in the left arm for COVID-19 immunization (18 year old at vaccination). On 21Jun2021 at 14:00 (30 minutes after the vaccination), the patient experienced Anaphylaxis, SpO2 decreased, Lip swelling, lip redness and Redness generalized. The reporter classified the events as serious (hospitalization 1day) and stated the events result in Emergency room/department or urgent care. The outcome of the event was recovering with treatment including Adrenaline, Solu-Cortef and POLARAMINE. Since the vaccination, the patient has been tested for COVID-19 on 21Jun2021. The result of PCR test (Nasal Swab) was negative. The reporter classified the event as serious (hospitalized from 21Jun2021 to 22Jun2021). The reporter commented as follows: Adrenaline administration improved skin and mucosal symptoms and SpO2. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1413190 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-06
Onset:2021-06-20
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Feeling cold, Impaired work ability, Injected limb mobility decreased, Malaise, Nausea, Pain, Somnolence, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: NO
Diagnostic Lab Data: NO
CDC Split Type:

Write-up: Fine until about 4 a.m. on the 20th, day after vaccine. Woke up with uncontrollable shaking, nausea and teeth chattering, cold and could not move my left arm . Same arm as shot. I had a temperature of 101.2 Took tylenol, still sore and chills. Had to call in to work to say I was sick. Took naps mostly throughout the day, fever still persisting around 101. Took Tylenol, 2 hours later fever down to 99.1. Could not stay awake for long. Slept most of the day.


VAERS ID: 1413220 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

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

Write-up: rapid heart rate - resting heart rate 113


VAERS ID: 1413259 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose, Blood pressure measurement, Cold sweat, Flat affect, Heart rate, Hyperhidrosis, Joint contracture, Mydriasis, Oxygen saturation, Pulmonary artery compression, Pulse absent, Respiration abnormal, Resuscitation, Seizure, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: none reported
Diagnostic Lab Data: blood pressure, pulse ox, heart rate, blood glucose, CPR
CDC Split Type:

Write-up: 43yo Female collapsed into husband?s arms after receiving Janssen vaccine at 08:46. Observation nurses responded, assisted client to ground and determined client was having a seizure and was not breathing. Pupils dilated, non-responsive, not breathing, initial carotid pulse not found, immediately began chest compressions and called 911 at 08:49. At the start of first chest compression client inhaled and carotid pulse returned. Client continued without responsiveness and atypical grunting for about 20 seconds before regular breathing returned at 08:50. Pupils returned to normal size and client alertness returned 08:50. Client remained flat, was very diaphoretic and clammy and hand and arms remained in contractures; BP 90/72 Client able to state her name and location and identify husband. Repeat BP 110/72; client remained diaphoretic 09:02 Client hands and arms remained in contractures until 09:03 Client reported similar event has happened in the past but unable to state details of prior event EMS arrived at 09:11; BP 110/70, HR 122, SpO2 98%, blood glucose 145 Client began vomiting at 09:16, assisted to her side. EMS assisted client to chair Client refused transfer to hospital. EMS left at 09:47 Wheelchair called for transport Client left with husband via wheelchair at 10:06


VAERS ID: 1413275 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Injection site pain, Muscle spasms, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache, fever, cramping, nausea, joint pain, injection site pain.


VAERS ID: 1413276 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Cranberry, pomegranate
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen eyes, took Benadryl but not sure if it works yet.


VAERS ID: 1413278 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

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

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: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache started at 8:00 AM, rash started after that when pt received Tylenol from mother


VAERS ID: 1413282 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event, Off label use
SMQs:

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

Write-up: Patient vaccinated with 2D Moderna after presenting documentation from PCP giving authorization to administer as off label use, per CDC recommendation. No adverse reaction noted during the 30 minute post vaccination observation period.


VAERS ID: 1413303 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Injection site pain, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Fever, chills, nausea, general malaise, site pain


VAERS ID: 1413308 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Fatigue, Pain, Pain in extremity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1st Covid shot, just tired and body aches.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin, penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm day of, continuing into day two. Woke at 9am day 2 feeling very achy and tired but with an upset stomach and shortly after vomited. He has a fever of around 101 and still has all other symptoms but stomach ache & nausea has subsided.


VAERS ID: 1413315 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 RA / IM

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

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

Write-up: Patient received vaccine and was seated for 5 minutes in vaccination room and was moving to the waiting area and fainted once she got up. Patient was given oral glucose gel and felt better. Paramedics were called and checked vitals and she was fine and mother refused going to the hospital


VAERS ID: 1413320 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-14
Onset:2021-06-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Energy increased, Fatigue, Feeling abnormal, Feeling jittery, Headache, Nightmare, Sleep disorder
SMQs:, Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amantamine Gabepentum Methadone Zolpidem
Current Illness:
Preexisting Conditions: Severe restless leg syndrome Periodic limb movement disorder Obstructive sleep apnea Degenerative disc disease in back Pacemaker for low heart rate Spinal cord stimulator implant
Allergies: latex Licinipril Ropinirole
Diagnostic Lab Data: I haven''t gone to a clinic as of yet
CDC Split Type:

Write-up: adverse effects started about 6 hours after the injection for the 2nd shot. The adverse reaction to the 1st shot was the normal tired, arm sore, chills and upset stomach stomach. After the 2nd shot the adverse effect started with feeling like my nighttime meds were wearing off from the night before about 3-4 hours earlier than normal. I would get these antsy type feelings running thru both my arms and up and down my legs. Just a constant need to be moving. I took my meds early and things settled down closer to normal. The next day was even worse and its stayed at about the 16-20 hour medicine efficacy instead of the normal 24-28 hour normal efficacy. This has continued since the shot 6 days. I''ve also had a nagging headache fir the last 4 days along with an upset stomach for 2 days. Since the 2nd shot I''ve also had nightmares every night where I''m startled awake and I usually do not have dreams/nightmares. And just an overall feeling of exhaustion.


VAERS ID: 1413327 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 allergic rash to MD on 6/20/2021


VAERS ID: 1413330 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-17
Onset:2021-06-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: School       Purchased by: ?
Symptoms: Chest pain, Troponin I increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Melatonin
Current Illness: Previous viral like illness a few days prior to 2nd dose of covid vaccine. Sore throat and fever. Has documentation of negative COVID test prior to 2nd vaccination.
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Trop I: 2418 ng/L
CDC Split Type:

Write-up: Elevated troponin with chest pain.


VAERS ID: 1413334 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Feeling jittery, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: sinusitus in 2015
Allergies: none
Diagnostic Lab Data: blood glucose 91
CDC Split Type:

Write-up: Patient started experiencing dizziness and light headedness approx 10 minutes after administration of vaccine. Pt stated that he felt like the room was shaking, and also felt his body shaking. Vital signs were taken an were as follows: 180/80 on right arm HR 73 o2 99, temp 97.6, respirations 19. Vitals retaken throughout the course. bp at 1002 decreased to 180/100 on right arm. Pt stated that he still felt same symptoms with no improvement. Pt was given epinepherine auto-injector for adults. BP taken at 1014 bp 175/82. stated that he was feeling a little better but still felt jittery, light headed and dizzy still. ems arrived at the scene at 1031 and took over. pt BP on right arm was 138/100. left arm was 135/83. ems asked pt if he wanted to go to hospital. pt stated no. pt determined that pt was stable and did not needed to go to hospital.


VAERS ID: 1413335 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: n/a
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: patient had vomiting after getting the vaccine


VAERS ID: 1413340 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Enlarged lymph node in left armpit.


VAERS ID: 1413341 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-12
Onset:2021-06-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Red swollen lump at injection site. Very itchy.


VAERS ID: 1413351 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: Fainted, fell and lost consciousness for a few seconds


VAERS ID: 1413358 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Peripheral coldness, Skin warm, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Patient loss consciousness for a few seconds, vomited, hot to the touch at first then cool to the touch. 911 was called and vitals were checked by the paramedics. Patient did not go to the hospital and vitals were within range.


VAERS ID: 1413363 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

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

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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: No
CDC Split Type:

Write-up: 10 mins following vaccination. Client stated, she?s not feeling well, and her husband slowly guided her to the ground. Paramedics provided oxygen and checked the blood pressure 132/78, P 82. Ambulance called. On arrival paramedics took client to ambulance, client refused to go to hospital. Client was monitored on vaccination bus until 1:50 pm, and at that point a he was ready to go. Client walked away from vaccination site with her husband.


VAERS ID: 1413364 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

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

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

Write-up: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Severe, Systemic: Weakness-Mild


VAERS ID: 1413370 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient was given an expired shot from yesterday by mistake.


VAERS ID: 1413377 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: pain in both legs


VAERS ID: 1413378 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-11
Onset:2021-06-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Furosemide 40mg 1x daily; ferrous sulfate 325mg ec tabs 3x daily; vitamin c 250-500mg with iron pill 3x daily
Current Illness: None though did start having a sore throat (still have) from post nasal drainage from what I assume is a sinus infection. No fever and no other significant illnesses.
Preexisting Conditions: Lymphadema in legs; Morbid obesity; PCOS
Allergies: Sulfa drug allergy, mold and grass allergy.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Injection site started itching, noticed lump 2-3 inches in diameter at injection site. Event just started, so no treatment or outcome yet.


VAERS ID: 1413383 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

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

Write-up: Dizziness, nausea


VAERS ID: 1413386 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye movement disorder, Hyperhidrosis, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: BACHLORETTE PARTY LAST NIGHT
Preexisting Conditions: UNKNOWN
Allergies: RAW FRUIT
Diagnostic Lab Data: UNKNOWN I REQUESTED TO CALL 911. PATIENT REFUSED MEDICAL TREATMENT. WE GAVE HER JUICE AND CRACKERS AND SAT WITH HER UNTIL SHE COULD GET SOMEONE TO PICK HER UP. I TOLD HER SHE COULDN''T DRIVE. I DID REQUEST SHE GO TO EMERGENCY ROOM OR URGENT CARE JUST TO GET LOOKED AT.
CDC Split Type:

Write-up: PATIENT FAINTED, FEET AND HANDS CURLED INWARD, EYES ROLLED BACK. SHE REGAINED CONSCIOUSNESS AFTER ABOUT 45-60 SECONDS.. PATIENT WAS SEATED AND DID NOT FALL. PATIENT WAS VERY PALE AND SWEATY.


VAERS ID: 1413392 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: within 5 minutes, became light headed and very sweaty. blood pressure 78/50 taken twice on our automatic cuff. got pale, felt weak. got some color back by the time the medics arrived.


VAERS ID: 1413396 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Not sure
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt passed out after getting the shot. When pt recovered after 5 mins,she started vomiting and was really shaken


VAERS ID: 1413398 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient received dose 1 of the Pfizer COVID vaccine (lot ER8735, exp 7/2021) at 1015. At 1020, patient reported to LVN that he felt nauseous and dizzy. Patient was given emesis bag. Patient''s sister reported patient had not eaten since the night before. Vital signs: blood pressure 110/60, pulse 90, respirations 16. PHN approached the patient, noting diaphoretic skin. Patient was placed supine in zero-gravity chair and given juice and granola bar. Patient denied allergies, medical conditions, and medications. At 1025, vital signs: blood pressure 112/60, pulse 80, respirations 16. Patient reported symptoms improving, PHN noted patient''s skin was no longer diaphoretic. At 1030, vital signs: blood pressure 110/60, pulse 77, respirations 16. Patient finished snack and juice, reported feeling better. Patient reported similar reaction when having blood drawn previously. At 1035, vital signs: blood pressure 114/62, pulse 72, respirations 16. PHN encouraged patient to stay for monitoring for 30min. PHN educated patient about following up with medical provider and when to call 911. At 1040, patient sat up. Vital signs: blood pressure 110/64, pulse 70, respirations 16. At 1045, patient stood up closely monitored by PHN and EMT, reported symptoms had resolved. Vital signs: blood pressure 110/62, pulse 77, respirations 16. Patient drank water. At 1050, vital signs: 112/60, pulse 74, respirations 16. Patient left walking with steady gait at 1052 accompanied by sister to drive him home.


VAERS ID: 1413406 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / UNK - / SYR

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

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

Write-up: Fever of 103


VAERS ID: 1413407 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fall, Hyperhidrosis, Loss of consciousness, Pallor, Syncope, Thirst
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patinet received his Janssen Covid Vaccine today. He was fine in the immunization room and he went to the waiting area. Patient lost conciousness and fell on his partner. We went to him when we heard from another customer. He said he was feeling really lightheaded and thirsty. He had Syncope (Paleness, excessive sweating, and Loss of Consciousness for few seconds). He mentioned he did not drink much water today before the appt and also worked outside in the sun. We had him wait for 30 mins and he was perfectly fine. Coach came to do an incident report and then he left. His partner was with him all the time.


VAERS ID: 1413410 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Fever, headache, body aches. Extreme fatigue


VAERS ID: 1413411 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Depressed level of consciousness, Fall, Seizure
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: 18 yo Male client received Janssen vaccine at 12:54. Immediately following injection, client slumped over in chair and began seizing. Seizure lasted 2 seconds, client immediately became alert and responsive. Client stated he got ?cloudy? but feels normal post event. Client assisted to floor to lay down. After 20 seconds client wanted to get up stating he was feeling normal. Client escorted to observation area where he was observed for full time without further events. No EMS called Ambulatory upon leave with his family


VAERS ID: 1413415 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dizziness, Headache, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: 14 yo Female client received Pfizer vaccine at 13:29. Client reported feeling dizzy and light headed, appeared pale. Client escorted to the floow to lie down, father present BP 138/94, client reported feeling anxious Father gave client cookies, client reported feeling better but had a headache, color returned No EMS called Ambulatory upon leave with father


VAERS ID: 1413423 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: Patient did not have his Vaccination card. Data Team/Registration did not provide a copy of the card or the consent form to the vaccination table, from the patient''s first dose. The consent form was then marked, incorrectly, Pfizer. The patient was then given a dose of the Pfizer vaccine when he should have received a second dose of Moderna. There were no adverse symptoms noted at vaccine facility.


VAERS ID: 1413424 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Throat irritation
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported
Current Illness: anxiety reported
Preexisting Conditions: none reported
Allergies: none reported
Diagnostic Lab Data: blood pressure, HR
CDC Split Type:

Write-up: 51 yo Female client received Janssen vaccine at 15:00. Client reported feeling dizzy and then developed an itchy throat Client assessed by observation nurse; no airway or tongue swelling, no difficulty breathing, BP 116/66 HR 110 Client reported feeling anxious and decided to take antihistamine medication she had with her Client reported symptoms improving No EMS called Ambulatory upon leave


VAERS ID: 1413427 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: none reported
Diagnostic Lab Data: Blood pressure: 96/67, HR 63 taken on 6/20/21, ~11:10am
CDC Split Type:

Write-up: Pt left vaccination room and roamed around the store around 11:00am. About 5-7 minutes later, Pt suddenly felt lightheaded and stood against the wall. Pt then got dizzy and sat down and was laid down on the floor by father. Pharmacist arrived to check on pt. Blood pressure for pt was found to be 96/67 with a HR of 63. Pt provided water and sprite to help bring sugars up since pt stated skipping breakfast in the morning. Pt started feeling better when paramedics arrived to check on pt. Paramedics cleared pt to go.


VAERS ID: 1413430 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 UN / IM

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

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

Write-up: 19 yo female reported to her father she was not feeling well after receiving Janssen vaccine at 15:00. Father flagged observation nurse over as patient displayed a syncopal episode. Client reported her vision went black but did not recall if she lost consciousness. Client became alert without assist. BP 72/50; client appeared pale client given gatorade and reported feeling better BP 100/50 client finished observation and was ambulatory upon leave with father


VAERS ID: 1413431 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Full blood count, Hypersensitivity, Metabolic function test, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: augmentin
Diagnostic Lab Data: CBC/BMP WNL 6/20/21
CDC Split Type:

Write-up: allergic reaction- diffuse hives started 6/20/21, ER visit, arrived 1:59pm, symptoms started approximately 30 min prior to arrival. also took a tylenol but no prior issues with tylenol in the past


VAERS ID: 1413444 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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:
Current Illness:
Preexisting Conditions: svt
Allergies: macrolides
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: after 15 minutes pt. complained of racing heart dizziness and sweating , had pt. remain in seat and asked if wanted water there was no apparent anaphalactic issue , pt. was in site of pharmacist entire time , rph or tech also went talked to her + checked on her symptoms every 5 minutes pt. showed slow improvement refused 911 stayed seated for total 1 hour 5 minutes symptoms per pt. had mainly subsided and she chose to was able to leave


VAERS ID: 1413448 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LL / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Heart rate decreased, Pallor, Pharyngeal swelling, Seizure, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), 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 (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: NONE AT OUR PHARMACY EMS WAS CALLED AND HE WAS BROUGHT IN TO THE HOSPITAL
CDC Split Type:

Write-up: AFTER VACCINATION, PATIENT SAT AT THE WAITING ROOM. WITHIN A FEW MINUTES HE BECAME PALE WITH COLD CLAMMY SKIN, THROAT SWELLING, SLOW THREADY PULSE, SEIZURE LIKE SYMPTOM, BARELY RESPONDING WHEN WE TRIED TALK TO HIM. 911 WAS CALLED IMMEDIATELY AND EPIPEN WAS GIVEN WITH DADS PERMISSION. AFTER A FEW SECONDS, PT BECAME ALERT AND CAN RESPOND WITH US. I MONITORED HIS RESPIRATION AND PULSE RATE WHILE WAITING FOR EMS. EMS TOOK OVER APPROX. WITHIN 10 MINUTES AND TOOK THE PATIENT TO THE EMERGENCY ROOM.


VAERS ID: 1413460 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Administration error, patient under 18


VAERS ID: 1413463 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-01
Onset:2021-06-20
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Fainting Nausea Sweating Chills


VAERS ID: 1413464 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Vomiting
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: After the vaccination, within 5 minute the patient felt faint and started to lightly vomit. The stayed seated and over the next 25 minutes, periodically vomited small amounts and eventually started to feel better and in better spirits.


VAERS ID: 1413467 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dysstasia, Gait inability
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Unable to stand up and walk.


VAERS ID: 1413468 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not aware of
Current Illness: not aware of
Preexisting Conditions: not aware of
Allergies: no aware of
Diagnostic Lab Data: no
CDC Split Type:

Write-up: Patient said felt lightheaded and dizzy. Said that she had a migraine earlier in the day. She said she just felt a little off, nothing major.


VAERS ID: 1413474 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Pallor
SMQs:, Anticholinergic syndrome (broad), 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 (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Patient was experiencing paleness and trouble swallowing saliva shortly after administration of the vaccine. She was fine a couple minutes later.


Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=84&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166