|
| VAERS ID: |
903682 (history) |
| Form: |
Version 2.0 |
| Age: |
37.0 |
| Sex: |
Female |
| Location: |
Vermont |
| Vaccinated: | 2020-12-18 |
| Onset: | 2020-12-18 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-18 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
LA / SYR |
Administered by: Private Purchased by: ?
Symptoms: Feeling hot,
Heart rate increased,
Paraesthesia,
Rash,
Rash erythematous,
Rash macular,
Tearfulness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pt has history of extreme anxiety
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Within 2 minutes after injection, patient started to feel very hot and with increased heart rate. Pt states that she feels "tingly" and is tearful. Pt denies difficulty breathing. Patient then started to have a red blotchy rash on her neck and chest. No redness at injection site. Pt brought to Emergency room for evaluation/observation. Pt able to talk in full sentences. Pt states that she has a history of anxiety and has gone into SVT because of anxiety in the past. Pt received steroids in ER. |
|
| VAERS ID: |
904042 (history) |
| Form: |
Version 2.0 |
| Age: |
46.0 |
| Sex: |
Male |
| Location: |
Vermont |
| Vaccinated: | 2020-12-17 |
| Onset: | 2020-12-18 |
| 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 |
EH9899 / 1 |
RA / IM |
Administered by: Other Purchased by: ?
Symptoms: Gout,
Pain in extremity
SMQs:, Arthritis (narrow), Tendinopathies and ligament disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: BANANA
Diagnostic Lab Data: No
CDC Split Type:
Write-up: Right Foot Pain - sudden onset/similar to gout pain, however affecting the entire foot region and not the large toe. |
|
| VAERS ID: |
904389 (history) |
| Form: |
Version 2.0 |
| Age: |
32.0 |
| Sex: |
Female |
| Location: |
Vermont |
| Vaccinated: | 2020-12-19 |
| Onset: | 2020-12-19 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-20 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EJ1685 / UNK |
LA / IM |
Administered by: Work Purchased by: ?
Symptoms: Chills,
Dizziness,
Feeling abnormal,
Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Chrons disease..... gets infusions
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:
Write-up: Employee reported chills, shaking, dizziness "like you feel after you faint, spacey". |
|
| VAERS ID: |
906873 (history) |
| Form: |
Version 2.0 |
| Age: |
49.0 |
| Sex: |
Female |
| Location: |
Vermont |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-17 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-22 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
- / - |
Administered by: Private 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Temp 100.8 next day, took Motrin and all issues resolved Outcome: Resolved and fine |
|
| VAERS ID: |
906892 (history) |
| Form: |
Version 2.0 |
| Age: |
61.0 |
| Sex: |
Male |
| Location: |
Vermont |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-17 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-22 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
- / - |
Administered by: Private Purchased by: ?
Symptoms: Chills,
Fatigue,
Pain
SMQs:
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Body aches, fatigue and chills day after vaccine and following day, symptoms then resolved |
|
| VAERS ID: |
906908 (history) |
| Form: |
Version 2.0 |
| Age: |
34.0 |
| Sex: |
Female |
| Location: |
Vermont |
| Vaccinated: | 2020-12-18 |
| Onset: | 2020-12-18 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-22 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
- / - |
Administered by: Private Purchased by: ?
Symptoms: Erythema,
Fatigue,
Headache,
Induration,
Mass,
Nausea,
Pruritus,
Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: significant headaches, nausea, fatigue and local redness/swelling/hard lump/itching.Outcome: Resolved and fine |
|
| VAERS ID: |
907628 (history) |
| Form: |
Version 2.0 |
| Age: |
50.0 |
| Sex: |
Male |
| Location: |
Vermont |
| 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 |
EH9899 / 1 |
RA / IM |
Administered by: Work Purchased by: ?
Symptoms: Dyspnoea,
Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Employee received vaccine, stayed 15 minutes and left ?. came back within 5-10 minutes c/o throat tightness and difficulty breathing |
|
| VAERS ID: |
907637 (history) |
| Form: |
Version 2.0 |
| Age: |
42.0 |
| Sex: |
Female |
| Location: |
Vermont |
| 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 |
EH9899 / 1 |
LA / IM |
Administered by: Work Purchased by: ?
Symptoms: Asthenia,
Dizziness,
Dysphagia,
Hypoaesthesia oral,
Paraesthesia oral,
Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: has had previous rx to an injection, carries epipen
Other Medications:
Current Illness:
Preexisting Conditions: Hx myasthenia gravis Carries epi pen for allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Employee received vaccine, within 10minutes, c/o of weakness, dizziness, shaking.... no complaints of Shortness of breath or tightness... refused to receive any additional treatment. Continued monitoring for another 2 hours, no additional symptoms, then developed numbness and tingling around mouth and trouble swallowing.... sent to ER. |
|
| VAERS ID: |
908021 (history) |
| Form: |
Version 2.0 |
| Age: |
47.0 |
| Sex: |
Male |
| Location: |
Vermont |
| Vaccinated: | 2020-12-23 |
| Onset: | 2020-12-23 |
| 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 |
- / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Dyskinesia,
Injection site pain,
Muscle twitching
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Dystonia (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins, D, C, B complex, magnesium oxide supplement, red rice yeast extract, fish oil,
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfa
Diagnostic Lab Data: N/A
CDC Split Type:
Write-up: I have been experiencing intermittent, involuntary twitching of my my left thumb that started around 12;00 noon. There is no numbness or tingling (normal injection site ache, however) or recognizable pattern of when the twitching occurs, and the twitching does not seem to last longer than 10 seconds at the most before stopping. 1-3 minutes will pass before my thumb starts twitching again. Other digits do not seem to be affected. I did not experience this prior to the COVID-19 vaccine administration and not have any neurological conditions that this would be a symptom of. |
|
| VAERS ID: |
908588 (history) |
| Form: |
Version 2.0 |
| Age: |
38.0 |
| Sex: |
Female |
| Location: |
Vermont |
| Vaccinated: | 2020-12-23 |
| Onset: | 2020-12-23 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-24 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
025J20A / 1 |
- / IM |
Administered by: Private Purchased by: ?
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: itchy nose and chin. Lasted about 5 minutes |
|
