VAERS 2021 Database www.vaers.hhs.gov

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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: 1652482
Sex: F
Age:
State: NY

Vax Date: 05/31/2021
Onset Date: 05/31/2021
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:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Dizziness; weakness; headache began within on hour of vaccination; nausea began the next day; This is a spontaneous report from a contactable consumer or other non hcp. A 36-years-old female patient received bnt162b2 (BNT162B2 PFIZER-BIONTECH COVID-19 MRNA VACCINE; Solution for injection (Batch/Lot number was not reported), dose 1 via an unspecified route of administration, administered in Arm Left on 31May2021 18:15 (Batch/Lot number was not reported) as dose 1, single for covid-19 immunisation. Medical history included migraines, drug hypersensitivity, food allergy, food allergy, rubber sensitivity, allergy to arthropod sting. The patient's concomitant medications were not reported. The patient did not receive any other vaccine in four weeks. Prior to vaccination patient diagnosed with COVID. Post vaccination patient did not test for COVID.It was reported that, the patient experienced dizziness, weakness, headache and nausea began within one hour of vaccination on 31May2021 19:00 with outcome of not recovered. Follow-up attempts are needed; Information about lot/batch number has been requested. Follow-up (05Jul2021): This follow-up is being submitted to notify that the lot/batch number is not available despite the follow-up attempts made. Follow-up attempts completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652483
Sex: M
Age:
State: WA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
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:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: left arm are sore; Inappropriate schedule of vaccine administered; This is a spontaneous report from a contactable consumer, the patient. A 46-year-old male patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 11May2021 at 17:15, as a single dose for COVID-19 immunisation. Medical history included allergy to pineapples and some shellfish. The patient did not receive any other medications within 2 weeks of 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. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously took first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 27Apr2021 at 17:15, as a single dose for COVID-19 immunisation. On 14May2021, the muscles in the patient back that connect his left arm were sore almost every day. He worked in front of the computer. He did not notice it much when he was moving around. If he was stationary for more than an hour, he needed to do lots of stretching. The event did not result in doctor or other healthcare professional office or clinic visit, and emergency room or department or urgent care. Therapeutic measures were taken as a result of left arm sore and included treatment with TYLENOL. The clinical outcome of the event left arm sore was not recovered at the time of this event. The information on lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1652484
Sex: M
Age:
State: CA

Vax Date: 05/02/2021
Onset Date: 05/03/2021
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: 20210521; Test Name: left leg DVT ultrasound; Result Unstructured Data: Test Result:found a baker's cyst; Test Date: 20210519; Test Name: d-dimer blood test; Result Unstructured Data: Test Result:0.54

Allergies:

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

Symptoms: left leg DVT ultrasound found a baker's cyst; Left calf (more serious closed to knee) stiff, pain and swollen; Left calf (more serious closed to knee) stiff, pain and swollen; Left calf (more serious closed to knee) stiff, pain and swollen; red, swollen and pain on left ankle; red, swollen and pain on left ankle; red, swollen and pain on left ankle; headache for 3 days; This is a spontaneous report from a contactable consumer (patient). A 64-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution injection; Lot Number: EW0167), via an unspecified route of administration, administered in left arm on 02May2021 at 15:00 (at the age of 64-years-old) as single dose for covid-19 immunisation at Pharmacy or Drug Store. Medical history included hepatitis B career, minor left knee pain for last 2 years and platelet clumper needs extra blue tube for platelet test. The patient's concomitant medications were not reported. Historical Vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution injection; Lot Number: ER8730), via an unspecified route of administration, administered in left arm on 04Apr2021 at 15:15 (at the age of 64-years-old) as single dose for covid-19 immunisation at Pharmacy or Drug Store. 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 had not been tested for COVID-19. On 03May2021 at 07:00, patient experienced left calf (more serious closed to knee) stiff, pain and swollen on 5/3 morning woke up. 3 days later, red, swollen and pain on left ankle and headache for 3 days. In 2nd and 3rd week, ankle was not red, but light swollen on ankle and calf. After 4.5 weeks ankle swollen was gone, and calf was still swollen with less pain. The patient underwent lab tests and procedures which included d-dimer blood test 0.54 on 19May2021, left leg DVT ultrasound found a baker's cyst on 21May2021. Adverse events resulted in Doctor or other healthcare professional office/clinic visit. No hospitalization prolonged. No treatment received. The outcome of the events red, swollen on left ankle was recovered in 2021; for other events was not recovered. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652485
Sex: M
Age:
State: NY

Vax Date: 03/02/2021
Onset Date: 03/02/2021
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: Could not keep my balance when walking; This is a spontaneous report from a contactable consumer (Patient). A 74-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: En6198), via an unspecified route in left arm on 02Mar2021 at 10:00 AM (at the age of 74 years) as dose 2, single for Covid-19 immunization. The patient medical history included Just high blood pressure which is under control and allergic to penicillin. The concomitant medications was Azor, pot Chlor tabs. No other vaccines within 4 weeks prior to the Covid vaccine. Prior to vaccination, patient was not diagnosed with Covid-19. Since the vaccination, the patient has not been tested for Covid-19. The patient historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: El9269), via an unspecified route in right arm on 09Feb2021 at 10:00 AM as dose1, single for Covid-19 immunization. On 02Mar2021 at 11:00 AM, the patient reported that after one hour taking the second shot he could not keep his balance when walking have been this way exactly 3 months never had this before the vaccine. Events assessed as non-serious. The clinical outcome of the events were not resolved. Follow-Up (30Jun2021): Follow-up attempts are completed. No further information is expected.

Other Meds: AZOR [ALPRAZOLAM]; POTASSIUM CHLORIDE

Current Illness:

ID: 1652486
Sex: F
Age:
State: NY

Vax Date: 05/22/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Bad itchy; red rash on hands and arms; This is a spontaneous report from a contactable consumer, the patient. A 52-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0176), via an unspecified route of administration on 22May2021 at 12:45 as a single dose for COVID-19 immunisation. Medical history was not reported. Concomitant medications included ethinylestradiol, ferrous fumarate, norethisterone acetate (LO LOESTRIN FE) for an unknown indication from an unknown date. The patient did not receive any other vaccines within four weeks prior to the vaccination. On an unknown date, the patient experienced bad itchy, red rash on hands and arms. Therapeutic measures were not taken as a result of the events. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. The clinical outcomes of the events bad itchy, red rash on hands and arms were not recovered at the time of this report. No follow-up attempts are needed. No further information is expected.

Other Meds: LO LOESTRIN FE

Current Illness:

ID: 1652487
Sex: M
Age:
State: NJ

Vax Date: 05/12/2021
Onset Date: 05/20/2021
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:

Allergies:

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

Symptoms: Chest pain; Shortness of breath; Heart palpitations; This is a spontaneous report from a contactable consumer, the patient. A 39-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 12May2021 at 10:00 (at the age of 39-year-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient did not receive any concomitant medication. The patient did not have any allergies to food, medications, or other products. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 20May2021, the patient experienced chest pain, shortness of breath and heart palpitations. The events did not result in doctor or other healthcare professional office/clinic visit/ emergency visit. The patient did not receive any treatment for the events. The clinical outcome of the events chest pain, shortness of breath and heart palpitations was not resolved. The lot number for BNT162b2 was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1652488
Sex: M
Age:
State:

Vax Date: 04/08/2021
Onset Date: 05/01/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Rash on trunk of body; Rash on trunk of body that was tingly; Rash on trunk of body that was painful; Nose bleed; swollen gums; This is a spontaneous report from a non-contactable pharmacist. A 35-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6199) via intramuscular route of administration on 08Apr2021(at the age of 35-year-old) as a single dose for COVID-19 immunisation. Medical history included depression. The patient previously received Vistaril and experienced drug allergy. Concomitant medications included trazodone (MANUFACTURER UNKNOWN), bupropion hydrochloride (WELLBUTRIN) and iron (MANUFACTURER UNKNOWN) all for unknown indications from an unknown date and unknown if ongoing and sertraline hydrochloride (ZOLOFT) for unknown indication from an unknown date and was ongoing. It was unknown whether the patient had received any other vaccines within four weeks prior to the vaccination. Prior to vaccination, it was unknown whether the patient was diagnosed with COVID-19. On 21May2021 the patient experienced rash on trunk of body that was tingly and painful and on an unknown date in May2021 patient experienced nose bleeds and swollen gums. The patient had been out of Zoloft five day prior to events. Patient was recommended follow up with PCP (primary care physician) and he went to urgent care where was given amoxicillin and a topical ointment for the irritation and also refilled Zoloft prescription after initial presentation. On 24May2021 phone follow up with the patient revealed pain was gone and rash had subsided. The event rash on trunk of body that was tingly and painful resulted in emergency room/department or urgent care. Therapeutic measures were taken as a result of rash on trunk of body that was tingly and painful and included treatment with amoxicillin (MANUFACTURER UNKNOWN) and topical cream (MANUFACTURER UNKNOWN). Since the vaccination, it was unknown whether the patient had been tested for COVID-19. The clinical outcome of the events rash on trunk of body that was tingly and painful was recovered on an unknown date in May2021; while that of nose bleeds and swollen gums was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds: TRAZODONE; ZOLOFT; WELLBUTRIN; IRON

Current Illness:

ID: 1652489
Sex: F
Age:
State:

Vax Date: 05/04/2021
Onset Date: 05/26/2021
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 Name: Chest x-ray; Result Unstructured Data: Test Result:unknown result; Test Name: EKG; Result Unstructured Data: Test Result:unknown result

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Chest pains; coughing; This is a spontaneous report from a contactable consumer (patient). A 22-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: EW0168), dose 1 via an unspecified route of administration, administered in Arm Left on 04May2021 08:00 as dose 1, single (age at vaccination 22-year-old) for covid-19 immunisation. Medical history included allergy to metals (gold known allergy). The patient's concomitant medications were not reported. 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 did not receive any other vaccines within four weeks prior to the vaccination. No other medications in two weeks of vaccination. The patient was not pregnant at the time of vaccination. The patient experienced chest pains and coughing on 26May2021 09:30. The patient underwent lab tests and procedures which included chest x-ray: unknown result and electrocardiogram: unknown result on an unknown date. Therapeutic measures were taken as a result of events includes Chest x-ray and EKG. The outcome for event was recovered on an unknown date in 2021. Follow-up (05Jul2021): This follow-up is being submitted to notify that the lot/batch number is not available despite the follow-up attempts made. Follow-up attempts completed. No further information is expected. Follow-Up (30Jul2021): Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652490
Sex: F
Age:
State: CA

Vax Date: 04/29/2021
Onset Date: 05/16/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: I haven't had a menstrual cycle in over 2 years. I had a full week heavy menstrual cycle 2 weeks after receiving the 2nd vaccination. I had read that this has been a side ef; This is a spontaneous report from a contactable consumer (patient herself). A 53-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number: EW0164), via an unspecified route of administration in Left Arm on 29Apr2021 at 13:45 as single dose for COVID-19 immunization. Patient medical history and concomitant medications were not reported. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: ER8729) via an unspecified route of administration in Left Arm on 06Apr2021 at 12:30 for COVID-19 immunization. It was reported that, patient was in menopause age at time of vaccination and haven't had a menstrual cycle in over 2 years. No known allergies. within 2 weeks of vaccination and patient had not received any other vaccines 4 weeks prior to the COVID vaccine. On 16May2021, she had experienced full week heavy menstrual cycle, 2 weeks after receiving the 2nd vaccination. It was stated that, she read that this was a side effect for many women and wanted to report it so it can be investigated as being a side effect from the vaccine. Unspecified treatment was taken for the adverse event. It was reported that the event was non-serious. Patient visited physician office for the event. The outcome of the events was unknown.

Other Meds:

Current Illness:

ID: 1652491
Sex: F
Age:
State:

Vax Date: 06/01/2021
Onset Date: 06/01/2021
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: Injection site pain; This is a spontaneous report from a non-contactable consumer, the patient. A 29-year-old non-pregnant female patient received unknown dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 01Jun2021 at 08:30 (at the age of 29-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported. The patient did not receive any other medications within 2 weeks of vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Since the vaccination, the patient had not been tested for COVID-19. On 01Jun2021, the patient experienced injection site pain. Therapeutic measures were not taken as a result of the event. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. The clinical outcome of the event injection site pain was not recovered at the time of this report. Information on lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1652492
Sex: F
Age:
State: NJ

Vax Date:
Onset Date: 06/02/2021
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: Dizziness; Chills; Fatigue; Diarrhea; This is a spontaneous report from a non-contactable consumer, the patient. A 45-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0217) via an unspecified route of administration in the left arm on an unknown date in 2021 (at the age of 45-years-old) as a single dose for COVID-19 immunisation. Medical history included obesity and diabetes. The patient had no known allergies to medications, food or other products. Concomitant medication included metformin (MANUFACTURER UNKNOWN) from an unknown date for unknown indication. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0182) via an unspecified route of administration in the left arm on 11May2021 at 10:00 (at the age of 45-years-old) as a single dose for COVID-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not tested for COVID-19. On 02Jun2021 at 12:00, the patient experienced dizziness, chills, fatigue and diarrhea. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. No therapeutic measures were taken as a result of the reported events. The clinical outcome of dizziness, chills, fatigue and diarrhea was not recovered at the time of this report. No follow-up attempts are possible. No further information is expected.

Other Meds: METFORMIN

Current Illness:

ID: 1652493
Sex: F
Age:
State: VA

Vax Date: 06/02/2021
Onset Date: 06/03/2021
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:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Body pins and needles started at 2 am/ tingling arms, hands, feet; fingers and toes numbness/ right heel numbness; tongue tingling; Heavy head; Slight headache; This is a spontaneous report from a contactable consumer (patient). A 55-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), intramuscular in right arm on 02Jun2021 13:00 (at the age of 55-years-old) as dose 1, single for COVID-19 immunization. Medical history included none. There were no concomitant medications. Prior to vaccination, the patient was not diagnosed with COVID-19, did not receive any vaccines within four weeks and was not pregnant. The patient was not having any known allergies. The patient experienced body pins and needles started at 2 am/ tingling arms, hands, feet, fingers and toes numbness/ right heel numbness, tongue tingling, heavy head and slight headache on 03Jun2021 02:00. The events Body pins and needles started at 2 am/ tingling arms, hands, feet, fingers and toes numbness/ right heel numbness and tongue tingling were considered as medically significant. Since the vaccination, patient has not been tested for COVID-19. No treatment was received for the event. The events were on and off intermittent, patient had right heel numbness every morning for couple hours. Outcome of events was resolving.

Other Meds:

Current Illness:

ID: 1652494
Sex: F
Age:
State: PA

Vax Date: 05/15/2021
Onset Date: 05/01/2021
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: Test Name: WBC; Result Unstructured Data: Test Result:6.4; Comments: thou/cmm; Test Name: Absolute Basophils; Result Unstructured Data: Test Result:0.0; Comments: thou/cmm; Test Name: Basophils; Test Result: 0 %; Test Name: Blood pressure; Result Unstructured Data: Test Result:107/57 mmHg; Test Name: temperature; Result Unstructured Data: Test Result:98.7 Fahrenheit; Comments: degrees; Test Name: CT HEAD WO CONTRAST; Result Unstructured Data: Test Result:Normal; Test Name: ECG 12-Lead; Result Unstructured Data: Test Result:Normal; Test Name: Absolute Eosinophils; Result Unstructured Data: Test Result:0.1; Comments: thou/cmm; Test Name: Eosinophils; Test Result: 2 %; Test Name: Hematocrit; Test Result: 40.9 %; Test Name: hemoglobin; Result Unstructured Data: Test Result:13.8 g/dl; Test Name: Pulse; Result Unstructured Data: Test Result:70; Test Name: Urine HCG POCT; Result Unstructured Data: Test Result:Normal; Test Name: Absolute lymphocytes; Result Unstructured Data: Test Result:2.4; Comments: thou/cmm; Test Name: Lymphocytes; Test Result: 37 %; Test Name: MCH; Test Result: 26.8 pg; Test Name: MCHC; Result Unstructured Data: Test Result:33.8 g/dl; Test Name: MCV; Result Unstructured Data: Test Result:85; Comments: fL; Test Name: MPV; Result Unstructured Data: Test Result:9.9; Comments: fL; Test Name: Absolute Monocytes; Result Unstructured Data: Test Result:0.5; Comments: thou/cmm; Test Name: Monocytes; Test Result: 7 %; Test Name: Absolute Neutrophils; Result Unstructured Data: Test Result:3.4; Comments: thou/cmm; Test Name: Neutrophils; Test Result: 54 %; Test Name: oxygen saturation; Test Result: 100 %; Test Name: Platelet count; Result Unstructured Data: Test Result:228; Comments: thou/cmm; Test Name: Percut allergy skin test; Result Unstructured Data: Test Result:Negative; Test Name: RBC; Result Unstructured Data: Test Result:4.83; Comments: mill/cmm; Test Name: RDW; Test Result: 13.2 %; Test Name: Respiration; Result Unstructured Data: Test Result:20

Allergies:

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

Symptoms: nausea; dizziness; 15-year-old female patient received BNT162B2; headache; difficult breathing; a little palpitation; This case has been considered invalid as the event cannot be assessed with the information provided (unspecified AE). Upon receipt of follow up information the case was kept as valid. This is a spontaneous report from a contactable consumer (patient). A 15-year-old female patient received BNT162B2 (BNT162B2), dose 1 intramuscular, administered in Arm Right on 15May2021 16:00 (Batch/Lot Number: EW0182) as dose 1, single for covid-19 immunisation. Medical history included Penicillin allergy, lactose intolerance. There were no concomitant medications. The patient previously took amoxicillin and experienced drug hypersensitivity, gardasil and experienced allergy to vaccine, azithromycin and experienced allergy, cefdinir and experienced allergy. Historical vaccine of Gardasil was for immunisation which was 1st dose and then Soreness, redness and very visible Swelling at the injection site, nausea and dizziness for a month. She did not take the 2nd dose. Historical vaccine of hep B, Adolscent or Pediatric for immunization (24May2006, 22Mar2006, 28Dec2005), Varicella for immunization (05Nov2010, 28Jan2007), Dtap for immunization 22Aug2017, ProQuad (MMRV) for immunization on 05Nov2010, Pneumococcal conjugate for Immunisation on 26Jan2007, 06Nov2006, 08Aug2006, 15Feb2006, meningococcal conjugate (Menactra) for immunization on 23Aug2017, MMR for immunization (05Nov2010, 13Apr2007), Influenza TIV (IM) for immunization, Influenza (IM) for immunization, IPV for immunization on 24May2008, 05Nov2010, 08Aug2006, 24May2006, 22Mar2006, HiB (PRP-T) for immunization on 13Apr2007, 08Aug2006, 24May2006, 15Feb2006, HiB for immunization on (24may2008, 13Apr2007, 08Aug2006,24May2006, 15Feb2006), Hepatitis B for immunization, Hep A, Unspecified for immunization on 28Sep2007, 26Jan2007, Hep A, 2 Dose for immunization on 28Sep2007, 26Jan2007, H1N1 Inj for immunization on 19Dec2009, H1N1 All forms for immunization on 19Dec2009, Flu Vaccine Quadrivalent 6MO+ preservative free (single dose syringe) for immunization on 17Jan2020 and DTAP for immunization on 22Aug2017. The patient had nausea and dizziness. She was a little bit not sure about like headache right after like it stayed there like half hours because the doctor said to stay there because she has her reaction to which but then she just felt the nausea and everything was so bright. 5 days after then she but she was already with this nausea, dizziness and 5 days after she got the palpitation, bad headache, nausea, dizziness and then she was taken to the emergency room. The patient underwent lab tests and procedures which included basophil count: 0.0 on thou/cmm, basophil count: 0 %, blood pressure measurement: 107/57 mmhg, body temperature: 98.7 fahrenheit, computerised tomogram head: normal, electrocardiogram: normal, eosinophil count: 0.1 thou/cmm, eosinophil count: 2 %, haematocrit: 40.9 %, haemoglobin: 13.8 g/dl, heart rate: 70, human chorionic gonadotropin: normal, lymphocyte count: 2.4 thou/cmm, lymphocyte count: 37 %, mean cell haemoglobin: 26.8 pg. Outcome of nausea and dizziness was not recovered and rest of the events was unknown. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652495
Sex: F
Age:
State: NY

Vax Date: 03/31/2021
Onset Date: 04/30/2021
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:

Allergies:

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

Symptoms: Irregular menstruation following vaccine.; Bleeding more frequently than usual - every 12 to 14 days; This is a spontaneous report from a contactable consumer. This 41-Year-old non pregnant female consumer (patient) reported that she received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: ER8732, Expiry Date: Unknown), via an unspecified route of administration, administered in left arm on 31Mar2021 at 10:00AM (at the age of 41 years old) as dose 2, single for COVID-19 immunization. The patient's medical history was not reported. Concomitant medications included fluticasone propionate (FLOVENT) and cetirizine hydrochloride (ZYRTEC [CETIRIZINE HYDROCHLORIDE]), started on unknown dates and for unknown indications. No relevant past drug history. She received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EN6199, Expiry Date: Unknown), via an unspecified route of administration, administered in left arm on 10Mar2021 at 10:00AM (at the age of 40 years old) as dose 1, single for covid-19 immunization. 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 did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 30Apr2021, she had irregular menstruation following vaccine. Bleeding more frequently than usual: every 12 to 14 days. Patient visited doctor or other healthcare professional office/clinic. No hospitalization prolongation or treatment received for the events. The outcome of events was not recovered. Follow-up attempts are completed. No further information is expected.

Other Meds: FLOVENT; ZYRTEC [CETIRIZINE HYDROCHLORIDE]

Current Illness:

ID: 1652496
Sex: F
Age:
State: GA

Vax Date: 02/24/2021
Onset Date: 02/27/2021
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: Tinnitus and dizziness started 3 days after receiving the second dose; Tinnitus and dizziness started 3 days after receiving the second dose; This is a spontaneous report from a contactable other hcp (patient). A 37-years-old non-pregnant female patient received bnt162b2 (Pfizer-BioNTech Covid-19 Vaccine, solution for injection, Batch/Lot number was not reported), dose 2 via an unspecified route of administration, administered in Arm Left on 24Feb2021 17:00 (age at vaccination 37years), as DOSE 2, SINGLE for covid-19 immunisation at facility. Medical history included depression, anxiety from an unknown date and unknown if ongoing. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient previously took bnt162b2 (Pfizer-BioNTech Covid-19 Vaccine, solution for injection), dose 1, administered in Arm Left on 14Jan2021 04:45 (Batch/Lot number: EJ1685) for covid-19 immunisation. On 27Feb2021, the patient experienced tinnitus and dizziness started 3 days after receiving the second dose. The events resulted in physician office visit. Therapeutic measures were taken as a result of events with meclizine. Device Date was 03Jun2021. The clinical outcome of the events was Recovered with Sequel in 2021. The lot/batch number is not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected.

Other Meds:

Current Illness:

ID: 1652497
Sex: F
Age:
State: UT

Vax Date: 05/26/2021
Onset Date: 05/27/2021
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: Muscle soreness; stiffness in the hand; arm feeling heavy; This is a spontaneous report from a contactable consumer, the patient. A 25-year-old, non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the right arm on 26May2021 at 17:00 (at the age of 25-years-old) as a single dose for COVID-19 immunisation. No relevant medical history reported. Concomitant medications included escitalopram oxalate (LEXAPRO) and ethinylestradiol, levonorgestrel (MARLISSA) for an unknown indication and from an unknown date. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in left arm on 05May2021 at 19:15 as a single dose for COVID-19 immunisation. On 27May2021 at 07:00, the patient experienced muscle soreness, stiffness in the hand and arm feeling heavy which was reported to get worse on 06/03/2021 at 03:00. The events did not result in a visit to the doctors or other healthcare professional office/clinic visit emergency room/department or urgent care. No therapeutic measures were taken as a result of adverse events. The clinical outcome of the events, muscle soreness stiffness in the hand and arm feeling heavy was not resolved at the time of report. No follow-up attempts are needed. Information about lot number cannot be obtained.

Other Meds: LEXAPRO; MARLISSA

Current Illness:

ID: 1652498
Sex: F
Age:
State:

Vax Date:
Onset Date:
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: Vertigo; This is a spontaneous report from a non-contactable pharmacist, the patient. A 37-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date in 2021 as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date as a single dose for COVID-19 immunisation. 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 an unknown date in 2021, two weeks post the second vaccination, the patient experienced vertigo. The clinical outcome of the event vertigo was unknown at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1652499
Sex: M
Age:
State: TN

Vax Date: 05/29/2021
Onset Date: 06/02/2021
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:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: not hungry; "barely slept last night because whole body hurt" "dizziness weakness cant stand straight lack of perception aches and soreness""headache"second dose too early per recommendation shot given MAy 2; "barely slept last night because whole body hurt" "dizziness weakness cant stand straight lack of perception aches and soreness""headache"second dose too early per recommendation shot given MAy 2; Dizziness; Weakness; cant stand; "barely slept last night because whole body hurt" "dizziness weakness cant stand straight lack of perception aches and soreness""headache"second dose too early per recommendation shot given MAy 2; Headache; really really sick; This is a spontaneous report from a contactable consumer. This contactable consumer (patient's parent) reported for a 15-years-old male that: A 15-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: Unknown), via an unspecified route of administration in left arm on 29May2021 as dose 2, single for COVID-19 immunisation. Medical history included conversion disorder from an unknown date and unknown if ongoing, amnesia type from an unknown date and unknown if ongoing, breathing issue from an unknown date and unknown if ongoing (heartrate episodes paediatrician says if heartbeat goes over 200 per min and breathing), ADHD allergies (attention deficit hyperactivity disorder) from an unknown date and unknown if ongoing, food allergy from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. The patient previously took bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: Unknown), via an unspecified route of administration in left arm on 18May2021 as dose 1, single for COVID-19 immunisation, PEPTO BISMOL [bismuth subsalicylate;calcium carbonate] and experienced drug hypersensitivity, pineapple and experienced drug hypersensitivity, asprin and experienced drug hypersensitivity. No COVID prior vaccination and unknown, if COVID tested post vaccination. The patient did not receive any other vaccines within four weeks prior to the vaccination. It was reported that reporter's son was with his Bio and has not sent card copy only son reported side effects to "me" and second dose was supposed to be 08Jun2021 at 12:15PM not sure if second dose was given at the same location as first dose, reporter was in another state reporting to our son's doctor, side effects out of concern vaccine given too early second dose. Bio was with son not with reporter. Reported first dose with pictures sent to patient's parent of proof which arm so reporter was able to mark it on this form. the picture of registration shows a local grocery store website. reporter do not know if that was where they received it or not. Address was from the picture sent by bio of registration of dates and times. second dose was to be administered 08Jun2021, 12:15pm instead was administered May 29,2021 confirmed twice by patient who was really really sick afterwards. The reporter contacted patient's doctor up here on call and emailed. The patient was barely slept last night because whole body hurt, dizziness, weakness cannot stand straight lack of perception aches, soreness, headache and second dose too early per recommendation shot given 29May2021. These other symptoms were reported also from reporter's son on Sunday at 11:40. " No thanks, not hungry" on Monday at 10:02 and "Still have a horrible headache so I am resting". Reporter was called about the review that she did online for the Pfizer Covid Vaccine for adolescents and she did put the wrong area code for where patient received the vaccine. she does not have them (NDC, Lot, Expiration date) with her at that time. She just wanted to correct the information at this time. The information that was incorrect was the area code for the facility details. The street address and postal code are correct, but she provided the phone number with the third digit of the area code being incorrect. The area code should be 615, even though on the form it reads 616. The treatment for the events was unknown. The outcome of the events was unknown.

Other Meds:

Current Illness:

ID: 1652500
Sex: M
Age:
State: FL

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: Feel stiffness all time and fell pain when I move my arm in any direction. I thought it would go away by time and now feel it is worsen by time.; Feel stiffness all time and fell pain when I move my arm in any direction. I thought it would go away by time and now feel it is worsen by time.; Feel stiffness all time and fell pain when I move my arm in any direction. I thought it would go away by time and now feel it is worsen by time.; This is a spontaneous report from contactable consumer (patient). A 59-years-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection), via an unspecified route of administration, administered in Arm Left on 08Apr2021 15:00 (at the age of 59 years old) (Lot Number: EP7533) as dose 2, single for COVID-19 immunization. Patient didn't receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, patient was not diagnosed with COVID-19. No known allergies. Relevant medical history was none. Concomitant medications were not reported. Patient historical vaccine included on 18Mar2021 at 03:00 AM (at the age of 59 years), patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), administered in Left arm (Lot Number: EP7534) for COVID-19 immunization. On 08Apr2021 patient reported that, feel stiffness all time and fell pain when I move my arm in any direction. I thought it would go away by time and now feel it is worsen by time. No therapeutic measures were taken as a result of events. Since the vaccination, patient had not tested for COVID-19. The outcome of the events was not resolved. Follow-Up (14Jul2021): Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652501
Sex: F
Age:
State: MD

Vax Date: 05/25/2021
Onset Date: 06/03/2021
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:

Allergies:

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

Symptoms: Heavy debilitating painful period came earlier than usual 8 days after shot.; Heavy debilitating painful period came earlier than usual 8 days after shot.; This is a spontaneous report from a contactable consumer (patient) reported for herself that: A 14-years-old female non pregnant patient received bnt162b2 (Pfizer-BioNTech COVID-19 Vaccine, solution for injection), dose 1 via an unspecified route of administration, administered in Arm Left on 25May2021 16:00 (at the age of 14-years-old), (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient was not tested positive for covid 19 prior and post vaccination. On 03Jun2021 the patient experienced heavy debilitating painful period came earlier than usual 8 days after shot. Patient did not receive other vaccine in four weeks. Patient did not received treatment. prior vaccination and post vaccination patient did not test for covid. The outcome of the events was unknown. Follow-up attempts are completed. Information about lot/batch number cannot be obtained

Other Meds:

Current Illness:

ID: 1652502
Sex: F
Age:
State: MD

Vax Date: 05/26/2021
Onset Date: 05/26/2021
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: Test Date: 20210531; Test Name: Nasal Swab; Test Result: Negative.

Allergies:

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

Symptoms: Fever; Chills; Nausea; Headache; Body aches; This is a spontaneous report from a contactable consumer, the patient. A 55-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 26May2021 at 16:00 (at the age of 55-year-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19. The patient did not receive any medication within two weeks of vaccination. Prior to the vaccination, the patient was diagnosed with COVID-19. Since the vaccination, the patient had been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 26May2021, the patient experienced fever, chills, nausea, headache, body aches. Therapeutic measures were taken as a result of event and included treatment with Ibuprofen and fluids. The events did not result in doctor or other healthcare professional office or clinic visit, and emergency room or department or urgent care. On 31May2021, the patient underwent nasal swab and the result was negative. The clinical outcome of the events fever, chills, nausea, headache, body aches was recovered on an unknown date of 2021. No follow-up attempts are needed; information about lot number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1652503
Sex: F
Age:
State: CA

Vax Date: 03/01/2021
Onset Date: 03/24/2021
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 started having a migrane on the left top side of my head. about a 1hour 30 after vaccine. I have experienced head pain every day since and pain in my left ear.; About a 1hour 30 after vaccine. I have experienced head pain every day since and pain in my left ear.; About a 1hour 30 after vaccine. I have experienced head pain every day since and pain in my left ear.; This is a spontaneous report from a contactable consumer. A 63-years-old female patient received first dose of bnt162b2 (BNT162B2; Batch/Lot Number: ER8730), via an unspecified route of administration on Mar2021 as single dose, second dose via an unspecified route of administration, administered in Arm Left on Mar2021 (Batch/Lot Number: EWB153) as single dose for COVID-19 immunisation. Medical history included blood pressure measurement from an unknown date and unknown if ongoing, asthma from an unknown date and unknown if ongoing. The patient previously took codeine and experienced drug hypersensitivity. The patient was diagnosed with COVID-19, prior to vaccination. Since the vaccination, the patient has not been tested for COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient received other medications within 2 weeks of vaccination. The patient experienced migraine, headache, ear pain on 24Mar2021 14:00. Clinical course reported as I started having a migrane on the left top side of my head. about a 1hour 30 after vaccine. i have experienced head pain every day since and pain in my left ear. Therapeutic measures were taken as a result of adverse events as Medication, Mri, Nerve block. The outcome of the events was not recovered. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652504
Sex: M
Age:
State: WA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Vision went very blurry; Things became very distant in hearing; Hard to focus; Felt like was burning up; Sweating; This is a spontaneous report from a contactable consumer, the patient. An 18-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0171) via an unspecified route of administration in the left arm on 13May2021 at 17:00 (at the age of 18-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported. The patient had known allergies to lactose (slightly lactose intolerant) and sever Acetaminophen allergy. The patient did not receive any other concomitant medications. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 13May2021 at 17:00, shortly after having the vaccination, the patient vision went very blurry and things became very distant in hearing, these side effects were hard to focus on however as he started sweating and felt like he was burned up. These effects lasted around 10 minutes. No therapeutic measures were taken as a result of reported events. The clinical outcome of the events vision went very blurry, things became very distant in hearing, hard to focus, felt like he was burned up and sweating were resolved on 13May2021 at 17:10 (after the duration of 10 minutes). No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652505
Sex: F
Age:
State: TX

Vax Date: 04/28/2021
Onset Date:
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: The same happen to another patient / his fingers went numb; This is a spontaneous report from another manufacturer company from contactable female consumer (patient). A female patient of unspecified age received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: Unknown), via an intramuscular route on 28Apr2021 as dose 2, single in the left arm for covid-19 immunisation. The patient medical history was not reported. The patient concomitant medications included Medication for blood pressure. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: Unknown), via an unspecified route on 21May2021 as dose 1, single for covid-19 immunisation. On unspecified date, the patient experienced that his fingers went numb. Patient called to report that after having the second dose of the vaccine on 28Apr2021 on the left, non-dominant arm, side effects developed. The same happen to another patient that received another covid19 vaccine. The patient wanted to knew what to do. The outcome of the event was unknown.; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021650410

Other Meds:

Current Illness:

ID: 1652506
Sex: F
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: since having the vaccine she is experiencing more pain with increased frequency; This is a spontaneous report from a sponsored program. A female patient of an unspecified age received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: Unknown), via an unspecified route on unspecified date as dose number unknown, single for covid-19 immunisation. The patient medical history included from Oct2019 to current rheumatoid arthritis and she had been experiencing flare ups. The patient concomitant medications were not reported. On an unspecified date, the patient experienced since having the vaccine more pain with increased frequency. Patient reports MD placed her on hold from Xeljanz for 12 days to have the covid vaccines. Patient notes since the hold she had been experiencing flare ups, MD not aware patient advised to contacted MD. Patient restarted Xeljanz a few weeks ago. The outcome of the event was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness: Rheumatoid arthritis

ID: 1652507
Sex: F
Age:
State: CA

Vax Date: 05/22/2021
Onset Date: 05/22/2021
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: Headaches all day; Extremely tired; No energy; This is a spontaneous report from a contactable consumer, the patient. A 58-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 22May2021 at 12:15 (at the age of 58-year-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient did not take any concomitant medication. The patient had no known allergies to medications, food or other products. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 22May2021 the patient experienced headaches all day and extremely tired no energy. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. The patient did not receive any treatment for the reported event. The clinical outcome of the events headaches all day and extremely tired, no energy were not recovered. The lot number for BNT162b2 was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1652508
Sex: F
Age:
State: KS

Vax Date: 03/31/2021
Onset Date: 04/01/2021
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: Period was two weeks later having both doses of Pfizer; This is a spontaneous report from a contactable consumer, the patient. A 25-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER8733) via an unspecified route of administration in the left arm on 31Mar2021 (at the age of 25-years-old) as a single dose for COVID-19 immunisation and the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0170) via an unspecified route of administration in the left arm on 21Apr2021 (at the age of 25-years-old) as a single dose for COVID-19 immunisation. The patient had no relevant medical history. The patient had no known allergies. The patient did not receive any medication within two weeks of 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. The patient did not receive any other vaccines within four weeks prior to the vaccination. On Apr2021, the patient was expecting her period within a week after the second dose but she had her period which was two weeks later on 13May2021 (delayed period), after having both doses of Pfizer. The patient's cycle was of 28-33 days long and this one was 55 days. The event did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. No therapeutic measures were taken as a result of the event. The clinical outcome of the event delayed period was resolved on 13May2021. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652509
Sex: F
Age:
State: TN

Vax Date: 03/18/2021
Onset Date: 04/18/2021
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:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I have a Nexplanon implant and do not experience menstruation typically since receiving the implant. I had light spotting in April 2021 and a full heavy period in May 2021.; I have a Nexplanon implant and do not experience menstruation typically since receiving the implant. I had light spotting in April 2021 and a full heavy period in May 2021.; This is a spontaneous report from a contactable consumer (patient herself). A 34-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot Number: EN6207), dose 2 via an unspecified route of administration, administered in Arm Left on 18Mar2021 at 07:15 as dose 2, single for COVID-19 immunisation. The patient received first dose of BNT162B2 (lot number: EN6198) administered in Arm Left on 25Feb2021 at 07:15 AM (at the age of 34-year-old) for COVID-19 immunisation. Medical history included Hidradenitis Suppurativa, depression and generalised anxiety disorder. The patient previously took nexplanon and experienced amenorrhoea (do not experience menstruation typically since receiving the implant). Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient did receive any other medications within 2 weeks of vaccination. Patient was not diagnosed with COVID 19 prior to vaccination. On 18Apr2021, the patient experienced i have a nexplanon implant and do not experience menstruation typically since receiving the implant. i had light spotting in april 2021 and a full heavy period in may 2021. Patient not received treatment for the adverse event. Since the vaccination, patient has not been tested for COVID-19. At the time of this report events outcome was unknown. Follow-Up (12Jul2021): Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652510
Sex: F
Age:
State:

Vax Date: 05/01/2021
Onset Date: 05/02/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Dehydration; Dry mouth; Unquenchable thirst; Urine that stayed yellow after drinking a lot of water; Dry stool and anus.; Dry stool and anus.; This is a spontaneous report from a contactable consumer, the patient. A 18-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the right arm on 01May2021 at 15:00 (at the age of 18-years-old) and the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the right arm on 22May2021 at 12:00 (at the age of 18-years-old), both as a single dose for COVID-19 immunisation. Medical history included depression. Concomitant medications included drospirenone (SLYND) for unspecified indication from unknown date. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient had no known allergies to medications, food or other products. The clinical course was reported as follows: on 02May2021, the patient experienced dehydration and dry mouth, unquenchable thirst, urine that stayed yellow after drinking a lot of water, dry stool and anus. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. The clinical outcome of the events dehydration, dry mouth, unquenchable thirst, urine that stayed yellow after drinking a lot of water, dry stool and anus was not recovered at the time of reporting. The batch/lot numbers for, BNT162b2, were not provided and will be requested during follow up.

Other Meds: SLYND

Current Illness:

ID: 1652511
Sex: F
Age:
State: TN

Vax Date: 03/15/2021
Onset Date: 05/15/2021
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: 2021; Test Name: Nasal Swab; Test Result: Negative ; Comments: covid test post vaccination

Allergies:

Symptom List: Nausea

Symptoms: I was late starting my menstrual cycle the month of May by 8 days; now been on my cycle for 7 days. My normal cycle is 4-5 days.; Had bodyaches the entire time.; This is a spontaneous report received from a contactable nurse (patient). A 42-years-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EN6201), via an unspecified route of administration, administered in Arm Left on 15Mar2021 at 15:30 (at the age of 42-years) as single dose for covid-19 immunization. Medical history included rheumatoid arthritis, hyperlipidaemia, covid-19 (prior to the vaccination the patient was diagnosed with COVID-19); all from an unknown date and unknown if ongoing. The patient had no known allergies. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any concomitant medications. The patient was not pregnant at the time of vaccination. On 15May2021 at 19:00, the patient reported that it was late starting her menstrual cycle the month of May by 8 days and now been on her cycle for 7 days. Her normal cycle was 4-5 days and had body aches the entire time. The patient did not receive any treatment for the events. Since the vaccination the patient was tested for COVID-19. The patient underwent lab tests and procedures which included nasal swab (sars-cov-2 test): negative on an unspecified date in 2021 (post vaccination). The outcome of events menstruation delayed, menstrual cycle prolonged and generalized aching was not resolved. Follow-up attempts are completed. No further information is expected

Other Meds:

Current Illness:

ID: 1652512
Sex: F
Age:
State:

Vax Date: 05/09/2021
Onset Date: 05/09/2021
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:

Allergies:

Symptom List: Injection site pain

Symptoms: tired; moderate headache; left arm pain at injection site; anxious; didn't sleep much that first night; This is a spontaneous report from a non-contactable consumer, the patient. A 44-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: EW0167) via an unspecified route of administration in the left arm on 09May2021 at 16:15 (at the age of 44-years-old) as a single dose for COVID-19 immunisation. Medical history included hypothyroidism. Concomitant medications included liothyronine (MANUFACTURER UNKNOWN), levothyroxine (MANUFACTURER UNKNOWN), iron (MANUFACTURER UNKNOWN) and melatonin (MANUFACTURER UNKNOWN); all taken for unknown indication on an unknown date and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: EW0161) via an unspecified route of administration in the left arm on 18Apr2021 at 16:15 (at the age of 44-years-old) as a single dose for COVID-19 immunisation. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 09May2021 at 16:15, the patient felt tired, moderate headache, left arm pain at injection site for about 48 hours after the vaccination. The patient was likely more tired the second day because the patient felt that this shot gave her adrenaline and made her anxious so she didn't sleep much that first night. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. No therapeutic measures were taken as a result of the events. The clinical outcome of the events tired, headache, left arm pain at injection site, anxious, didn't sleep much that first night were recovered on an unknown date in May2021 No follow-up attempts are needed. No further information is expected.

Other Meds: LIOTHYRONINE; LEVOTHYROXINE; IRON; MELATONIN

Current Illness:

ID: 1652513
Sex: F
Age:
State: CA

Vax Date: 04/14/2021
Onset Date: 04/14/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: After first shot stared to hear blood pressure in ears; This is a spontaneous report from a contactable consumer, the patient. A 45-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot EW0162, first dose) solution for injection intramuscular in the left arm on 14Apr2021 at 15:15 (at the age of 45-years-old) as a single dose for COVID-19 vaccination. The patient was not pregnant at the time of vaccination. Medical history included rheumatoid arthritis (RA). Concomitant medications included methotrexate sodium, adalimumab (HUMIRA), and folic acid. The patient did not receive any other vaccine within 4 weeks prior to the vaccine. Prior to the vaccination, the patient was not diagnosed with COVID-19. After first shot the patient started to hear blood pressure in ears on 14Apr2021 at 15:30. No treatment was provided for the event. The outcome of the event was not recovered. Since the vaccination, the patient has not been tested for COVID-19. Information on Lot/Batch number was available. Additional information has been requested. Follow-up (20Jul2021): Follow-up attempts are completed. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021651479 same patient/drug and different dose, different/similar event

Other Meds: METHOTREXATE SODIUM; HUMIRA; FOLIC ACID

Current Illness:

ID: 1652514
Sex: F
Age:
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
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: After first shot started to hear blood pressure in ears; This is constant and became worse after the second dose; This is a spontaneous report from a contactable consumer, the patient. A 45-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot EW0161, second dose) solution for injection intramuscular in the left arm on 05May2021 at 15:00 (at the age of 45-years-old) as a single dose for COVID-19 vaccination. The patient was not pregnant at the time of vaccination. Medical history included rheumatoid arthritis (RA). Concomitant medications included methotrexate sodium, adalimumab (HUMIRA), and folic acid. Historical vaccine included BNT162B2 (first dose, lot EW0161) for COVID-19 vaccination on 14Apr2021 and experienced hear blood pressure in ears. The patient did not receive any other vaccine within 4 weeks prior to the vaccine. Prior to the vaccination, the patient was not diagnosed with COVID-19. After first shot started to hear blood pressure in ears and this was constant and became worse after the second dose on 05May2021. No treatment was provided for the events. The outcome of the events was not recovered. Since the vaccination, the patient has not been tested for COVID-19. Follow-up (20Jul2021): Follow-up attempts are completed. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021651464 same patient/drug and different dose, different/similar event

Other Meds: METHOTREXATE; HUMIRA; FOLIC ACID

Current Illness:

ID: 1652515
Sex: F
Age:
State: MD

Vax Date: 06/03/2021
Onset Date: 06/03/2021
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: Intense shaking; This is a spontaneous report from a contactable consumer, the patient. A 15-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Lot number: UNKNOWN) via an unspecified route of administration in the left arm on 03Jun2021 at 14:00 (at the age of 15-years-old) as a single dose for COVID-19 immunisation. Medical history included asthma, psoriasis and depression. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient received unspecified medications within two weeks of vaccination. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Lot number: UNKNOWN) via an unspecified route of administration in the left arm on 13May2021 at 14:00 as a single dose for COVID-19 immunisation. The patient had known allergy to tree nuts. On 03Jun2021 at 00:00, 10 hours after injection the patient experienced intense shaking and could not stop and it was continuing at the 11th hour after injection. The event resulted in doctor or other healthcare professional office/clinic visit. It was unknown whether any therapeutic measures were taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event intense shaking was not recovered at the time of this report. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1652516
Sex: F
Age:
State: AL

Vax Date: 05/18/2021
Onset Date:
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: 2021; Test Name: Blood glucose; Result Unstructured Data: Test Result:fluctuating; Comments: glucose levels fluctuating

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: chest pain; severe headaches; SI joint pain; swollen lymph nodes; panic attacks; glucose levels fluctuating; This is a spontaneous report from a contactable healthcare professional reported for herself. A 39-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number and Expiration date was not reported) via an unspecified route of administration on 18May2021 at 16:15 (at the age of 39-years-old) as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 immunisation. Patient was not pregnant at the time of vaccination. Medical history was not reported. The patient did not receive any medication within two weeks of 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. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient experienced chest pain, Sacroiliac (SI) joint pain, severe headaches, swollen lymph nodes, panic attacks and glucose levels were fluctuating on unspecified date in 2021. The patient underwent lab tests and procedures which included blood glucose: fluctuating on unspecified date in 2021. The events resulted in a visit to the doctors or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were taken as a result of the events and included treatment with Augmentin and flexril. The clinical outcome of the events was recovering at the time of this report. Information about lot/batch number will be obtained during follow-up.

Other Meds:

Current Illness:

ID: 1652517
Sex: F
Age:
State:

Vax Date:
Onset Date: 05/27/2021
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: I have not had a minstral cycle since 2015 but after taking the second Pfizer dose Im experiencing minstral cramps and spotting.; I have not had a minstral cycle since 2015 but after taking the second Pfizer dose Im experiencing minstral cramps and spotting.; This is a spontaneous report received from a contactable consumer or other non-health care professional. A 54-year-old non-pregnant female patient received bnt162b2 (COMIRNATY, formulation: solution for injection, Batch/Lot Number: EW0161), via an unspecified route of administration on 01May2021 as dose 1, single and received bnt162b2 (COMIRNATY, formulation: solution for injection, Batch/Lot Number: EW0176), via an unspecified route of administration on an unspecified date, as dose 2, single for COVID-19 immunisation. The patient's medical history included none. No past drug events. No known allergies. Concomitant medication(s) were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any other medications within 2 weeks of vaccination. Prior to vaccination. The patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 27May2021, the patient experinced I have not had a menstral cycle since 2015 but after taking the second Pfizer dose I am experiencing menstral cramps and spotting. All the events were non-serious. The outcome of all the events was not recovered. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652518
Sex: F
Age:
State: IL

Vax Date: 04/02/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: huge area of discoloration behind my right knee and up the back of my thigh.; This is a spontaneous report from a contactable consumer, the patient. A 36-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER 8733) via an unspecified route of administration in the arm left on 02Apr2021 at 13:30 as a single dose for COVID-19 immunisation. Medical history included migraine and anxiety. Concomitant medications included rizatriptan benzoate (MAXALT) from unknown date for migraine, an unknown if on going and sambucus nigra (ELDERBERRY GUMMIES) from unknown date for an unknown indication, unknown if on going. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient had no known allergy. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6208) via an unspecified route of administration in the left arm on 12Mar2021 at 13:30 as a single dose for COVID-19 immunisation. On an unknown date in 2021, the patient experienced, huge area of discoloration behind her right knee and up the back of her thigh. The event resulted in doctor or other healthcare professional office/clinic visit. The patient did not receive any treatment for the event. The clinical outcome of the event huge area of discoloration behind right knee and up the back of thigh was recovering at time of this report. No follow-up attempts are needed. No further information is expected.

Other Meds: MAXALT; ELDERBERRY [SAMBUCUS NIGRA]

Current Illness:

ID: 1652519
Sex: F
Age:
State: MA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Fever; Chills; Aches in joints; Aches in kidney; Aches in bladder area; Headaches; Nausea; Diarrhea; Burning in nail beds of big toes; This is a spontaneous report from a contactable consumer, the patient. A 62-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 21May2021 at 09:30 (at the age of 62-years-old) as a single dose for COVID-19 immunisation. The patients' medical history was reported as none, the patient reported that she was healthy and was not on medications. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any medication within two weeks of the vaccination. The patient previously took FLAGYL and and codeine and experienced a drug allergy. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccination. On 21May2021 at 10:15, with in an hour, the patient experienced fever, chills, aches in joints and kidneys and bladder area, headaches, nausea, diarrhea and burning in nail beds of big toes. "All side effects lasted 4 days except the toes." Since the vaccination, the patient had not been tested for COVID-19. The events did not result in doctor or other healthcare professional office/clinic, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. The clinical outcome of the events fever, chills, aches in joints and kidneys and bladder area, headaches, nausea, diarrhea was resolved on 25May2021. The clinical outcome of the event burning in nail beds of big toes was resolved on an unknown date in 2021. The lot number for BNT162b2 was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1652520
Sex: F
Age:
State: FL

Vax Date: 04/14/2021
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: SYR
Vax Site: LA

Lab Data: Test Date: 2021; Test Name: White blood cell count; Result Unstructured Data: Test Result:3.1 (unknown units); Comments: A low white blood cell count

Allergies:

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

Symptoms: Blood work came back with a low white blood cell count of 3.1; This is a spontaneous report from a contactable consumer, the patient. A 53-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, lot number: ER2613) via an unspecified route of administration in the right arm on 14Apr2021 (at the age of 53-years-old) as a single dose for COVID-19 immunisation. The patient did not have any relevant medical history. The patient did not have any other medications in two weeks. The patient previously took codeine (MANUFACTURER UNKNOWN) for an unknown indication on an unknown date and experienced rashes. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, lot number, unknown) via an unspecified route of administration in the right arm on 24Mar2021 (at the age of 53-years-old) as a single dose for COVID-19 immunisation. 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 an unknown date in 2021, the patient blood work came back with a low white blood cell count of 3.1(unspecified units). The patient never ever had a low white blood cell and the patient gets her blood tested twice per year. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event blood work came back with a low white blood cell count of 3.1 was unknown at the time of this report. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652521
Sex: F
Age:
State: CA

Vax Date: 05/01/2021
Onset Date: 05/23/2021
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:

Allergies:

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

Symptoms: About a week after my first vaccination shot, I had an oral herpe breakout (bottom lip).; This is a spontaneous report from a contactable consumer (patient). A 38-year-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Lot number was not reported) dose 1 via an unspecified route of administration on May2021 (at the age of 38-year-old) as dose 1, single for COVID-19 immunisation. The facility in which the vaccination was administered was a hospital. Medical history included seasonal allergy from known Seasonal allergies, lactose intolerance from Known allergies, anxiety, depression from an unknown date and unknown if ongoing. Concomitant medication included bupropion hydrochloride, phentermine resin and vitamins. Prior to vaccination, it was unknown whether the patient was diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 23May2021 19:00 about a week after her first vaccination shot the patient experienced an oral herpes breakout. The patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection Lot Number: EW0178) dose 2 via an unspecified route of administration in the left arm on 02JUN2021 at 14:15 (at the age of 38-year-old) as a single dose for COVID-19 immunization. The event did not result in doctor office visit, emergency room. Therapeutic measures were taken as a result of event and included treatment with docosanol 10%. The clinical outcome of the event was resolved on an unspecified date of 2021. The lot number for BNT162b2 was not provided and will be requested during follow up.

Other Meds: WELLBUTRIN XL; ADIPEX [PHENTERMINE RESIN]

Current Illness:

ID: 1652522
Sex: F
Age:
State:

Vax Date: 06/02/2021
Onset Date: 06/03/2021
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: swollen tonsil; collar bone lymph node swollen; muscle tension in left arm, shoulder, and side of neck.; Severe pain and muscletension in left arm, shoulder, and sideof neck.; mild fever; irritability; fatigue; This is a spontaneous report from a non-contactable consumer, the patient. A 37-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 02Jun2021 (at the age of 37-years-old) as a single dose for COVID-19 immunisation. Medical history included fibromyalgia, sulfonamide allergy and fruit allergy (Bananas). Concomitant medications were not reported. The patient previously took aspirin (MANAFACTURER UNKNOWN) from an unknown date for an unspecified indication and experienced drug allergy. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in left arm on 12May2021 (at the age of 37-years-old) as a single dose for COVID-19 immunisation. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 03Jun2021, the patient experienced swollen tonsil, collar bone lymph node swollen, severe pain and muscle tension in left arm, shoulder, and side of neck. Mild fever, irritability, fatigue. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of events and included treatment with muscle relaxants. The clinical outcome of the events swollen tonsil, collar bone lymph node swollen, severe pain and muscle tension in left arm, shoulder, and side of neck. Mild fever, irritability, fatigue was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected

Other Meds:

Current Illness: Fruit allergy (banana allergy); Sulfonamide allergy (allergic to sulfa based antibiotics)

ID: 1652523
Sex: F
Age:
State:

Vax Date:
Onset Date:
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:

Allergies:

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

Symptoms: Metal taste in tongue 15 minutes after injection; Itchy eyes; Itchy skin; Runny nose; Nausea; caffeine-like mental excitedness mixed with body feeling very heavy; caffeine-like mental excitedness mixed with body feeling very heavy; This is a spontaneous report from a non-contactable consumer, the patient. A female patient of unknown age received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration on an unknown date as a single dose for COVID-19 immunisation. Medical history included allergy to red wine. Concomitant medications were not reported. The patient previously took TYLENOL and BENADRYL on unknown date for unknown indication and experienced drug allergy. 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 an unknown date in 2021, the patient experienced metal taste in tongue 15 minutes after injection, itchy eyes, itchy skin, runny nose, nausea, caffeine-like mental excitedness mixed with body feeling very heavy. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. The patient did not receive any treatment for the reported events. The clinical outcome of the events metal taste in tongue 15 minutes after injection, itchy eyes, itchy skin, runny nose, nausea, caffeine-like mental excitedness mixed with body feeling very heavy was not recovered at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1652524
Sex: M
Age:
State: SC

Vax Date: 05/27/2021
Onset Date: 05/31/2021
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: 4 days after first dose started getting frequent and severe heart palpitations at night lasting 4 - 8 hours.; This is a spontaneous report from a contactable consumer or other non-health care professional (Patient). A 38-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0191 and expiration date was no reported), first dose via an unspecified route of administration, administered in Arm Left on 27May2021 11:15 (at the age of 38 years) as single for covid-19 immunisation. Medical history included gastroesophageal reflux disease from an unknown date and unknown if ongoing. Concomitant medication(s) included ibuprofen (MANUFACTURER UNKNOWN) and acetaminophen (MANUFACTURER UNKNOWN) taken for an unspecified indication, start and stop date were not reported. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient was not diagnosed with COVID-19, prior vaccination and since the vaccination. On 31May2021 the patient experienced 4 days after first dose started getting frequent and severe heart palpitations at night lasting 4 - 8 hours. The adverse event resulted in Doctor or other healthcare professional office/clinic visit. The outcome of the event was unknown. Follow-up attempts are completed. No further information is expected.

Other Meds: IBUPROFEN; ACETAMINOPHEN

Current Illness:

ID: 1652525
Sex: F
Age:
State: FL

Vax Date: 02/23/2021
Onset Date: 02/23/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: upper body measles-type rash (stomach, chest, back); facial flush; This is a spontaneous report from a contactable other healthcare professional (patient) reported for herself. A 66-year-old (non-pregnant) female received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EL9267), via intramuscular route of administration, administered in the Left arm on 23Feb2021 at 14.00 as dose 1, single for COVID-19 immunisation. The patient's medical history includes known allergies to Benadryl, codeine, gadolinium contrast medium, PCN, Tramadol, Zyrtec, mushrooms. Other medical History includes, esophageal spasms, inverse psoriasis, tachycardia, IBS, Vitamin B & D deficiency. The patient's concomitant medications/List of other medications the patient received within 2 weeks of vaccination includes: Famotidine; Metoprolol; Trazodone; fexofenadine hydrochloride (ALLEGRA); colecalciferol (D3); cyanocobalamin (B12) all taken for unspecified indication and unknown if ongoing. 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. The adverse events (AE) start time was reported as 14:15, on 23Feb2021 the patient experienced upper body measles-type rash (stomach, chest, back); facial flush Symptoms began 12 minutes after medication dispensed IM Symptoms began dissipating 90 minutes after onset, completely cleared at 3 hours post injection. Seen at site by paramedics, suggested Benadryl, refused due to allergy; remained at site for 90 minutes, then sent home. Reaction reported to primary care physician 24Feb2021. No treatment received for the adverse events. Since the vaccination, patient has not been tested for COVID-19. The adverse events were reported as non-serious. The outcome of the adverse events was reported as recovered on 23Feb2021. Follow-up attempts are completed. No further information is expected.

Other Meds: FAMOTIDINE; METOPROLOL; TRAZODONE; ALLEGRA; D3; B12 [CYANOCOBALAMIN]

Current Illness:

ID: 1652526
Sex: M
Age:
State: FL

Vax Date: 05/24/2021
Onset Date: 05/28/2021
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:

Allergies:

Symptom List: Vomiting

Symptoms: Cold sores around the mouth; swollen lymph under chin; Swollen and pain on chin; Swollen and pain on chin; This is a spontaneous report from a contactable consumer, the patient. A 40-year-old male patient received unknown dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 24May2021 at 20:00 (at the age of 40-year-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19. The patient did not have any allergies to medications, food, or other products. Concomitant medication included amoxicillin (AMOXICILLIN). The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to vaccination, the patient was diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 28May2021, the patient experienced swollen and pain on chin, swollen lymph under chin and cold sores around the mouth. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. The clinical outcome of the events Cold sores around the mouth, pain on chin, swollen on chin and swollen lymph under chin were not resolved at the time of this report. The lot number for the vaccine BNT162b2, was not provided and will be requested during follow up.

Other Meds: AMOXICILLIN

Current Illness:

ID: 1652527
Sex: F
Age:
State: TX

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Period started the week got the vaccine. It normally lasts 5-7 days, but it hasn't stopped since.; This is a spontaneous report from a contactable consumer, the patient. A 16-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER8731), via an unspecified route of administration in the left arm on 10Apr2021 at 10:30 (at the age of 16-years-old), as a single dose for COVID-19 immunisation. Medical history included seasonal allergies. Concomitant medications included ibuprofen (ADVIL), pseudoephedrine hydrochloride; cetirizine hydrochloride (ZYRTEC D 12HR), fluoxetine (MANUFACTURER UNKNOWN) capsule PO 20mg; all from unknown dates for unspecified indications. On 16Mar2021, the patient received meningococcal vaccine B rfHbpA/fHpB (MEN-B (TRUMENBA) PFS) vaccine in the right arm within four weeks of 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 11Apr2021, the patient experienced period started the week she got the vaccine.It normally lasts 5-7 days but it hasn't stopped since. The event did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the event. The clinical outcome of the event period started the week she got the vaccine, it normally lasts 5-7 days but it hasn't stopped since was not resolved at the time of reporting. The patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0167), via an unspecified route of administration on 01May2021 at 10:30 (at the age of 16-years-old), as a single dose for COVID-19 immunisation. No follow-up attempts are needed. No further information is expected.

Other Meds: ADVIL [IBUPROFEN]; ZYRTEC-D 12 HOUR; FLUOXETINE

Current Illness:

ID: 1652528
Sex: M
Age:
State: MI

Vax Date: 06/03/2021
Onset Date: 06/05/2021
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: Test Name: Body temperature; Result Unstructured Data: Test Result:101

Allergies:

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

Symptoms: Rash on both legs from top of feet about 8 inches up the leg; fatigue; muscle soreness; fever for 1.5 days/ fever (a bit over 101); nausea; achiness; This is a spontaneous report from a contactable consumer (patient). A 12-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: EW0176), intramuscular in left arm on 03Jun2021 15:15 (at the age of 12-years-old) as dose 2, single for COVID-19 immunization. Medical history included urticaria pigmentosa from 2010 (started to present in the summer of 2010, when he was 1.5years old. It has nearly completely gone away. No flare ups for few years/getting better over the last 3 years). Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: EW0169), intramuscular in left arm on 13May2021 15:00 as dose 1, single for COVID-19 immunization. There were no concomitant medications. Prior to vaccination, the patient was not diagnosed with COVID-19, did not receive any vaccines within four weeks and was not having any known allergies. The patient experienced rash on both legs from top of feet about 8 inches up the leg on 05Jun2021 10:13, fatigue, muscle soreness, fever for 1.5 days/ fever (a bit over 101), nausea and achiness on 05Jun2021. The patient called physician and mentioned over the phone about rash on both legs from top of feet about 8 inches up the leg. The patient was treated with Benadryl for 2 days. It was reported that rash came 1.5 days after shot and lasted about a day. Outcome of all events was resolved on 06Jun2021. Comments: Got his vaccine at 03:15 PM on 03Jun2021. The morning of 05Jun2021 around 10 AM, alerted me to the rash on his ankles over about 1.5 days, it got worse later spread to feet and up to knee and then eventually went away. He also had the usual side effect of fever (a bit over 101), achiness, fatigue, and nausea. Withheld is a 12-years-old. The nurse kept in touch with me over the phone and had me give him Benadryl. She was going to home to have him go to the emergency room (ER), until pointed at that he has urticaria pigmentosa.

Other Meds:

Current Illness:

ID: 1652529
Sex: M
Age:
State: NJ

Vax Date: 03/01/2021
Onset Date: 03/04/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Major change in bowel function; Stools became Messy, sticky and smelly, totally uncharacteristic of my prior functioning; This is a spontaneous report from a contactable consumer (patient). A 75-year-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EN6205) via an unspecified route of administration in right arm on 01Mar2021 (at the age of 75-year-old) as single dose for COVID-19 immunization. Medical history of the patient included Prostate cancer 2006. No other medications/concomitant within two weeks. Patient did not receive any other vaccine in four weeks. Patient did not have COVID prior vaccination and was not tested for COVID post vaccination. Patient previously took Penicillin on an unspecified date and experienced allergy. Patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EM9808) via an unspecified route of administration in right arm on 08Feb2021 as single dose for COVID-19 immunization. On 04Mar2021, three days after receiving second dose of vaccination, patient experienced major change in bowel function, stools became messy, sticky, and smelly, totally uncharacteristic of his prior functioning. Condition was persisting for 3 months. AE resulted in visit to Doctor or other healthcare professional office/clinic visit. Patient tried various supplements with no change. Outcome of the events were not resolved. Follow-Up (15Jul2021, 30Jul2021): Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1652530
Sex: F
Age:
State: CA

Vax Date: 06/04/2021
Onset Date: 06/05/2021
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:

Allergies:

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

Symptoms: Appetite lost; This is a spontaneous report from a contactable consumer, the patient. A 64-years-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 04Jun2021 at 15:45 (at the age of 64-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient had no known allergy. 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 05Jun2021, at 04:00 the patient experienced appetite lost. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the reported events. The clinical outcome of the event appetite lost was unknown at the time of this report. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1652531
Sex: F
Age:
State: CA

Vax Date: 06/01/2021
Onset Date: 06/01/2021
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: Lymph nodes under right armpit is very swollen; Ankles became swollen; This is a spontaneous report from a contactable consumer, the patient. A 57-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the right arm on an unknown date in Jun2021 at 13:00 (at the age of 57-years-old) as a single dose for COVID-19 immunisation. Medical history included allergy (makeup) and fruit allergy (Mango). The patient did not receive any medication within two weeks of vaccination. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the right arm on an unknown date in May2021 at 13:00 (at the age of 57-years-old) as a single dose for COVID-19 immunisation. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On an unknown date in Jun2021, the patient experienced lymph nodes under right armpit was very swollen, also noticed the day she had the shot, both her ankles became swollen as well. That had subsided, but swollen lymph nodes remained. Including in the back of her head. The patient did not receive any treatment for the events. The clinical outcome of the event lymph nodes under right armpit was not recovered. While that of ankles became swollen was recovered on an unknown date in Jun2021. Information on the lot/batch number has been requested.

Other Meds:

Current Illness: Allergy (Known Allergies: makeup); Fruit allergy (Known Allergies: Mangos)

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am