|
| VAERS ID: |
904115 (history) |
| Form: |
Version 2.0 |
| Age: |
42.0 |
| Sex: |
Female |
| Location: |
Oklahoma |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EK5730 / 1 |
RA / IM |
Administered by: Other Purchased by: ? Symptoms: Petechiae,
Urticaria SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (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: acyclovir 400mg tid, albuterol hfa 180mcg q4h prn, buproprion SR 100mg bid, diclofenac 1% gel 4g qid prn, gabapentin 100mg tid, hydroxychloroquine 200mg bid, ibuprofen 800mg q8h prn, loratadine 10mg qday prn, montelukast 10mg qhs, omeprazol Current Illness: Preexisting Conditions: left sided heart failure, raynaud''s syndrome, sick sinus syndrome, GERD, systemic lupus erythematosus Allergies: codeine, latex Diagnostic Lab Data: CDC Split Type:
Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA PATIENT DEVELOPED HIVES ON INCISION SCARS ON HER RIGHT FOREARM AND CHEST AT 15 MINUTES POST VACCINATION. AT 24 HOURS POST VACCINATION, PATIENT DEVELOPED PETECHIAE ON INCISION SCAR ON CHEST AND LEFT COLLAR BONE. |
|
| VAERS ID: |
904258 (history) |
| Form: |
Version 2.0 |
| Age: |
42.0 |
| Sex: |
Male |
| Location: |
California |
| Vaccinated: | 2020-12-17 |
| Onset: | 2020-12-17 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-19 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
- / - |
Administered by: Private Purchased by: ? Symptoms: Disturbance in attention,
Dizziness,
Fatigue,
Flushing,
Hyperhidrosis,
Memory impairment,
Petechiae,
Rash,
Rash erythematous,
Rash pruritic SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: None Current Illness: None Preexisting Conditions: None Allergies: None Diagnostic Lab Data: None CDC Split Type:
Write-up: 1) flushing, sweats, and dizziness 2 hours after dose #1. Resolved after about 15 minutes. 2) severe fatigue next day with poor concentration and forgetfulness 3) whole body palpable rash with redness, itching, and development of patches of petechiae |
|
| VAERS ID: |
904445 (history) |
| Form: |
Version 2.0 |
| Age: |
52.0 |
| Sex: |
Male |
| Location: |
South Carolina |
| Vaccinated: | 2020-12-18 |
| Onset: | 2020-12-20 |
| Days after vaccination: | 2 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-20 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EK5730 / 1 |
LA / SYR |
Administered by: Private Purchased by: ? Symptoms: Petechiae SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Bupropion XL, Pantoprazole, Docusate Sodium Current Illness: None Preexisting Conditions: Depression, Gastroesophageal Reflux Allergies: None Diagnostic Lab Data: None CDC Split Type:
Write-up: Petechiae - very mild on proximal area of right thigh. Noted two days after vaccine. Appears to be resolving. |
|
| VAERS ID: |
905345 (history) |
| Form: |
Version 2.0 |
| Age: |
22.0 |
| Sex: |
Male |
| Location: |
Wisconsin |
| Vaccinated: | 2020-12-17 |
| Onset: | 2020-12-20 |
| Days after vaccination: | 3 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-21 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
- / IM |
Administered by: Private Purchased by: ? Symptoms: Haemorrhage,
Platelet count decreased,
SARS-CoV-2 test negative,
Thrombocytopenia SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
Extended hospital stay? No Previous Vaccinations: Other Medications: None reported by patient Current Illness: No known past medical history Preexisting Conditions: None Allergies: No known allergies Diagnostic Lab Data: COVID (-) Platelets 2000 cells/mcL CDC Split Type:
Write-up: Patient received Pfizer COVID 19 vaccine last Thursday 12/17. Admitted today (12/21) with bleeding and low platelet count - working up for ITP, TTP. Given recency of vaccination and no known contributory allergy or medical history, physician thought potentially associated with vaccination. |
|
| VAERS ID: |
905774 (history) |
| Form: |
Version 2.0 |
| Age: |
57.0 |
| Sex: |
Male |
| Location: |
Indiana |
| Vaccinated: | 2020-12-18 |
| Onset: | 2020-12-19 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-21 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EJ1685 / 1 |
UN / IM |
Administered by: Private 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? 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: Nurse reports that patient had no problems after receiving vaccination. Patient went home and EMS was called early the next morning and team administered vaccination was contacted physician that the associate works for stating the patient had a heart attack. |
|
| VAERS ID: |
906489 (history) |
| Form: |
Version 2.0 |
| Age: |
33.0 |
| Sex: |
Female |
| Location: |
New York |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-19 |
| Days after vaccination: | 3 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-22 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
- / IM |
Administered by: Work Purchased by: ? Symptoms: Full blood count normal,
Liver function test normal,
Petechiae,
Platelet count normal SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Multivitamin Current Illness: denies Preexisting Conditions: denies Allergies: denies Diagnostic Lab Data: CBC - normal platelets, LFTs - normal CDC Split Type:
Write-up: Petechiae developed on 12/19 on legs and torso and back Took Benadryl although not pruritic. |
|
| VAERS ID: |
906910 (history) |
| Form: |
Version 2.0 |
| Age: |
56.0 |
| Sex: |
Male |
| Location: |
Florida |
| Vaccinated: | 2020-12-18 |
| Onset: | 2020-12-21 |
| Days after vaccination: | 3 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-22 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
AR / IM |
Administered by: Private Purchased by: ? Symptoms: Blood bilirubin increased,
Blood osmolarity increased,
Blood urea increased,
Contusion,
Haemorrhage,
Immune thrombocytopenia,
Monocyte percentage increased,
Platelet count decreased,
Platelet transfusion,
Thrombocytopenia SMQs:, Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (narrow), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (narrow), Accidents and injuries (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune 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? Yes
Hospitalized? Yes, 1 days
Extended hospital stay? No Previous Vaccinations: Other Medications: No home medications at the time of vaccination or hospital admission Current Illness: No pertinent past medical history prior to vaccination Preexisting Conditions: No pertinent past medical history prior to vaccination Allergies: No known allergies of any type Diagnostic Lab Data: BP: 159/106 (12/22/20), Platelets 0 (12/22/20), monocytes 12.1% (12/22/20), BUN 22.3 (12/22/20), BILI 1.50 (12/22/20), calculated osmolality 297 (12/22/20). All other labs are w CDC Split Type:
Write-up: HPI: 56 y.o. male with no pmhx c/o generalized bruising for 2 days, noticed small blood tinged spots generalized. Gradual onset, severe on severity, no alleviating or aggravating factors. Patient denies fevers, chills, N/V/D, abdominal pain. In ER: Platelet <1. Platelet transfusion in ER. Admitted for Thrombocytopenia/ITP |
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| VAERS ID: |
907526 (history) |
| Form: |
Version 2.0 |
| Age: |
60.0 |
| Sex: |
Female |
| Location: |
California |
| Vaccinated: | 2020-12-21 |
| Onset: | 2020-12-21 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-23 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EK5730 / 1 |
RA / IM |
Administered by: Private Purchased by: ? Symptoms: Injection site rash,
Injection site swelling,
Petechiae,
Swelling,
Swelling face SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: to TDAP, Tetanus Toxoid and Influenza Other Medications: takes bendaryl, Loratadine, & rescue inhaler PRN Current Illness: No Preexisting Conditions: hx sinusitis, asthma Allergies: hx of allergy to influenza vaccine, TDAP & Tetanus Toxoid Diagnostic Lab Data: CDC Split Type:
Write-up: Per Vaccine recipient approximately 4-4 1/2 hours after receiving vaccine she noticed facial swelling in and around nose, to neck area, to R elbow and a petechial rash near R elbow. She immediately took Benadryl and Pepcid and then went to ER for further evaluation, where she was given a dose of Zyrtec and 5 day course of Prednisone. She left ER with no further complication. |
|
| VAERS ID: |
908846 (history) |
| Form: |
Version 2.0 |
| Age: |
49.0 |
| Sex: |
Female |
| Location: |
Missouri |
| Vaccinated: | 2020-12-24 |
| Onset: | 2020-12-24 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-24 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
039K20A / 1 |
RA / IM |
Administered by: Private Purchased by: ? Symptoms: Epistaxis,
Thrombosis SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Escitalopram, spironolactone, valcyclovir, trazodone, atomoxetine, pseudoephedrine with loratadine. Current Illness: None known Preexisting Conditions: Allergic rhinitis, adhd, anxiety, acne, facial herpes simplex, migraines Allergies: Sertraline - rash Diagnostic Lab Data: None CDC Split Type:
Write-up: Very mild, but unexpected nose bloody nose from left nostril. Only noted when blowing nose. With 1 clot. |
|
| VAERS ID: |
908869 (history) |
| Form: |
Version 2.0 |
| Age: |
73.0 |
| Sex: |
Male |
| Location: |
Oklahoma |
| Vaccinated: | 2020-12-18 |
| Onset: | 2020-12-19 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-24 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Blood bilirubin increased,
Blood creatinine increased,
Contusion,
Immunoglobulin therapy,
International normalised ratio normal,
Metabolic function test normal,
Petechiae,
Platelet count decreased,
Platelet transfusion,
Prothrombin time normal SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (narrow), Accidents and injuries (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
Extended hospital stay? No Previous Vaccinations: Other Medications: Comprehensive list displayed in additional information below. ascorbic acid daily, atorvastatin 40mg daily, cholecalciferol daily, docusate 100mg daily, levothyroxine 100mcg daily, losartan 100mg daily, zinc 50mg daily Current Illness: Vague symptoms (anorexia, fatigue) 11/29/2020 - 12/6/2020; Received high-dose influenza vaccination on 11/25/2020 at employee health department. On 11/29/2020 patient began having generalized fatigue, anorexia, and occasional chills. Presented to Urgent care on 12/4/2020 and reported same symptoms for past 5 days with 10-12 lb weight loss and worsening fatigue. Pfizer rapid PCR COVID test negative. Patient''s symptoms improved and he returned to normal activities of daily living until 12/19/2020, 1 day after COVID19 vaccination. Preexisting Conditions: HTN, Type II Diabetes Allergies: NKDA Diagnostic Lab Data: 12/21/2020 CBC: platelets of 1,000 CDC Split Type:
Write-up: 12/18/2020: COVID19 vaccine received. 12/19/2020: Patient noticed petechiae/bruising on arms, legs and face. Worsened over next 48 hours. 12/21/2020: Patient had blood drawn (CMP, PT/INR, CBC) at lab. 12/22/2020: Labs resulted; CMP and PT/INR WNL (exceptions: SCr 1.24, TBil 1.7); CBC with platelet count of 1,000 resulting in patient admission to Hospital. At admission he received 80 mg of prednisone, 40 g of IV Ig and a unit of platelets. 12/23/2020: Continued hospitalization. Patient''s platelets improved to 20,000 and he received another 35g of IV Ig. 12/24/2020: Patient discharged with platelets of 38,000. |
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