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: 1712019
Sex: F
Age:
State: CA

Vax Date: 09/05/2021
Onset Date: 09/06/2021
Rec V Date: 09/18/2021
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: Muscle pain; Joint pain; Feeling dizzy/dizzness; Unwell; Swollen lymph nodes; Swelling of throat; Weakness; This is a spontaneous report from a contactable consumer, the patient. A 49-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2588) via an unspecified route of administration in the left arm on 05Sep2021 (at the age of 49-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported. 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 vaccination. The patient received unspecified concomitant medications from an unknown date for an unknown indication and unknown if ongoing. On 06Sep2021, the patient experienced muscle pain, joint pain, feeling dizzy and unwell, swollen lymph nodes, swelling of throat, dizziness and weakness. The events did not result in a visit to the doctors or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events muscle pain, joint pain, feeling dizzy/dizzness, unwell, swollen lymph nodes, swelling of throat and weakness was not resolved at the time of report.

Other Meds:

Current Illness:

ID: 1712020
Sex: F
Age:
State: CO

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/18/2021
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: Metallic taste within minutes of injection; This is a spontaneous report from a contactable other healthcare professional, the patient. A 34-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: 301358a) via an unspecified route of administration in the left arm on 11Sep2021 at 11:30 (at the age of 34-years-old) as a single dose for COVID-19 immunisation. The patient did not have any medical history. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. The patient did not take any concomitant medications. On 11Sep2021 at 11:45, within minutes of injection, the patient experienced metallic taste. 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. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event metallic taste within minutes of injection was resolving at the time of this report.

Other Meds:

Current Illness:

ID: 1712021
Sex: M
Age:
State: GA

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/18/2021
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:

Allergies:

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

Symptoms: Just not feeling well; Nausea; fluttering in stomach (butterflies instomach feeling); This is a spontaneous report from a non-contactable consumer, the patient. A 48-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FE3592) via an unspecified route of administration in the left arm on 07Sep2021 at 18:45 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. Medical history included hyperlipidemia. The patient did not have any known allergies. 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-19 vaccine. Concomitant medications included colecalciferol (VITAMIN D3), acetylsalicylic acid (ASPIRIN), curcuma longa rhizome (TURMERIC) and unspecified multivitamin; all from an unknown date for an unknown indication and unknown if ongoing. On 07Sep2021 at 18:45, the patient was not feeling well, nausea and fluttering in stomach (butterflies in stomach feeling). The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the events. The clinical outcome of the events just not feeling well, nausea and fluttering in stomach (butterflies in stomach feeling) was not resolved at the time of report. No follow-up attempts are possible. No further information is expected.

Other Meds: VITAMIN D3; ACETYLSALICYLIC ACID; TURMERIC [CURCUMA LONGA RHIZOME]

Current Illness:

ID: 1712022
Sex: F
Age:
State: VA

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/18/2021
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: Swelling under the armpit on the left side where the injection was taken on the upper part of the arm; Under arm felt really weird like irritated; Under arm felt really weird like irritated and painful from movement; This is a spontaneous report from a contactable other healthcare professional, the patient. A 30-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 10Sep2021 at 14:00 (at the age of 30-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history and no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. The patient did not receive concomitant medications. On 10Sep2021 at 23:00, the night of the vaccination, the patient's under arm felt really weird like irritated and painful from movement. On 11Sep2021, the patient experienced swelling under the armpit on the left side where the injection was taken on the upper part of the arm. 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. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events underarm felt really weird like irritated and painful from movement and swelling under the armpit was unknown at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1712023
Sex: F
Age:
State: NY

Vax Date: 05/28/2021
Onset Date: 09/04/2021
Rec V Date: 09/18/2021
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: Sharp pain in right hip; Right leg muscular pain; Irregular period; This is a spontaneous report from a contactable consumer, the patient. A 32-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0179) via an unspecified route of administration in the right arm on 28May2021 at 10:00 (at the age of 32-years old) as a single dose for COVID-19 immunisation. Medical history included COVID-19 from an unknown date. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications were not reported. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EP8036) via an unspecified route of administration in the right arm on 07May2021 at 10:00 (at the age of 32-years old) as a single dose for COVID-19 immunisation. On 04Sep2021, the patient experienced sharp pain in right hip, right leg muscular pain and irregular period. 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 event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events sharp pain in right hip, right leg muscular pain and irregular period was not recovered at the time of report.

Other Meds:

Current Illness:

ID: 1712024
Sex: F
Age:
State:

Vax Date: 05/14/2021
Onset Date:
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Test Date: 20210906; Test Name: Nasal Swab; Result Unstructured Data: Test Result: Unknown result.

Allergies:

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

Symptoms: Heart palpitations since receiving the 2nd dose; This is a spontaneous report from a non-contactable consumer, the patient. A 49-year-old female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0185) via an unspecified route of administration in the left arm on 14May2021 (at the age of 49-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported. 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-19 vaccine. Concomitant medications included atenolol (MANUFACTURER UNKNOWN) and verapamil (MANUFACTURER UNKNOWN); both for an unknown indication from unknown date and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER8729) via an unspecified route of administration in the left arm on 23Apr2021 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. On an unknown date in 2021, since receiving second dose, the patient experienced heart palpitations. The heart palpitations resulted in doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient had been tested for COVID-19. On 06Sep2021, the patient underwent Nasal Swab SARS CoV-2 test and the result was unknown. Therapeutic measures were not taken as a result of heart palpitations. The clinical outcome of the event heart palpitations was not resolved at the time of this report. No follow-up attempts are possible. No further information is expected.

Other Meds: Atenolol; Verapamil

Current Illness:

ID: 1712025
Sex: F
Age:
State: MI

Vax Date: 09/09/2021
Onset Date: 09/10/2021
Rec V Date: 09/18/2021
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: This is a spontaneous report from a contactable consumer, the patient. A 48-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FE3592) via an unspecified route of administration in the left arm on 09Sep2021 at 14:30 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. Medical history included bad disk in back. The patient had no known allergies. 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 vaccination. Concomitant medications included meloxicam (MANUFACTURER UNKNOWN) for an unspecified indication from an unknown date and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3181) via an unspecified route of administration in the left arm on 16Aug2021 at 10:00 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. On 10Sep2021 at 07:00, the patient had swelling in left armpit. The patient woke up with a migraine and vomiting. On 11Sep2021, whole next day, the patient felt exhausted and slept. 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. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events swelling in left armpit, migraine, vomiting, exhausted and slept the whole next day were resolving at the time of this report.

Other Meds: MELOXICAM

Current Illness:

ID: 1712026
Sex: M
Age:
State: IL

Vax Date: 09/05/2021
Onset Date: 09/01/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Test Date: 202105; Test Name: COVID; Test Result: Positive ; Comments: diagnosed with COVID then I formally tested and I did test Positive so that was through May.

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: dealing with this dehydration through the night and probably for days; Soreness from his arm/ Arm pain; Felt like he had to urinate a lot; Mild to moderate headache; waking up a lot during the night to use the bathroom several times; feeling some kidney pain, he was experiencing kidney pain, bad kidney pain; tiny little bit of warm sensation in my heart; develop a headache which was kind of like a hangover headache; just got tired; little bit of chills and body ache; little bit of chills and body ache; little bit of foggy headedness; the diuresis was probably the cause behind the headache; This is a spontaneous report Pfizer from a contactable consumer (patient). A male patient of an unspecified age reported for himself that he received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot Number: FC3184; Expiration Date: Oct2021), via an unspecified route of administration on 05Sep2021 at 15:30 PM as DOSE 1, SINGLE for covid-19 immunisation. Medical history included allergy sensitive person from an unknown date and unknown if ongoing (Event verbatim: allergy sensitive person little more hyper allergic to things and so I have that type of tendency), covid-19 from Feb2020 to an unknown date (had COVID back in last year Feb. I can down with COVID, never officially diagnosed because there wasn't very good testing method but I could tell I had the respiratory pump then I was shut down pretty hard for about a month), covid-19 from May2021 to an unknown date (I got COVID and I got it even the worse than I had it in the first time I did not get admitted to the hospital but I did have to go in that second time it hit me gastro-intestinally in the lungs again and also very much in the kidneys. And I had this site burning the sunburn type feeling for properly about week and a half or two weeks and when they diagnosed with COVID then I formally tested and I did test Positive so that was through May). The patient concomitant medications were not reported. Additional context stated, The patient was a doctor and was calling about covid-19 vaccine for himself. This sunday, on 05Sep2021, he received the first dose of the Pfizer COVID-19 Vaccine at 15:30 in the afternoon and about 5 hours later he started experiencing soreness from his arm, he talking big deal with that and then 8 hours after the first dose, he said it felt like he had to urinate a lot and so he started drinking more water and then went to bed and later experienced mild to moderate headache throughout the night and was waking up a lot during the night to use the bathroom several times. The patient took some Tylenol and had been taking an aspirin and now he was feeling some kidney pain. So, he took another Tylenol and he said even now he still has a 'doe ache' and he did have some questions too because he had COVID back in last year Feb(history) and then he said he was hit bad for about a month and then he had COVID again this past May and now he was questioning if he should receive the second dose after 21 days after the first? The reporter stated as, 'So done the last week, I got to about 4 months and this last Sunday I decided to vaccinate and I did the Pfizer shot and it was interesting and I did it at 15:30 in the afternoon. Five hour and I had the no problems, just a tiny little bit of warm sensation in my heart but like a little like there was a little hot water in there and then I, at about 5 hours I started getting the arm pain and that wasn' a big deal and then at 8 hours I noticed I started to have to urinate more and now it's like wow, this is reminding me a little bit of what I went to look this second COVID the dehydration, the excessive dehydration. So this time I am going to be smarter, I am going to rest and I am going to hydrate very vigorously. So I drink some water went to bed and then I develop a headache which was kind of like a hangover headache from dehydration because throughout the night I have to wake up and go urinate which was compulsory for me and I figured okay so I am going to be dealing with this dehydration through the night and probably for days, so just keep hydrating and will see what the body is doing, flushing this out or something else is going on but just (voice not clear) well this is a mild (voice not clear), so I went about the whole day like that just laying bed truly rested and that was the smartest thing to do and then I just got tired, I got a little bit of chills and body ache and this is all to be expected and then I did take a Tylenol with an aspirin (treatment) and it helped me relieve in arm pain and all the headache pain and everything and I was able to sleep. It gave me a good 6-7 or 7-8 hours of sleep. And then I woke up with really bad kidney pain like someone punched me in my kidneys on both sides and I am like god this really hurts bad and then I started let'ee what it does if it's kind of go down and about 3 hours after and it just didn' improve, so I was like I am going to do another Tylenol and I am not taking plenty of them so then with took Tylenol its took away all the pain and I was able to sleep and then the next day I had the 'doe ache' my kidneys and you know little bit of foggy headedness and thinks to be expected. So I talked couple of my patients about and couple other people and I thought yeah it wasn't that bad I had the same type symptoms that's why the kidney pain hurt that bad and the diuresis was probably the cause behind the headache, but when I was telling them they said wow that sounds like how I felt like on my second dose (further clarification unknown hence split not made) and I was like interesting this was my first dose. So the reason I am calling you guys is I kind of want to get you guidance because if I felt like this on my first dose and it's what several people have said how they felt on their second. I am wondering should I be very practice a little more reservation in getting the second dose? Like could I really over amplifying my immune system like historically I would say I was a very allergy sensitive person growing up, that I would be a little more hyper allergic to things and so I have that type of tendency that I am wondering like from what I am telling me do I risk that I can cause like some immuno damage on the second dose if I don't give it enough time or (incomplete sentence)'. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on May2021 (diagnosed with COVID then I formally tested and I did test Positive so that was through May). Therapeutic measures were taken as a result of soreness from his arm, mild to moderate headache, waking up a lot during the night to use the bathroom several times, feeling some kidney pain, develop a headache, hangover and little bit of chills and body ache. The outcome of the events soreness from his arm, mild to moderate headache, waking up a lot during the night to use the bathroom several times was recovered on an unspecified date in Sep2021; event feeling some kidney pain was not recovered and rest of the events was unknown.

Other Meds:

Current Illness:

ID: 1712027
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/18/2021
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: under the arm where I got the vaccine which is my right arm, is swollen; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, batch/lot number was not reported) via an unspecified route of administration at right arm on an unspecified date as dose number unknown, single for covid-19 immunization. The patient medical history and concomitant medications were not reported. On an unspecified date the patient experienced under the arm where I got the vaccine which was my right arm, was swollen. The outcome of the event was unknown. Follow-up attempts are completed. No further information is expected. Batch/lot number not available for BNT162B2.

Other Meds:

Current Illness:

ID: 1712028
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/18/2021
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: Having heart issues; This is a spontaneous report from a contactable consumer. A male patient of an unspecified age received bnt162b2 (PFIZER BIONTECH COVID-19 VACCINE, Solution for injection and Lot number: Not reported), via an unspecified route of administration on an unspecified date as dose number unknown, single for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient experienced having heart issues on an unspecified date. The outcome of the event was unknown. No follow-up attempts are possible. Information about batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1712029
Sex: M
Age:
State: NC

Vax Date: 02/06/2021
Onset Date: 02/09/2021
Rec V Date: 09/18/2021
Hospital: Y

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

Lab Data: Test Date: 20210204; Test Name: Cat scan; Test Result: Negative ; Test Date: 20210209; Test Name: EEG; Result Unstructured Data: Test Result:Facio Brachial Dystonia; Test Date: 20210427; Test Name: Spinal tap; Result Unstructured Data: Test Result:Clear; Test Date: 20210204; Test Name: MRI; Test Result: Negative ; Test Date: 20210816; Test Name: MRI; Test Result: Negative ; Test Name: Pet scan; Test Result: Negative

Allergies:

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

Symptoms: couldn't get up; seizures/Multiple seizure episode at home; ketoacidosis; started falling; EEG on 09Feb2021: Facio Brachial Dystonia; This is a spontaneous report from a contactable consumer or other non hcp. A 73-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 intramuscular, administered in Arm Right on 06Feb2021 14:30 (at age of 73 years)(Lot Number: EN9581) as DOSE 2, SINGLE for covid-19 immunisation. Medical history included Diabetes type-2, High blood pressure, High cholesterol, all from 01Jan2005 and ongoing and Seizure episode affecting left side from 27Jan2021 to an unknown date (1 episode lasting 30-45 sec, MRI with/without contrast (Negative result)). Historical Vaccine included first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE), dose 1, intramuscular, administered in Arm left at single dose on 16Jan2021 02:30 pm(at age of 73 years),( lot number: EL3248) for Covid-19 immunization and experienced seizure episodes Multiple. Prior vaccinations within 4 weeks was None. Concomitant medication(s) included amlodipine besilate, benazepril hydrochloride (LOTREL) orally for Blood pressure, atorvastatin calcium (LIPITOR) orally for Cholesterol, empagliflozin orally for Diabetes type-2, insulin glargine (LANTUS) for Diabetes type-2, metformin oral for Diabetes type-2, all from an unspecified start date and ongoing. The patient experienced ketoacidosis on 06Mar2021 with outcome of unknown , seizures/multiple seizure episode at home on 04Mar2021 with outcome of not recovered , required visit to Emergency room, solumedrol and Dexamethasone received as treatment, Seriousness criteria: Life threatening, Hospitalization, Persistent/significant disability/ Incapacity; couldn't get up transported to hospital by ambulance on 24Aug2021 with outcome of unknown , started falling on 08Mar2021 with outcome of unknown , spinal tap-liquid clear on 27Apr2021 with outcome of unknown. The patient was hospitalized for ketoacidosis from 06Mar2021 to 16Mar2021. The patient was hospitalized for seizures/multiple seizure episode at home from 08Feb2021 to 22Feb2021. The patient was hospitalized for couldn't get up from 25Aug2021 to 28Aug2021. The patient underwent lab tests and procedures which included: MRI on 04Feb2021, 16Aug2021 with Result as Negative (Comments: Did tests MRIs); Cat scan on 04Feb2021 (negative); EEG on 09Feb2021: Facio Brachial Dystonia; Pet scan Between 03Jun2021 and 12Jun2021(unknown date), Result: Negative; Spinal tap on 27Apr2021 (Result: Clear).

Other Meds: LOTREL [AMLODIPINE BESILATE;BENAZEPRIL HYDROCHLORIDE]; LIPITOR; EMPAGLIFLOZIN; LANTUS; METFORMIN

Current Illness: Blood pressure high; Diabetes mellitus; High cholesterol

ID: 1712030
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/18/2021
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: Tiredness/I just had tiredness; diarrhea/Have had some diarrhea; Little bit of cramping in my feet; stomach issue; This is a spontaneous report from a contactable consumer or other non-health care professional (patient). A 56-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration (at the age of 56-years), on an unspecified date as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On an unspecified date, the patient experienced tiredness/i just had tiredness, diarrhea/have had some diarrhea, little bit of cramping in my feet, stomach issue. It was further stated that patient stated that okay I got my shot 2 weeks no way, is it 3 weeks apart, anyway I am supposed to get my second shot tomorrow and I have had some diarrhea all day yesterday and today and I am not sure if I am still, if they are still going to give that to me tomorrow, do you know. Consumer stated, okay so you do not know the answer. Consumer was informed about the role of Pfizer Drug Safety Department and also informed that Pfizer Medical Information is the concerned department to answer the question that consumer have and offered the number. When probed if diarrhea was caused because of the first vaccine or of some other reason, Patient stated, I have no idea, I have not had diarrhea in a very long time now but I have no idea how I got it, and I mean I do not have any other symptoms other than just that I do not feel, nothing was wrong other than just that. So, I do not know I mean I am not a doctor, so I have no idea if it was from this Pfizer shot. Patient stated that I just had tiredness. Patient stated, Yeah, I mean have there been any, I am kind of concern about the second shot because I have heard people say that there is, you get sick sometimes and stuff and I guess I am kind of concerned about that, has there been any effects from the second shot? Patient stated, I mean I do not know what the report is for, I mean I do not know, I am not sure what, I am kind of confuse you are asking me questions and I am answering, but I do not know, I mean. Patient stated that okay, you can report it if you want, I have tiredness after the first shot, and may be a little bit of cramping in my feet and stuff that I noticed, but other than that I have felt pretty good, I mean I think I worry about things a little bit, so maybe we all may be think things, I was fine with the first one. Like I said I am leaving out of town on Thursday, so I don't want to feel sick through my trip and I do not want it to cause me any problems with me already having some stomach issue. So I need to find that out, because I do not want, because I am having stomach issue right now is that going to cause more problems getting the shot, that is my main concern, so I will call that number tomorrow, yes you can file that, and yes they can give me a follow up. The clinical outcome for all the events was reported as unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1712031
Sex: F
Age:
State: AZ

Vax Date: 08/17/2021
Onset Date: 08/18/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Over sleeping; Congestion; Severe lethargy; Night sweats; This is a spontaneous report from a contactable other healthcare professional, the patient. A 27-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 17Aug2021 at 18:30 (at the age of 27-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported and the patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included amfetamine/dexamfetamine (MANUFACTURER UNKNOWN) from an unknown date for unspecified indication and unknown if ongoing. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 18Aug2021 at 07:00, the patient experienced severe lethargy, over sleeping, night sweats, and congestion. The events did not result in doctor or other healthcare professional office/clinic, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the events. The clinical outcome of the events severe lethargy, over sleeping, night sweats, congestion was resolving at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.

Other Meds: AMFETAMINE;DEXAMFETAMINE

Current Illness:

ID: 1712032
Sex: F
Age:
State:

Vax Date:
Onset Date: 09/08/2021
Rec V Date: 09/18/2021
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: Severe diarrhea; This is a spontaneous report from a non-contactable consumer, the patient. A 37-year-old female patient received 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 and also received second 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. The medical history was not reported. Prior to the vaccination, the patient was not diagnosed with COVID-19. The concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 08Sep2021, the patient experienced severe diarrhea. The event did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient was not tested for COVID-19. Therapeutic measures were not taken as a result of the reported event. The clinical outcome of the event severe diarrhea was not resolved 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: 1712033
Sex: F
Age:
State: MT

Vax Date: 04/23/2021
Onset Date:
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Test Date: 2021; Test Name: shingles; Test Result: Positive

Allergies:

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

Symptoms: another doctor who recently treated a female patient with the same symptoms who was test for Shingles and tested positive; this person also received the Pfizer COVID 19 vaccine in the same time frame; This is a spontaneous report from a contactable consumer or other non hcp. A female patient of an unspecified age received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19, Solution for injection, lot number: unknown), via an unspecified route of administration, administered in Arm Right on 23Apr2021 12:00 as DOSE 2, SINGLE for covid-19 immunisation. The patient medical history was not reported. The patient's concomitant medications were not reported. Historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19, Solution for injection; Lot number: unknown), via an unspecified route of administration on 02Apr2021 12:00 administered in left arm as single dose for COVID-19 immunisation. The patient experienced another doctor who recently treated a female patient with the same symptoms who was test for shingles and tested positive; this person also received the pfizer covid 19 vaccine in the same time frame on 2021. The patient underwent lab tests and procedures which included herpes zoster: positive on 2021. The outcome of event was unknown.

Other Meds:

Current Illness:

ID: 1712034
Sex: F
Age:
State:

Vax Date: 09/08/2021
Onset Date: 09/09/2021
Rec V Date: 09/18/2021
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: Fatigue; Tingling of teeth; Heaviness in chest; Dizzy; This is a spontaneous report from a non-contactable consumer, the patient. A 14-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 on 08Sep2021 (at the age of 14-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported and the patient had no known allergies. 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-19 vaccine. The patient did not receive any concomitant medications. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date in Aug2021 (at the age of 14-years-old) as a single dose for COVID-19 immunisation. On 09Sep2021, 24 hours after the vaccination, the patient experienced fatigue, tingling of teeth, heaviness in chest and dizzy. The events did not result in a visit to the doctors or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events fatigue, tingling of teeth, heaviness in chest and dizzy was resolved on an unknown date in Sep2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1712035
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/18/2021
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: This is a spontaneous report from a contactable consumer (patient herself). A 69-years-old female patient received bnt162b2 (COMIRNATY, Formulation: Solution for injection, Batch/Lot Number- Unknown) via an unspecified route of administration, administered on unknown date as DOSE 2, SINGLE for covid-19 immunisation. The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Batch/Lot Number- not reported) via an unspecified route of administration, administered on unknown date as Dose 1, single. Patient had has low immune system. The patient medical history and concomitant medications were not reported. On an unspecified date, the patient experiencing chills, headache and fever. The outcome of event was not unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness: Immune system disorder (she has low immune system)

ID: 1712036
Sex: M
Age:
State: WA

Vax Date: 09/05/2021
Onset Date: 09/08/2021
Rec V Date: 09/18/2021
Hospital: Y

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: Patient administered first dose of Pfizer-BioNTech Covid-19 Vaccine on 05Sep2021 and second dose on 07Sep2021; sleeping a lot; has not been opening his eyes; has not been much responsive; This is a spontaneous report from a contactable consumer or other non-health care professional. A 68-year-old male patient received bnt162b2 (PFIZER BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: FD0809, NDC and UPC number: unknown) dose 1 via an unspecified route of administration on 05Sep2021 (at the age of 68 years old) as dose 1, single and dose 2 via an unspecified route of administration on 07Sep2021 (Lot Number: FF2589) as dose 2, single for COVID-19 immunization at hospital. Vaccine was not administered at military facility. Medical history included urinary tract infection but prior to these events the patient was admitted to the hospital on 01Sep2021 for a urinary tract infection and was discharged home on 08Sep2021. Concomitant medication(s) included atorvastatin calcium; docusate; ferrous sulphate; midodrine; milk of magnesia; pantoprazole; quetiapine; dutasteride accord; fludrocortisone acetate; levetiracetam; venlafaxine; spiriva handihaler (tiotropium bromide monohydrate); cholecalciferol; acetaminophen; montelukast sodium; senna glycosides; amoxicillin taken from 08Sep2021 and. Investigation assessment was reported as unknown. He has other unspecified medications that are prescribed only as needed and have not been taken in the 2 weeks prior to onset of events. On an unspecified date the patient experienced patient administered first dose of pfizer-BioNTech covid-19 vaccine on 05sep2021 and second dose on 07sep2021. On 08Sep2021 sleeping a lot, has not been opening his eyes, has not been much responsive. Reporter stated that these doses were administered while the patient was hospitalized for unrelated reason. The clinical outcome of the events was unknown. No follow-up attempts are possible. No further information is expected

Other Meds: ATORVASTATIN CALCIUM; DOCUSATE; FERROUS SULFATE; MIDODRINE; MILK OF MAGNESIA; PANTOPRAZOLE; QUETIAPINE; DUTASTERIDE ACCORD; FLUDROCORTISON; LEVETIRACETAM; VENLAFAXINE; SPIRIVA HANDIHALER; CHOLECALCIFER EG; ACETAMINOPHEN; MONTELUKAST [MONTEL

Current Illness:

ID: 1712037
Sex: F
Age:
State: TX

Vax Date: 08/19/2021
Onset Date: 08/19/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Test Date: 20210820; Test Name: BP; Result Unstructured Data: Test Result:high then low; Comments: my BP is high then low; Test Name: CT scan; Result Unstructured Data: Test Result:normal; Test Date: 20210820; Test Name: heartbeat; Result Unstructured Data: Test Result:106-120; Comments: rapid heartbeat 106-120 sporadically

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: muscle discomfort on my left arm and leg; rapid heartbeat 106-120 sporadically; nausea; lightheadedness & tightness; lightheadedness & tightness; random dizzy episodes; intermittent muscle pains in my left arm & left leg; BP is high then low; fatigue; Sleeping is irregular; pressure headache/pressure pounding headaches; my booster 19Aug2021; my booster 19Aug2021; This is a spontaneous report from a contactable consumer. This 48-year-old female consumer (patient) reported that: A 48-year-old female (Non pregnant) patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot Number: FC3183) via an unspecified route of administration, administered in arm left on 19Aug2021 as dose 3, (age at the time of vaccination 48-years-old), single for covid-19 immunization. The patient previously took first dose of received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot Number: EL9262) via an unspecified route of administration, administered in arm left on 22Jan2021 12:00 PM as dose 1, and dose 2 bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot Number: EL9266) via an unspecified route of administration, administered in arm left on 12Feb2021 (age at the time of vaccination 47-years-old), single for covid-19 immunization. The patient medical history included Thyroid. Patient was known allergies to PCN and Tramadol. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Other medications in two weeks RX by my doctor. I have been having symptoms since my booster 19Aug2021. I was able to manage the first few days after my shot because I knew/researched what is expected. On 20Aug2021 07:00AM, the patient stated my pressure pounding headaches are continuous, rapid heartbeat 106-120 sporadically with nausea, lightheadedness and tightness, random dizzy episodes, and intermittent muscle pains in my left arm & left leg-same side as my shot, my BP is high then low. Sleeping is irregular/fatigue. This symptoms come in different phases and not all at once. As combination of shot 1 and 2, but this time its weeks not 48 hours. I had a CT scan just to check, it is normal. I am not worried because it is better then getting COVID. No treatment was received in response to the adverse events. The patient was not diagnosed with COVID-19 prior to vaccination. Since the vaccination, patient was not tested for COVID-19. On an unspecified date, the events were recovered with sequel. At the time of reporting, the events muscle discomfort on my left arm and leg and pressure headache/pressure pounding headaches was not recovered and event my booster 19Aug2021 was unknown.

Other Meds:

Current Illness:

ID: 1712038
Sex: F
Age:
State:

Vax Date: 05/01/2021
Onset Date:
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Test Name: Covid test; Test Result: Positive

Allergies:

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

Symptoms: My husband & I both received our Covid-19 vaccines between 26March - 01May2021. We both tested positive for Covid-19 last week; My husband & I both received our Covid-19 vaccines between 26March - 01May2021. We both tested positive for Covid-19 last week; This is a spontaneous report from a contactable consumer (Patient). A female patient of an unspecified age received second dose of bnt162b2 (BNT162B2, solution for injection; Batch/Lot number was not reported), via an unspecified route of administration on 01May2021 as single dose and first dose of (BNT162B2, solution for injection; Batch/Lot number was not reported), via an unspecified route of administration on 26Mar2021 as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On an unspecified date the patient experienced my husband & i both received our covid-19 vaccines between 26march - 01may2021. we both tested positive for covid-19 last week. On an unspecified date the patient underwent lab tests and procedures which included sars-cov-2 test positive results. The outcome of the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101193487 Same reporter/drug/AE, different patient

Other Meds:

Current Illness:

ID: 1712039
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/18/2021
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 Name: tested positive for Covid-19; Test Result: Positive

Allergies:

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

Symptoms: My husband & I both received our Covid-19 vaccines between 26Mar-01May2021. We both tested positive for Covid-19 last week; My husband & I both received our Covid-19 vaccines between 26Mar-01May2021. We both tested positive for Covid-19 last week; This is a spontaneous report from a contactable consumer (patient wife). A male patient of an unspecified age received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was unknown), via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was unknown), via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunisation. The patient and his wife both received COVID-19 vaccines between 26Mar2021-01May2021. They both tested positive for COVID-19 last week, on an unspecified date. The patient underwent lab tests and procedures which included sars-cov-2 test: positive. Outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101193383 Same reporter/drug/AE, different patient

Other Meds:

Current Illness:

ID: 1712040
Sex: F
Age:
State: GA

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 09/18/2021
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: Swollen lymph node at neck/shoulder of right side; This is a spontaneous report from a non-contactable consumer, the patient. A 59-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the right arm on 23Aug2021 at 07:30 (at the age of 59-years-old) as a single dose for COVID-19 immunisation. Medical history included diabetes and penicillin allergy. 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-19 vaccine. Concomitant medications were not reported. On 24Aug2021, the patient had swollen lymph node at neck/shoulder of right side. 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. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event swollen lymph node at neck/shoulder of right side was not resolved 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: 1712041
Sex: M
Age:
State: GA

Vax Date: 04/07/2021
Onset Date: 04/22/2021
Rec V Date: 09/18/2021
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: Test Date: 20210422; Test Name: Cholesterol; Result Unstructured Data: Test Result:High

Allergies:

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

Symptoms: Acid indigestion; Cholesterol is high; This is a spontaneous report from a contactable consumer, the patient. A 58-year-old male 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 07Apr2021(at the age of 58-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient had no known allergies. 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 vaccination. Concomitant medications were reported as not applicable (Na). The patient previously received 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. On 22Apr2021, the patient experienced acid indigestion since the vaccination and the patient did not have it before. Also, the cholesterol was high which the patient never had it high before. It was unknown whether any therapeutic measures were taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events acid indigestion and cholesterol is high was unknown at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1712042
Sex: F
Age:
State: NY

Vax Date: 04/13/2021
Onset Date: 09/01/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Test Date: 20210911; Test Name: COVID-19 Test; Result Unstructured Data: Test Result:Positive

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: positive Covid-19 test; positive Covid-19 test; She has sniffles; Nose congestion/Stuffy nose; Stuffy nose and I think she might have little scratchy throat type of; This is a spontaneous report from a contactable consumer (Patient's Parent). A 17-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, batch number: EP6955), via an unspecified route of administration on 13Apr2021, as dose 2, single and first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, batch number: EP6955), via an unspecified route of administration on 23Mar2021 (age at vaccination was 17 years), as dose 1, single for covid-19 immunisation. The patient's medical history and concomitant medications were not reported. There were not taken other products. The patient stated that she had sniffles on Sep2021 and tested and day before reporting, she received a positive Covid-19 test on 11Sep2021 and there were just sniffles, just like nose congestion on Sep2021 if anything else she would call back. No that was it at the moment she had no other symptom besides that actually like stuffy nose and she thought she might had little scratchy throat type on Sep2021. She did not receive treatment for adverse events. The outcome of event covid-19 was unknown and outcome of other events was not recovered. No follow-up attempts were possible. No further information was expected.

Other Meds:

Current Illness:

ID: 1712043
Sex: F
Age:
State: CA

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/18/2021
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: vomiting; diarrhea; dizziness; Tiredness; Fever; Headache; Chills; This is a spontaneous report from a contactable consumer reported for herself. A 31-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number: FC3182, Expiration date: unknown), via an unspecified route of administration, administered at an unspecified anatomical location on 10Sep2021 (age at vaccination was 31 years) as dose 2, single for COVID-19 immunization. The patient's medical history and concomitant medications were unknown. The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number and Expiration date: was not reported) via an unspecified route of administration, administered at an unspecified anatomical location on an unspecified date as dose 1, single for COVID-19 immunization. On 11Sep2021 on Saturday patient woke up with a headache that last with the whole day, dizziness, tiredness, Chills and Fever, candex diarrhea and vomiting at night. On 11Sep2021, after the second dose the patient experienced vomiting, diarrhea, dizziness, tiredness, fever, headache and chills. The medication that patient took was pain medication, over the counter pain medication just one pill but it didn't help it is Acetaminophen and it was 500 milligrams. Therapeutic measures were taken as a result of vomiting, diarrhea, dizziness, tiredness, fever, headache and chills. The outcome of the events was unknown.

Other Meds:

Current Illness:

ID: 1712044
Sex: F
Age:
State: MI

Vax Date: 09/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/18/2021
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: Extreme fatigue; Pain and swelling on the left arm pit; Pain and swelling moved to my left arm pit.; General sickness; Threw up a little and got all sweaty; Threw up a little and got all sweaty; Headache; Body aches; Left arm became swollen and very painful.; Left arm swollen and very painful; Slept for about 20 hours getting up for a couple hours then becoming so tired I went back to sleep; This is a spontaneous report from a contactable consumer, the patient. A 26-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0169) via an unspecified route of administration in the left arm on 01Sep2021 at 15:00 (at the age of 26-years-old) as a single dose for COVID-19 immunisation. Medical history included Crohn's disease of ileum. The patient did not have any known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included sertraline hydrochloride (ZOLOFT), lisdexamfetamine mesilate (VYVANSE), buspirone hydrochloride (BUSPAR) and vedolizumab (ENTYVIO) all for an unknown indication from an unknown date and unknown if ongoing (also reported as 09Aug). The patient did not receive any other vaccines within four weeks prior to the vaccination. On 02Sep2021 at 00:00, night after the vaccination, the patient experienced headache and body aches, left arm was swollen and very painful. The patient could not sleep if it got touched or gravity was pulling on it at all and would wake up with a sharp pain. On 03Sep2021 (reported as the following day), the patient experienced extreme fatigue and was tired. The patient slept for about 20 hours and got up for a couple of hours then became so tired and went back to sleep. On the same day, the patient threw up a little and got all sweaty. On day 2, 03Sep2021 after the vaccination, the patient's arm was less swollen but the pain and swelling moved to the left armpit and general sickness and body aches but less than the previous day. It was reported that each following day it got better and swelling went down over the course of the next week. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures taken as a result of the events headache, body aches, left arm swollen and painful which included unspecified pain medication which helped her to get to sleep but it did not take all the pain away. No therapeutic measures were taken as a result of the events extreme fatigue, tired, threw up a little and got all sweaty, left arm swollen, pain and swelling of the left arm pit and general sickness. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events headache, body aches, extreme fatigue, tired, threw up a little and got all sweaty, left arm swollen and very painful, pain and swelling of the left arm pit and general sickness were resolved on an unknown date in Sep2021.

Other Meds: ZOLOFT; VYVANSE; BUSPAR; ENTYVIO

Current Illness:

ID: 1712045
Sex: F
Age:
State:

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/18/2021
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: Soreness at injection site; This is a spontaneous report from a non-contactable consumer, the patient. A 36-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FD8448) via an unspecified route of administration in the left arm on 08Sep2021 at 10:00 (at the age of 36-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history reported. The patient had no known allergies. 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 vaccination. Concomitant medications were not reported. On 08Sep2021, approximately 6 hours later, the patient experienced soreness at injection site which lasted for 2 to 3 days. 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. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event soreness at injection site was resolved on an unknown date in Sep2021. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1712046
Sex: F
Age:
State: CA

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/18/2021
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: Started bleeding later that evening after the shot.; Also started having severe menstual cramps; This is a spontaneous report from a contactable nurse, the patient. A 36-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FE3592) via an unspecified route of administration on 08Sep2021 at 16:30 (at the age of 36-years-old) as a single dose for COVID-19 immunisation. Medical history was reported as not applicable (N/A). The patient had no known allergies. 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 vaccination. Concomitant medications included ethinylestradiol, ferrous fumarate, norethisterone acetate (LO LOESTRIN FE) for birth control from an unknown date and was ongoing. On 08Sep2021 at 22:30, in the evening the patient started bleeding after the shot. The patient was on birth control in a very strict schedule. On the day of the COVID-19 shot, the patient was on day ten of the cycle (taking active pills). The patient also started having severe menstrual cramps. Both the bleeding and the cramping had not subsided even though the patient had continued to taking birth control at the exact same time every day. Prior to getting the COVID shot the patient had a full gynaecological work up and everything was normal, so the only variable was the COVID vaccine. 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. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events started bleeding later that evening after the shot and also started having severe menstrual cramps were not resolved at the time of this report.

Other Meds: LO LOESTRIN FE

Current Illness:

ID: 1712047
Sex: F
Age:
State: GA

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 09/18/2021
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: Skin reaction, which never had before; It first looked like a rash, then skin started peeling; It first looked like a rash, then skin started peeling; Headache; This is a spontaneous report from a contactable consumer, the patient. A 31-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0191) via an unspecified route of administration in the left arm on 27Aug2021 at 14:30 (at the age of 31-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient had no known allergies. 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 vaccination. The patient did not receive any concomitant medications. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0175) via an unspecified route of administration in the left arm on 06Aug2021 at 14:00 (at the age of 31-years-old) as a single dose for COVID-19 immunisation. On 28Aug2021, the day after the second dose, the patient experienced headache. On 02Sep2021 at 14:00, a week after the second dose, the patient experienced skin reaction, that the patient had never before. The reaction first looked like a rash, then the patient's skin started peeling. The patient thought it would go away in no time but it was then on the belly, breasts, back, and arms. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were taken as a result of the events skin reaction, rash, and skin peeling which included treatment with petroleum jelly but did not know what action to be taken. The clinical outcome of the events skin reaction, which never had before, it first looked like a rash, then skin started peeling and headache were not recovered at the time of this report.

Other Meds:

Current Illness:

ID: 1712048
Sex: F
Age:
State:

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Psoriasis which I have all over my body started clearing up/also have psoriatic arthritis It seems to have eased it some; This is a spontaneous report from a non-contactable consumer, the patient. A 50-year-old female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 22Aug2021 (at the age of 50-years-old) as a single dose for COVID-19 immunisation. Medical history included fibromyalgia, psoriatic arthritis, and psoriasis. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any concomitant medications. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 22Aug2021, immediately after the first dose of the vaccine, psoriasis which the patient had all over the body started clearing up. The vaccine had worked better than any medicine that the patient had ever tried and the patient had psoriasis since she was 18-years-old. The patient also had psoriatic arthritis which seemed to have eased it some. The patient received the second dose on 12Sep2021 and would see the affect as time goes on. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the event. The clinical outcome of the event psoriasis which the patient had all over body started clearing up/also had psoriatic arthritis which seemed to have eased it some was unknown. The patient received a second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3182) via an unspecified route of administration on 12Sep2021 (at the age of 51-years-old) as a single dose for COVID-19 immunisation. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1712049
Sex: F
Age:
State: VA

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/18/2021
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: Head felt like things were crawling all over; Eyes started watering; Forehead started to get red; Felt like something burst inside head/ head still feels weird; This is a spontaneous report from a contactable consumer, the patient. A 57-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FD8448) via an unspecified route of administration in the left arm on 24Aug2021 at 15:00 (at the age of 57-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. Prior to 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. The patient previously received metformin (MANUFACTURER UNKNOWN) for an unspecified indication on unknown date and experienced drug allergy. On 24Aug2021 at 15:00, within just a few seconds of receiving the shot, the patient felt like something burst inside her head and within minutes her head felt like things were crawling all over, also eyes started watering and forehead started to get red. The patient's head still felt weird where that "pop" happened. Therapeutic measure was taken as a result of the events which included treatment with diphenhydramine (BENADRYL) given by pharmacist and the patient waited around another 15 minutes or so. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events head felt like things were crawling all over, eyes started watering, forehead started to get red was unknown; whereas the event felt like something burst inside head/ head still feels weird was not resolved at the time of this report.

Other Meds:

Current Illness:

ID: 1712050
Sex: M
Age:
State: FL

Vax Date: 02/08/2021
Onset Date: 03/08/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Test Date: 2021; Test Name: Pulmonary exam; Result Unstructured Data: Test Result:coming back clean; Test Date: 2021; Test Name: MRI Chest; Result Unstructured Data: Test Result:coming back clean; Test Date: 2021; Test Name: Brain scan; Result Unstructured Data: Test Result:coming back clean; Test Date: 20210316; Test Name: Nasal swab; Test Result: Negative

Allergies:

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

Symptoms: Right eye neurologically closed, eventually opening and stayed 1/4 closed all the time; This is a spontaneous report from a contactable consumer, the patient. A 76-year-old male patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL9262) via an unspecified route of administration in the left arm on 08Feb2021 at 12:00 (at the age of 76-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL1284) via an unspecified route of administration in the left arm on 18Jan2021 (at the age of 76-years-old) as a single dose for COVID-19 immunisation. On 08Mar2021, about 30 days after the second shot of Pfizer for COVID, the patient's right eye was neurologically closed, eventually opening and stayed 1/4 closed all the time. The eye doctor referred the patient to a neurologist and the patient underwent a brain scan, magnetic resonance imaging (MRI) of the chest and a pulmonary exam and all came back clean. The event resulted in doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient had been tested for COVID-19. On 16Mar2021, the patient underwent COVID-19 test via nasal swab and the result was negative. Therapeutic measures were taken as a result of the event which included treatment with pyridostigmine bromide (MANUFACTURER UNKNOWN) 60 milligram tablet twice a day to keep the eye open. The clinical outcome of the event right eye neurologically closed, eventually opening and stayed 1/4 closed all the time was resolving at the time of the report.

Other Meds:

Current Illness:

ID: 1712051
Sex: F
Age:
State: OR

Vax Date: 09/11/2021
Onset Date: 09/12/2021
Rec V Date: 09/18/2021
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: Cramping; Spotting; Not supposed to start period for another week; This is a spontaneous report from a contactable other healthcare professional, the patient. A 34-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 11Sep2021 at 10:30 (at the age of 34-years-old) as a single dose for COVID-19 immunisation. Medical history included human immunodeficiency virus syndrome (HIV). 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 vaccination. Concomitant medication included emtricitabine, tenofovir disoproxil fumarate, rilpivirine hydrochloride (COMPLERA) for an unknown indication from an unknown date and unknown if ongoing. On 12Sep2021 at 09:00, the patient was not supposed to start period for another week, however she had uncomfortable cramping and spotting which were still ongoing two days after. The patient never had these symptoms before. 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. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events cramping, spotting and not supposed to start period for another week were not resolved at the time of this report.

Other Meds: COMPLERA

Current Illness:

ID: 1712052
Sex: M
Age:
State:

Vax Date: 05/16/2021
Onset Date:
Rec V Date: 09/18/2021
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: rash all over his body; inflamed, swollen, itchy spot under his eyes; inflamed, swollen, itchy spot under his eyes; inflamed, swollen, itchy spot under his eyes; This is a spontaneous report from a contactable consumer or other non hcp (Reporter's son) via medical information team. A 27-year-old male patient received second dose of bnt162b2 (COMIRNATY, Solution for Injection, Batch/Lot number was not reported), via an unspecified route of administration on 16May2021 as dose 2, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient previously took first dose of bnt162b2 for COVID-19 immunization. On an unspecified date in 2021, the patient experienced rash all over his body, inflamed, swollen, itchy spot under his eyes. Reporter is calling on behalf of her 27-year-old, Male, Son, who got the 2nd dose of the COMIRNATY vaccine on 16May2021. Post-vaccination, he observed a rash all over his body (like a little red spot) and has been there for a while now (a month). Also, reporter reported that his son developed an inflamed, swollen, itchy spot under his eyes and it is not going away (also described as extremely bad). Reporter even acknowledged it to look like an allergic reaction but not particular if it was caused by the vaccine. In line with this, reporter would like to know if these types of reactions are reported AE post vaccination and if these are expected to stay and last that long. Reporter mentioned that he already filed a safety report regarding this AE. Outcome of all the events was unknown. The lot number for the vaccine [BNT162B2] was not provided and will be requested during follow-up.

Other Meds:

Current Illness:

ID: 1712053
Sex: F
Age:
State: CT

Vax Date: 09/01/2021
Onset Date: 09/08/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: This is a spontaneous report from a contactable consumer, the patient. A 33-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3184) via an unspecified route of administration in the left arm on an unknown date in Sep2021 at 18:00 (at the age of 33-years-old) as a single dose for COVID-19 immunisation. Medical history included lyme. The patient had no known allergies. 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 vaccination. Concomitant medications were not reported. On 08Sep2021, the patient experienced stiff neck, headache, fatigue, nausea, muscle pain, insomnia and vision issues- bright light discomfort. The events resulted in doctor or other healthcare professional office/clinic visit. It was unknown whether any therapeutic measures were taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events stiff neck, headache, fatigue, nausea, muscle pain, insomnia and vision issues- bright light discomfort was not resolved at the time of this report.

Other Meds:

Current Illness:

ID: 1712054
Sex: M
Age:
State: TX

Vax Date: 09/12/2021
Onset Date:
Rec V Date: 09/18/2021
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: Chills; Tenderness in arm; Whole body hurting; This is a spontaneous report from a contactable consumer (mother) reported for a 14-year-old male patient. A 14-year-old male patient received unknown dose of bnt162b2 (Pfizer COVID-19 Vaccine, Solution for injection, Batch/lot number: Not Provided, Expiry date: Not provided), via an unspecified route on 12Sep2021 as a single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. On an unknown date, patient mother was looking on the website at the symptoms that could occur. Patient age at the onset of events was 14-year-old. She stated that he does have chills. She saw tenderness in the arm as a side effect, which he does have. However, also, his whole body was hurting. She wants to know if that was normal. The clinical outcome of the events was unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1712055
Sex: F
Age:
State: GA

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/18/2021
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: feel it now on her neck; Saturday, she had pain in her arm, shoulder, and on her back by her bra strap; back near her bra strap; same pain plus some in her shoulder blade area; discomfort in her arm; This is a spontaneous report from a contactable Other-Health Care Professional. A 39-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) via an unspecified route of administration, administered in Arm Left on 10Sep2021 at 18:00 (Lot Number: FF2588) (at the age 39-years-old) as dose 2, single for Covid-19 immunization. Medical history included ongoing fibromyalgia (diagnosed 9 years ago now). Concomitant medication included unspecified medication. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) via an unspecified route of administration, administered in Arm Left 20Aug2021 (Lot Number: FC3180) (at the age 39-years-old) as dose 1, single for covid-19 immunization and experienced Discomfort.There were no relevant tests. On 10Sep2021, the patient experienced discomfort in her arm, on 11Sep2021, the patient experienced Back pain, Shoulder blade pain and Pain in arm and on 12Sep2021, the patient experienced Neck discomfort. It was reported that patient had the usual arm discomfort Immediately after vaccination . By Saturday 11Sep2021, she had pain in her arm, shoulder, and on her back by her bra strap. By the night, she had all the same pain plus some in her shoulder blade area. The pain has increased to the point of unbearable now. She tried to make a doctor's appointment, but the doctor's office told her to call Pfizer. She didn't have a prescribing doctor. The pain started radiating to the other areas on Saturday 11Sep 2021. The initial discomfort started right after she got the vaccine at 6pm. She pretty much immediately experienced discomfort. She did have discomfort after the first vaccine. She has taken Tylenol arthritis because she has Fibromyalgia, and she typically has pain in this arm. If she were to go to the doctor, she wanted to know if this vaccine can exacerbate fibromyalgia or is it the placement of where she got the injection or how it was administered that is causing the pain she was experiencing. She got the vaccine both times in her left arm. The pain is on the left side. She has had Fibromyalgia. She was diagnosed 9 years ago now. No doctor has agreed to see her. There was no prior vaccinations within 4 weeks. The event did not result in emergency room or physician Office visit. On 13Sep2021 morning, at 5am, she took 2 Tylenol arthritis, and 2 more at 9am to control the pain. Therapeutic measures were taken as result for all events. The patient had not yet recovered from pain in arm and outcome of all other events were unknown. Follow-up activities are completed. No further information is expected.

Other Meds:

Current Illness: Fibromyalgia

ID: 1712056
Sex: F
Age:
State: MI

Vax Date: 02/13/2021
Onset Date:
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Test Name: Fever; Result Unstructured Data: Test Result:Fever; Comments: Fever

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: she felt like she had the flu; chattering teeth; fever; shooting pains; lethargic; sleepy; no appetite; shingle like rash on her neck; This is a spontaneous report from a Pfizer sponsored Program contactable consumer or other non hcp. A 68-years-old female patient received BNT162b2 (COMIRNATY, Solution for injection, Lot No was not reported), via an unspecified route of administration on 13Feb2021 as 2nd dose, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced she felt like she had the flu on an unspecified date with outcome of recovered , chattering teeth on an unspecified date with outcome of recovered , fever on an unspecified date with outcome of recovered , shooting pains on an unspecified date with outcome of recovered , lethargic on an unspecified date with outcome of recovered , sleepy on an unspecified date with outcome of recovered , no appetite on an unspecified date with outcome of recovered , shingle like rash on her neck on an unspecified date with outcome of recovered. The patient underwent lab tests and procedures which included body temperature: fever on fever. Patient stated she was totally coherent during this time. Patient stated it lasted for 3 days and then she was fine. Patient stated she saw her HCP and wanted to know if the history was or the same for the 3rd shot. The reactogenicity profile within seven days after the booster (third) dose was typically mild to moderate. The most common events included injection site pain, fatigue, headache, muscle and joint pain, and chills. The frequency of any severe systemic event after the booster dose was low. The frequency of reactogenicity was like or better than after dose two of the primary series. The adverse event profile was generally consistent with other clinical data. Patient asked is there anything she can do or take to mitigate the reaction and stated her HCP told her to take Tylenol. The outcome of the events was recovered. The lot number for [BNT162B2] was not Provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1712057
Sex: M
Age:
State: NC

Vax Date: 09/08/2021
Onset Date: 09/10/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: All over body rash on forearms, elbows, progressed to back, thighs, abdomen, waist; Welts; Pustules; Itchy; This is a spontaneous report from a contactable nurse. A 71-year-old male patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2588) via intramuscular route of administration in the left arm on 08Sep2021 at 16:00 (at the age of 71-years-old) as a single dose for COVID-19 immunisation. Medical history included leukemia (the patient receiving chemotherapy for leukemia). It was unknown whether the patient had any known allergies. Prior to vaccination, it was unknown whether the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included oral chemotherapy (unspecified) for leukemia from an unknown date and unknown if ongoing. On 10Sep2021, the patient experienced all over body rash, on forearms, elbows, progressed to back, thighs, abdomen, waist. It was reported that, it started as a fine rash and progressed to welts, pustules and was itchy. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measure was taken as a result of the events which included treatment with diphenhydramine hydrochloride (BENADRYL). Since the vaccination, it was unknown whether the patient had been tested for COVID-19. The clinical outcome of the events all over body rash, on forearms, elbows, progressed to back, thighs, abdomen, waist and it was started as a fine rash and progressed to welts, pustules and itchy was resolving at the time of this report.

Other Meds:

Current Illness:

ID: 1712058
Sex: F
Age:
State: TN

Vax Date: 09/08/2021
Onset Date: 09/09/2021
Rec V Date: 09/18/2021
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: 28 hours after shot High fever; Muscle aches on entire side of body as the shot; Large lump under shot arm; Extremely painful; This is a spontaneous report from a non-contactable consumer, the patient. A 48-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3184) via an unspecified route of administration in the right arm on 08Sep2021 at 14:00 (at the age of 48-year-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient had no known allergies. 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 vaccination. Concomitant medications included estradiol (ESTROGEN) and zolpidem tartrate (AMBIEN) from unknown dates for unknown indications and unknown if ongoing. On 09Sep2021 at 16:00, 28 hours after the shot, the patient experienced high fever, muscle aches on entire side of her body as the shot and a large lump under the shot arm and extremely painful. Therapeutic measures were not taken for the reported events. Since the vaccination, the patient was not tested for COVID-19. 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 events 28 hours after the shot high fever, muscle aches on entire side of body as the shot, large lump under the shot arm and extremely painful were recovering at the time of this report. No follow-up attempts are possible. No further information is expected.

Other Meds: ESTROGEN; AMBIEN

Current Illness:

ID: 1712059
Sex: F
Age:
State:

Vax Date: 08/06/2021
Onset Date:
Rec V Date: 09/18/2021
Hospital: Y

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: acute pericarditis; pain in the arm and up through her neck and she went to the hospital again and was diagnosed with cervical radiculopathy; pain in the arm and up through her neck and she went to the hospital again and was diagnosed with cervical radiculopathy; bubble in her chest and was in pain so went to the ER; Covid arm/rash; This is a spontaneous report from a non-contactable consumer (patient). A 31-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot number: not reported, Expiry date: not reported), via an unspecified route of administration on 06Aug2021 as dose 1, single for covid-19 immunisation. The patient medical history was not reported. The patient's concomitant medications were not reported. On an unspecified date, the patient experienced acute pericarditis, pain in the arm and up through her neck and she went to the hospital again and was diagnosed with cervical radiculopathy, pain in the arm and up through her neck and she went to the hospital again and was diagnosed with cervical radiculopathy, bubble in her chest and was in pain so went to the er, covid arm/rash. The patient received the first dose on 06Aug2021 and was wondering if she should receive the second dose due to side effects. The patient was required to receive the vaccine for her job or she will be terminated. A few days after the first dose she developed Covid arm/rash, then she felt a bubble in her chest and was in pain so went to the emergency room (ER). She was diagnosed with acute pericarditis and was told it would go away in a couple of days and it did. She then developed pain in the arm and up through her neck and she went to the hospital again and was diagnosed with cervical radiculopathy. It just started going away a week and a half ago but was still having tingling in the right had from time to time. She actually was waiting to receive the second dose but wanted to call and see if she should. Her doctor did give her a note that she shouldn't receive the vaccine until further notice but she had to get the vaccine or she will be terminated. Her doctor recommended her to see a neurologist. They prescribed gabapentin, toradol and another medication but it didn't help her. The events resulted in visit to the emergency room. The patient was hospitalized due the events acute pericarditis, pain in the arm and up through her neck and she went to the hospital again and was diagnosed with cervical radiculopathy, pain in the arm and up through her neck and she went to the hospital again and was diagnosed with cervical radiculopathy, bubble in her chest and was in pain so went to the er. The outcome of acute pericarditis was recovered and outcome of the event pain in the arm and up through her neck and she went to the hospital again and was diagnosed with cervical radiculopathy (cervical radiculopathy) was not recovered while outcome of rest of the events was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1712060
Sex: F
Age:
State:

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/18/2021
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: swelling in left leg; burning in her torso and upper arms and upper chest; Caller received her 3rd Pfizer Covid BT Vaccine, Comirnaty, dose on 03Sep2021; Caller received her 3rd Pfizer Covid BT Vaccine, Comirnaty, dose on 03Sep2021; This is a spontaneous report from a contactable consumer (patient). A female patient of an unspecified age received third dose of bnt162b2 (COMIRNATY, formulation: Solution for injection, lot number was not reported), via an unspecified route of administration on 03Sep2021 as DOSE 3, SINGLE for covid-19 immunization. Medical history included RA for which Humira injection and Ibuprofen was received. The patient's concomitant medications were not reported. Historical vaccine included first and second dose of bnt162b2 (COMIRNATY, formulation: Solution for injection, lot number was not reported), via an unspecified route of administration on unspecified date as DOSE 1, SINGLE and DOSE 2, SINGLE both for covid-19 immunization. On 03Sep2021, the patient experienced caller received her 3rd Pfizer covid BT vaccine, comirnaty, dose on 03sep2021, on 05Sep2021, the patient experienced burning in her torso and upper arms and upper chest, on 12Sep2021, the patient experienced swelling in left leg. Therapeutic measures were taken as a result of burning in her torso and upper arms and upper chest. No Serious events reported. The outcomes of events (swelling in left leg, Caller received her 3rd Pfizer Covid BT Vaccine, Comirnaty, dose on 03Sep2021) were unknown and the outcome of event (burning in her torso and upper arms and upper chest) was recovering. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1712061
Sex: M
Age:
State: NY

Vax Date: 05/06/2021
Onset Date: 05/01/2021
Rec V Date: 09/18/2021
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: Felt sick; Arm starting having pin and needle sensation in it; Lost grip and strength in arm and hand/ the feeling is mostly on the under part of right arm, pinky and ring finger on the right side where got the shot and right side of hand; Lost grip and strength in arm and hand; This is a spontaneous report from a contactable consumer, the patient. A 30-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 right arm on 06May2021 (at the age of 30-years-old) as a single dose for COVID-19 immunisation. The patient did not have any medical history and known allergies. 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-19 vaccine. The patient did not take any concomitant medications. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0162) via an unspecified route of administration in the right arm on 15Apr2021 at 16:00 (at the age of 30-years-old) as a single dose for COVID-19 immunisation. The patient reported that he got his first shot on 15Apr2021 and was fine then went back for his second shot on 06May2021 and after the second shot on an unknown date in May2021, he felt sick and was sick for a few days and the patient didn't think much about it. Within a week, the patient's arm started having pin and needle sensation in it and he had the same feeling ever since then. The patient lost grip and strength in his arm and hand and the feeling was mostly on the under part of his right arm, pinky and ring finger on the right side where he got the shot and right side of his hand. The events did not result in a visit to the doctors or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken for the reported events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events felt sick, arm starting having pin and needle sensation in it and lost grip and strength in arm and hand/ the feeling is mostly on the under part of right arm, pinky and ring finger on the right side where got the shot and right side of hand was not recovered at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1712062
Sex: F
Age:
State: MD

Vax Date: 05/20/2021
Onset Date: 06/10/2021
Rec V Date: 09/18/2021
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: Missed menstrual cycle; This is a spontaneous report from a contactable consumer, the patient. A 34-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0187) via an unspecified route of administration in the left arm on 20May2021 at 09:00 (at the age of 34-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history and no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 10Jun2021 at 00:00, the patient had missed menstrual cycle. The event resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were not taken as a result of the reported event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event missed menstrual cycle was unknown at the time of this report. The patient also received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0186) via an unspecified route of administration in the right arm on 10Jun2021 at 09:00 (at the age of 34-years-old) as a single dose for COVID-19 immunisation.

Other Meds:

Current Illness:

ID: 1712063
Sex: F
Age:
State: TN

Vax Date: 09/12/2021
Onset Date: 09/12/2021
Rec V Date: 09/18/2021
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: Sensitive to light; Loss of balance; Stomach pain; Lightheaded; Nauseous; This is a spontaneous report from a contactable consumer, the patient. A 29-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 12Sep2021 at 14:00 (at the age of 29-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history and no known allergies. 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 vaccination. The patient did not receive any concomitant medications. On 12Sep2021 at 18:00, the patient had been sensitive to light, lightheaded, experienced stomach pain and felt nauseous and loss of balance. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events sensitive to light, lightheaded, stomach pain, nauseous and loss of balance was not resolved at the time of the report. The lot number for BNT162b2 was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1712064
Sex: F
Age:
State: GA

Vax Date: 08/29/2021
Onset Date: 08/29/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Test Date: 20210829; Test Name: Body temperature; Result Unstructured Data: Test Result:100.9; Comments: fever of 100.9 At 19:00.

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 'I' started feeling tired; Weak; Having diarrhea; Fever of 100.9; Nausea; Just wanted to sleep but kept waking during night; Stomach cramps; This is a spontaneous report from a contactable consumer, the patient. A 59-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3182) via an unspecified route of administration in the left arm on 29Aug2021 at 10:15 (at the age of 59-years-old) as a single dose for COVID-19 immunisation. The patient did not have any relevant medical history. 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-19 vaccine. The patient did not take any concomitant medications. The patient previously received codeine (MANUFACTURER UNKNOWN) for an unknown indication on an unknown date and experienced allergy. On 29Aug2021 at 19:00 (Sunday), after the shot, the patient started feeling tired, weak, had diarrhea, fever of 100.9 (unit unspecified), nausea and the patient just wanted to sleep but kept waking during night with stomach cramps and felt nauseated. The patient woke up in the morning on 31Aug2021 (Tuesday) feeling fine. 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 reported events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events started feeling tired, weak, had diarrhea, fever of 100.9, nausea, just wanted to sleep but kept waking during night and stomach cramps were recovered on 31Aug2021.

Other Meds:

Current Illness:

ID: 1712065
Sex: F
Age:
State:

Vax Date: 08/01/2021
Onset Date:
Rec V Date: 09/18/2021
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 Date: 2021; Test Name: increase in blood pressure; Result Unstructured Data: Test Result:Increase; Test Date: 2021; Test Name: Heart Rate; Result Unstructured Data: Test Result:increased

Allergies:

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

Symptoms: This is a spontaneous report from a contactable consumer or other non-health care professional (patient). A 59-year-old female patient received BNT162B2 (COMIRNATY, formulation: Solution for injection, Lot Number: unknown), via an unspecified route of administration on an unspecified date in Aug2021 as dose 1, single for covid-19 immunisation. The patient medical history included Mercury poisoning, hot flashes (which she has had for a year or more), arthritis (she says she has arthritis in her neck and since receiving the vaccine feels like she is at the beginning of her physical therapy instead of towards the end) and physiotherapy. The patient concomitant medications were not reported. The patient reported that several adverse reactions after received the first dose of the vaccine 3.5 weeks ago. It was reported that on an unspecified date in 2021, the patient had an elevation in heart rate on and off for two weeks, an increase in blood pressure, aches, pain, brain fog, muscle weakness, and hot flashes, which she has had for a year or more. She also reported not feeling "as strong as I was before the first dose". The patient said she has arthritis in her neck and since receiving the vaccine feels like she is at the beginning of her physical therapy instead of towards the end. She reports not having a local HCP as she recently moved; her previous HCP recommended her not to get the vaccine as she has a history of mercury poisoning. The patient says she does want to be protected, wants to be a team player, and does want to get the second dose but says " I just know I would be in bad shape, I just need more time" (in getting the second dose now) wants more time than to recover from these symptoms so asked how long she can wait to get the second dose. The patient was referred to health care professional. The patient underwent lab tests and procedures which included blood pressure measurement: increase, heart rate: increased on an unspecified date in 2021. The outcome of the events was unknown. The lot number for the vaccine [BNT162B2] was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1712066
Sex: F
Age:
State: TX

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/18/2021
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: Left armpit (lymph) swelling and pain; Left armpit (lymph) swelling and pain; This is a spontaneous report from a contactable consumer, the patient. A 64-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2588) via an unspecified route of administration in the left arm on an unknown date in Sep2021 (at the age of 64-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. 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-19 vaccine. On an unknown date in Sep2021, the patient experienced left armpit (lymph) swelling and pain. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events left armpit (lymph) swelling and pain were not resolved at the time of this report. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1712067
Sex: M
Age:
State: NJ

Vax Date: 09/09/2021
Onset Date: 09/10/2021
Rec V Date: 09/18/2021
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: Aches; Metallic taste in mouth; Ears red and hot; Ears red and hot; Nausea; Chills; This is a spontaneous report from a contactable consumer, the patient. A 56-year-old male patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3181) via an unspecified route of administration in the left arm on 09Sep2021 at 19:30 (at the age of 56-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history. 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 vaccination. The patient did not receive concomitant medication. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3182) via an unspecified route of administration in the left arm on 18Aug2021 at 19:30 (at the age of 56-years-old) as a single dose for COVID-19 immunisation. The patient previously received codeine (MANUFACTURER UNKNOWN) for an unknown indication on an unknown date and experienced allergy. On 10Sep2021 at 15:30, the patient experienced aches, metallic taste in mouth, ears red and hot, nausea and chills. 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. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events aches, metallic taste in mouth, ears red and hot, nausea and chills was not resolved at the time of this report. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1712068
Sex: F
Age:
State: KY

Vax Date: 08/14/2021
Onset Date: 08/15/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Test Date: 20210815; Test Name: Body temperature; Result Unstructured Data: Test Result:100.1 degrees; Comments: At 03:00

Allergies:

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

Symptoms: Fever of 100.1 degrees; Chills; Body aches; General sleepiness; Swelling of the eyelids; Asthmatic wheezing; Shortness of breath; This is a spontaneous report from a contactable consumer, the patient. A 40-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0164) via an unspecified route of administration in the left arm on 14Aug2021 at 08:00 (at the age of 40-years-old) as a single dose for COVID-19 immunisation. Medical history included unspecified allergies. 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 vaccination. Concomitant medications were not reported. On 15Aug2021 at 03:00, the patient experienced fever of 100.1 degrees, chills, body aches for 24 hours and general sleepiness. On the same day, the patient also experienced swelling of the eyelids, asthmatic wheezing and shortness of breath lasting for 48 hours. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the reported events. The clinical outcome of the events fever of 100.1 degrees, chills, and body aches were resolved on 16Aug2021 at 03:00 (after the duration of 24 hours). The clinical outcome of the event general sleepiness was resolved on an unknown date in 2021; while that of the events swelling of the eyelids, asthmatic wheezing and shortness of breath were resolved on 17Aug2021 at 03:00 (after the duration of 48 hours).

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am