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

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



Case Details (Reverse Sorted by Onset Date)

This is page 95 out of 5,069

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VAERS ID: 1457209 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-25
Onset:2021-06-25
   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 - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: about 2 hours afterwards i had slight problem breathing. Chest pains have been on and off ever since. Sometime i feel like my heart is thumping.


VAERS ID: 1457214 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-17
Onset:2021-06-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA165969 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest discomfort, Chest pain, Chills, Diarrhoea, Echocardiogram, Fatigue, Feeling of body temperature change, Nausea, Troponin increased, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin; Crestor'' Testosterone Cypionate
Current Illness: none
Preexisting Conditions: MI, GERD, Hernia, hyperlipidemia, hypogonadism
Allergies: Wellbutrin
Diagnostic Lab Data: on 6/29/21--increasing troponin; Cardiac ECHO; Cardiac Cath
CDC Split Type:

Write-up: Reports hot/cold shivering started 6/25 then started with nausea, vomiting & Diarrhea. Chest pain/pressure started 6/29 and went to hospital. MD reports increasing Troponin so admitted to hospital for ECHO & Cardiac Cath. Discharged on 6/30. Still reports Fatigue


VAERS ID: 1457256 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-05
Onset:2021-06-25
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram thorax abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
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: Beta Blocker Aspirin BP Med
Current Illness: None
Preexisting Conditions: Type 1 Diabetic
Allergies: None
Diagnostic Lab Data: CT Scan or chest.
CDC Split Type:

Write-up: Pulmonary embolism treated with blood thinner. NO prior history of clotting.


VAERS ID: 1457327 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Headache, Hyperhidrosis, Injection site induration, Injection site swelling, Injection site warmth, Nausea, Pain, Pyrexia, SARS-CoV-2 test negative, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Yeast
Diagnostic Lab Data: 07-01-2021 - Covid test administered - Results of the test were negative
CDC Split Type:

Write-up: Swelling at injection site and extremely hot to touch and formed a hard mass for over one week and started within an hour of injection. 24 hours later, fatigue, fever, shakes, headache and aches set in. The second night all the previous mentioned symptoms continued but at an elevated state. This integrity lasted for three days. One week post injection, still suffering headaches, nausea, fatigue, shortness of breath, aches and sweats. Two weeks post injection, still suffering from previously mentioned symptoms.


VAERS ID: 1457485 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Feeling abnormal, Headache, Influenza, Influenza A virus test positive, Mononucleosis heterophile test negative, Neck pain, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (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: Tetanus combo vaccine (unknown combo) - very exhausted and ill feeling, unknown date/age
Other Medications: Human Growth Hormone nightly
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Morphine & morphine derivative; gluten
Diagnostic Lab Data: Tests on June 29/30, 2021, Flu A test positive, Mono test negative, COVID rapid negative
CDC Split Type: vsafe

Write-up: I got the Flu A with throbbing head pain almost constantly in the right side of my head and neck. No stuffy nose or anything like that. Just general pain and feeling terrible. I was bed ridden from Friday 25th June to Wednesday 30th June. My fever was up to 102 and was generally high throughout that time as well. I took ibuprofen and ate healthily, when I could eat though I had no appetite. I went to the DR and got a flu test on the 29th or 30th of June.


VAERS ID: 1457487 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Rash macular
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: Spotty rash formed on her entire body by the evening of the same day. Still has some rash remaining.


VAERS ID: 1458632 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-21
Onset:2021-06-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest pain, Dizziness, Dyspnoea, Electrocardiogram normal, Pain in extremity, Paraesthesia, X-ray normal
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc and men''s daily gummies
Current Illness: None
Preexisting Conditions: Currently have broken tibial plateau and fibular head
Allergies: None
Diagnostic Lab Data: Blood came back ok. X-ray looked ok.
CDC Split Type:

Write-up: About 4 hours post injection ring finger nerves became painful at tip with pins and needles feeling. Still present, but not as painful. About 1 week post injection, began getting chest pains, difficulty breathing, and dizziness/lightheadedness. We to urgent care 1 week after symptoms started to appear as they got worse. EKG ran showing potential heart attach in past, but I don''t think I''ve had one before. Was noted and told might have been due to crutches. Symptoms got worse next day so went to urgent care at different facility. Brought to ER for x-ray, blood , and EKG. Told no myocarditis, but potentially pericarditis.


VAERS ID: 1459686 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2037217 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Feeling abnormal, X-ray normal
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Allergy related asthma specifically in the northeast region. No asthma in state where I lived for years and received vaccination. Issue started in state.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Inability to take a full breath. Asthma inhalers, including steroidal ones do nothing for the first time ever. Condition persisted past 2 weeks, so visited ER. ER prescribed strong steroids as x-rays came back clean. Feeling better but not good.


VAERS ID: 1459728 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-05
Onset:2021-06-25
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood immunoglobulin M increased, Blood test, C-reactive protein increased, Chest X-ray normal, Electrocardiogram normal, Gastric disorder, Iron binding capacity total decreased, Muscle spasms, Pain in extremity, Stool analysis normal, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, vitamin D, vitamin C, zinc, biotin
Current Illness: N/a
Preexisting Conditions: High BP
Allergies: Azithromycin, Bactrim, K-Flex, Biaxin, penicillin
Diagnostic Lab Data: Blood work - 6/30/2021 - white blood count high, c reactive high, High levels of IgM, TIBC iron bind low; Stool Samples - 6/30/2021 - all negative; EKG - 4/8/2021 - normal; Chest xray - 4/26/2021 - normal
CDC Split Type: vsafe

Write-up: So on Friday at 10:30PM On the Friday 25th of June, I had GI issues and a lot of stomach pain. I also had cramping and pain in the back of my legs as well. I went to the DR and she put me on antibiotics, Cipro and something else I cannot remember. I went to the DR on Wednesday the 30th of June. The GI problems have been happening for about 2 weeks. I also saw my cardiologist on 4/8/2021 and he saw I was ok, the pulmonary DR also said my lungs looked fine on 4/26/2021.


VAERS ID: 1459789 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin Calcium Tablet 80 MG, , Ferrous sulfate(65 Fe) MG , Ergocalciferol Capsule 50 MCG (2000 UT) Tablet 325 ,Multivitamin Tablet (Multiple Vitamin) ,Aspirin Tablet Chewable 81 MG ,Omeprazole Capsule Delayed Release 20 MG
Current Illness: n/a
Preexisting Conditions: cva, , duodenal ulcer, ATOH dependence, hemiplegia/hemiparesis, dysarthria, dysphagia all secondary to stroke.
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: second day after vaccine on 6/25/21 100.3


VAERS ID: 1459906 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-06-25
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Gallbladder disorder
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gallbladder related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: no
Preexisting Conditions: COPD
Allergies: some antibiotics
Diagnostic Lab Data: not yet
CDC Split Type: vsafe

Write-up: Pain in abdomen area. Dr thinks it is the gall bladder. Dr has ordered an ultrasound an August 2nd. No treatment yet.


VAERS ID: 1459953 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 RA / IM

Administered by: Other       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Duragesic-12 Patch 72 Hour 12 MCG/HR (fentaNYL) Insulin Lispro Solution ASA 81mg 1 x say ferrous and vit D supplements Tamsulosin HCl Capsule 0.4 MG amLODIPine Besylate Tablet 5 MG Lorsartan
Current Illness: Osteomyelitis,
Preexisting Conditions: HTN, muscle wasting, DMII, PVD, seizures, hyperlipidemia
Allergies: Bactrim, MS contin
Diagnostic Lab Data: na
CDC Split Type:

Write-up: fever on 6/25/2021 of 100.1


VAERS ID: 1459960 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-05
Onset:2021-06-25
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Cardiac failure congestive, Cardiomegaly, Cardiomyopathy, Chest X-ray abnormal, Echocardiogram abnormal, Ejection fraction decreased, Left ventricular dysfunction, Left ventricular enlargement, Mitral valve incompetence, Pericardial effusion, Pleural thickening, Pulmonary arterial pressure abnormal, Pulmonary vasculitis, Right ventricular dysfunction, Right ventricular enlargement, Ultrasound Doppler abnormal, Vasodilatation
SMQs:, Cardiac failure (narrow), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Pulmonary hypertension (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (narrow), Vasculitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ECHO Summary: 1. Severely increased left ventricular cavity size. 2. The visually estimated left ventricular ejection fraction is <20%, which is severely decreased. 3. Grade III diastolic dysfunction. 4. Moderately enlarged right ventricle with severely reduced global right ventricular systolic function. 5. Moderate mitral regurgitation by color Doppler observation. 6. Moderately elevated pulmonary artery systolic pressure (49 mmHg). 7. Trivial pericardial effusion, as described above. 8. No prior studies are available for comparison. 6/28/2021 at 12:46:52 PM Chest X-ray: Moderate to more pronounced cardiomegaly. Dilated azygos vein suspected. Pulmonary vascularity. Thickening of fissures. Above findings are suspicious for presence of CHF. BNP 1598
CDC Split Type:

Write-up: Congestive heart failure, cardiomyopathy


VAERS ID: 1460046 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra 250 mg, Topamax 100 mg, Metoprolol 25 mg, Ambien 5 mg, Cialis 5 mg, Flonase nasal spray
Current Illness:
Preexisting Conditions: Insomnia, GERD, Hypertension, ED, Epilepsy
Allergies: Iodine, shellfish, garlic, lactose (patient has many allergies. this is what our office has documented)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient broke out in a red, diffused rash within one hour after receiving vaccine.


VAERS ID: 1460307 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-15
Onset:2021-06-25
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait disturbance, Hypoaesthesia, Muscle spasms, Pain in extremity, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
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: Coumadin, Lipitor,Metoprolol
Current Illness: Aortic Stenosis, Peripheral Artery Disease
Preexisting Conditions: Aortic Stenosis, Peripheral Artery Disease
Allergies: None
Diagnostic Lab Data: Ultrasound 7/6/2021
CDC Split Type:

Write-up: I have Peripheral Artery disease and have had bypasses done on both legs. It has been managed fairly well with a several minor "tune ups" by angio. I was able to walk pretty well with minimal pain. About a week after my second dose I started noticing increased pain in both of my calves which has become considerably worse since then. I cannot walk 1/10 of a mile without taking a break. Also, around July 1st, my fingers went numb in my right hand, then I started getting pain in my right forearm and cramping in my hand. That pain has made it so the way up my arm. I saw my vascular surgeon and an ultrasound revealed a clot in the bend of my elbow. I was asked how I think I could have gotten the clot, the only thing I''ve done differently was get that vaccine. It''s extremely obvious to me that the vaccine has caused a severe reaction in me. I have a surgery scheduled on Wed. July 14 to have the clot removed.


VAERS ID: 1461717 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Asthenia, Blood test, Haemoglobin decreased, Heavy menstrual bleeding, Menstrual disorder, Pallor, Syncope, Thrombosis, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Blood work (Hemoglobin) taken on June 28 (10.3), June 29 (9?), July 3 (7.3), July 7 (8).
CDC Split Type:

Write-up: Abnormal menstrual cycle started on June 25, the day after dose 2; she already had a period June 10-16. This involved increasingly heavy bleeding, with large blood clots. My daughter became very pale, weak on the morning of Mon, June 28, she fainted, then vomited. Made dr appt and got bloodwork. Started her on iron supplements. Dr said the hemoglobin was at 10.6, but had us get blood checked 3 more times, lowest hemoglobin was at 7.3.


VAERS ID: 1461943 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-03
Onset:2021-06-25
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Menstruation delayed, Menstruation irregular, Paranasal sinus discomfort, Secretion discharge, Sneezing, Vaccine positive rechallenge, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Fertility disorders (broad), Hypersensitivity (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: Zyrtec, ibprofren, caffeine, Tylenol, florastor; Pfizer COVID vaccine: 1st vac: 6/3/21 2nd vac: 6/25/21
Current Illness: None
Preexisting Conditions: Seasonal allergies (typically fall - winter); diverticulitis; low gallbladder function; GERD; PCOS
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After 1st, shot, within days I developed painful sinus pressure in cheek above left jaw that persisted for a week, followed by constant pressure and mucus drainage; coughing; wheezing; sneezing. After 2nd shot, same as above has persisted. HOWEVER, I have not menstruated ! I had typical period pains, felt like I was going to start on schedule, but I have not to date. All typical menstral pains are now gone. Date of last cycle began normal on 6/5/21, lasted 4 days.


VAERS ID: 1462098 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Tingling/needle/itchy feeling in hands, feet, scalp, inner thighs


VAERS ID: 1462117 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-06-21
Onset:2021-06-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dermatitis allergic, 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: ZOLOFT, HYDROXYZINE, TRAZODONE
Current Illness: NO
Preexisting Conditions: N/A
Allergies: TETRACYCLINE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT EXPERIENCED A DELAYED CUTANEOUS REACTION OCCURING ABOUT A WEEK AFTER RECEIVING VACCINE RESULTING IN A RASH THAT IS STILL PRESENT


VAERS ID: 1463258 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FW0181 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Electrocardiogram, Mitral valve disease, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210625; Test Name: EKG; Result Unstructured Data: Test Result:premature contractions in the mitral
CDC Split Type: USPFIZER INC2021784928

Write-up: Heart palpitations; Premature contractions in the mitral valve; This is a spontaneous report from a contactable consumer (patient herself). A 32-year-old non pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection and Lot Number: FW0181) via an unspecified route of administration, administered in Arm Right on 23Jun2021 09:45 (at the age of 32 years old) as single dose for COVID-19 immunization. Medical history included known Known allergies: Penicillin. Concomitant medications included ibuprofen taken for occasionally for headaches. It was reported that the patient had the vaccine on Wednesday and this morning on Friday on 25Jun2021 07:00, (two days later) started having heart palpitations which she never had before. They''ve been on and off. She went to the doctor this morning and had an EKG, she said she had premature contractions in the mitral valve. No treatment was received for the adverse events. The adverse event resulted in Doctor or other healthcare professional office/ or clinic visit. The patient was not diagnosed with COVID-19 prior to the vaccination and has not been tested for COVID-19 since the vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient underwent lab tests and procedures which included electrocardiogram: premature contractions in the mitral on 25Jun2021. The outcome of the events was unknown. Follow-up attempts have been completed and no further information is expected.


VAERS ID: 1463273 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   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 EW0177 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Blood test, Chest discomfort, Circumstance or information capable of leading to medication error, Dysgeusia, Dyspnoea, Fatigue, Hypoaesthesia, Insomnia, Loss of consciousness, Pain in extremity, Paraesthesia, Peripheral swelling, Productive cough, Seizure, Ultrasound scan
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cancer; COVID-19 (doctors believe I had Covid-19 in 2019)
Allergies:
Diagnostic Lab Data: Test Date: 20210625; Test Name: blood work; Result Unstructured Data: Test Result:unknown; Test Date: 20210625; Test Name: ultrasound; Result Unstructured Data: Test Result:unknown
CDC Split Type: USPFIZER INC2021787568

Write-up: seizure; unconscious; passed out; stopped breathing; received Pfizer vaccine, first dose 3 days ago, technically I got pneumonia vaccine, PPsV23; lost my sense of taste; I can''t smell; I am feeling like a tingling sensation in my hands, like numbness; I am feeling like a tingling sensation in my hands, like numbness; metallic taste; fatigue; coughing up phlegm; hard time getting to sleep; Left arm hurt a lot and hand is swollen; Left arm hurt a lot and hand is swollen; Tightness of Chest; I can breath but it''s like I can''t get any oxygen; it''s like very hard for me to get air; This is a spontaneous report from a contactable consumer (patient). A 34-years-old male patient received first dose BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, batch/lot number: EW0177) via an unspecified route of administration in Arm Left on 25Jun2021 15:30 as DOSE 1, SINGLE for covid-19 immunisation. Medical history included covid-19 from 2019 to an unknown date doctors believe I had Covid-19 in 2019, neoplasm malignant from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The first dose of the Pfizer vaccine was on 25Jun2021, I have got this kind, out of order. So, he said from what he remembers that he was fine following the vaccination, and everything was good but he took a few steps and collapsed. He started having a seizure and he said, my mom said, you stopped breathing, I was unconscious, tightness of chest I can breathe but it''s like I cannot get any oxygen it''s like very hard for me to get air. He says, the doctors there, the doctors, he says don''t get me started on the (sentence incomplete) and he went to the hospital and was there for like 5 hours and they gave him 5 mg of Valium treatment and he said that was it. They could not find his vein, they did an ultrasound, I guess to find his vein and apparently, he had a couple of seizures. He says, I don''t recall, all I remember is waking up in a hospital and I received the Pfizer vaccine first dose and then he said, 3 days ago, technically, I got Pneumonia vaccine which he said he received the PPSV23 vaccine prior the same day of his Pfizer vaccine. Also, he says, I hate needles, so I got tortured. I had the pneumonia vaccine (PPSV23 vaccine) first, he was with his mom, they went out for a while and then went back to where he got the Pfizer vaccine following that (PPSV23 Vaccine). He said, he was there after the Pfizer vaccine for about 30 minutes, got up and had a seizure and he says, that also his mom said that he cannot remember anything because he was unconscious, and they took him to the hospital. Also, he said, he lost his sense of taste, I cannot smell, he said, he was feeling like tingling sensation in his hands like numbness and left arm hurt a lot and hand was swollen. In 2019, he says, he got sick with respiratory issues. He was not sure if he had Covid because they did not know about Covid at that time when he was in the hospital then (consumer had respiratory issues before getting the vaccine, hence not captured as event). He said, it was freaking him out and he was scared to take the second shot. He said, he does not know if this was the combination of getting two vaccination and he says, he used to have cancer (not clarified further, hence not captured as event) and then he says, that they did blood work, it was been followed by the place and they did not tell me anything about the blood work. He says, should I be considered or concerned about getting the second dose of the vaccine because I am experiencing various symptoms and what can I do about my side effects because he is still experiencing metallic taste, loss of smell, fatigue, coughing of Phlegm, having a hard time getting to sleep. Then he says, I forgot to mention, I could feel my heartbeat and I have a cough, I have had a cough from very long time when doctors believe I had Covid-19 in 2019 (further clarification unknown). He wanted to know how safe the vaccine was. Therapeutic measures were taken as a result of seizure, unconscious, passed out. The outcome of the events was unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1463291 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-06-25
Onset:2021-06-25
   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 EW017A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Gait disturbance, Illness, Movement disorder, Myalgia, Urine analysis, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Splenectomy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210626; Test Name: urine sample; Result Unstructured Data: Test Result:Negative; Test Date: 20210626; Test Name: Xray; Result Unstructured Data: Test Result:Negative
CDC Split Type: USPFIZER INC2021795481

Write-up: he is having trouble moving and getting up and walking; he is having trouble moving and getting up; he has never had the back pain before with the pain in the muscle; Sick; My husband experienced lower back pain, well today the back pain is really severe; This is a spontaneous report from a contactable consumer. This consumer (patient''s Wife) reported for a 64-year-old Male patient (Reporter''s husband) that he received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW017A and expiry date was not reported, at the age of 64-year-old), via an unspecified route of administration, administered in Arm Left on 25Jun2021 08:00 as dose 1, single for covid-19 immunisation. Medical history included ongoing splenectomy. The concomitant medications were not reported. Patients wife reported that her husband experienced lower back pain well today the back pain is really severe, he is having trouble moving and getting up and walking on 25Jun2021. She states she took him to the ER, and they gave him a muscle relaxer and a pain pill, which didn''t help at all. She states they were there for about 4 hours and sent home with some more pain pills and still is not helping; when he left the hospital, he was still in pain. He has never had the back pain before with the pain in the muscle. She states he had no soreness in his left arm. She states she told the ER nurse this as well, but he doesn''t have a spleen and she doesn''t know if the shot affected him worse because of the immune system to fight it. She remarks her husband is having regrets taking the vaccine because he is so sick. She states the second shot is scheduled for 16Jul2021. Additional Vaccines Administered on Same Date of the Pfizer Suspect were none. Other vaccinations within four weeks prior to the first administration date of the suspect vaccine(s) was none. The patient underwent lab tests and procedures which included urine analysis and x-ray both negative on 26Jun2021. The outcome of event low back pain was recovering and for all the events was unknown.


VAERS ID: 1463309 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-17
Onset:2021-06-25
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Blood bilirubin, Blood magnesium, Blood magnesium decreased, Blood phosphorus, Blood potassium, Discomfort, Glomerular filtration rate, Glomerular filtration rate decreased, Inappropriate schedule of product administration, Mineral deficiency, Monocyte count, Renal disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Medication errors (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: SIMVASTATIN; ALOPURINOL; INDAPAMIDE; LEVOTHYROXINE; DIGOXIN; METFORMIN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210413; Test Name: Bilirubin; Result Unstructured Data: Test Result:1.8; Comments: Unspecified 1.8; Test Date: 20210413; Test Name: Magnesium; Result Unstructured Data: Test Result:1.7; Comments: Unspecified 1.7; Test Date: 20210413; Test Name: Phosphorus; Result Unstructured Data: Test Result:2.1; Comments: Unspecified 2.1; Test Date: 20210413; Test Name: Potassium level; Result Unstructured Data: Test Result:3.1; Comments: Unspecified 3.1; Test Date: 20210623; Test Name: Potassium level; Result Unstructured Data: Test Result:3.3; Comments: Unspecified 3.3; Test Date: 20210413; Test Name: GFR; Result Unstructured Data: Test Result:59; Comments: Unspecified 59; Test Date: 20210623; Test Name: GFR; Result Unstructured Data: Test Result:59; Test Date: 20210413; Test Name: Monocyte absolute; Result Unstructured Data: Test Result:0.9; Comments: Unspecified 0.9; Test Date: 20210623; Test Name: Monocyte absolute; Result Unstructured Data: Test Result:1.0; Comments: Unspecified 1.0
CDC Split Type: USPFIZER INC2021800479

Write-up: inappropriate schedule of vaccine administered; kidney problem; it is causing me some real concern; Magnesium becomes low; GFR is low; minerals are going low; strange sensation; This is a spontaneous report from a contactable consumer. A 75-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: EL8982), dose 1 via an unspecified route of administration, administered in Arm Left on 17Jan2021 as (At the age of 75-years) DOSE 1, SINGLE, dose 2 via an unspecified route of administration, administered in Arm Left on 02Jun2021 (Batch/Lot Number: EL8982) as DOSE 2, SINGLE for covid-19 immunisation. The patient medical history was not reported. Concomitant medication included simvastatin 20 milligrams; alopurinol; indapamide 2.5 milligrams; levothyroxine100 micrograms; digoxin; metformin, and Potassium Pill, Potassium COER 20 mEq. It was reported that he was not diabetic at metabolic syndrome at the extended release 500 that effect last A1C was 4.8. No Prior vaccination within 4 weeks. It was reported that patient had no Family medical history related to adverse event. The patient experienced kidney problem, it is causing me some real concern, magnesium becomes low, gfr is low, minerals are going low (mineral deficiency), and strange sensation on 25Jun2021. It was reported that patient got the situation rising, it was causing some real concern. It was reported that he was vaccinated the corona virus in early February and then in the early mid-April he had some blood lab with again some worrying results and today he has follow up with that then he got information on and results are more concerning like those concerns involve kidney problem. It was reported that When probed whether consumer took first dose of the vaccine or both doses, Consumer stated, he got the second shot in February. Later patient reported that It will be good, and he should mention also that one of just when he got that final vaccination, he had some strange sensation afterwards and he reported those, and they sent some paper works but he did not see on anything going on at that time. So, he didn''t follow up with it. It was reported that patient was not exactly sure when the onset was. He was seeing it that was between the date of the vaccination and date of the first blood test on 13Apr2021. So, that would say March, somewhere in March, this year. That would be 75. first Starting date of Adverse Event, he noticed there was a problem that''s when he had the first blood test done and that was on 13Apr2021. It was reported that There are probably 20 or 30 different tests on each one of these sheets, he got the first one here, Monocyte absolute 0.9, the next one, Potassium level is 3.1, and here most concerning one GFR 59. It was reported that Magnesium becomes low 1.5 that is only the first test Monocyte was now 1.0, potassium is 3.3, GFR is still 59, bilirubin is now 1.8, there was one more magnesium was 1.7, Phosphorous is 2.1. It was reported that GFR is low, and the minerals are going low one by one and the bilirubin that''s the most recent now, it was high which was this is going, it''s bad and now better looking again. The patient underwent lab tests and procedures which included blood bilirubin: 1.8 on 13Apr2021, blood magnesium: 1.7 on 13Apr2021, blood phosphorus: 2.1 on 13Apr2021, blood potassium: 3.1 on 13Apr2021, blood potassium: 3.3 on 23Jun2021, glomerular filtration rate: 59 on 13Apr2021, glomerular filtration rate: 59 on 23Jun2021, monocyte count: 0.9 on 13Apr2021, monocyte count: 1.0 on 23Jun2021. Treatment: Consumer stated, "There is no treatment that I still continue because there is more here. Magnesium becomes low 1.5, Okay that is only the first test. So, here GFR went down and minerals are the one went down, Now, the second one, so, this is for the date of 6/23/21. Monocyte is now 1.0, potassium is 3.3, GFR is still 59, bilirubin is now 1.8, there is one more magnesium is 1.7, Phosphorous is 2.1. So, hang on more page, that should cover. So, what you see happening here is the GFR is low and the minerals are going low one by one and the bilirubin that''s the most recent now, it was high which was this is going, it''s bad and now better looking again. The outcome of events was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1463318 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210625; Test Name: tested positive COVID; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC2021805308

Write-up: Four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated; Four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated; This is a spontaneous report from a Pfizer sponsored program. This consumer reported adverse events with similar suspect for 4 patients. This report is One of four patients. This consumer (patient) reported that: A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient reported that four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated. Exposure could not have occurred before Monday 21Jun2021 and symptom onset (all positive tested individuals were symptomatic) was by 25Jun2021. We are all researchers and recognize the impossibility of this not being a variant. I am totally willing to participate in any studies that might help understand variants and the efficacy of the vaccine on them. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 25Jun2021. The outcome of the event Four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1463319 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210625; Test Name: Covid-19; Test Result: Positive
CDC Split Type: USPFIZER INC2021805357

Write-up: Four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated; Four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated; This is a spontaneous report from a contactable consumer via Pfizer sponsored program via contactable consumer reported for an unknown patient (colleague #1 of 3). A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: Unknown), via an unspecified route of administration on an unspecified date as dose number unknown, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On 25Jun2021, four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated. Exposure could not have occurred before Monday 21Jun2021 and symptom onset (all positive tested individuals were symptomatic) was by 25Jun2021. We were all researchers and recognized the impossibility of this not being a variant. Reporter was totally willing to participate in any studies that might help understand variants and the efficacy of the vaccine on them. The patient underwent lab tests and procedures which included SARS-CoV-2 test: positive on 25Jun2021.The clinical outcome of the events was reported as unknown. Information about batch/Lot number has been requested.


VAERS ID: 1463320 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210625; Test Name: Covid; Test Result: Positive
CDC Split Type: USPFIZER INC2021805359

Write-up: Four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated; This is a spontaneous report from a contactable consumer from Pfizer sponsored program. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, lot number: unknown; Expiration date: unknown) via an unspecified route of administration on Jun2021 as unknown single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. It was reported that four of my colleagues (including myself) reporter''s colleagues (including reporter) have contracting COVID within a week despite all having been vaccinated. Exposure could not have occurred before Monday 21Jun2021 and symptom onset (all positive tested individuals were symptomatic) was by 25Jun2021. They all were researchers and recognize the impossibility of this not being a variant. Consumer was totally willing to participate in any studies that might help understand variants and the efficacy of the vaccine on them. The patient underwent lab tests and procedures which included SARS-COV-2 test which was positive on 25Jun2021. The outcome of event was unknown. Information on the lot/batch number has been requested. .


VAERS ID: 1463667 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-06-01
Onset:2021-06-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Hyperaesthesia, Muscle twitching, Pain in extremity, Pyrexia, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Pcn, sulfur
Diagnostic Lab Data: None I didn?t go I waited it out. My joints still have pain. I?m improving.
CDC Split Type:

Write-up: I had the sore arm after 12 hours. Started running fever 102.8 then 103 for three days joint pain all over my body that was so severe you couldn?t touch me, for several days, headache, facial twitching, blurred vision, I


VAERS ID: 1463779 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-18
Onset:2021-06-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Malaise, Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow)

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

Write-up: FELT SICK ON JUNE 25TH AND REPORTED TO EMERGENCY ROOM. ADMITTED FOR BLOOD CLOT IN LUNG


VAERS ID: 1463898 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-25
   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 EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Mouth swelling, Ocular hyperaemia, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Additional Details: patient reported redness in her eyes, and went to urgent care and noted inflammation and prescribed steriod eye drop for redness which helped with redness.


VAERS ID: 1464049 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast enlargement, Feeling hot, Galactorrhoea, Pregnancy test negative
SMQs:, Lipodystrophy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot 8 years ago, I broke out in hives and made my eyes yellow
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to x-ray cat scan dye, seasonal environmental allergies.
Diagnostic Lab Data: 6 pregnancy test that all came back negative, so I am not pregnant.
CDC Split Type:

Write-up: The only side effect I had was my head was a little hot but really did not have any fever, and two days after the shot my breasts began to lactate and grew a cup size. I am not pregnant and my child is 8 years old.


VAERS ID: 1464075 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-15
Onset:2021-06-25
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Blindness, Cerebrovascular accident, Computerised tomogram, Echocardiogram, Ultrasound Doppler
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Biotin supplement.
Current Illness: No illnesses at the time of vaccination.
Preexisting Conditions: No chronic or long standing health conditions.
Allergies: No known allergies.
Diagnostic Lab Data: I had a CT scan, CT angiogram, echocardiogram, an ultrasound of my arm and a MRA of my pelvis.
CDC Split Type: vsafe

Write-up: I had a left occipital stroke and I lost part of my vision.


VAERS ID: 1464131 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-04
Onset:2021-06-25
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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

Write-up: MI on 6/25/21


VAERS ID: 1464184 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-21
Onset:2021-06-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza Vaccine
Other Medications: No
Current Illness: No
Preexisting Conditions: Endometriosis, Heat-induced urticaria, Iron deficiency anemia, Lichen planus, Migraine, Mitral regurgitation , Myalgias.
Allergies: Shellfish Influenza Vaccine Adhesive Bandage
Diagnostic Lab Data: None
CDC Split Type:

Write-up: diminished sensation, numbness nd tingling in bilateral hand and feet


VAERS ID: 1464236 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-06-21
Onset:2021-06-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood potassium decreased, Cellulitis, Electrocardiogram, Feeling abnormal, Near death experience, Palpitations, Supraventricular tachycardia
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Dementia (broad), Cardiomyopathy (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: Hepatitis B vaccine 04/21/2016
Other Medications: Fish Oil Fluoxetine HC 20 mg qd Aspirin 81 mg qd Vitamin D3 OTC once daily Otelza 30 mg 1 po daily lorazepam 0.5 mg 1 po bid as need for anxiety Metoprolol Succinate ER one tab po daily for BP and heart rate Lisinopril 20 mg one po bid
Current Illness: pain in right arm post vaccination SVT vertigo daytime somnolence depression
Preexisting Conditions: essential hypertension tinnitus deviated nasal septum suicidal thoughts anxiety and depression steatosis of liver chronic maxillary sinusitis palpitations
Allergies: Hepatitis B vaccination-chest pain, sweating, and swelling of entire arm Sulfa
Diagnostic Lab Data: as above + cardiology consult on 06/29/21, diagnosed with SVT, discontinued potassium and hydrochlorothiazide(patient did not report HCTZ use when obtaining medications for VAERS) with treatment plan to include echo scheduled 07/27/2021 to evaluate heart muscle and valves(to call with results post procedure) and follow up with doctor in 6 months. Electrophysiology referral scheduled on 08/11/2021
CDC Split Type:

Write-up: cellulitis rt arm post vaccination; treated and resolved When called to follow up on above cellulitis diagnosis, patient reported she had an event on 06/25/21 as she was driving out of town. experienced "weird, really strange" feeling, "heart running away, pulled over, called ambulance," states had EKG done and medication administered, heard parmedic states "did not want to shock you, but i am going to have to". states "hurt like hell" and woke up in hospital. said "i died because i saw my daddy" who had passed away 5 months prior. states admitted to hospital 06/25/21, discharged 06/26/21, also stated potassium was "critically low, 2.4". states received medications to get heart rate down, was discharged home on potassium 10 mg once per day. follow up with PCP and also referred to cardiologist


VAERS ID: 1464475 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-09
Onset:2021-06-25
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 UN / SYR

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

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

Write-up: Hospitalization


VAERS ID: 1466501 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear discomfort, Ear pruritus, Headache, Pain in extremity, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: About 2 days after I got the vaccine, my arm was sore and I had a pretty bad headache. About 6 days later, my ears and throat would get itchy and it felt like my ear and throat would close. I''ve taken allergy meds for the reaction, but I have not seen a doctor yet.


VAERS ID: 1466623 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Paraesthesia, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt reports GI symptoms (nausea, vomitting), tingling in fingers, fever. Pt believes she has developed Guillian Barre.


VAERS ID: 1466642 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-21
Onset:2021-06-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Dyspnoea at rest, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (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: Unsure
Current Illness: Unsure
Preexisting Conditions: asthma, seasonal allergies, hyperplasia of tonsils and adenoids, obstructive sleep apnea, xerosis of skin, unspecified Vitamin D deficiency, adverse food reaction
Allergies: Shrimp, chocolate
Diagnostic Lab Data: 6/25/2021 - chest x-ray, 7/13/2021 - SARS Coronavirus 2 PCR
CDC Split Type:

Write-up: Per MD Note: She developed the shortness of breath on 06/25, which was four days after she received her first dose of the mRNA Pfizer vaccine. The child describes experiencing shortness of breath, but denies any cough, tightness of the chest, or fever. Since onset, her shortness of breath has been occurring random episodes, but more so at rest than with activity. She mentions that these episodes do not make her conscious of her breathing.


VAERS ID: 1466717 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Electrocardiogram, Fatigue, Headache, Injection site pain, Neck pain, Pain
SMQs:, Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

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

Write-up: Back pain, left arm pain from shoulder down to elbow that is continuously, had pain, neck pain, tired and fatigue, headaches


VAERS ID: 1466777 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-16
Onset:2021-06-25
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Eczema, New daily persistent headache, Vaccination site pain
SMQs:, Hypersensitivity (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: benadryl, Vit E, Omega 6 and 9 , tylenol, allopurinol, carvedilol. colchicine-probenecid, cyclobenzaprine, valium, hydroxyzine, losartan, valacyclovir
Current Illness: shingles
Preexisting Conditions: Eczema, hypertension
Allergies: Penicillin and Sulfa Drugs
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pain on the vaccine site. After that everyday headache until now. Eczema flare up all over his body after the second dose of Moderna.


VAERS ID: 1466820 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-20
Onset:2021-06-25
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A210 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Guillain-Barre syndrome, Hypoaesthesia, Visual impairment
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Active Outpatient Medications Status ========================================================================= 1) ALBUTEROL 90MCG (CFC-F) 200D ORAL INHL INHALE ONE TO TWO PUFFS BY INHALATION EVERY SIX HO
Current Illness:
Preexisting Conditions:
Allergies: Magnesium
Diagnostic Lab Data:
CDC Split Type:

Write-up: Began with visual changes, numbness on June 25th; admitted to hospital July 9-12th, 2021 w/ presumtive Guillain Barre syndrome; has had CT scan showing no lesions


VAERS ID: 1467067 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWNWILLCALL / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest X-ray, Cough, Diarrhoea, Dyspnoea, Influenza like illness, Nausea, Pain, Pneumonia, Pyrexia, Rash, Rash erythematous, Rash pruritic, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

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

Write-up: After the 2nd dose vaccine, I had nausea, vomiting and diarrhea. A few days later, I developed a rash on both my arms. The rash looked like little raised bumps and was itchy. I applied some Benadryl cream on it and it hasn''t improved. About a week after my vaccination, I had flu like symptoms- shortness of breath, cough, low grade fever, body aches and joint pain. I went to the ER (Hospital) and was given oxygen, breathing treatments and was diagnosed with pneumonia. I was given a prescription of Z-pak azithromycin and discharged to follow up with my PCP.


VAERS ID: 1467068 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac disorder, Chest discomfort, Chest pain, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (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? 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: Cardiac Disorder (diagnosed by MD)-Mild, Systemic: Chest Tightness / Heaviness / Pain-Mild, Additional Details: pericarditis


VAERS ID: 1467986 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain, 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: Buspar, 30 mg per day Trileptal, 900 mg per day
Current Illness: None
Preexisting Conditions: None
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme soreness throughout body, 3 days duration Hives I''m multiple areas, unresolved with over the counter allergy medicine, 2 week duration (ongoing)


VAERS ID: 1469620 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hyperlipidemia (Treated by specialist.)
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210625; Test Name: Antibody test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210717374

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 49 year old White and Not Hispanic or Latino male. The patient''s height, and weight were not reported. The patient''s concurrent condition included hyperlipidemia and the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805020, expiry: not reported) dose was not reported, 1 total, administered on 16-MAR-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the patient had done an antibody test which resulted as negative and hence, it was confirmed as immunological vaccine failure. The patient reported that he was going to do a spike protein test to confirm his immunity. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from confirmed immunological vaccine failure. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000185426.; Sender''s Comments: V0:20210717374- covid-19 vaccine ad26.cov2.s-Confirmed immunological vaccine 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: 1469675 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-25
Onset:2021-06-25
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Dysarthria, Facial paralysis, Facial paresis, Headache, Hypoaesthesia, Skin wrinkling, Vaccination site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Bell''s Palsy; After the second dose, his arm was sore at the site; Face felt more droopy; Face felt more weak; Wrinkles on the right side of his forehead; His speech got messed up and slurry; The right side of his face was going numb; Severe headache; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 06-Jul-2021 and was forwarded to Moderna on 06-Jul-2021. This spontaneous case was reported by an other health care professional and describes the occurrence of BELL''S PALSY (Bell''s Palsy) and FACIAL PARALYSIS (Face felt more droopy) in a 37-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 25-Jun-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced HEADACHE (Severe headache). On 29-Jun-2021, the patient experienced HYPOAESTHESIA (The right side of his face was going numb). On 01-Jul-2021, the patient experienced FACIAL PARALYSIS (Face felt more droopy) (seriousness criterion medically significant). 01-Jul-2021, the patient experienced FACIAL PARESIS (Face felt more weak), SKIN WRINKLING (Wrinkles on the right side of his forehead) and DYSARTHRIA (His speech got messed up and slurry). On an unknown date, the patient experienced BELL''S PALSY (Bell''s Palsy) (seriousness criterion medically significant) and VACCINATION SITE PAIN (After the second dose, his arm was sore at the site). The patient was treated with NORTRIPTYLINE for Headache, at a dose of 30 milligram once a day; PREDNISONE at a dose of 50 milligram once a day and VALACICLOVIR HYDROCHLORIDE (VALTREX) at a dose of 1000 milligram three times a day. At the time of the report, BELL''S PALSY (Bell''s Palsy), FACIAL PARALYSIS (Face felt more droopy), HYPOAESTHESIA (The right side of his face was going numb), SKIN WRINKLING (Wrinkles on the right side of his forehead), DYSARTHRIA (His speech got messed up and slurry) and HEADACHE (Severe headache) outcome was unknown, FACIAL PARESIS (Face felt more weak) had not resolved and VACCINATION SITE PAIN (After the second dose, his arm was sore at the site) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications reported. Patient underwent tests such as the EKG, chest X-RAY and results were not reported and also received a neurology consultation. Patient was discharged from the hospital at 2:15AM in the morning. Limited information regarding the events has been provided at this time and is insufficient for causality assessment. This case was linked to MOD-2021-249536 (Patient Link).; Sender''s Comments: Limited information regarding the events has been provided at this time and is insufficient for causality assessment.


VAERS ID: 1470142 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-25
Onset:2021-06-25
   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 EW0162 / 1 LA / IM

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

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

Write-up: Incorrect BUD date of 6/25/21 was entered into the vial label and it should have been 6/23/21. Patient was given the dose 2 days after BUD date. No treatment was needed. Dr. spoke to the patient on 7/12/21 and explained the events. The patient felt comfortable and did not have any further concerns. Patient is returning for the second dose on 7/16/21. No additional treatment needed


VAERS ID: 1470364 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   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 EW / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Areflexia, Asthenia, Balance disorder, Disturbance in attention, Dizziness, Feeling abnormal, Hypersomnia, Immediate post-injection reaction, Impaired driving ability, Impaired work ability, Influenza like illness, Lethargy, Migraine, Musculoskeletal stiffness, Pain, Vertigo
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), Depression (excl suicide and self injury) (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Humolog Lexapro Levothyroxine
Current Illness: Hypothyroid Diabetes 1
Preexisting Conditions: Diabetes neuropathy
Allergies: n/A
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Right after vaccine I slept for 3 days straight with Massive migraine ( big ball of fire) i need a ice to soothe the pain/ body pain. On Monday afternoon on June 28, 2021, with less severe flu like symptoms , i went to the store and i felt dizzy and loss my balance tilting to the right, neck stiff and lac of reflect. i was in no condition for driving. Wednesday June 30th ,2021, i went to the Urgent care with dizziness/ light head/ body ache. I was diagnoses with vertigo and was giving a couple days off work. ( Meclizine prescript) making me drowsy and upset stomach... feeling worst! I still felt weak, light headed and dizzy, lethargic. on Wednesday July 7, 2021 my primary doctor gave me more days to rest. Im back at work today, still feel off, hard to focus and bit dizzy behind the wheel. fyi..


VAERS ID: 1470404 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-06-25
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Azotaemia, Dyspnoea
SMQs:, Acute renal failure (narrow), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Chronic kidney disease (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: HTN, Gastritis, obesity, hypokalemia, Hypomagnesemia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 6.25.2021 positive test
CDC Split Type:

Write-up: SOB, Acute uremia


VAERS ID: 1470496 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dry mouth, Fatigue, Feeling abnormal, Loss of personal independence in daily activities, Nausea, Retching, Taste disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Probiotics, Glutathione
Current Illness: Ear ache prior to vaccine
Preexisting Conditions: n/a
Allergies: Sulfa drugs, Penicillin, most antibiotics
Diagnostic Lab Data: n/a
CDC Split Type: vsafe

Write-up: Probably immediately, I was lightheaded and woozy. As soon as she put it in my arm I could taste it and I felt like I was going to vomit. She kept me there for 45 minutes to keep an eye on me. As a disclaimer, I am a vegan and very earthy, I do not take any drugs or anything like that. When I was driving home the lightheadedness got so bad that I had to pull over and sat for 15-20 minutes. I called my brother and he told me to get something to eat. I just had some steamed vegetables. I came home, ate and drank a lot of water to try and get the wooziness to pass. I did not have an unusual amount, no more than I would usually drink. Then after the last bottle of water I had, I started getting more queasy and started to feel dizzy. I then vomited all over my self from head to toe. That lasted for two or three hours and then after that I was dry heaving. That happened on Friday, on Saturday I was too afraid to eat anything I only had toast and a smoothie. On Sunday I was just so woozy and lightheaded and exhausted. I didn''t feel chills or anything though. My brother brought me soup on Sunday and I did have some broth. I also started drinking a little bit more water. The water didn''t taste good though - it tasted like the vaccine so I did not want to have it. I did not workout at all for that week, I was just so tired. I felt like I could sleep for a month and just not get up. I normally workout five days a week. I got an IV with fluids for hydration and a glutathione push on 7/2/2021. On the following Saturday 7/3/2021, I was still lightheaded. Now, I still am extremely tired and there are days that focusing takes more energy than it typically does. My mouth feels like I have cotton balls in it, the nausea and the lightheadedness is still present, but the tiredness is the worst. I normally run everyday but I cannot even do that at all, walking is hard enough. I just had another IV today 7/14/2021. When this started happening, I did contact my DR but I am unable to get in yet, I need to schedule for a full blood panel and see the DR.


VAERS ID: 1470530 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-17
Onset:2021-06-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21B / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eosinophil count increased, Eosinophilia, Leukocytosis, Monocyte count increased, Monocytosis, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Eosinophilia, low grade leukocytosis, monocytosis, without neutrophilic predominance patient received vaccine on 6/17. These were normal when checked 6/3 monocytes and wbc normal when check 6/16 (eso not checked 6/16) Next time these labs were check was on 6/25 - WBC and eso - elevated eosinophils & monocytes remained elevated until 7/13 WBC still elevated more substantial now - maybe be increased for other reasons now Inpatient from 6/27- to present Patient admitted for other reasons -


VAERS ID: 1470681 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-11
Onset:2021-06-25
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CVS5872 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Eye irritation, Inflammation, Lacrimation increased, Ocular hyperaemia, Photophobia, Slit-lamp examination
SMQs:, Anaphylactic reaction (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Lacrimal disorders (narrow)

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

Write-up: Two weeks after receiving the 1st dose my eyes became irritated. I assumed it was dry eye, since they were not red, and used artificial tears. That didn?t work, so I visited my optometrist. He said it was likely an inflammatory reaction to something and told me to use Zatidor drops. The drops helped tremendously. I was still using them when I received the second dose on 7/2/2021, but the irritation was under control with the drops. Within 30 minutes of receiving the second dose, my eyes were extremely irritated, light sensitive, watering, and red. I sent a text and photo to my optometrist and he told me to take a Benadryl and use the eyes drops. The next morning the redness was gone. My eyes still felt irritated and I kept using the Zatidor drops twice a day. When I stopped using them the redness returned so I started again. My left eye still feels irritated & I?m still using the drops in it, but the right eye is fine. I?m not sure that this is related to the vaccine or not. If definitely got much worse within 30 minutes of getting the second dose, but it seems to be going on too long to have been an allergic reaction to the vaccine.


VAERS ID: 1470748 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 2 LA / IM

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

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

Write-up: Patient informed this writer that she had had COVID approximately 1 week after her initial vaccination. I informed the patient that she could then defer 90 days to receive her 2nd Moderna dose without any worry. She indicated she would rather receive the second Moderna dose today, for fear of getting COVID again. She was vaccinated. After vaccination was given, she informed this writer that she had in fact been hospitalized with COVID. This writer asked, "Did you receive monoclonal antibody during that hosp" She replied, "Yes." This writer informed the patient that she would need to contact Agency to report the incident, as the vaccination should have been deferred. No adverse event reported in the patient.


VAERS ID: 1470798 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-23
Onset:2021-06-25
   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 EW0181 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, buspar, gabapentin, levothyroxine, atorvastatin, strattera, vit d,
Current Illness: none
Preexisting Conditions: high cholestrol, thyroid, gaba for head injury, anxiety, depression , adhd, arthritis
Allergies: none
Diagnostic Lab Data: . Labs ok per pt
CDC Split Type:

Write-up: numbness from middle forearm to hand from 6/25 to 7/14


VAERS ID: 1471266 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Blood test, Chills, Computerised tomogram, Dizziness, Eye haemorrhage, Eye pain, Fatigue, Headache, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 100mg Omeprazole 20mg
Current Illness: No
Preexisting Conditions: Anxiety, Panic attacks.
Allergies: No
Diagnostic Lab Data: 07/08/2021 CT scan 07/08/2021 Blood Test
CDC Split Type:

Write-up: Muscle pain (up to 7 days after vaccination) Joints and body pain (up to 11 days after vaccination) Weakness and dizziness (after vaccination until now) Tiredness (after vaccination until now) Chills (after vaccination until now) Headaches (after vaccination until now) I took Tylenol Eye pain (after vaccination until now) A blood vessel burst in my left eye on 7/7/21 and I still recovering from that.


VAERS ID: 1471271 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO217 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: SARS-CoV-2 test negative, Streptococcus test negative, Unevaluable event
SMQs:, COVID-19 (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: Gabapentin, amitriptalin, metapropolol, ecchinecea, vitamin D, and C, multivitamin, bedesonide
Current Illness: Not sick at vaccination day- had a low grade fever and general flu like symptoms. A couple weeks letter- woke up feeling like swallowing razors. Low grade fever, body aches, sneezing, chills, headache and extreme fatigue.
Preexisting Conditions: Asthmatic
Allergies: Nnone
Diagnostic Lab Data: Strep culture and COVID test- both negative
CDC Split Type:

Write-up: None stated.


VAERS ID: 1471832 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-01
Onset:2021-06-25
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Differential white blood cell count, Fibrin D dimer, Full blood count, Hypertension, International normalised ratio, Lymphadenopathy, Metabolic function test, Troponin I
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapenten, 300 mg 2 x day Vitamin D 25 mcg 1 x day Allegra 180 mg 1 x day Calcium 500 mg 1 x day Amlodipine 10 mg 1 x day
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: Iodine, Sulfur Pecans Feathers
Diagnostic Lab Data: CBC with Differential, Comprehensive Metabolic Panel, D-Dimer, Protime INR, Troponin I
CDC Split Type:

Write-up: On 6/4/2021 was diagnosed with high blood pressure, had usually been low to regular. Was prescribed Amlodipine to correct. On 6/28/2021 experienced pressure and pain in the heart area and went to emergency room. They found signs of possible blood clots, so also performed additional tests. Found lymph nodes under the right arm enlarged (lymphadenopathy)


VAERS ID: 1471844 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Heart rate increased, Pain, Palpitations, Vascular pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: Stabing chest pains, increased heartbeat(resting heart rate is now about 85-90 while it used to be about 65-70), heart pounding, pain in neck vessels while doing any exercise (even walking or light cleaning), have to take breaks from doing things because I feel like I am going to pass out, It is still ongoing as of today 07/15/2021 Haven''t received any treatment


VAERS ID: 1474507 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Heart palpitations, shortness of breath, breathing problems, difficulty taking deep breaths.


VAERS ID: 1474548 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-19
Onset:2021-06-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 LA / SYR
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK LA / -

Administered by: Military       Purchased by: ?
Symptoms: Blood urine present
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Cefprozil, Sulfa
Diagnostic Lab Data: 06/25/2021 - urine test finding 200 units of blood in urine and infection. 07/02/2021 - urine test finding 5 units of blood in urine.
CDC Split Type:

Write-up: Blood in urine starting a week later. Put on antibiotic for 12day but still having same issue.


VAERS ID: 1474766 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-27
Onset:2021-06-25
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 RA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 037C21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Hyperhidrosis, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: no
CDC Split Type:

Write-up: Nausea , dizziness, tired, sweaty, , and arm was extemely sore


VAERS ID: 1474971 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Headache
SMQs:, Dementia (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 Brain Fog Chills Fatigue


VAERS ID: 1475428 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxybutynin 10mg 1x daily June?s Fe 1 - 20 mcg tablet Multi-vitamin Bisacodyl USP 5 mg
Current Illness: None
Preexisting Conditions: Spina Bifida (myelomeningocele) VP shunted hydrocephalus Neurogenic bowel and bladder
Allergies: Sulfa allergy Amoxicillin allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bilateral hand rash. Symptom onset on day 3 (June 25, 2021) with progressive worsening. Itching and soreness. Treated with Clobetas 0.05% cream - 2x daily beginning on July 2, 2021 through July 8, 2021.


VAERS ID: 1477799 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-11
Onset:2021-06-25
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Lymphadenopathy, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Pain at Injection Site-Medium, Systemic: Lymph Node Swelling-Medium, Additional Details: Patient came in to pharmacy on 7/15 to report symptoms. Per pt, left arm soreness lasted for 1 month after vaccine administration on 6/11. Per pt, noticed swollen lymph node under left armpit that developed 2 weeks after vaccine administration. Can feel pain when she stretches or extends her left arm. Pain does not interfere with daily activities. Advised patient to make an appointment to have the swollen lymph node examined by physician. Pt agreed to make an appointment with a physician.


VAERS ID: 1478366 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-14
Onset:2021-06-25
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JINJ / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac disorder, Chest pain, Dyspnoea, Fatigue, Headache, Impaired work ability, Investigation, Myalgia, Oropharyngeal pain, Pericarditis, Pyrexia, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril/Hydraclorathorazide; Multivitamin; Vitamin D
Current Illness: Absolutely none! I have been healthy most of my life.
Preexisting Conditions: High blood pressure (treated).
Allergies: Allergic to hay.
Diagnostic Lab Data: I had daily tests 7/7/21 through 7/9/21 and again on 7/13/21. I will have them weekly for at least the next 2 weeks. You will have to get the medical reports from the facility.
CDC Split Type:

Write-up: June 14, I had the vaccine. June 25, I started having muscle aches, severe headache and sore throat. This continued through the next week along with being extremely tired. July 5, I went to the ER due to severe chest pains (I have NEVER had chest pains before). They sent me home that same day. By July 7th, I felt like my heart was seizing and went back to the ER this time also with shortness of breath and a fever. I was admitted on July 7th and discharge on July 9th, with diagnosis of Pericarditis--a SIDE EFFECT OF THE VACCINE. I am now currently on sick leave as I cannot work. I was told by medical staff to report this so that is what I am doing.


VAERS ID: 1478472 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Fatigue, Headache, Lymphadenopathy, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, swollen lymph node under arm, extreme fatigue, headache and nausea.


VAERS ID: 1478683 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-06-25
Onset:2021-06-25
   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 EW0170 / UNK RA / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Fatigue, Injection site pain, Intermenstrual bleeding, Joint swelling, Lymphadenopathy, Neuralgia, Swollen tongue, Throat tightness, Vaccination site rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 20 minutes after vaccination my throat felt tight and my tongue felt large. Benadryl taken before vaccination helped that subside. 12 hours: menstrual spotting, pain at injection site, fatigue, nerve pain on both sides of my chest, lymph node swelling on the left side of my chest and my left breast. I was vaccinated in my right arm. 4 days: left elbow swelling 7 days: rash under my right arm near the vaccination site 21 days: left elbow still swollen I participated in V-safe and I was asked to submit this form.


VAERS ID: 1481192 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Head discomfort, Magnetic resonance imaging, Magnetic resonance imaging abnormal, Muscular weakness, Musculoskeletal stiffness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Demyelination
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210705; Test Name: CAT scan; Result Unstructured Data: unknown; Test Name: MRI; Result Unstructured Data: White matter and vasculo ischemic changes, micro angiopathic ischemia; Comments: White matter changes (patient had history of this), vasculo ischemic changes, micro angiopathic ischemia , multifocal white matter changes
CDC Split Type: USJNJFOC20210727785

Write-up: MAGNETIC RESONANCE IMAGING ABNORMAL; RIGHT ARM WEAKNESS; STIFF NECK; HEAVY HEAD FEELING; TINGLING; This spontaneous report received from a physician concerned a 73 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included white matter changes. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1820095 expiry: UNKNOWN) dose was not reported, administered on 21-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced stiff neck. On 25-JUN-2021, the subject experienced heavy head feeling. On 25-JUN-2021, the subject experienced tingling. On 25-JUN-2021, the subject experienced right arm weakness. On 05-JUL-2021, Laboratory data included: CAT scan (NR: not provided) unknown. On an unspecified date, the subject experienced magnetic resonance imaging abnormal. Laboratory data (dates unspecified) included: MRI (NR: not provided) White matter and vasculo ischemic changes, micro angiopathic ischemia. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from stiff neck, heavy head feeling, and right arm weakness, and the outcome of tingling and magnetic resonance imaging abnormal was not reported. This report was non-serious.


VAERS ID: 1481329 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea, Dizziness, Fatigue, Headache, Injection site pain, Lethargy
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Mild, Systemic: Abdominal Pain-Medium, Systemic: Diarrhea-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Headache-Severe


VAERS ID: 1481508 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Injection site discolouration
SMQs:, Peripheral neuropathy (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: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: After then 2nd vaccination, patient had a burning sensation for at least 6 hour after the injection. Patient put some ice on the injection site. Patient claims that the burning sensation went away after 6 hours but a discoloration of the skin is noticeable on the vaccinated arm. Patient claims it occurred after the burning sensation went away. The discoloration is till present on day 22 after the vaccination. Patient is not in pain currently.


VAERS ID: 1482969 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-21
Onset:2021-06-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SERTRALINE; HYDROXYZINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Congenital anomaly
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021787665

Write-up: Difficulty breathing; Chest pain; Upper back pain; This is a spontaneous report from a contactable consumer (patient). A 24-year-old non pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, lot number: EW0191, expiration date: un-known) via an unspecified route of administration in Arm Right on 21Jun2021 at 04:30 PM (at the age of 24-year-old) as single dose for covid-19 immunization. Medical history included Congenital anamoly (ARSA), and No known allergies reported. Concomitant medications (taken within 2 weeks of vaccination) included Sertraline and Hydroxyzine. It was reported that patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to vaccination, and was not tested for COVID-19 since the vaccination. On 25Jun2021 at 10: PM, the patient experienced difficulty breathing, chest pain, and upper back pain. No therapeutics measures were taken for events. The events resulted to visit Emergency room/department or urgent care. Device Date: 27Jun2021. The outcome of the events was reported as not recovered. Follow-up attempts were completed. No further information was expected.


VAERS ID: 1482976 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose decreased, Disorientation, Dizziness, Fear, Hallucination, Hyperhidrosis, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: XIFAXAN; PROPRANOLOL; WELLBUTRIN; CELEXA [CELECOXIB]; URSODIOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Liver disorder (other_medical_history: Liver Disease)
Allergies:
Diagnostic Lab Data: Test Date: 20210625; Test Name: Blood test; Result Unstructured Data: Test Result:Low; Comments: my blood sugar very low
CDC Split Type: USPFIZER INC2021788762

Write-up: hallucinating; blood sugar very low; very dizzy; disorientated; I wasn''t able to hold conversation; very scary; sweaty; This is a spontaneous report from a contactable consumer or other non hcp (Patient). A 37-year-old male patient received bnt162b2 (BNT162B2 PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number: EW0217), dose 2 via an unspecified route of administration in arm left on 25Jun2021 at 17:00 (at the age of 37-years-old) as dose 2, single for COVID-19 immunisation. The medical history of the patient included liver disease from an unknown date and unknown if ongoing. The concomitant medications of the patient included rifaximin (XIFAXAN), propranolol (PROPRANOLOL), bupropion hydrochloride (WELLBUTRIN), celecoxib (CELEXA [CELECOXIB]) and ursodiol (URSODIOL) all taken for an unspecified indication, start and stop date were not reported. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number: EW0178), via an unspecified route of administration in arm left on 04Jun2021 at 15:00 (at the age of 37-years-old) as single dose for COVID-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the covid vaccine. Prior to vaccination, the patient was not diagnosed with covid-19. Since the vaccination, the patient not been tested with covid-19. The patient experienced reported that on 25Jun2021 at 18:00 approx 30 min after injection, while shopping, I became very dizzy, sweaty and disorientated. I wasn''t able to hold conversation and was rolling and running in circles. I did not know where I was and was hallucinating, very scary and all happened very quickly. Was taken to ER for observation, was told my blood sugar very low. I''ve never had glucose problems and am not diabetic. The patient underwent lab tests and procedures which included blood glucose decreased was low on 25Jun2021. Therapeutic measures were taken as a result of events that included ate food and observed. The outcome of all the events was reported as resolving.


VAERS ID: 1482980 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN0187 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Pharyngeal swelling, Pruritus, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Sunburn
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021789366

Write-up: Chest and back itch incredibly; Does feel hot; now swelling of his face or throat; now swelling of his face or throat; This is a spontaneous report from a contactable consumer or other non-healthcare professional (Patient''s father). An 18-years-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for Injection, batch/lot number: EN0187 and Expiration date was not reported), via an unspecified route of administration, administered in Arm Left on 25Jun2021 14:30 (at the time of vaccination 18-years-old), as a single dose for COVID-19 immunization. The patient''s medical history include sunburn and reported that he did have a sunburn 3 days ago. No concomitant medications were not reported. The caller provided other relevant medical history including but not limited to these conditions; diagnosed allergies, compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity. The patient did not have any other vaccination prior to COVID vaccine (within 4 weeks). No family Medical History Relevant to adverse events. On 25Jun2021, the patient experienced chest and back itch incredibly, does feel hot, and now swelling of his face or throat. It was reported that, today (25Jun2021) the caller 18-year-old son had the Covid-19 vaccination. He had the vaccine about 2 hours ago. Everything was fine up until about 30 minutes ago. He claims his chest and back itch incredibly. He had no other symptoms and no rash. He does feel hot. He had no difficulty breathing and now swelling of his face or throat. The caller wife was a nurse. She did not feel like it was an emergency at that point but being a nurse, she wanted him to check and see if they have any Benadryl. No relevant tests. Patient did not visit to emergency room, physician office and not hospitalized. The outcome for all the events was not resolved. Additional Information has been requested.


VAERS ID: 1483000 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Hallucination, Muscle spasms, Seizure
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Dystonia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021791440

Write-up: Convulsions; Hallucinations; cramping; Chest pain; This is a spontaneous report from a contactable consumer or other non health professional (parent). A female patient of an unspecified age 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 on 25Jun2021 as dose 2, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient historical vaccine included first dose of BNT162B2 via unspecified route of administration on an unspecified date as single dose for COVID-19 immunization. It was reported that, reporter daughter was given a second shot today (25Jun2021) of Pfizer and it''s now about 4 hours since she was given the shot and she had reacted to the shot having convulsions, hallucinations and cramping, chest pains and all that. The outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1483063 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Vaccination site mass
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE; MONTELUKAST
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021805969

Write-up: A week later and I have a round hard lump in the vaccination site.; This is a spontaneous report from a contactable other health care professional. A 33-year-old non pregnant female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot Number: EW0185, Expiration date not reported), via an unspecified route of administration in arm left on 18Jun2021 at 15:45 (at the age of 33-year-old) as a single dose for COVID-19 immunization at Doctors office/urgent care. The patient medical history was reported as none. The patient had no known allergies. Prior vaccination, the patient was not diagnosed with COVID. Post vaccination, the patient was not tested with COVID. The concomitant medications included Levothhroxine (MANUFACTURER UNKNOWN), montekulast (MANUFACTURER UNKNOWN) and birth control; both for an unknown indication from an unknown start date and unknown if ongoing. The patient did not receive any other vaccine in four weeks. On 25Jun2021 12:00, a week after the vaccination, the patient had a round hard lump in the vaccination site. The patient did not receive any treatment for the event. The outcome of the event was unknown. Follow-Up (01JUL2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1483142 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 RA / OT

Administered by: Other       Purchased by: ?
Symptoms: Fibrin D dimer, Fibrin D dimer increased, Hypoaesthesia, Hypotonia, Mobility decreased, Myalgia, Pain in extremity, Paraesthesia, Pericardial effusion, Scan, Syncope, Vaccination site pain
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Rheumatoid arthritis (She was diagnosed at 21. 15 years before 2021. She thinks 2006.)
Preexisting Conditions: Medical History/Concurrent Conditions: Immune disorder (NOS); Stokes-Adams syndrome; TIA (She is only saying that because she had thought she herself had a TIA.)
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: D dimer; Result Unstructured Data: Test Result:Elevated to 1.14; Test Date: 20210629; Test Name: scan; Result Unstructured Data: Test Result:pericardial effusion
CDC Split Type: USPFIZER INC2021810001

Write-up: Syncope; Right arm went completely numb; small pericardial effusion; Her right arm lost function and went completely flaccid; she could not move it; tingling; soreness was in her muscle where the injection was; muscle pain; soreness in right arm; D dimer: Elevated to 1.14; This is a spontaneous report from a contactable Other Health Professional (patient). A 36-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EW0191), intramuscular, administered in Deltoid Right on 25Jun2021 15:00 (at age of 36 years old) as single dose for COVID-19 immunisation. Medical history included Rheumatoid arthritis from 2006 ongoing (She was diagnosed at 21. 15 years before 2021. She thinks 2006), compromised immune status, Family Medical History Relevant to AE(s): Mother has a history of stoke. She is only saying that because she had thought she herself had a TIA. That is why she went in because her arm was so numb. Her arm was numb Sunday through Monday. So she thought she better go and get it checked out. Fortunately there was no PE or evidence of stroke or anything. With her mom''s medical history she thought she should get it checked out. The patient''s concomitant medications were not reported. Prior Vaccinations (within 4 weeks) No, but she had a varicella booster on 21May2021 (at 36 years old). She had to put off her vaccine to make sure she waited the full month before the Pfizer vaccine. No AEs following prior vaccinations. Caller is calling regarding the COVID vaccine. She is reporting an adverse reaction to the first shot which she had on Friday at 3pm. Caller had to go to emergency department last night. She has a small pericardial effusion on 29Jun2021. It was very bizarre. She has never had any kind of adverse reaction to a vaccine before. She is calling because she feels like Pfizer needs to know. After she received the shot everything was fine, she just had soreness in her arm, no big deal. Then Sunday (27Jun2021) she had a syncope event where she almost lost consciousness and simultaneously her right arm went completely numb. Her right arm lost function and went completely flaccid. She had no voluntary control over her right arm. It went completely numb and she could not move it. soreness in right arm: Arm was very sore probably Friday (25Jun2021) and Saturday morning. She took some Ibuprofen and it was completely fine. She no longer felt pain by Saturday (26Jun2021) night. She no longer was feeling any kind of muscle pain from the injection. Caller clarifies that the soreness was in her muscle where the injection was. The muscle pain and soreness are the same thing caller further clarifies. It wasn''t anything. It happened. The pericardial effusion was actually last night. It is probably the last one in the order of events. She states she found that out yesterday, actually early this morning. Probably 2am since she was in the Emergency Department forever. This is probably something that will need follow up with an echocardiogram and monitoring and possible medication. It''s ok right now but if fluid keeps accumulating it can be lethal and would require a surgery to take the fluid off of the heart. Pericardial effusion is a small amount of fluid that builds up around the heart. The sack that holds your heart muscle, it builds up in-between there. She went to the hospital because of the adverse reactions she was having with the syncope and the numbness in the arm and that is what they discovered. The small pericardial effusion is what her scan found. Caller clarifies that she was not admitted to the hospital. Caller states that the fact that the syncope and numbness in her arm happened together is medically significant. If these things happen on their own it is one thing, but if they happen together that is medically significant that they happen simultaneously. They are less significant on their own than if they happened together. The right arm numbness did not resolve with the syncope. She regained function of her arm but she had numbness and tingling until yesterday. Today it feels much better. Caller states she wanted the Pfizer because that was her pick between that and Moderna. She preferred the Pfizer. She researched about it. She is just sad that she had an adverse reaction. She hopes no one else is having that, that is why she wanted to call to inform Pfizer. Reporter seriousness for Right arm went completely numb: Medically significant. The patient was hospitalized for Syncope and Right arm went completely numb on unknown date. The patient underwent lab tests and procedures which included D dimer: Elevated to 1.14 in 2021, scan: pericardial effusion on 29Jun2021. AE (except D dimer: Elevated) require a visit to Emergency Room. The outcome of the event Syncope was recovered on 27Jun2021, for Numbness of upper arm, Tingling was recovered on 28Jun2021, for Pericardial effusion was not recovered, for Pain in arm, Vaccination site pain, muscle pain was recovered on 26Jun2021, for other events was unknown. Relatedness of drug to reactions/events: For soreness in right arm was Related, for small pericardial effusion was Unknown, for Syncope was Related, for Right arm went completely numb was Related.; Sender''s Comments: Based on the available information in the case, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported events syncope ,hypoaesthesia and pericardial effusion. 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: 1483280 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Vertigo
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: WARFARIN; LOSARTAN; HYDROCHLOROTHIAZIDE; METOPROLOL; AMLODIPINE; METFORMIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: AFib; Blood pressure; Diabetes; Polymyalgia (Years ago, he had a shingles shot. it was weeks, they said he had Polymyalgia)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021820935

Write-up: Very dizzy; Room spinning; "dizziness 3 to 4 days after the shot which lasted a while then stopped/Felt a little dizzy getting out of bed; almost fell over getting out of bed, it didn''t last very long/During the next several days, lost the balance; This is a spontaneous report from a contactable consumer (patient''s wife). A 70-year-old male patient (reporter''s husband) received second dose BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: ER8734, expiry date not reported, age at the time of vaccination: 70-year-old), via an unspecified route of administration, in Arm Left on 24Jun2021 11:00 as dose 2, single for covid-19 immunisation. Medical history included Polymyalgia, AFib, blood pressure, diabetes. Concomitant medications included warfarin ongoing (blood thinner) taken for atrial fibrillation at a dosage of 5mg every day except Tuesday, which dose is 7.5mg and has been taking for 15-20 years; Losartan taken for blood pressure at a dosage of 25 mg once a day from an unspecified start date and ongoing; hydrochlorothiazide taken for blood pressure at a dosage of 25 mg once a day; ongoing; metoprolol taken for blood pressure at a dosage of 100 mg once a day; ongoing; amlodipine taken for blood pressure at a dosage of 5 mg once a day (ongoing); metformin taken for diabetes mellitus at a dosage of 500 mg twice a day (has been taking for probably about 6 years) and ongoing. Previously, the patient received first dose of BNT162B2 (Batch/Lot Number: ER8734), Arm left on 03Jun2021 11:00 as dose 1, single for covid-19 immunization, and years ago, the patient had a shingles shot and the couple of weeks later, he could not move or get out of bed and after weeks of testing, they said he had Polymyalgia, they do not know if it was actually from the vaccine. No other vaccines administered on same date of the Pfizer vaccine. The patient did not receive any prior Vaccinations within 4 weeks of Pfizer vaccination. On 25Jun2021, the next day, after the patient got the vaccine, he almost fell over getting out of bed and it did not last very long and during the next several days, lost the balance and the reporter had been reading all over the internet that people losing their balance and getting dizzy. On 29Jun2021, 3 to 4 days after the shot, the patient experienced dizziness, felt a little dizzy getting out of bed which lasted a little while and then stopped. The reporter wanted information if this is a side effect of the vaccine and how long they will last. And she "researched online and read a bunch of people talking about their experience with the vaccine and several people had the same experience as her husband''s dizziness, almost like a vertigo effect". On 01Jul2021 14:00, the patient again felt very dizzy for a couple of hours and he felt like the room is spinning and thinks it was probably on and off with the dizziness. And when waking up to use the bathroom, he was so dizzy, he had to hold onto walls and It has stayed the same. The patient did not receive any corrective treatment. The patient did not visit emergency room or physician office for the adverse events. The outcome of events dizziness 3 to 4 days after the shot which lasted a while then stopped/felt a little dizzy getting out of bed was recovered on an unspecified date in 2021, very dizzy was not recovered and other events was unknown. Information on batch/lot number has been requested. .


VAERS ID: 1483332 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Headache, Hot flush, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament 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: ZOLOFT; IRON
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Seafood allergy; Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021822395

Write-up: Headache for 5 days starting 12 hours after vaccine. Hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine. Currently breastfeeding and 5/8 weeks postpartum at time; Headache for 5 days starting 12 hours after vaccine. Hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine. Currently breastfeeding and 5/8 weeks postpartum at time; Headache for 5 days starting 12 hours after vaccine. Hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine. Currently breastfeeding and 5/8 weeks postpartum at time; Headache for 5 days starting 12 hours after vaccine. Hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine. Currently breastfeeding and 5/8 weeks postpartum at time; Headache for 5 days starting 12 hours after vaccine. Hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine. Currently breastfeeding and 5/8 weeks postpartum at time; This is a spontaneous report from a non-contactable consumer (patient) reported for herself that: A 36-years-old female patient received BNT162B2 (Pfizer-BioNTech Covid-19 Vaccine Solution for injection), dose 2 via an unspecified route of administration, administered in Arm Left on 25Jun2021 11:15(Age at vaccination: 36-years) (Batch/Lot Number: EW0196) as DOSE 2, SINGLE for covid-19 immunization. Facility where the most recent COVID-19 vaccine was administered: Pharmacy or Drug Store. The patient past Medical history included, food allergy, drug hypersensitivity from an unknown date and unknown if ongoing. Concomitant medication(s) included sertraline hydrochloride (ZOLOFT) taken for an unspecified indication and iron (IRON) taken for an unspecified indication. The patient previously took pcn 200 and experienced drug hypersensitivity, diflucan and experienced drug hypersensitivity, bnt162b2 for covid-19 immunization. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccine within 4 weeks prior to covid-19 vaccination. On 25Jun2021, at 23:00 the patient experienced Headache for 5 days starting 12 hours after vaccine. Hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine. Currently breastfeeding and 5/8 weeks postpartum at times of vaccine. No treatment was received. The event outcome was Recovered on unspecified date. Device Date: 01Jul2021 No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021823853 same reporter/drug, different patient and event


VAERS ID: 1483347 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Headache, Hot flush, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament 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: PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]; ZOLOFT; IRON
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Seafood allergy (Shrimp, PCN, sulfa, diflucan.); Sulfonamide allergy (Shrimp, PCN, sulfa, diflucan.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021823853

Write-up: Headache for 5 days starting 12 hours after vaccine; Hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine; Hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine; Hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine; Hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine; This is a spontaneous report from a non-contactable consumer (patient). A 36-year-old female patient (non-pregnant) received BNT162B2 (BNT162B2, Solution for injection, Batch/Lot number: EW0196) via an unspecified route of administration, in the left arm on 25Jun2021 (at the age of 36-year-old) as DOSE 2, SINGLE for covid-19 immunisation. The patient was non-pregnant at the time of vaccination. The vaccination facility type was pharmacy or drug store. The patient medical history includes food allergy, (allergy: shrimp), drug hypersensitivity (Allergy: Sulfa). Concomitant medications included (received within 2 weeks of vaccination) Prenatal vitamin, Sertraline Hydrochloride (ZOLOFT) and Iron. Past drugs included PCN, Diflucan and there allergy. Prior to vaccination, the patient was not diagnosed with COVID-19 and had not been tested for COVID-19 since the vaccination. The patient previously received BNT162B2 (BNT162B2, Solution for injection, Batch number: EW0180) via an unspecified route of administration, in the left arm on 04Jun2021 as DOSE 1, SINGLE for COVID-19 immunisation. On 25Jun2021 23:00, 12 hours after vaccine, the patient experienced headache for 5 days. She also experienced hot flashes, cold sweats, muscle aches and generalized malaise for 3 days after vaccine. She was currently breastfeeding and 5/8 weeks postpartum at times of vaccine. The patient did not receive treatment for events. Outcome of the event was recovered on an unspecified date in Jun2021 while rest events recovered on 28Jun2021. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021822395 same reporter/drug, different patient and event


VAERS ID: 1483397 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000-01 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Fall, Feeling cold, Tunnel vision
SMQs:, Supraventricular tachyarrhythmias (narrow), Accidents and injuries (narrow), Optic nerve disorders (broad), Retinal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diverticulitis; Hiatal hernia
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021829890

Write-up: Atrial fibrillation was detected but not sure yet if it was an underlying condition or caused by vaccine.; Tunnel vision; Extreme sense of coldness; Face planted to the floor.; This is a spontaneous report from a contactable consumer or other non hcp. This consumer(patient) reported for himself thata 41-years-old male patient received first dose of BNT162B2 (Formulation: Solution for injection, Batch/Lot number: 59267-1000-01), via an unspecified route of administration, administered in Arm Right on 25Jun2021 18:00 (Age at vaccination 41 years) as single dose for COVID-19 immunisation. Medical history included hiatus hernia and diverticulitis. Concomitant medication(s) included paracetamol (TYLENOL). Patient had no known allergies. On 25Jun2021 18:00, the patient experienced atrial fibrillation was detected but not sure yet if it was an underlying condition or caused by vaccine; tunnel vision; extreme sense of coldness and face planted to the floor. Patient was received treatment for events. It was reported that after patient received shot and exited the medical room, he had extreme sense of coldness come over me, tunnel vision, then face planted to the floor. Ambulance was called, patient regained consciousness about a minute or so later, and my chin was split open. They took me to ER, stapled my chin, and ran tests. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, patient was not diagnosed with COVID-19. Since the vaccination, patient has been not tested for COVID-19. Other medications the patient received within 2 weeks of vaccination include Tylenol. Patient received Cardizem 1/day till doc follow-up visit. The clinical outcome of all events were unknown. Information on the lot/batch number has been requested.


VAERS ID: 1483415 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-06
Onset:2021-06-25
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac disorder
SMQs:

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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (If covid tested prior vaccination: Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021830041

Write-up: Diagnosis: Inflammation around the heart; This is a spontaneous report received from a contactable consumer (patient). A 30-years-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0176), via an unspecified route in right arm on 06May2021 as single dose and second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0182) via an unspecified route on 06May2021 for covid-19 immunisation. The patient ''s medical history included Covid-19 on unspecified date. The patient had no known allergies. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any other vaccines within 2 weeks prior to the vaccination. Prior to the vaccination, the patient was diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 25Jun2021 at 11:00, the patient experienced and diagnosed inflammation around the heart. Patient visited emergency room and received treatment for event. The patient had hospitalization for 7 days. The outcome of the event was unknown. Follow-Up (06Jul2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1483494 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-24
Onset:2021-06-25
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arrhythmia, Atrioventricular block complete, Chest X-ray, Electrocardiogram, Heart rate
SMQs:, Conduction defects (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Name: Chest X-Ray; Result Unstructured Data: Test Result:Unknown result; Test Name: EKG; Result Unstructured Data: Test Result:Unknown result; Test Name: heart rate; Result Unstructured Data: Test Result:37; Test Name: heart rate; Result Unstructured Data: Test Result:up to 42; Test Name: heart rate; Result Unstructured Data: Test Result:up to 50; Test Date: 20210702; Test Name: heart rate; Result Unstructured Data: Test Result:52; Test Date: 20210702; Test Name: heart rate; Result Unstructured Data: Test Result:44
CDC Split Type: USPFIZER INC2021832247

Write-up: 3rd Degree Heart Block/had a 30 degree heart blockage; Caller states his heart rate at rest is 37 up to 42 up to 50, just all over the place.; This is a spontaneous report from a contactable consumer (Patient) reporting himself. A 75-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection) dose 1 via an unspecified route of administration, administered in Arm Left on 03Mar2021 (Batch/Lot Number: EN6202) as dose 1, single (at the age of 75 years), dose 2 via an unspecified route of administration, administered in Arm Left on 24Mar2021 at 12:50 (Batch/Lot Number: ER2613) as dose 2, 0.3 mL single (at the age of 75 years) for COVID-19 immunisation at Hospital. Medical history included none and the patient''s concomitant medications were not reported. Patient did not receive any vaccine within 4 weeks prior vaccinations. On 25Jun2021, patient has had both doses of the Pfizer Covid Vaccine and reported 3rd degree heart blocked. Patient stated a 3rd degree blockage was what his primary physician and cardiologist were reporting. Patient stated that patient had an appointment scheduled with his Cardiologist for Mar2020 and then the Covid thing hit and so patient cancelled it. Patient stated that patient usually went in every 6 months. Patient went to his primary physician for his annual physical the 16Jun2021 or 17Jun2021 and received an annual physical and since patient had cancelled the appointment with the cardiologist, the doctor did an EKG and Chest X-ray and she saw something disturbing and called patient at home and told to patient that patient needs to go see his Cardiologist immediately. Patient stated the the Cardiologist got him in last Monday. Patient has been going to this Cardiologist for years and between his last visit in the 12 months prior and this visit, patient has developed 3rd degree block. Patient stated nothing has changed and patient was very fit and eats properly and does everything patient was supposed to do. Patient stated the only thing that was different was that patient took the vaccine. Patient stated that they put a chest monitor on him on Monday 28Jun2021 and patient was supposed to wear it for 3 days, so patient took it off yesterday and sent that in. On an unspecified date in 2021, patient heart rate at rest is 37 up to 42 up to 50, just all over the place. Patient stated when patient was resting, like right now, it was 52 2 minutes ago and it is 44 now on 02Jul2021. Patient stated his doctor called him on Friday 25Jun2021 to tell him about the 3rd degree blockage. Patient stated both reports because she wasn''t sure that patient''s report was right. Patient was on no medications, no medical conditions. Patient stated this through them all off because patient was very healthy for his age. Most people of his age are on medications or using a walker. Patient stated that patient was trying to do all can do. The Cardiologist said the only thing they can do was a pacemaker, and patient doesn''t want that. Patient was trying to exercise and patient was set up on 13Aug2021 for a stress test and cardio echogram. Patient stated after that they will look and see if they have to monitor it or put in a pacemaker. Patient stated they were trying to see how it goes from resting to exhaustion. The outcome of event Atrioventricular block third degree was not recovered and for Arrhythmia was unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1483897 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antibody test positive, Dizziness, Injection site pain, Paraesthesia, Visual impairment, Vitreous floaters
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Vestibular disorders (broad), Vasculitis (broad), Hypersensitivity (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: Flu vaccine in 2019 caused swelling, warmth, pain at the injectcion site for a month.
Other Medications: Synthroid
Current Illness: None
Preexisting Conditions: Hypothyroid.
Allergies: Penicillin, peanuts.
Diagnostic Lab Data: 7/14/21 I got an antibody test that was positive (6.03). The technician, in error, told me that getting the vaccine prior to an antibody test would NOT affect the result. I have since learned she was wrong. The 1st dose of Pfizer on 6/25/21 had caused my antibody test to be positive.
CDC Split Type:

Write-up: 1 hour after receiving the injection I had black spots in my left eye, I got lightheaded, my vision was affected while watching TV. I took 2 Tylnenol and layed down on the couch. I also had a tingling sensation in my left armpit lymph nodes and down into my left arm. The black spots & lightheadedness went away in about an hour. Generally so did the left arm sensations. The injection site was mildly sore for about a week.


VAERS ID: 1484058 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Ear discomfort, Feeling hot, Headache, Paraesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril, warfarin, novolog
Current Illness: blood clot
Preexisting Conditions: hypertension, diabetes
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: lient reported 20 mins after receiving vaccine she experienced headache, warmth in ears, and tingling of the lip lasting 30 minutes. Per client no shortness of breath or swelling. Client stated she did not take any medication or followed up with provider


VAERS ID: 1484091 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Feeling hot, Influenza like illness, Pruritus, Sensitive skin, Skin abrasion, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Accidents and injuries (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none that i''m aware of
Diagnostic Lab Data: none
CDC Split Type:

Write-up: My skin has become sensitive and itchy. Any abrasion causes redness and low hives - even holding the steering wheel. For the first day or two my skin felt hot -- similar to the feeling when you come out of a tanning bed. I was worried about getting the 2nd shot, but i did it. The skin condition continues, but it did not get worse with the 2nd shot. I did get the flu feeling that is the normal reaction (for 1 day). i am hoping that my skin gets back to normal soon.


VAERS ID: 1484475 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-06-25
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abortion spontaneous, Maternal exposure before pregnancy, Ultrasound antenatal screen abnormal, Uterine dilation and curettage
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: Ultrasound June 10, 2021 Ultrasound June 25, 2021 D&C June 30, 2021
CDC Split Type:

Write-up: Miscarriage. First day of last menstrual cycle was March 30, 2021. Pregnancy was confirmed through home test on May 7, 2021 and with doctor on May 10th, 2021. The doctor referred me to OBGYN and first appointment was on June 9th, 2021. Expected delivery date was January 4, 2022. The first ultrasound occurred on June 10th, 2021. This ultrasound showed concerns of development as I was measuring 6 weeks and should have been at 10 weeks based on the previous dates. A follow-up ultrasound occurred on June 25th and confirmed the baby was not viable. My body was not recognizing the miscarriage and therefore had to go in for a D&C on June 30, 2021.


VAERS ID: 1484638 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 1 LA / IM

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

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

Write-up: No adverse events, no treatments, no negative outcomes


VAERS ID: 1484721 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Malaise
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Labetalol, vitamin d, iron, multivitamin
Current Illness: Post parting pre eclampsia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills night of injection lasting 2 hours. Headache starting next morning lasting three days Malaise started next morning lasting three days


VAERS ID: 1484769 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

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

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

Write-up: Patient found kneeling on the floor with family member holding him. Other staff member in clinic was taking photos of the family and seen patient kneels quickly and was already assisting. Patient lost awareness of the surroundings for a second. Patient states " I got slightly dizzy after the vaccine and I dont know what happened after I stood up to take a picture." Pt found alert and verbally responsive. Patient was put into wheelchair and assisted to gurney. Placed in supine position with both lower extremities elevated. Patient denies dizziness, w/o headache, no nausea/vomiting. Vital signs monitored w/i 15 mins. 9:55 am bp-103/66,P-96,RR-18, o2 sat 99% 10:15 am bp-95/66,P-88,RR-17, o2 sat 99% , 10:35 AM BP-104/62, P-93, RR-17, 02SAT 99%, Patient stable, after care vaccination explained to family, patient sent home.


VAERS ID: 1484943 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Hypoaesthesia, Hypoaesthesia oral, Ocular discomfort, Pain in extremity, Paraesthesia, Paraesthesia oral, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Statin but did not take that day
Current Illness: None
Preexisting Conditions: high cholesterol.
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Approximately 18 hours post 1st injection of Pfizer vaccine, patient developed 103.5 fever with the following additional symptoms which lasted approximately 24 hours: numbness tingling in toes teeth and gums hurt blood vessels in eyes felt like they were spasming felt brief momentary pains up through legs and in chest


VAERS ID: 1485000 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-20
Onset:2021-06-25
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Thrombocytopenia
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? 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: D69.6 - Thrombocytopenia, unspecified


VAERS ID: 1485650 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Feeling hot, Pruritus, Rash papular, Rash pruritic, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: On June 25th, 2021 at around 4 A.M. I started feeling itchiness and warmth on my face, neck and arms. Shortly after I noticed red spots on my face, neck, elbows, and hands. Some of the red spots on my face and elbows were raised bumps that were itchy and other red spots were not raised or itchy. On the same day around 10 A.M., the spots on my face faded but others appeared around my knees that were warm to the touch and were raised and itchy. I took allergy medicine (Zyrtec) and applied anti-itch cream (Gold Bond) to the spots which helped with the itchiness and raised bumps but the red spots remained. The following day some of the spots faded on my neck and elbows but some had appeared on my legs, feet and chest. I continued taking the allergy medicine and cream until they completely faded away on like the 4th day, June 28th, 2021.


VAERS ID: 1486285 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Biopsy lung, Blood test, Skin burning sensation
SMQs:, Peripheral neuropathy (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: SPIRIVA; ADVAIR
Current Illness: Lung cancer
Preexisting Conditions: Medical History/Concurrent Conditions: Palpitations; Sickness (Her grandson was very sick in Jan 2021 as was her dentist); Tachycardia
Allergies:
Diagnostic Lab Data: Test Name: Lung Biopsy; Result Unstructured Data: Test Result:Unknown; Comments: There was squamous cells in there, then they did the radiology.; Test Name: Blood test; Result Unstructured Data: Test Result:Unknown; Comments: She has had plenty of blood tests in the last year
CDC Split Type: USPFIZER INC2021799391

Write-up: Caller stated she has been from Friday experiencing sunburn like sensation around her abdomen and now to her back as well./Skin on abdomen feels sunburned and now moving around to her back; This is a spontaneous report from a contactable consumer (patient) via Medical information team. An 82-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in left arm on 22Jun2021 10:27 as DOSE 1, SINGLE for covid-19 immunisation. Medical history included ongoing Lung cancer, Heart palpitations and AKA tachycardia. Family history included Her grandson was very sick from unknown date Jan2021 to unspecified date (Her grandson was very sick in Jan 2021 as was her dentist). Concomitant medication included tiotropium bromide (SPIRIVA, Lot number: unknown, Expiration date Jul2022) at 2 puffs every day and fluticasone propionate, salmeterol xinafoate (ADVAIR, Lot number: 294N, Expiration date Feb2022) taken for an unspecified indication, start and stop date were not reported. Historical vaccine included Pneumonia vaccine from Nov2020 to unspecified date and experienced Whooping cough (The first of Jan 2021, she was extremely sick, with what felt to her like whooping cough), She just did not get out of bed, Sick, her temp was 100.4, It felt like she was going to cough up her lungs and It was horrible/ It was that awful. Patient received her first dose of the Pfizer covid vaccine on 22Jun2021. patient stated she has been from Friday experiencing sunburn like sensation around her abdomen and now to her back as well on 25Jun2021. She was treated for lung cancer Apr2021 with radiology. It was 3 weeks, 5 days a week. She was told by her oncologist to expect the skin to burn because of the radiology treatment. However, the radiology treatment was done just underneath the breasts, for the lungs. The skin never burned. She was instructed to get cream for the burns but, it never burned. Just finds it curious that having taken this vaccine, that her abdomen is feeling like it is sun burning. There is probably no connection. She did put some first aid cream on it, which supposedly soothes and heals, moisture protects and relieves minor burns. It is plant based and has 9 kinds of elements to it. Everybody kept bugging her to get it. She was going to wait until Aug2021 to get it because, that is when she was going to have another PET scan. She was waiting until Aug2021 because supposedly her lungs were still swollen from the radiology. Patient was going to wait so she could separate the symptoms the symptoms are from 2 different places. What further motivated her was the delta variant. She thought that was another reason she did not want to get if for a while. While reporting symptoms from the Pfizer Covid 19 vaccine, the caller had mentioned that she was taking 2 inhalers, Spiriva and Advair. She stated that they really weren''t working, and she had started experiencing heart palpitations. She stopped using them. She started having heart palpitations again when she started using Spiriva again. The instructions said to take 2 puffs every day. She backed down to 1, then backed down to 1 puff every other day, then she finally just quit. The patient underwent lab tests and procedures which included lung biopsy: unknown (There was squamous cells in there, then they did the radiology) and blood test (She has had plenty of blood tests in the last year) on an unspecified date. The outcome of the event was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1486840 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Disturbance in attention, Dizziness, Fatigue, Haematocrit decreased, Haemoglobin decreased, Heavy menstrual bleeding, Mean cell volume normal, Menstruation irregular, Nausea, Pallor, Red blood cell count decreased
SMQs:, Acute pancreatitis (broad), Haematopoietic erythropenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Fertility 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 6/28 hemoglobin 9.8, hematocrit 29.9, RBC 3.48, MCV 85.9 6/29 hemoglobin 8.4, hematocrit 25.5, RBC 3.06, MCV 83.3 (bleeding stopped this day) 7/3 hemoglobin 7.3, hematocrit 22.2, RBC 2.6, MCV 83.7 (bleeding restarted this day and stopped again same day) 7/7 hemoglobin 8.0, hematocrit 25.6, RBC 2.81, MCV 91.1
CDC Split Type:

Write-up: Patient started a heavy menstrual period the day after her 2nd dose of pfizer vaccine (she had already had her regular period 6/10/21-6/16/21). The bleeding was very heavy (changing overnight pads every 1.5 hours) and caused patient to become pale, dizzy,- fatigue, nausea, and hard to concentrate. Sent for CBCs which showed drop in hemoglobin. Bleeding stopped 6/29 and restarted briefly on 7/3. Patient started on iron supplementation and recovered otherwise once bleeding stopped by 7/7.


VAERS ID: 1487210 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Blood test, Cerebrovascular accident, Computerised tomogram, Dysarthria, Injected limb mobility decreased, Magnetic resonance imaging abnormal, Nodule, Ultrasound scan, Vertigo
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lantus, Humalog, lisinoprl, levothyroxine, metformin, amlodipine, pantoprazole, sertraline and atorvastatin
Current Illness: none
Preexisting Conditions: Diabetes, Hypo-thyriodism
Allergies: none
Diagnostic Lab Data: MRI, MRA, CT scans, Bloodwork, and ultra sound
CDC Split Type:

Write-up: June 24th I received the vaccine, June 25 a baseball sized "knot" formed under my right arm. On July 2nd i was rushed to the Emergency dept . with what was described as "vertigo". I returned to the hospital at my doctors behest because i was not able to use my right hand correctly and my speech was slurred. after a MRI was done it was determined that i had had a stroke.


VAERS ID: 1487776 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-01-07
Onset:2021-06-25
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Injected limb mobility decreased, Magnetic resonance imaging abnormal, Magnetic resonance imaging head normal, Magnetic resonance imaging neck, Muscular weakness, Neck pain, Neuralgic amyotrophy, 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), 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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Wellbutrin, Claritin, flonase
Current Illness: none
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: MRI shows edema to Left Brachial plexus and diagnosed with Parsonage Turner Syndrome. MRI of my neck and Brain were normal
CDC Split Type:

Write-up: June 25,2021 I developed severe left sided neck pain that radiating into my left shoulder and left arm. Then I woke up with left arm weakness on July 10,2021 that progressed to near loss of use of my left arm. I went to the ER on July 11, 2021 and I was diagnosed with Parsonage-Turner Syndrome. I had no preceding illness, no injury and I have tested negative to all autoimmune disorders.


VAERS ID: 1490383 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-01
Onset:2021-06-25
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Mastitis
SMQs:, Functional lactation disorders (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: Diagnostic mammogram to be performed at the end of July 2021.
CDC Split Type:

Write-up: Mastitis on left breast.


VAERS ID: 1490612 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / IM

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

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

Write-up: patient stated when getting her second shot. She got a red itchy blistered rash on the bottom of her arm a couple day later. She took a Benadryl and it got better.


VAERS ID: 1490875 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-05-27
Onset:2021-06-25
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial nerve disorder, Induration, Swelling face, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swelling in cheek. Patient states swelling was at the site of nerve in cheek. Nerve felt hard. Was not painful, just slightly tender if touched. Patient read online to take Benadryl. Swelling subsided in a couple of days.


VAERS ID: 1492848 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood immunoglobulin G, Computerised tomogram, Malaise, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness: Primary immunodeficiency syndrome
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210627; Test Name: CT scan; Result Unstructured Data: Blood clot in the lungs; Test Name: IgG; Result Unstructured Data: Under ideal range
CDC Split Type: USJNJFOC20210738853

Write-up: PULMONARY EMBOLISM; DID NOT FEEL GOOD; This spontaneous report received from a health care professional (nurse) concerned a 54 year old unspecified race and ethnic origin female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number: unknown and expiry: unknown) dose was not reported, 1 total, administered on 2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. Non-company suspect drugs included: Hizentra (immunoglobulin human normal), (infusion, subcutaneous, batch number: Unknown and expiry; Unknown) 10 gram of weekly infusion, from 28-MAR-2021 for primary immunodeficiency. Concomitant medications included Tylenol (paracetamol) for unknown indication. Earlier this year (unspecified date), after receiving Covid-19 vaccine (Johnson and Johnson), per patient, things started to spiral down. On 25-JUN-2021, the patient took previous infusion Hizentra. The patient did not feel good after the infusion but ignored these symptoms, which tends to be her state post infusion. On 27-JUN-2021, the patient was having mucus and started coughing blood. On the same day, she was sitting on her couch, and her watch alerted her of a tachycardia rhythm. The spouse took the patient to the emergency room (ER), where a computerised tomogram (CT) scan was ordered, and a blood clot (pulmonary embolism) in the lungs was confirmed. The patient did not confirm any hospital admission. Still, the physician for Hizentra decided to hold her infusions for four weeks to monitor the patient and let the new medication, Eliquis (anticoagulant), settle in the system. The patient adds that on the brighter side, her IgG levels were in the ideal range. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the pulmonary embolism and did not feel good was not reported. This report was serious (Other Medically Important Condition, and Life Threatening).; Sender''s Comments: V0: 20210738853-covid-19 vaccine ad26.cov2.s -pulmonary embolism. This event is considered not related. The event 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 than the drug. Specifically: CONMEDS-OTHER SUSPECT DRUGS


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