VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1648271
Sex: F
Age:
State: FL

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 20210221; Test Name: Temperature; Result Unstructured Data: Test Result:101.5; Test Date: 20210222; Test Name: Temperature; Result Unstructured Data: Test Result:99.1

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: dizzy; severe body aches; 12 hours after second vaccine I woke with a 101.5 temperature; headache; 24 hours later temperature of 99.1 still have headache and body aches very weak.; This is a Spontaneous report from a Contactable other Health care professional (patient). A 69-year-old non-pregnant female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, lot number: EL9265) via an unspecified route, administered into left arm on 20Feb2021 04:00 PM (Age at the time of vaccination: 69 and patient was not pregnant at the time of vaccination) as DOSE 2, SINGLE for COVID 19 immunisation. The patient's medical history was not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient had not received other medications in two weeks of vaccination. She had not known allergies. Prior to vaccination, patient was not diagnosed with COVID-19. Since the vaccination, had not been tested for COVID-19. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, lot: number: EL9265) via an unspecified route of administration administered into left arm on 30Jan2021 04:00 PM as DOSE 1, SINGLE for COVID-19 Immunisation. On 21Feb2021 7: 00 AM, 12 hours after second vaccine she woke with a 101.5 temperature, dizzy, severe body aches and headache and 24 hours later temperature of 99.1 still had headache and body aches very weak. The patient underwent lab test and procedure of body temperature and resulted into 101.5 on 21Feb2021 and 99.1 on 22Feb2021. She had not received treatment for adverse events. The outcome of event was recovering. Follow-up attempts are completed. No further information was expected.

Other Meds:

Current Illness:

ID: 1648272
Sex: F
Age:
State: MO

Vax Date: 01/29/2021
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Test Name: Covid; Test Result: Negative

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: rash on stomach, back and neck; This is a spontaneous report from a Pfizer-sponsored program COVAX US Support. A contactable consumer reported for a female patient (daughter) that she received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: unknown) via an unspecified route of administration on 29Jan2021 as dose 1, single for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On an unspecified date the patient experienced rash on stomach, back and neck. The patient underwent lab tests and procedures which included sars-cov-2 test was negative. The event outcome was unknown. She wanted to know if it was ok to still receive second dose scheduled 19Feb2021. Follow-up (12MAY2021): Follow-up attempts were completed. No further information was expected.

Other Meds:

Current Illness:

ID: 1648273
Sex: M
Age:
State: NY

Vax Date: 01/19/2021
Onset Date: 02/20/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 20210220; Test Name: Fever; Result Unstructured Data: Test Result:38.2 C

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Fever (38.2 C); malaise; lethargy; muscle ache; sore arm; This is a spontaneous report from a contactable physician (patient). A 30-years-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Lot Number: EL3240) via an unspecified route of administration, administered in right arm on 19Jan2021 10:30 (at the age of 30-years-old) as dose 2, single for COVID-19 immunization. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Lot Number: EK5730) via unspecified route of administration, administered in right arm on 29Dec2020 08:30 as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 20Feb2021, the patient experienced fever (38.2 c), malaise, lethargy, muscle ache and sore arm. The patient underwent lab test which included body temperature 38.2c on 20Feb2021. The outcome of the events was recovered on an unspecified date. Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648274
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Chest pain; pressure; This is a spontaneous report received from a contactable consumer via Pfizer-sponsored program COVAX US Support. A patient of unspecified age and gender received 1st dose of bnt162b2 (COMIRNATY,Batch/Lot number was not reported) via an unspecified route of administration on an unspecified date as Dose 1,single for covid-19 immunization.The patient medical history and concomitant medications were not reported.The patient experienced chest pain and pressure ( on an unspecified date.The outcome of the event was unknown.Pharmacist was calling because a patient had adverse reaction to Covid vaccine and he is calling to see if the patient should take 2nd dose. Relayed PMI information.Cold transferred to PSCC due to long hold times and faxing AE. Follow-up (18Feb2021): This is a follow-up spontaneous report received from a Pfizer-sponsored program COVAX US Support. A contactable consumer reported for a patient that No patient identifiers were provided but the reporter has firsthand knowledge of the patient and was reporting on a specific patient.The pharmacist called to COVAX US support for patient 2nd dose clarification. Information on the lot/ batch number has been requested. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1648275
Sex: F
Age:
State: CT

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 20210220; Test Name: Body temperature; Result Unstructured Data: Test Result:102

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Sore body; fever of 102 for 2 days; chills; sore throat; stuffy nose; migraine; lethargy; injection site is still sore; injection site red and hot to touch; This is a spontaneous report from a contactable consumer (patient herself). A 23-year-old female patient received BNT162B2 ((PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in Arm Left on 19Feb2021 11:00 as dose 2, single for COVID-19 immunization. Medical history included depression, migraine and COVID-19. The patient's concomitant medications were not reported. Patient previously took BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in Arm Right on 29Jan2021 11:00 as dose 1, single for COVID-19 immunization. Patient reported that she was not pregnant at the time of vaccination. She did not receive any other vaccines within 4 weeks prior to the COVID vaccine. She was diagnosed with COVID-19 prior to vaccination and since the vaccination, she does not have COVID-19. On 20Feb2021, patient underwent lab tests and procedures which included body temperature: 102. On 20Feb2021, patient experienced sore body, fever of 102 for 2 days, chills, sore throat, stuffy nose, migraine and lethargy. Even though fever broke after two days, still was experiencing all the other symptoms still. Also, the injection site is still sore, red and hot to touch. The patient did not receive any treatment for the events. Seriousness of the events was reported as non-serious. The outcome of the events was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1648276
Sex: M
Age:
State: ME

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Test Name: heart rate; Result Unstructured Data: Test Result:110 bpm; Comments: heartrate of 110 bpm

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: rapid heart rate; This is a spontaneous report from a contactable consumer (Patient) via Medical Information Team. A 78-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: EN6198; Expiration Date: 30Jun2021), via an unspecified route of administration, administered in left arm on 20Feb2021 at 16:15 (at the age of 78-years-old) as dose 1, single for COVID-19 immunisation. Medical history included stent placement (he has 3-4 stents put in), bypass surgery in Jul2019, Defibrillator/pacemaker insertion (that was implanted originally back in 2006 or 2007, for which he had the battery changed in it in 2014 maybe). Patient thinks that he was 5 feet 8 inches to 5 feet 9 inches tall, he is shrinking every year. There were no concomitant medications. On 20Feb2021 at 19:00, the patient experienced rapid heart rate. The patient was looking at a list of possible side effects for the vaccine and noticed it stated something about a rapid heartbeat, and that information was lumped in there. He says that after he had his shot which he had about at 04:15PM Saturday afternoon and then he sat there for 15 minutes he didn't experience any side effects at all. He says about 3 hours later after about 07:00 PM his heart took off, and his heart rate was 110 bpm and this lasted probably 3 hours. He says he wondered if this had anything to do with vaccine he got. The patient underwent lab tests which included heart rate: 110 bpm on an unspecified date. It was unknown if the patient received any treatment for the event. The outcome of the event was recovered on 20Feb2021. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1648277
Sex: F
Age:
State: OH

Vax Date: 02/05/2021
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: ask if it is okay to take antibiotics prescribed by her Urologist for possible bladder infection; This is a spontaneous report from a Pfizer-sponsored program Pfizer Covax US Support. A contactable Female consumer (Patient) of unspecified age reported that she received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration on 05Feb2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. It was reported that patient asked if it is okay to take antibiotics prescribed by her urologist for possible bladder infection before the schedule of her second dose for Covid-19 vaccine on 26Feb2021. The outcome of the event was unknown. Information on the lot/batch number has been requested. Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648278
Sex: M
Age:
State: IL

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 20210202; Test Name: Heart rate; Result Unstructured Data: Test Result:Increased; Comments: during day is low 50s.; Test Date: 20210202; Test Name: Heart rate; Result Unstructured Data: Test Result:80s

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: pulse rate had increased; This is a spontaneous report from a contactable consumer (Reported for himself). A 47-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot Number: EL9264/Batch number was not reported), dose 1 via an unspecified route of administration, administered in arm left on 02Feb2021 at 10:00 (at the age of 47-years-old) as dose 1, single for covid-19 immunisation. Medical history included hypertension from an unknown date and unknown if ongoing (on medication). Concomitant medication included lisinopril (LISINOPRIL) taken for an unspecified indication, start and stop date were not reported. The patient previously took neomycin and experienced drug hypersensitivity. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 02Feb2021 at 10:45, the patient experienced pulse rate had increased. It was reported that, adverse event was very mild. Approximately 45 minutes after receiving the shot, patient noticed his pulse rate had increased. Normal RHR for patient during day is low 50s, patient fit and a runner. Patient took pulse and it was in 80s. Patient then took it every 5 min or so for another half hour and it began returning to normal. 2 hours after shot, pulse was back to normal RHR. It was not a big deal but it was something patient thought was related to response to the shot. All is well now. Dose 2 scheduled on 25Feb2021. The patient underwent lab tests and procedures which included heart rate: increased (during day is low 50s) and heart rate: 80s on 02Feb2021. No treatment was given for the events. The outcome of the event was resolved on an unspecified date in 2021. Follow-up attempts completed. No further information expected.

Other Meds: LISINOPRIL

Current Illness:

ID: 1648279
Sex: F
Age:
State: VA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 202012; Test Name: GFR; Result Unstructured Data: Test Result:44; Test Date: 20210222; Test Name: rapid pulse; Result Unstructured Data: Test Result:119 to 120; Comments: Pulse rapid

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: dizziness; arm hurting; felt extreme discomfort; nausea; feeling sick; fatigue; headache; rapid pulse; she was in bed 13Feb21 to 15Feb21 feeling sick; This is a spontaneous report from a contactable consumer (patient, self-reported). A 73-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number: EN6210 and expiry date was not reported), via an unspecified route of administration, in Arm Left, on 12Feb2021 (age at vaccination: 73 years), as a single dose for COVID-19 immunization. The patient's medical history included diabetic, renal problems, and chronic back problems. Concomitant medications included insulin and dulaglutide (TRULICITY) both for diabetic. The patient experienced side effects such as nausea, headache, fatigue, dizziness, arm hurting the next day. She stated that she also experienced having a rapid pulse yesterday on 16Feb2021 which was a week after getting the vaccine and wanted to know if it's still ok for her to get the 2nd dose since she experienced these side effects and if having a rapid pulse was one of the normal side effects from the vaccine. Also wanted to know if there were any known interactions of the vaccine with insulin or Trulicity since she mentioned that she took Trulicity last Saturday morning and noticed that she experienced a rapid pulse the day after. The patient also felt extreme discomfort and an elevated heart rate and stated she was in bed 13Feb2021 to 15Feb2021 feeling sick. She felt better then was sick again on Sunday. The patient underwent lab tests and procedures which included glomerular filtration rate: 44 on an unspecified date in Dec2020 and heart rate increased: 119 to 120 on 22Feb2021 (Pulse rapid). The patient stated that they did not give her a second dose date. Outcome of the event she was in bed 13Feb21 to 15Feb21 feeling sick was recovered on 15Feb2021 and for all other events, it was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds: INSULIN; TRULICITY

Current Illness:

ID: 1648280
Sex: F
Age:
State: FL

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Tightening of the throat; head discomfort; This is a spontaneous report from non-contactable consumer reported that a 69-years-old female patient received BNT162B2 (Pfizer-Biontech COVID-19 Vaccine, Solution for injection, batch/lot number: unknown), via an unknown route of administration on 15Feb2021 at 14:00 as dose number unknown, single for COVID-19 immunisation. Facility type vaccine was other. The patient's medical history included chronic cholangitis. No known allergies. Concomitant medications included levothyroxine (LEVOTHYROXINE), pancreatin (CREON), ursodiol (URSODIOL), sertraline (SERTRALINE), omeprazole (OMEPRA); all were taken for an unknown indication and from an unknown date. No other vaccine in four weeks. On 15Feb2021 at 14:00, the patient experienced tightening of the throat and head discomfort. Patient had not been diagnosed with COVID-19 prior to vaccination and had not been tested post the vaccination. No treatment received for events. The outcome of the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds: LEVOTHYROXINE; CREON; URSODIOL; SERTRALINE; OMEPRA

Current Illness:

ID: 1648281
Sex: F
Age:
State: SD

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: head like spinning round and round and like the room is spinning really really fast; Getting really really dizzy and it was hard to even move on that first day, I couldn't even turn my head/couldn't move her head, couldn't turn her tv on; Getting really really dizzy and it was hard to even move on that first day, I couldn't even turn my head; Sick; nausea; I couldn't lay down and I couldn't even get any rest without just getting sick all over again; sick stomach/Upset stomach; Headache; This is a spontaneous report from a contactable consumer (patient). A 73-years-old female patient received BNT162B2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot Number: EN6200 and Expiration date and NDC number was unknown), via an unspecified route of administration on 18Feb2021 as dose 1, single (at the age of 73-years-old) for covid-19 immunisation. Medical history included blood pressure from an unknown date and unknown if ongoing. Concomitant medication(s) included moexipril taken for blood pressure measurement, start and stop date were not reported. On 19Feb2021, the day after, the Friday, patient woke up with my head like spinning round and round and like the room was spinning really really fast. Patient was really really dizzy, and it was hard to even move on that first day. Patient stated that it was scary, and patient could not move/turn her head, could not turn her tv on, could not lay down and could not even get any rest without just getting sick all over again. On an unspecified date of 2021, patient experienced nausea and sick stomach/upset stomach. Patient asked if that was normal like she could not lay down to sleep or anything for few days finally, morning she could but she still talks to these other people. But at least patient was able to lay down her head a little bit and get some rest. But she had not been able to do that because she had been so sick and every time, she tries to put any pressure, put her head down to get some, it starts spinning. Patient asked if it was normal and should she receive the second dose, as patient mentioned that she heard that patients had more severe reactions after receiving the second dose. Patient also asked that does the first dose had some antibodies/some protection and would she be able to receive only one dose. Patient was probably 4 foot 9, well let's say 5 feet. Patient used to be 5 foot 2 so she does not know after she get older, but her weight was probably right about a 100 pounds. On an unspecified date of 2021, patient had headache. Patients stated that she does not take treatment for headache, but she does like Tylenol and the Excedrin because she kind of had a headache too and then she took Gaviscon for my upset stomach she took a couple of those. The outcome of all the events was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds: MOEXIPRIL

Current Illness:

ID: 1648282
Sex: F
Age:
State: NY

Vax Date: 02/09/2021
Onset Date: 02/01/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: Test Name: temp; Result Unstructured Data: Test Result:100.4-102.; Test Date: 20210215; Test Name: COVID; Test Result: Negative

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Felt tired; developed a temp of 100.4-102; This is a spontaneous report from a Pfizer-sponsored program COVAX US Support. A contactable consumer reported for herself that. A female patient of an unspecified age received bnt162b2 (COMIRNATY; Formulation: Solution for injection, Batch/Lot Number: was not reported) via an unspecified route of administration on 09Feb2021 as dose 2, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On an unspecified date of Feb2021 the patient experienced felt tired and developed a temp of 100.4-102. The patient underwent lab tests and procedures which included body temperature: 100.4-102 on an unspecified date and sars-cov-2 test on 15Feb2021 and result was negative. The outcome of the events was unknown. Follow-up (12MAY2021): Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648283
Sex: F
Age:
State: FL

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: swelling under her injection arm in the lymph nodes; arm soreness/Could not maneuver her arm which was sore; neck was a little painful; swelling under her arm; Not feeling good at all; nausea; pain in the injection arm; Injection was a quite little, felt like a sting and a burn; chills; weakness; This is a spontaneous report from a contactable consumer (patient) via a Pfizer sponsored program COVAX US support. A 69-year-old female patient received bnt162b2 (BNT162B2, Solution for injection, Batch/Lot Number: EL9269), dose 1 via an unspecified route of administration, administered in Left arm on 13Feb2021 (at the age of 69-year-old) as single for vaccination. Medical history included blood pressure, cholesterol from an unknown date and unknown if ongoing, Patient was allergic to squash. Prior Vaccinations (within 4 weeks) and AEs following prior vaccinations was reported as none. Concomitant medications included hydrochlorothiazide, lisinopril 20/25mg once daily, taken for blood pressure and simvastatin taken for cholesterol 40 mg once daily, start and stop date were not reported. On 13Feb2021 the patient experienced chills, weakness and reported that injection was a quite little, felt like a sting and a burn. On 14Feb2021 she had nausea, pain in the injection arm, arm soreness/ she could not 'maneuver' her arm which was sore, side of her neck was a little painful, swelling under her arm, not feeling good at all. On 15Feb2021 she has swelling under her injection arm in the lymph nodes. The patient was administered the first dose of Pfizer COVID-19 Vaccine 13Feb2021. The injection was a quite little, felt like a sting and a burn but it was just quick. That's ok. She had cold chills though the night of 13Feb2021 and onset of sore arm night of 13Feb2021. On 14Feb2021 morning she just was not feeling good at all, could not 'maneuver' her arm which was sore. She was just feeling nauseated but she did not actually bring anything up. On 14Feb2021 night she noticed the side of her neck was a little painful and right under her arm was a painful swelling. She called to ask if these are side effects of the first dose of Pfizer COVID-19 Vaccine, what can she expect with the second dose of Pfizer COVID-19 Vaccine; will effects be the same or worse. On 15Feb2021 morning, when she got up the right under her arm was a painful swelling is there but is not as painful but it's fading out, going away. She is not having the cold chills, not having nausea, not having not feeling good at all today. The rest were kind of better today. The events not required emergency room and physician office. Outcome of the events neck was a little painful and swelling under her arm was resolving and outcome of other events was unknown. Follow-up attempts completed. No further information expected.

Other Meds: LISINOPRIL/HCTZ; SIMVASTATIN

Current Illness:

ID: 1648284
Sex: F
Age:
State: PA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Test Date: 20210130; Test Name: fever; Result Unstructured Data: Test Result:100 - 102.2

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: fever; severe body aches; fatigue; This is a spontaneous report from a contactable Other Health Care Professional (HCP) (Patient) via in response to HCP follow-up letter sent in cross reference case. A 53-year-old female patient second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection) via intramuscular route of administration at left arm on 29Jan2021 13:00 (at the age of 53-year-old) (Lot Number: EJ1685) as single dose for COVID-19 immunisation. Patient Medical history included HBP (hypertension) and concomitant medication included hydrochlorothiazide with a daily dose of 12.5 mg for (HBP) hypertension. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection) via intramuscular route of administration at left arm (at the age of 53-year-old) on 08Jan2021 08:15 (Lot number: EJ1685) for COVID-19 immunization and experienced headache, myalgia, chills, pyrexia and fatigue on 08Jan2021 at 12:00. On 29Jan2021 13:00, the patient received 2nd dose of vaccine and symptoms started around 30Jan2021, 03:00 (AM) early and developed severe body aches, fatigue, 100-100.2 fever which lasted until 02Feb2021. Fatigue lasted until 03Feb2021. Then all symptoms subside. The patient underwent lab tests and procedures which included body temperature: 100 - 102.2 on 30Jan2021. Patient did not visit the emergency room or physician office for the events. Patient was not admitted in the hospital and did not received any treatment for the events. Patient was not deceased. Outcome of fever and severe body aches recovered on 02Feb2021 and fatigue recovered on 03Feb2021. Follow-up attempts completed. No further information expected.

Other Meds: HYDROCHLOROTHIAZIDE

Current Illness:

ID: 1648285
Sex: M
Age:
State: AZ

Vax Date: 02/17/2021
Onset Date: 02/21/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: extreme shortness of breath/ongoing minor shortness of breath; This is a spontaneous report from a contactable consumer (patient himself). A 71-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: E19267), via an unspecified route of administration, administered in Arm Left on 17Feb2021 12:30 as DOSE 1, SINGLE (age at vaccination was 71 years old) for covid-19 immunisation. Medical history included hypertension, depression and arthritis, all from an unknown date and unknown if ongoing. Concomitant medication(s) included lisinopril, bupropion, glucosamine and multi-vit. The patient reported absolutely nothing until four days after, on 21Feb2021 04:00, he had maybe eight hours of extreme shortness of breath, followed by ongoing minor shortness of breath for another day or two. It was reported that the patient did not have Covid prior to vaccination and Covid was not tested post vaccination. The patient did not receive any other vaccination 4 weeks prior of BNT162B2. It was unknown if any treatment was provided. At the time of this report, the outcome of the event was recovering. Follow-up attempts completed. No further information expected. .

Other Meds: LISINOPRIL; BUPROPION; GLUCOSAMINE

Current Illness:

ID: 1648286
Sex: F
Age:
State: NY

Vax Date: 01/26/2021
Onset Date: 02/14/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: This is a spontaneous report from a contactable consumer. A female patient, of an unspecified age, received the 1st dose of BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine, solution for injection, batch/lot# not reported), via an unspecified route of administration, on Jan 26, 2021, single dose, for COVID-19 immunisation. The patient's medical history and concomitant medications not reported. On Feb 14, 2021, patient experienced cough and fatigue. On an unspecified date in 2021, patient felt sick. Patient has been sick for two or three days now. Patient didn't know if it was safe to get the COVID-19 vaccine as her immune system was down. Cold started on Sunday. The second dose was scheduled Feb 16, 2021. The outcome of events: unknown. Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648287
Sex: F
Age:
State: NC

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: severe fatigue; acute headache; malaise; nausea; inability to perform normal duties; Heavy eyelids which resulted in patient having to rest immediately; This is a spontaneous report from a non-contactable other hcp. An adult non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), intramuscular, administered in Arm Left on 22Feb2021 08:00 (Batch/Lot number was not reported)as dose number unknown, single for covid-19 immunisation. Medical history included asthma and allergies to medications, food, or other products to Shrimp, levaquin and tequin. The patient concomitant medications were not reported. The patient did not received 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 had not been tested for COVID-19. On 22Feb2021 10:00, after 2nd hour post vaccine, the patient experienced severe fatigue, acute headache, malaise, nausea, inability to perform normal duties and heavy eyelids which resulted in patient having to rest immediately. Therapeutic measures were taken as a result of the events (Tylenol, extra fluids). The clinical outcome of the events were not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1648288
Sex: F
Age:
State:

Vax Date: 02/17/2021
Onset Date: 02/20/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data: Test Date: 20210220; Test Name: Body temperature; Result Unstructured Data: Test Result:102.8; Test Date: 20210221; Test Name: Nasal Swab; Test Result: Negative

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: She reported over 102.8 fever with chills and nausea; She reported over 102.8 fever with chills and nausea; She reported over 102.8 fever with chills and nausea; This is a spontaneous report from a non-contactable consumer (patient). A 40-years-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Batch/Lot number: unknown), via an unspecified route of administration on 17Feb2021 (at the age of 40 years) as DOSE 2, SINGLE for covid-19 immunisation. Medical history included asthma from an unknown date and unknown if ongoing. No known allergies were reported. The patient had no allergy to medications, food, or other products. The patient did not have Covid prior vaccination and Covid tested post vaccination. No other vaccines were received within four weeks prior to the administration of bnt162b2. The patient previously took bnt162b2 (Batch/Lot Number: unknown) on an unspecified date as DOSE 1, SINGLE for covid-19 immunisation. Concomitant medications were not reported. On 20Feb2021, the patient experienced over 102.8 fever with chills and nausea. She said she started experiencing these symptoms 4 days after vaccination. She tested negative for COVID-19. On 21Feb2021, the patient underwent rapid covid test post vaccination with covid test type nasal swab: negative. Treatment received was unknown. Outcome of the events was recovering. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1648289
Sex: F
Age:
State: NC

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Terrible dizziness; numbness on tips middle 4th and 5 finger on 2/20.; This is a spontaneous report from a contactable consumer or other non-healthcare professional (patient). A 66-years-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in right arm on 20Feb2021 08:00 (age at the time of vaccination was 66 years) as dose 1, single for covid-19 immunisation at hospital. Medical history included rheumatoid arthritis, asthma, no spleen born without, allergies to stone crab claws and Azulfadine both from an unknown date and unknown if ongoing. Concomitant medications within 2 weeks of vaccination included methotrexate (METHOTREXATE) 12.5 mg and infliximab (REMICADE) IV 1/12/21 both taken for an unspecified indication, start and stop date were not reported. The patient was not diagnosed with COVID-19 prior to vaccination. It was reported that the patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 20Feb2021 09:15, the patient experienced terrible dizziness and numbness on tips middle 4th and 5 finger on 2/20. Since the vaccination, has the patient has not been tested for COVID-19. It was reported that no treatment was received for the adverse events. The case was non-serious with Seriousness criteria-Results in death/ Seriousness criteria-Life threatening/ Seriousness criteria caused/prolonged hospitalization/Seriousness criteria Disabling /Incapacitating/ Seriousness criteria-Congenital anomaly/birth defect were reported as No. The outcome of the events was not recovered. Follow-up attempts completed. No further information expected.

Other Meds: METHOTREXATE; REMICADE

Current Illness:

ID: 1648290
Sex: F
Age:
State: NJ

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data: Test Name: Height; Result Unstructured Data: Test Result:168; Comments: cm; Test Date: 20210203; Test Name: heart beat; Result Unstructured Data: Test Result:Rapid; Comments: she went into the bath at 08:00PM and experienced a rapid heart beat; Test Date: 20210203; Test Name: fever; Result Unstructured Data: Test Result:99.2 to 99.5 Fahrenheit; Test Date: 20210203; Test Name: fever; Result Unstructured Data: Test Result:101.5 Fahrenheit

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: Rapid HR/ I had rapid heartbeat; a slight fever of 99.2 to 99.5 degrees Fahrenheit/ temperature went to 101.5 under the tongue; Achy joint; dry mouth and nose; dry mouth and nose; This is a spontaneous report from a contactable consumer, the patient. A 59-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), dose 1 via an unspecified route of administration, administered in arm right on 02Feb2021 at 17:30 (age at vaccination was 59-years-old) (Batch/Lot Number: EL3302) as DOSE 1, SINGLE for covid-19 immunization. Medical history included thyroid disorder. Concomitant medication included levothyroxine taken for thyroid, start and stop date were not reported. Patient reported she had first Pfizer Covid vaccine on 02Feb2021. The following day, 03Feb2021, she had a fever, joint aches, rapid HR/ heart beat, dry nose and mouth. She wants to know if she can get second dose. Patient was calling about the Pfizer COVID-19 vaccine to report and ask a question. She said she would also like to say she was grateful that she was able to get the first dose 02Feb2021. She said she was supposed to get her second dose tomorrow after she got her first dose late in the day that day, at 05:30PM. She said it was the following day after all those hours passed that all of her joints were achy and she had a slight fever of 99.2 to 99.5 degrees Fahrenheit. She went into the bath at 08:00PM and experienced a rapid heart beat, dry nose and mouth, and she felt like she was totally out of it. AE treatment: patient took Tylenol Extra Strength 500mg, two of them by mouth, after she took her temperature and had a 101.5 fever and after that everything was ok, her rapid heart beat stopped and her fever went away. She says she does not know if she was supposed to take the Tylenol, it was the following night. She said NDC/EXP were not provided on her handwritten Pfizer COVID-19 vaccine card. She took Tylenol following day after getting the vaccine, on 03Feb, at about 09:00PM. Caller says she felt totally out of it took, and then she took her temperature under her tongue and it was 101.5 degrees Fahrenheit so she took the Tylenol. Tylenol Extra Strength 500mg UPC/LOT/EXP: Unknown, caller does not have this product with her. Caller says she had actually gone to bed afterwards and slept very soundly, then woke up happy as can be. Other Medical Conditions: she did not have her thyroid anymore also stated she used to take Levothyroxide, clarified to Levothyroxine. Levothyroxine NDC/LOT/EXP was unknown because she did not have product with her. Patient stated "I did have some reaction from the first dose I had it on 02Feb2021 at 5:30 at night I got it and I never got symptoms until the following day to about 2 o clock and I just had a few achy joint and then by 7 o clock at night I was running a fever and I went to the bed may be the bed could have brought it on but I had rapid heartbeat and soon my temperature went to 101.5 under the tongue but as soon I took the Tylenol (Treatment) I went to the bed and all the symptoms subsided. I noticed that the rapid heartbeat was the severity of the symptoms of course it went happened so much later that when I got the shot. Is it okay do you think if I get the second shot tomorrow" and also stated "I am sad to say 195 pounds, I am overweight, 195". The patient underwent lab tests and procedures which included height: 168 cm,heart rate was rapid on 03Feb2021 (she went into the bath at 08:00PM and experienced a rapid heart beat), fever was 99.2 to 99.5 fahrenheit and also 101.5 fahrenheit on 03Feb2021. Therapeutic measures were taken as a result of a slight fever of 99.2 to 99.5 degrees fahrenheit/ temperature went to 101.5 under the tongue. The outcome of the events rapid HR/ I had rapid heartbeat and a slight fever of 99.2 to 99.5 degrees Fahrenheit/ temperature went to 101.5 under the tongue was recovered on an unknown date in 2021, whereas the events achy joint and dry mouth and nose was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds: LEVOTHYROXINE

Current Illness:

ID: 1648291
Sex: F
Age:
State: WI

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: Intense arm and muscle pain; Intense arm and muscle pain; intense headaches for 3 days. Still have headache, on day 4; This is a spontaneous report from a non-contactable consumer (patient). An elderly female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection), dose 1 via an unspecified route of administration, administered in Arm Right on 18Feb2021 at 13:00 hours (Batch/Lot Number: EL9267) as DOSE1, SINGLE for COVID-19 immunisation. The patient's medical history included allergies: sulfa from an unknown date and unknown if ongoing. Concomitant medications included preventative sodium, and hydrochlorothiazide. On 18Feb2021 at 08:00 PM, the patient experienced intense arm and muscle pain, and intense headaches for 3 days. The patient reported that she still has headache, on day 4, rest going away. 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 and Since the vaccination, the patient has not been tested for COVID-19. The patient did not receive any treatment for the adverse event. The events were non serious and did not result in death/Life threatening/Caused/prolonged hospitalization/Disabling/Incapacitating/Congenital anomaly/birth defect. The patient was recovering from the events. No follow up attempts are possible. No further information is expected.

Other Meds: SODIUM; HYDROCHLOROTHIAZIDE

Current Illness:

ID: 1648292
Sex: M
Age:
State: VA

Vax Date: 02/18/2021
Onset Date: 02/20/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: I have raised itchy clusters of bumbs on my left arm, left leg, genitals, right ear, and fingers.; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 36-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 18Feb2021 (at the age of 36-year-old) (Batch/Lot Number: EL9264) as dose 2, single for covid-19 immunisation. Medical history included migraine, colitis ulcerative, anxiety and depression. The patient had no known allergies. Concomitant medications included azathioprine (IMURAN [AZATHIOPRINE]) and infliximab (RENFLEXIS [INFLIXIMAB]) taken for an unspecified indication, start and stop date were not reported.The patient did not received 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 had not been tested for COVID-19. The patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 28Jan2021 15:30 (Batch/Lot Number: EL3302) as dose 1, single for covid-19 immunisation. On 20Feb2021 09:00, the patient experienced raised itchy clusters of bumbs on his left arm, left leg, genitals, right ear, and fingers. They are beginning to puss and are very itchy. It feels like poison ivy, but he have not been any where near the woods this winter. Therapeutic measures were taken as a result of the event (Benadryl). The clinical outcome of the event was not recovered. Follow-up attempts completed. No further information expected.

Other Meds: IMURAN [AZATHIOPRINE]; RENFLEXIS [INFLIXIMAB]

Current Illness:

ID: 1648293
Sex: F
Age:
State: CA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Extreme joint pain; fever; blurry eyesight; confusion; severe sensitivity to light; migraine headache; sore muscles; extreme tiredness; This is a spontaneous report from a contactable other healthcare professional (patient). A 41-year-old non pregnant female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: en6200) via an unspecified route of administration, administered in Arm Left on 18Feb2021 16:30 (at the age of 41-year-old) as single dose for COVID-19 immunization. Medical history included migraines. The patient had allergies to medications, food, or other products such as Penicillin, pineapple, gold, lanolin, hair dye. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient received other medications (unspecified) within 2 weeks of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: el8982) via an unspecified route of administration, administered in Arm Left on 25Jan2021 09:15 (at the age of 41-year-old) as single dose for COVID-19 immunization. Since 19Feb2021 04:00, the patient experienced extreme joint pain, fever, blurry eyesight, confusion, severe sensitivity to light, migraine headache, sore muscles, extreme tiredness lasting 3 days. Joint pain subsided after 30 hours. The reporter assessed the events as non-serious. Since the vaccination, the patient had not been tested for COVID-19. Outcome of events was recovered with sequelae in Feb2021. Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648294
Sex: M
Age:
State: GA

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Swollen lymph node in armpit of left arm; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 59-year-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EN6201) via an unspecified route of administration, administered in arm left on 20Feb2021 11:30 (at the age of 59-year-old) at dose 2, single for covid-19 immunisation. Medical history included penicillin allergy. Concomitant medications included losartan (LOSARTAN); simvastatin (SIMVASTATIN); ibuprofen (IBUPROFEN); mometasone furoate (FLONASE [MOMETASONE FUROATE]) (medications the patient received within 2 weeks of vaccination) all drugs taken for an unspecified indication, start and stop date were not reported. Patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EL3247) via an unspecified route of administration, administered in arm left on an unspecified date in Jan2021 14:30 at dose 1, single 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 has not been tested for COVID-19. On 21Feb2021 09:00 the patient experienced swollen lymph node in armpit of left arm. Patient did not receive treatment for the adverse event. Outcome of the event was resolving. Follow-up (12May2021): Follow-up attempts completed. No further information expected.

Other Meds: LOSARTAN; SIMVASTATIN; IBUPROFEN; FLONASE [MOMETASONE FUROATE]

Current Illness:

ID: 1648295
Sex: U
Age:
State: FL

Vax Date: 02/01/2021
Onset Date: 02/12/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: I was a little sick from the chest with cough; Cough; This is a spontaneous report from a contactable consumer or other non hcp. A patient of unspecified age and gender received first dose of bnt162b2 (BNT162B2, solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as SINGLE for covid-19 immunization. The patient medical history and concomitant medications were not reported. During the call the patient stated, who got the first dose of the pfizer vaccine and they told to wait two weeks. But to get the second dose, but it turns out that when went to get the second dose the patient was a little sick from the chest with cough (occurred on 12Feb2021). The nurse told to wait, to consult with the doctor to see if could put it back on, and felt better today who went to put it on the second dose but there was nothing, and everyone has left here. The outcome of events was recovering. Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648296
Sex: F
Age:
State:

Vax Date: 02/20/2021
Onset Date: 02/01/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: numbness in fingers and hands on the right side where she received the vaccine,; Arm was extremely sore; bad headache; This is a spontaneous report from a contactable consumer, the patient. A 59-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number was not provided), via an unspecified route of administration on 20Feb2021 as dose 1, single for covid-19 immunization. Medical history and concomitant medications were not reported. The patient stated that, yesterday evening, on 21Feb2021, she developed numbness in fingers and hands on the right side where she received the vaccine, and one of her fingers felt like rubber, basically had no control over it. On an unspecified date in Feb2021, her arm was extremely sore and she had a bad headache all day, laid down early. She reported that she could not pick up phone in the middle of the night. The outcome of the events was unknown at the time of report. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1648297
Sex: F
Age:
State:

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: fever; headache; It was extremely uncomfortable and I was non functioning; body aches; This is a spontaneous report from a non-contactable consumer (patient) reporting herself. A 48-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/lot number: EL9269), via unspecified route of administration in the left arm, on 12Feb2021 at 02:00 (At the age of 48-year-old), as dose 2, single for COVID-19 Immunization. Medical history and concomitant medications were not reported. The patient had no known allergies. The patient was not a pregnant at the time of vaccination. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/lot number: EL3247), via unspecified route of administration in the left arm, on 22Jan2021, as dose 1, single for COVID-19 Immunization. The patient had no covid prior vaccination and not tested for covid post vaccination. It was reported that, on 13Feb2021 at 02:00 AM, the patient experienced fever, body aches and headache, and the events were lasted for 24 hours. The patient did not take any pain reliever, but it was extremely uncomfortable, and he was non-functioning. Even 10 days later, she still has headache. The outcome of the events was recovered with lasting effects. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1648298
Sex: M
Age:
State: PA

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data: Test Name: Body temperature; Result Unstructured Data: Test Result:101.3

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever of 101.3; chills; This is a spontaneous report from a contactable consumer or other non hcp. A 68-year-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: Unknown), via an unspecified route of administration on 21Feb2021 15:30 (age at the time of vaccination 68-year-old) as single dose for COVID-19 immunisation. The patient's medical history and concomitant medications were not reported. The patient did not receive any other vaccine in four weeks. The patient took other medications in two weeks. The patient had Covid prior vaccination. The patient did not Covid tested post vaccination. There were no known allergies. On 22Feb2021 16:45, the patient experienced fever of 101.3, chills. Therapeutic measure was taken as no. The patient underwent lab tests and procedures which included body temperature was 101.3. The outcome of event was recovering. Information on lot number/batch number has been requested. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1648299
Sex: F
Age:
State:

Vax Date: 02/12/2021
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Fever; Body aches; Very bad headaches in the back of her head; This is a spontaneous report from a contactable consumer, reported for a female patient (mom) that. A female patient of an unspecified age received bnt162b2 (Pfizer-BioNTech COVID-19 Vaccine, solution for injection), via an unspecified route of administration on 12Feb2021 (Batch/Lot number was not reported) as DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunisation. The patient medical history was not reported. The patient's concomitant medications were not reported. It was reported that the reporter called and reported on behalf their mother who had Covid 19 vaccine the before day. She was having side effects which were expected like fever, body aches but especially very bad headaches in the back of her head. As Tylenol was advised to take for the symptoms, Is it okay to take Aspirin or is Aspirin not recommended reporter questioned. No other medical information was provided. The outcome of all the events was unknown. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1648300
Sex: F
Age:
State: SC

Vax Date: 02/11/2021
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Red rash from my top under my chin down to my chest; It has been itching and just making me crazy; deep itching; Penicillin allergy; I'm in a very uptight state of mind because my husband is dying, it could be nerves because I'm under a lot of stress right now; This is a spontaneous report from a contactable consumer (patient herself). A 76-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EL9266), via intramuscular route in the right shoulder muscle on 11Feb2021 (age at vaccination: 76 years) as DOSE 1, SINGLE for covid-19 immunisation. The patient's medical history included diabetic and drug hypersensitivity to penicillin. Concomitant medication(s) included insulin. On an unknown date, the patient experienced red rash from my top under my chin down to my chest, it has been itching and just making me crazy; deep itching, penicillin allergy, she is in a very uptight state of mind because her husband was dying, it could be nerves because she is under a lot of stress right now. The patient took Benadryl as treatment to see if that would maybe help with these deep itching and everything. She did see rash as one of the things on the paper work that they gave her on 11Feb2021 (Thursday). She don't have any known allergies except to Penicillin. She did not take second shingles shot, because she didn't wanted to and couldn't have it within 30 days of the vaccine. The outcome of the events was unknown. Follow-up attempts completed. No further information expected.

Other Meds: INSULIN

Current Illness:

ID: 1648301
Sex: M
Age:
State: NY

Vax Date: 02/05/2021
Onset Date: 02/10/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 20210210; Test Name: fever; Result Unstructured Data: Test Result:101.7; Comments: went down a little bit; Test Date: 20210211; Test Name: fever; Result Unstructured Data: Test Result:about 100.1; Comments: about half an hour ago.; Test Date: 20210126; Test Name: COVID test; Result Unstructured Data: Test Result:Negative

Allergies:

Symptom List: Injection site pain

Symptoms: Body ache; Fever; Chills; This is a spontaneous report from a contactable consumer (patient) via Pfizer- A 45-year-old male patient received First dose of bnt162b2 (BNT162B2, Solution for injection, Lot number: EN5318 and Expiration Date: 31May2021), via an unspecified route of administration on 05Feb2021 as DOSE 1 SINGLE for covid-19 immunization. Medical history and concomitant medications were none. Patient was calling because after he got the first dose of the vaccine, the COVID Vaccine. He is experiencing body ache, fever and chills on 10Feb2021. He wanted to know if that is coming from the Pfizer first dose of the vaccine or it was symptom of the COVID virus. Patient stated the chills he do not have that much, the body ache was only when patient stressed and fever went down a little bit, it was 101.7 yesterday and about 100.1 about half an hour ago. The event outcome was unknown. No follow up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1648302
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: I started to have sneezing fits like sneeze 2 or 3 times in a row; My nose is still running, I still have a tickle in my nose that sensation that you want to sneeze; This is a spontaneous report from a contactable consumer (patient). A patient of an unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; formulation: solution for injection), dose 1 via an unspecified route of administration on an unspecified date (Batch/Lot Number: EI9266) as DOSE 1, SINGLE for COVID-19 immunisation. The patient's medical history and concomitant medications were not reported. On an unspecified date, the patient experienced I started to have sneezing fits like sneeze 2 or 3 times in a row, and my nose is still running, I still have a tickle in my nose that sensation that you want to sneeze. The patient when probed reported of having first dose (Clarified as COVID-19 vaccine Pfizer) several hours ago and as was leaving the centre. The patient started to have sneezing fits like sneeze 2 or 3 times in a row and then may be not for couple of minutes and then again, a couple of times in a row and that went on for about an hour and it was subsided at the time of report. But the patient's nose was still running, the patient still had a tickle in nose reported as that sensation that you want to sneeze. The patient just really wanted to know whether it starts up again and could the patient take something for it. The patient queried whether could take a Benadryl or something or could use Neti pot to send it out. The patient recovered from the event I started to have sneezing fits like sneeze 2 or 3 times in a row. The clinical outcome for the other event was unknown. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1648303
Sex: F
Age:
State: MA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: whole body shivers; feeling freezing cold; Stuffy nose; Nausea; migraine; exhaustion; hives; tightness in chest; achey; going between being very hot; This is a spontaneous report from a contactable consumer or other non hcp (Patient). A 21-years-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) dose 2 via an unspecified route of administration, administered in Arm Left on 11Feb2021 01:00 (at the age of 21-year-old) (Batch/Lot Number: EL2202) as dose 2, single for covid-19 immunisation. Medical history included chronic migraine, history of inflammatory arthritis and ANA titer, Thin basement membrane disease, exercise induced asthma, eczema and Penicillin allergies. Concomitant medication included diclofenac potassium (CAMBIA), ondansetron (ZOFRAN [ONDANSETRON]), salbutamol (ALBUTEROL HFA) and drospirenone, ethinylestradiol betadex clathrate (YAZ) taken for an unspecified indication, start and stop date were not reported. The patient had not received other vaccine in four weeks. The patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE). dose 1 via an unspecified route of administration, administered in Arm Left on 25Jeb2021 11:15 AM. (Batch/Lot Number: GL9262) as dose 1, single for covid-19 immunization and experienced crying spell. On 11Feb2021, 03:00, the patient reported that going between being very hot and having whole body shivers and feeling freezing cold, nausea, stuffy nose, achey, migraine, exhaustion, hives and tightness in chest. The patient was not received treatment for the events. The clinical outcome of the events were recovering. Follow-up attempts completed. No further information expected.

Other Meds: CAMBIA; ZOFRAN; ALBUTEROL HFA; YAZ

Current Illness:

ID: 1648304
Sex: M
Age:
State:

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: dizzy; Full body rash; This is a spontaneous report from a contactable consumer reported for a male patient. A male patient of unspecified age received first dose of bnt162b2 (Pfizer covid-19 vaccine, Solution for injection, Batch/lot number: Unknown, Expiry date: Unknown), via an unspecified route on 13Feb2021, as a single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. Co-suspect medication included diphenhydramine hydrochloride (BENADRYL) on 13Feb2021. On 14Feb2021 after 24hours of covid shot, patient developed a rash, like a full body rash. He didn't get it immediately after the vaccine, he got it now 24 hours into it. Reporter gave him some Benadryl and he seems to be okay with the Benadryl but he's gotten very dizzy, he is kind of like almost tripped little dizzy. He says he feels fine. Reporter was wondering if that is something common or should she take him to the emergency room should we sit it out with the Benadryl to see if it gets better with that. The clinical outcome of the events was unknown. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1648305
Sex: F
Age:
State: OR

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Headache; Swollen throat; This is a spontaneous report from a non-contactable consumer (patient). This 33-year-old non-pregnant female consumer (patient) reported that she received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EN6201) via an unspecified route of administration on 11Feb2021 at 04:00 PM (at 33-year-old) on left arm as dose 1, single for COVID-19 immunization. The medical history of the patient included latex allergy, nickel allergy, Gluten intolerance and dairy intolerance. The patient received other medications in two weeks. It was mentioned that patient had no other vaccine in four weeks, patient did not have COVID prior vaccination and was not tested for covid post vaccination. On 13Feb2021 at 07:30 AM the patient experienced headache, sore/swollen throat (two days after injection). It was unknown if any treatment was received for event. The event outcome was unknown. No follow-up attempts were possible. No further information was expected.

Other Meds:

Current Illness:

ID: 1648306
Sex: F
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: high fever; Nausea; Headache; Dizziness; Weakness; This is a spontaneous report from a contactable consumer (patient husband). A female patient of an unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. Medical history included previously they both had covid last year (2020). The patient's concomitant medications were not reported. The patient took the first dose of the covid vaccine on Saturday. The patient had reactions of high fever, some nausea, and headaches and then that passed. The patient had been experiencing dizziness and weakness. The reporter was asking what she can do about it and how long it would last for her. Outcome of events fever, nausea, headaches was recovered; dizziness, weakness was unknown. Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648307
Sex: F
Age:
State: VA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Under the site where I was given a shot above that I have a rash; Flu like symptoms; Fever; This is a spontaneous report from a contactable consumer (patient). A 67-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EN5813) via an unspecified route of administration on 10Feb2021 Wednesday (at the age of 67-year-old) as single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: unknown) via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunization and had no reaction. On 11Feb2021, Thursday, patient experienced flu like symptoms, and had little bit of fever, that day and went away yesterday on 12Feb2021. At night on 12Feb2021, patient noticed that not directly, under the site where she was given a shot above that she had a rash and that was her concern, but it was not all over her body just under my arms not directly below the site but below it. Patient was taking Benadryl in response to the event rash. Outcome of the event flu and fever was resolved on 12Feb2021 and for rash was unknown. Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648308
Sex: M
Age:
State: MI

Vax Date: 02/14/2021
Onset Date: 02/01/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Name: blood work; Result Unstructured Data: Test Result:good; Test Name: physicals; Result Unstructured Data: Test Result:they were well

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Throwing up; Fever; Sleeping all day; Just miserable; Very dizzy; Little off balance; Sick; This is a spontaneous report from a contactable consumer or other non hcp. An 86-year-old male patient received second dose of bnt162b2 (BNT162B2, solution for injection, Lot Number: EL9267), via an unspecified route of administration, administered in Arm Left on 14Feb2021 (age at the vaccination 86-years-old) as DOSE 2, SINGLE for covid-19 immunisation. Patient Medical history and concomitant medication were none. The patient experienced very dizzy on 14Feb2021, and on 15Feb2021 throwing up, fever, sleeping all day, just miserable. little off balance and sick on an unspecified date in Feb2021. Today is the first day because he just got the injection yesterday. She waited an hour for someone to answer. This department must be understaffed. The doctor said cold compresses so that is what she is doing for him right now. He was a little off balance last night and slept all night. Patient was never sick at 86 so it is troublesome to her to see him sick. They both knew it could happen, but it is worth it. She will not go around and tell people not to get it. She wants people to get it. She was going to keep pushing fluids and try to get him to take Tylenol. The patient underwent lab tests and procedures which included blood test: good and investigation: they were well on an unspecified date. The outcome of the event very dizzy, throwing up, fever, sleeping all day, just miserable was not recovered and other events was unknown. Follow-up (12May2021): Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648309
Sex: F
Age:
State: MA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Test Name: Fever; Result Unstructured Data: Test Result:100 Fahrenheit

Allergies:

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Fever; headache; chills; diarrhea; stomach cramps; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 50-years-old non-pregnant female patient received second dose of bnt162b2 (Pfizer covid 19, formulation: solution for injection, Batch/Lot Number: EL3247), via an unspecified route of administration, administered in Arm Left on 18Feb2021 14:00 (at the age of 50-years-old) as DOSE 2, SINGLE for covid-19 immunization. The patient medical history was not reported. The patient had no allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. Concomitant medications included colecalciferol (VITAMIN D [COLECALCIFEROL]) taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection; Lot Number: EL3247), via an unspecified route of administration in Arm left on 28Jan2021 11:30AM as dose 1, single for COVID-19 immunization. On 19Feb2021 04:00, the patient experienced fever, headache, chills, diarrhea, stomach cramps. The patient underwent lab tests and procedures which included body temperature: 100 fahrenheit on an unspecified date. Patient did not received treatment for adverse events. The outcome of the events was recovered on an unspecified date of 2021. Follow-up (17Jun2021): Follow-up attempts completed. No further information expected.

Other Meds: VITAMIN D [COLECALCIFEROL]

Current Illness:

ID: 1648310
Sex: M
Age:
State: TN

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 20210206; Test Name: BP; Result Unstructured Data: Test Result:BP was 205/118 normal is 140/73; Test Date: 20210206; Test Name: Blood; Result Unstructured Data: Test Result:blood was good; Comments: full blood work up; Test Date: 20210206; Test Name: test on gallbladder; Result Unstructured Data: Test Result:came back negative; Test Name: Ultrasound; Result Unstructured Data: Test Result:Unknown

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Got sick to my stomach; real bad pain in gallbladder area had to go to ER after six hours of nonstop pain; BP was 205/118 normal is 140/73; This is a spontaneous report from a contactable consumer, the patient. A 70-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: unknown), via an unspecified route of administration in the arm left on 05Feb2021 14:00 as dose 1, single (at the age of 70-years-old) for covid-19 immunization. The patient medical history was not reported. Concomitant medications included naproxen sodium (ALEVE) and paracetamol (TYLENOL). On 06Feb2021, the patient got sick to stomach and real bad pain in gallbladder area. The patient had to go to ER after six hours of nonstop pain. All test on gallbladder came back negative. Blood was good. BP was 205/118, normal was 140/73. The patient took shot for pain and after a few hours everything started back to normal. The patient was sent home and he was good now. After leaving ER, the patient had great concerns about getting second shot and if this was a reaction to the vaccine. The patient received pain nausea medication. The patient performed full blood work up and ultrasound for the events. The patient did receive any other vaccine in four weeks. The patient did not have a covid-19 prior to vaccination. The patient did not test for covid-19 post vaccination. The outcome of the events was recovered. Follow-up attempts completed. No further information expected.

Other Meds: ALEVE; TYLENOL

Current Illness:

ID: 1648311
Sex: F
Age:
State: MN

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Hurt all over; every muscle in my body, every joint hurt; Fever; I was weak; Tired; This is a spontaneous report from a contactable consumer reported that. A 77-years-old female patient received BNT162B2 PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 2 via an unspecified route of administration on Feb2021 (Batch/Lot Number: EN6201) as DOSE 2 SINGLE for covid-19 immunization. The patient past Medical history included liver disorder from an unknown date and unknown if ongoing. Concomitant medication(s) included ursodeoxycholic acid (URSODIOL) taken for an unspecified indication. The patient reported after the dose of vaccine she had very slight reaction like the soreness in the arm and maybe a little headache but then this past Thursday and after the second dose of vaccine the patient experienced quite a bit more of a reaction she had a fever, its hurt all over, had a (word incomprehensible) 'like I was on fire almost' (not clarified further) and of course she was weak, tired, well anyway it was, every muscle in my body, every joint hurt on an unspecified date in Feb2021. The patient is treated with Advil. The event outcome was Unknown. No further information expected.

Other Meds: URSODIOL

Current Illness:

ID: 1648312
Sex: F
Age:
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data: Test Date: 20210205; Test Name: fever; Result Unstructured Data: Test Result:101 and up

Allergies:

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Terrible headache could not even move my head for whole day; Muscle ache; Site pain; Fever 101 and up; This is a spontaneous report received from a non-contactable nurse (Patient). A 36-year-old non pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), Solution for injection, intramuscular, administered in Arm Left on 04Feb2021 18:00 (at the age of 36-year-old) as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient had no known allergy. The 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. The patient had not been tested for COVID-19 Since the vaccination. On 05Feb2021, the patient experienced terrible headache could not even move my head for whole day, muscle ache, site pain and fever 101 and up. The patient underwent lab tests and procedures which included body temperature: 101 and up on 05Feb2021. Patient received Tylenol as a therapeutic measure to treat adverse events. The events were recovered on an unspecified date in Feb2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained

Other Meds:

Current Illness:

ID: 1648313
Sex: F
Age:
State: PA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: patch on her back; red welt the size of a quarter; A 74-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Batch/Lot Number: ENS318; Expiration Date: May2021), via an unspecified route of administration in Arm Left on 22jan2021 (11:00) as a DOSE 1, SINGLE for COVID-19 immunization. The patient medical history was Dry Skin and scratching her back were reported. Concomitant medications included: VITAMIN C [ASCORBIC ACID], Colecalciferol (VITAMIN C [ASCORBIC ACID]), MAGNESIUM, TURMERIC [CURCUMA LONGA RHIZOME], Calcium taken for an unspecified indication, start and stop date were not reported. The reporter stated after her first shot on 22jan2021, and the second dose February 12th, each injection was given in her left arm at about 11:00AM on those days. She got her first shot and then a couple days later on 23Jan2021 she had a patch on her back with a red welt the size of a quarter, which she thought could be from scratching her back during the winter due to dry skin. It was reported that her welts have stayed about the same, she hasn't gotten any more, it is the same basic ones. Patient said that the first one looks like it is going away, and the others are smaller that appeared after the second dose, they are the size of a dime. She was applied Aloe Vera Clear Gel on it since it is unscented and has no smell or nothing. She stated that this product is an old one, but is still clear and didn't turn colours or anything. Aloe Vera Clear Gel UPC # LOT/EXP: Unknown, caller stated this product doesn't have this information to provide. Patient said the bottle says healing therapy, apply liberally to sunburn or irritated skin as needed. The patient was concerned because her sister looked at the welts and asked her if she thought she got shingles from it, and she was like no, it doesn't burn, though once in a while it does, and sometimes it doesn't itch, it is not something that bothers her, it's just there. The clinical outcome of the events were unknown. Follow-up attempts are completed. No further information is expected.

Other Meds: VITAMIN C [ASCORBIC ACID]; VITAMIN D [COLECALCIFEROL]; MAGNESIUM; TURMERIC [CURCUMA LONGA RHIZOME]; CALCIUM

Current Illness:

ID: 1648314
Sex: F
Age:
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 202102; Test Name: Nasal Swab, Covid Test; Test Result: Negative

Allergies:

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Total loss of taste; pain in ear; tingling in face; This is a spontaneous report from a contactable (patient herself). A 61-years-old non-pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, lot number: EN9581; Expiration date: unknown) via an unspecified route of administration, administered in Arm Right on Feb2021 10:00 (at age of 61-years-old) as DOSE 1, SINGLE for COVID-19 immunization. Patient was not pregnant at the time of vaccination. The patient medical history and concomitant medications were not reported. Patient had not known allergies. Other medical history was none. Patient did not receive any other vaccines within 4 weeks of COVID vaccine nor received any other medications within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. It was reported that, on an unspecified date in on Feb2021 patient experienced total loss of taste, pain in ear and tingling in face. The patient underwent lab tests and procedures which included SARS-COV-2 antibody test which was negative; (Nasal Swab) post the vaccination on an unspecified date inFeb2021. The outcome of all events was not recovered. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1648315
Sex: F
Age:
State: MD

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Test Date: 20210205; Test Name: Blood test; Result Unstructured Data: Test Result:Pending; Test Date: 20210205; Test Name: covid tested; Result Unstructured Data: Test Result:Result Unknown

Allergies:

Symptom List: Vomiting

Symptoms: Constant migraine; severe joint aches; extreme fatigue; upset stomach; chills; aches at injection site; This is a spontaneous report from a contactable consumer. A 39 years old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot Number: Not reported) via an unspecified route of administration on an unspecified date (39-year-old at vaccination) as a Dose 1, single for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient had no known allergies. Vaccination facility type was reported as other. The patient was not received any other vaccine within four weeks prior vaccination. The patient was not diagnosed with Covid prior to vaccination. On an unknown date, the patient had experienced constant migraine, severe joint aches, extreme fatigue, upset stomach, chills, ache at injection site. The patient underwent lab test and procedure which included blood test: result was pending and Covid test (post vaccination): results unknown at home on 05Feb2021: result was pending. No treatment medications received for the resulted events. The outcome of the events was unknown. The reporter allowed to contact and agreed for explicit consent. Information on the lot/batch number has been requested. Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648316
Sex: U
Age:
State:

Vax Date: 01/24/2021
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Test Date: 2021; Test Name: low grade fever like about 99; Result Unstructured Data: Test Result:about 99

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I started feeling extremely tired like absolutely no energy; Headache; Nausea; Low grade fever; loss of energy; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 24Jan2021 as dose 1, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient reported that on an unspecified date of 2021 the patient started feeling extremely tired like absolutely no energy and felt like that way for three days. Beside the loss of energy and extremely tired, patient had a headache and some nausea, it was not there all the time and a low-grade fever like about 99. The patient underwent lab tests and procedures which included body temperature: about 99 on an unspecified date of 2021. The outcome of events feeling extremely tired like absolutely no energy, headache, nausea, low grade fever, loss of energy was unknown. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1648317
Sex: F
Age:
State:

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: chills; trouble sleeping; feeling general body aches; This is a spontaneous report from a non-contactable consumer received via COVID-19 Vaccine Adverse Event Reporting System. An 82-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), via an unspecified route of administration on 12Feb2021 (Lot Number unknown, at the age of 82 years old) as dose 2, single for COVID-19 immunisation. The vaccine was received in a hospital facility. The patient's medical history and concomitant medications were not reported. She was not pregnant at the time of vaccination and she did not receive any other vaccines within four weeks prior to vaccination. The patient previously received first dose of BNT162B2 on 22Jan2021 (Lot Number: EL3247, at the age of 82 years old) for COVID-19 immunisation. On 13Feb2021, the patient described chills and trouble sleeping the day after receiving her vaccination, as well as feeling general body aches. The patient was not diagnosed with COVID-19 prior to vaccination and she has not been tested for COVID-19 since the vaccination. No therapeutic measures were taken as a result of the events. The patient recovered from the events on an unspecified date in 2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1648318
Sex: F
Age:
State: VA

Vax Date: 01/01/2021
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: nausea; minor soreness; This is a spontaneous report received from a contactable Nurse. This Nurse reported for a 91-Year-old female patient that: A 91-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection), dose 1 via an unspecified route of administration on Jan2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history and patient's concomitant medications were not reported. The patient experienced Nausea, Minor Soreness on an unspecified date. The outcome of event was unknown. Information on the lot/batch number has been requested. Follow-up (12May2021): Follow-up attempts completed. No further information expected.

Other Meds:

Current Illness:

ID: 1648319
Sex: F
Age:
State: MD

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Test Date: 20210205; Test Name: blood pressure; Result Unstructured Data: Test Result:okay; Test Date: 20210205; Test Name: listened to her lungs; Result Unstructured Data: Test Result:they were clear; Test Name: lab work; Result Unstructured Data: Test Result:Unknown result

Allergies:

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Wiped out; tired; Headache; Rash; Flushed; Redness; Warmth; This is a spontaneous report from a contactable consumer or other non hcp. A 70-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: EL9265), dose 1 via an unspecified route of administration, administered in Arm Left on 05Feb2021 (at the age of 70-years-old) as dose 1, single for covid-19 immunisation. Medical history included ongoing asthma Has had for years, ongoing diabetes Has had for 4 years, allergies with medications, Penicillin causes an anaphylactic reaction and this is when she was ten years old , urticaria With Sulfas she gets hives. She was on these various Sulfa medications when she was in her 30s-40s, she takes it to protect kidney due to diabetes. Concomitant medication included ongoing glipizide (2.5mg with dinner ) taken for diabetes mellitus; Ongoing fluoxetine hydrochloride (PROZAC) (20mg once a day) taken for depression; dulaglutide (TRULICITY) 1x/day (1.5 injected once a week) taken for diabetes mellitus from an unspecified start date and ongoing; valsartan (40mg) taken for renal disorder from an unspecified start date and ongoing. The patient reported Valsartan is a blood pressure medication, but she takes it to protect kidney due to diabetes. The patient previously took flu vaccine in Sep2020 for influenza immunisation and experienced pain in extremity, morphine [morphine sulfate] and experienced rash, flushing and burning sensation. She had the Pneumonia vaccine and had no problems with that. In 1990 IV Morphine was given to her after surgery and it was discontinued. On 05Feb2021, the patient experienced headache, rash, flushed, redness, warmth, wiped out; tired on 06Feb2021. The patient underwent lab tests and procedures which included blood pressure measurement: okay on 05Feb2021, investigation: they were clear on 05Feb2021, laboratory test: unknown result. The patient had her first injection last Friday afternoon. She mentioned she has a history of allergies with medications. Therefore, she stayed in the staging area for 30 minutes instead of waiting for 15 minutes. After getting the vaccine she left and went to her already scheduled Endocrinologist appointment. The Endocrinologist appointment was also in the same hospital where she got the vaccine. She went to the Endocrinologist appointment and it was noted one hour after the injection she started to feel warm while in the waiting room. She thought to herself it's possible the waiting room was warm, but when she was called back to have her blood pressure take she had to take her sweater off. When she took her sweater off for blood pressure to be checked it was noted she had a broken out in a rash all over. She could not see her face, but she had a rash there too. She had a rash all over her body. The doctor came in and listened to her lungs and they were clear. Her blood pressure was okay. Caller stated since her Endocrinologist appointment was also located in same facility where got the vaccine she should go back there to be checked out. The sheet she has indicates a rash can occur. The rash is indicative of a severe reaction. She could breathe okay. It took four hours for the rash to gradually get lighter and lighter in color. It appears that the rash has gone away. She also experienced a headache. Saturday, she felt total wiped out. It is like she had no "umph" to do anything. She also mentioned she saw her PCP on Monday. That appointment was already scheduled on the books for a regular check up. The doctor was concerned about if she should get the second dose injection or not. The doctor is hoping it would be okay. The patient wanted to know if it is okay to get the second dose, if so, would it be possible to get the same reaction or could it be worse. She also mentioned this week she has talked to a couple of people and they indicate they know someone who has gotten the rash after the COVID shot, but it was after the second shot. She further clarified and explained she got the COVID 19 Vaccine on 05Feb2021. It was one hour after getting the vaccine she noticed the rash, redness, flush feeling, warmth. The rash, redness, flush feeling, warmth were all gone totally by the next day. Attempted to clarify if recovered completely or with lasting effects and caller only able to state she guesses she is okay. She also added, that Friday the headache started . She does not know if it was from the vaccine or something else. It is not as bad now as it was on Friday and Saturday. It is more of an aggravation. She had a couple hours after injection. Stated may have noticed while in doctor's office. She confirmed she is still tired, but not wiped out like she was this weekend. Saturday it was like she forget about even thinking about trying to do anything. She had her regular lab work done prior to her doctor appointments. None were done specifically due to events that occurred.Time the vaccination was given was around 1:35PM. When she was in the observation area the clock said 1:39 PM on their clock. Then she had to wait half an hour there. Vaccination Facility Type was Hospital. History of all previous immunizations with the Pfizer vaccine not considered as suspect except this the first dose. No additional vaccines administered on same date of Pfizer Suspect. The events did not cause Emergency Room visit. She was seen by the doctor and mentioned details, but she already had these appointments scheduled. Prior vaccinations within 4 weeks was none. She then went on to add, she does not know if it is one of the fillers that may be in her ongoing or past medications that causes the reactions. Stated these fillers could potentially be in the COVID vaccine. She confirmed she has no lot/exp/NDC to provide for the Flu shot, Penicillin, IV Morphine, or Sulfa mediations. Outcome of the events headache and fatigue were recovering, and the outcome of the other events were recovered on 06Feb2021 Follow-up (12May2021): Follow-up attempts completed. No further information expected.

Other Meds: GLIPIZIDE; PROZAC; TRULICITY; VALSARTAN

Current Illness: Asthma (Has had for years); Diabetes (Has had for 4 years)

ID: 1648320
Sex: F
Age:
State: FL

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: immediately felt soreness in her left arm and also there was pain if she tried to raise her arm; developed a low grade fever, up 1 degree from her usual temperature; became dizzy; extremely tired; slept off and on; had a heavy head; This is a spontaneous report from a non-contactable consumer or other non hcp (patient). A 68-years-old non-pregnant female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, formulation: solution for injection, Lot number was not reported) via an unspecified route of administration, administered in left arm on an unspecified date in Feb2021 at 10:45 AM (at the age of 68-years-old) as dose 1, single dose for covid-19 immunisation. The patient's medical history included type 2 diabetes mellitus, sulfa drugs allergy and shellfish allergy from an unknown date and unknown if ongoing. The patient previously took codeine and experienced bad reaction to codeine. The patient's concomitant medications were not reported. Patient didn't got covid prior to vaccination. Patient not tested for covid-19 post vaccination. On unspecified date in Feb 2021 at 10:45 AM, after receiving the shot patient immediately felt soreness in her left arm and also there was pain if she tried to raise her arm. Approximately 9-10 hours after receiving the shot patient became dizzy, extremely tired, slept off and on and during the third day, patient developed a low-grade fever, up 1 degree from her usual temperature and on fourth day patient had a heavy head. Patient also reported that she was not as tired, the left arm soreness was all but gone, and she was no longer dizzy. soreness in her left arm, and all of these symptoms lasted for 72 hours. The patient did not receive any treatment for the adverse events. The outcome of all events was recovered on unspecified date. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am