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: 1721832
Sex: M
Age: 52
State: NC

Vax Date: 03/03/2021
Onset Date:
Rec V Date: 09/22/2021
Hospital:

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

Lab Data: Test Name: Body temperature; Result Unstructured Data: 102.1 degrees

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever of upto 102.1 for about 48 hours; Extreme soreness at injection site; All-over joint pain; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever of upto 102.1 for about 48 hours), VACCINATION SITE PAIN (Extreme soreness at injection site) and ARTHRALGIA (All-over joint pain) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 020B71A and 025AZ1A) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy and HIV disease since September 2010. Concomitant products included DOLUTEGRAVIR SODIUM, LAMIVUDINE (DOVATO) from October 2020 to an unknown date for an unknown indication. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PYREXIA (Fever of upto 102.1 for about 48 hours), VACCINATION SITE PAIN (Extreme soreness at injection site) and ARTHRALGIA (All-over joint pain). At the time of the report, PYREXIA (Fever of upto 102.1 for about 48 hours), VACCINATION SITE PAIN (Extreme soreness at injection site) and ARTHRALGIA (All-over joint pain) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 102.1 (High) 102.1 degrees. No treatment was provided by the reporter. Patient mistakenly took 2nd dose a month earlier. This case was linked to MOD-2021-305663 (Patient Link).

Other Meds: DOVATO

Current Illness: HIV disease; Penicillin allergy

ID: 1721833
Sex: M
Age: 67
State: FL

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 09/22/2021
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: Pain in his left injection site arm; This spontaneous case was reported by a patient and describes the occurrence of VACCINATION SITE PAIN (Pain in his left injection site arm) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016C21A) for COVID-19 vaccination. No medical history reported by reporter. Concomitant products included AMLODIPINE, ACETYLSALICYLIC ACID (ASPIRIN 81), AMOXICILLIN, TRAMADOL, DEXAMETHASONE and LEVOFLOXACIN for an unknown indication. On 10-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-May-2021, the patient experienced VACCINATION SITE PAIN (Pain in his left injection site arm). At the time of the report, VACCINATION SITE PAIN (Pain in his left injection site arm) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment medications provided by the reporter. This case was linked to MOD-2021-321103.

Other Meds: AMLODIPINE; ASPIRIN 81; AMOXICILLIN; TRAMADOL; DEXAMETHASONE; LEVOFLOXACIN

Current Illness:

ID: 1721834
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/22/2021
Hospital: Y

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: headaches in left side of the brain; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headaches in left side of the brain) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced HEADACHE (headaches in left side of the brain) (seriousness criterion hospitalization). At the time of the report, HEADACHE (headaches in left side of the brain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. Treatment information not reported. This case concerns a male patient of unknown age, who experienced the expected non-serious event of Headache. The event occurred an unknown number of days after receiving a dose of mRNA-1273 vaccine. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report. The event was downgraded to non-serious since the source document does not include any information to support the seriousness criteria.; Sender's Comments: This case concerns a male patient of unknown age, who experienced the expected non-serious event of Headache. The event occurred an unknown number of days after receiving a dose of mRNA-1273 vaccine. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report. The event was downgraded to non-serious since the source document does not include any information to support the seriousness criteria.

Other Meds:

Current Illness:

ID: 1721835
Sex: M
Age:
State: FL

Vax Date: 01/29/2021
Onset Date: 02/18/2021
Rec V Date: 09/22/2021
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: I had no immediate adverse event after 1st or2nd dose. 10 days after those doses ~15 wheals appeared. The wheals grow to 1in. get red & itch and then fade. Problem is over last 6 mo. Wheals Keep reap; I had no immediate adverse event after 1st or2nd dose. 10 days after those doses ~15 wheals appeared. The wheals grow to 1in. get red & itch and then fade. Problem is over last 6 mo. Wheals Keep reap; I had no immediate adverse event after 1st or2nd dose. 10 days after those doses ~15 wheals appeared. The wheals grow to 1in. get red & itch and then fade. Problem is over last 6 mo. Wheals Keep reap; uncomfortable and it is hard for him to breathe; uncomfortable and it is hard for him to breathe; Concern these are large lipid nanoparticles; This is a spontaneous report from a contactable other health care professional (patient). A 87-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: unknown) via an unspecified route of administration, in right arm on 11Feb2021 (at the age of 87-years-old) as dose 2, single and BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: unknown) via an unspecified route of administration, in left arm on 29Jan2021 (at the age of 86-years-old) as dose 1, single for COVID-19 immunization. The patient medical history included urothelial cancer, right kidney removed, chronic kidney disease from an unknown date and unknown if ongoing. The patient concomitant medication was not reported. Patient had not received any other medications in two weeks. Patient had no allergies to any kind prior to the vaccination. Patient had not been diagnosed with COVID-19 prior to vaccination and had not been tested since the vaccination. Patient had not received any other vaccines within 4 weeks prior to the COVID vaccine. On 18Feb2021, the patient stated that he had no immediate adverse event, after 1st or2nd dose. 10 days after those doses ~15 wheals appeared, the wheals grow to 1in. get red & itch and then fade problem is over and then fade, problem is over last 6Month, wheals keep repeating a process keep repeating, uncomfortable and it is hard for him to breathe and concern these are large lipid nanoparticles which have not been eliminated. Patient stated that the adverse event was the same for both doses -15-20 red/pruritic "wheels appears on both back and arms. Reporter explained that they started small and grew an inch in size. He notes that they keep re-appearing and this has been continuous for the last 6 to 7 months. He explains that this was uncomfortable, and it was hard for him to breathe. He has pre-existing kidney disease and has lost one kidney. Reporter concerned of long term effects on his body. Appeared and they were as large as one inch and each were separated from each other, they were itchy, they get redder and redder then fade. Reporter stated that about 10 days after he got the 1st dose that he experienced the event (around 08Feb2021) and then it went away in about a week. Reporter stated that the event came back again about one week after he received the 2nd dose and that it disappeared about a week later. Reporter added that a week after the event had disappeared, it came back again, and that it is now 6-7 months later and the event has not gone away. Reporter added that now he has about 5-10 wheals, as large as one inch and each are separated from each other. He said they are very itchy, they get redder and redder and then fade. Reporter was concerned about the long-term reaction to the Pfizer Covid-19 vaccine. Reporter wants to know if Pfizer has any safety data regarding the carrier lipid nano particles / pegylated lipid nano particles and the metabolic fate and elimination of these lipid nano particles and whether there were any long-term effects that can affect his kidneys, heart and liver. He added that this was a very important issue, whether to get vaccinated or not, that if these lipid carriers are not getting eliminated from the body, then this was an issue that needs to be addressed. Patient stated that the adverse event resulted in doctor or other healthcare professional office/clinic visit. Patient had not received any treatment for the events reported. The outcome of the events was not recovered. Information on the lot/batch number has been requested. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1721836
Sex: M
Age:
State: TN

Vax Date: 02/23/2021
Onset Date:
Rec V Date: 09/22/2021
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: pain on one side of his body; he could not sleep; he experienced numbness; first dose of the vaccine just hurt the caller's arm and he was in pain; It felt like something was crawling inside of the caller; This is a spontaneous report from a contactable consumer(patient) via Pfizer-sponsored program COVAX US Support. A 70-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number and Expiration date was not reported), dose 1 via an unspecified route of administration on 23Feb2021 as dose 1, single for covid-19 immunisation. Medical history included chronic sinusitis (he experiences it year round everyday). The patient's concomitant medications were not reported. On an unspecified date the patient experienced pain on one side of his body, he could not sleep, he experienced numbness, first dose of the vaccine just hurt the caller's arm and he was in pain, it felt like something was crawling inside of the caller. Patient stated, His doctor advised him not to take the second dose. He received his second dose on 20Jul2021 and is scheduled for a third dose on 10Aug2021. He is to receive the third dose because we are restarting. The patient took the second shot on 20Jul2021. It has been so long they scheduled the caller for a third dose on 10Aug2021. Should the patient do that since he's already had two doses? He thinks it was more scaring him and he's not trying to blame Pfizer. The outcome of event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1721837
Sex: F
Age:
State: OK

Vax Date: 04/13/2021
Onset Date: 04/27/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: chest pain from heart; heart palpitations; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 31-years-old non-pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, formulation: solution for injection, Lot number: FW0151) via an unspecified route of administration, administered in left arm on 13Apr2021 12:00 PM (at the age of 30-years-old) as single dose for covid-19 immunisation. The medical history included covid from an unknown date and unknown if ongoing. Patient not tested for Covid post vaccination. There were no concomitant medications. Historical vaccine included first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, formulation: solution for injection, #lot ER8739) via an unspecified route of administration, administered in left arm on 22May2021 11:45 AM (at the age of 30-years-old) as single dose for covid-19 immunisation. The patient previously took amoxicillin and was allergic to Amoxicillin. On 27Apr2021, patient experienced heart palpitations and chest pain from heart. No treatment received for the adverse events. The outcome of the events was unknown. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1721838
Sex: F
Age:
State: VA

Vax Date:
Onset Date:
Rec V Date: 09/22/2021
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: She went to see her doctor who prescribed her prednisone tablets for her knee; This is a spontaneous report from a contactable consumer (patient). A 45-years-old female patient received bnt162b2 (BNT162B2, Solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on unknown date in 2021 as dose 1, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. It was reported that She went to see her doctor who prescribed her prednisone tablets for her knee. She has taken 1 dose. she got the Pfizer COVID-19 vaccine first dose two weeks ago and she just went to the doctor who prescribed her Prednisone. Sher says she would like to know, will that mess with the vaccine in her body? She says she only took one dose of it, could it do anything to her? She says that she heard it can take away if take steroids, that it can downplay vaccine. Caller would like to know if prednisone PO would interfere with the Pfizer COVID-19 vaccine. Outcome of the event was unknown. No follow-up attempts are possible; information about batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1721839
Sex: F
Age:
State: TX

Vax Date: 04/07/2021
Onset Date:
Rec V Date: 09/22/2021
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: Pharyngeal swelling

Symptoms: felt very unwell; discomfort; dizziness; Nausea; This is a spontaneous report from a contactable consumer (patient) reporting herself. A 52-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number-UNKNOWN) via an unspecified route of administration in left arm on 07Apr2021 as dose 1, single (at the age of 52 years-old) for COVID-19 immunization. The patient medical history and concomitant medications were not reported. It was reported that, on an unspecified date after the first dose, the patient experienced felt very unwell, discomfort, dizziness, nausea. Upon follow-up (04Aug2021); patient stated she got her first shot in April, but never got the second shot. She doesn't remember the anatomical location she received her first dose in, but she thinks it was in her left arm. She would like to know, since it has been so long since her first dose, if she has to start with the vaccination series from scratch. Clinical outcome of the events was unknown at the time of report. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1721840
Sex: F
Age:
State:

Vax Date: 04/19/2021
Onset Date: 04/22/2021
Rec V Date: 09/22/2021
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: Urinary tract infection; This is a spontaneous report from a non-contactable consumer, the patient. A 34-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 19Apr2021 (at the age of 34-year-old) and second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 11May2021 (at the age of 34-year-old) as a single dose for COVID-19 immunisation. Medical history was reported as none. The patient did not receive any other medicines within two weeks prior to the COVID-19 vaccine. The patient had no known allergies to medications, food or other products. 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. On 22Apr2021, a few days after the first dose the patient began to experience symptoms of UTI (Urinary Tract Infection). The UTI was non responsive to antibiotics for almost 4 months. It finally went away. The patient went to the emergency room (ER) several times and saw several different doctors and was prescribed several different antibiotics. The patient had no history of UTIs, it was very out of the ordinary for the patient. The event resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were taken as a result of the event which included antibiotics. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event UTI (Urinary Tract Infection) was resolved on an unknown date in 2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1721841
Sex: F
Age:
State: TX

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data: Test Name: Lab test; Result Unstructured Data: Test Result:unknown results

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Frustrated; next day her palm was big as her arms; Date of 2st Shot: Consumer Stated, "2 August, 2021; arm is hot and red and itchy around where the shot was; arm is hot and red and itchy around where the shot was; arm is hot and red and itchy around where the shot was; This is a spontaneous report from a contactable consumer (Patient). A 59-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; solution for injection, Lot Number: Unknown), via unspecified route of administration, in left arm on 02Aug2021 (at the age of 59-year-old) as a dose 2, single for COVID-19 immunization. The patient medical history was not reported. The concomitant medication of the patient included levothyroxine sodium (SYNTHROID). The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: Unknown) via unspecified route of administration, on 17Apr2021 as a dose 1, single for COVID-19 immunization. On 02Aug2021 the patient experienced arm was hot and red and itchy around where the shot was and bigger than it was on Monday night. Three days ago, the patient had redness. Patient was frustrated. Patient reported that her palm was big as her arms, and she was very swollen and patient stills feels it warm to the touch. Patient was informed about Pfizer Medical Information Department. Patient stated that she will call her doctor because she had already talked to three people, and it was not getting patient anywhere. So, patient was okay to not going to call anybody else. Patient had lab test 2 twice 2 weeks ago. Patient stated that she was pretty healthy. The patient received the treatment of Advil 200 mg. Outcome of all the reported events was unknown. Information about Lot/Batch has been requested.

Other Meds: SYNTHROID

Current Illness:

ID: 1721842
Sex: M
Age:
State: NC

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

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

Lab Data:

Allergies:

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

Symptoms: got the covid Pfizer plus they gave me the shingles; got the covid Pfizer plus they gave me the shingles; Chills; Headache; This is a spontaneous report from a contactable consumer (patient). A male patient of an unspecified age received dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date as single dose for covid-19 immunisation. The patient medical history was not reported. Concomitant vaccine included varicella zoster vaccine (SHINGLE VACCINE) via an unspecified route of administration from an unspecified date for immunization. The patient went this past Monday he went to get the covid Pfizer plus they gave him the shingles, they said it was ok and everything. As soon Monday came he had a little bit of chills but that went away, and he had had a headache ever since Monday and that's been 6 days now. The outcome of the event chills was recovered and the outcome of the other events was unknown. The lot number for the BNT162B2, was not provided and will be requested during follow up. Follow up (26Aug2021): New information received from a contactable consumer (patient) includes reporter information. Follow-up (07Aug2021): This case is being submitted to notify that the initial information for this case was first received by the Company on 07Aug2021 and not on 26Aug2021 as previously reported.

Other Meds: SHINGLE VACCINE

Current Illness:

ID: 1721843
Sex: F
Age:
State: NJ

Vax Date: 08/03/2021
Onset Date: 08/04/2021
Rec V Date: 09/22/2021
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: feeling uneasy; I couldn't get down water; I woke up nauseous; started vomiting violently; diarrhea; This is a spontaneous report from a contactable consumer (patient herself). A 33-years-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; Batch/Lot number was not reported), via an unspecified route of administration, administered in left arm on 03Aug2021 18:00 (age at vaccination: 33 years) as DOSE 1, SINGLE for covid-19 immunisation. The patient's medical history included immune thrombocytopenia (ITP) , splenectomy which was recovered , cerebrovascular accident from Aug2012, gastrectomy from Feb2019, covid-19 prior vaccination. Concomitant medication(s) included cetirizine hydrochloride (ZYRTEC); aspirin (acetylsalicylic acid); esomeprazole magnesium (NEXIUM); risankizumab rzaa (SKYRIZI) and sertraline hydrochloride (ZOLOFT). The patient did not have any other vaccine in four weeks. It was unknown if patient had any known allergies. On 04Aug2021 02:00, the patient woke up nauseous, started vomiting violently approximately 6 to 8 times, diarrhea and couldn't get down water. The patient was prescribed zofran for nausea and it stopped 04Aug around 8pm. I had diarrhea and nausea through 06Aug. On 08Aug2021, the patient was feeling uneasy. Still was feeling uneasy on 08Aug2021. The adverse events resulted in physicians office visit. The patient was not tested for covid post vaccination. The outcome of all the events was recovering with sequalae. The lot number for the vaccine was not provided and will be requested during follow-up.

Other Meds: ZYRTEC [CETIRIZINE HYDROCHLORIDE]; ASPIRIN [ACETYLSALICYLIC ACID]; NEXIUM [ESOMEPRAZOLE MAGNESIUM]; SKYRIZI [RISANKIZUMAB RZAA]; ZOLOFT

Current Illness:

ID: 1721844
Sex: F
Age:
State: NY

Vax Date: 08/06/2021
Onset Date: 08/08/2021
Rec V Date: 09/22/2021
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: Bright red discharge from vagina; This is a spontaneous report from a contactable consumer or other non hcp reported for herself. A 40-years-old non-pregnant female patient received BNT162B2 (BNT162B2, Pfizer-BioNTech COVID 19 vaccine, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in Arm Right on 06Aug2021 09:30 as dose1, single (age at vaccination 40 years) for covid-19 immunisation (At Pharmacy or Drug Store). The patient medical history was not reported. Concomitant medication included prednisone (other medications in two weeks) taken for an unspecified indication, start and stop date were not reported. The patient experienced bright red discharge from vagina on 08Aug2021 12:00. Patient was not received any treatment for the event. The outcome of the event was not recovered. No follow-up attempts are possible. No further information is expected.

Other Meds: PREDNISONE

Current Illness:

ID: 1721845
Sex: F
Age:
State: CA

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 09/22/2021
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: Vaginal bleeding following the vaccine for 2 days; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 30-years-old non pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in Arm Left on 21Jul2021 11:00 (at the age of 30-year-old) as dose 1, single for covid-19 immunisation. The patient medical history was not reported. Patient took Prenatal vitamins in two weeks. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 21Jul2021 18:00, the patient experienced vaginal bleeding following the vaccine for 2 days. No treatment was taken as a result of events. The outcome of the event was recovered on an unspecified date in Jul2021. Information about lot/batch number cannot be obtained. No further information expected.

Other Meds:

Current Illness:

ID: 1721846
Sex: F
Age:
State: CA

Vax Date: 07/29/2021
Onset Date: 07/30/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fatigue; Arm was sore; Headache; Nausea; Diarrhea; This is a spontaneous report from a contactable consumer reported for herself. A 22-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EM9810, Expiration date: unknown), via an unspecified route of administration, administered in the left arm on 29Jul2021 (age at vaccination was 22 years) as dose 1, single for COVID-19 immunization. The patient's medical history included none from an unknown date. There were no concomitant medications reported. On 30Jul2021, after the first dose the patient experienced fatigue, arm was sore, headache, nausea and diarrhea. The side effects went away on 01Aug2021. Patient started having side effects again on 05Aug2021. Patient began with a headache yesterday. Then on 06Aug2021, Patient started having headache, nausea, diarrhea, and fatigue. They all came back the same. Patient was on no other medications. Patient has not gone to the doctor, but she was going to call the doctor after this. The outcome of event arm was sore was unknown. The outcome of event fatigue, headache, nausea and diarrhea was not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1721847
Sex: F
Age:
State: VA

Vax Date: 08/05/2021
Onset Date:
Rec V Date: 09/22/2021
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: Shortness of breath/difficulty breathingswollen lymph nodes on same side as injection- size of grapes.; Shortness of breath/difficulty breathingswollen lymph nodes on same side as injection- size of grapes.; Shortness of breath/difficulty breathingswollen lymph nodes on same side as injection- size of grapes.; This is a spontaneous report received from a contactable nurse or other hcp. A 24-years-old non pregnancy female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VAC-CINE, formulation: Solution for injection, Batch/lot number was not reported) via an unspecified route of administration in Arm Left on 05Aug2021 13:15 (age at vaccination 24years old) as single dose for covid-19 immunisation. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Medical history included drug hypersensitivity from an unknown date and unknown if ongoing. Since the vaccination, the patient had not been tested positive for COVID-19. Concomitant medication(s) included fluoxetine hydrochloride (PROZAC) taken for an unspecified indication, start and stop date were not reported. The patient had historical vaccine of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/lot number was not reported) via an unspecified route of administration in Arm Left on 08Jul2021 at 08:30 PM (age at vaccination 24years old) as single dose for covid-19 immunisation. On an unspecified date the patient experienced shortness of breath/difficulty breathing swollen lymph nodes on same side as injection- size of grapes. The patient received treatment for the adverse events reported as unknown. The clinical outcome of the event was not recovered. Follow-up attempts are completed. No further information is expected.

Other Meds: PROZAC

Current Illness:

ID: 1721848
Sex: F
Age:
State: MO

Vax Date: 07/21/2021
Onset Date: 07/29/2021
Rec V Date: 09/22/2021
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: Golf ball sized knot; Swelling of arm; hives; rash; Slow Breathing.; This is a spontaneous report from a contactable consumer. A 35-years-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0182, Expiration date was not reported), dose 1 via an unspecified route of administration, administered in Arm Right on 21Jul2021 11:00 (age at vaccination 35 years) as dose 1, single for covid-19 immunisation. Medical history included known allergies: Latex. There were no concomitant medications. The patient previously took codeine and experienced drug hypersensitivity, historical vaccine flu vaccine vii and experienced drug hypersensitivity. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 29Jul2021 the patient experienced golf ball sized knot, swelling of arm, purple colour hives, rash, slow breathing. Patient visited doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care. Patient received treatment of 40Mg prednisone, benadryl every 3 hours, zyrtec 2x. The outcome of events was recovered with sequelae. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1721849
Sex: F
Age:
State: CO

Vax Date: 05/21/2021
Onset Date: 05/24/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: After I got the vaccine my period came three days after but it was a week and a half early and I have never had that with my cycle; Then after the first shot my period went away for two and a half months; Then came back and I have been bleeding for 16 days straight.; My period is still flowing and my iron is very low due to how heavy it is.; This is a spontaneous report from a contactable consumer or other non hcp. A 29-years-old female patient received bnt162b2 (BNT162B2) Solution for injection, dose 1 (Lot number expiry date was not reported) via an unspecified route of administration at arm right on 21May2021 14:00 (at the age of 29-years-old) as a single dose, dose 2 (Lot number expiry date was not reported) via an unspecified route of administration at arm right on 06Jul2021 as a single dose for covid-19 immunisation. Medical history and concomitant medications were not reported. Patient did not have known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. After she got the vaccine her period came three days after, but it was a week and a half early and she have never had that with her cycle. Then after the first shot her period went away for two and a half months. Then came back and she have been bleeding for 16 days straight. she went to the doctor and they can't find any reason why her period was doing this as they checked her hormone levels and did a pap. Her period was still flowing, and her iron was very low due to how heavy it was. Outcome of the events was not recovered.

Other Meds:

Current Illness:

ID: 1721850
Sex: F
Age:
State: CA

Vax Date: 02/10/2021
Onset Date:
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Post-vaccination she experienced numbness on her face; This is a spontaneous report from report from Pfizer-sponsored program Support via a contactable consumer or other non HCP (Patient). A female patient of an unspecified age received bnt162b2 (BNT162B2 Formulation solution for injection), dose 1 via an unspecified route of administration on 10Feb2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation. Medical history included bell's palsy (when she was younger) from an unknown date and unknown if ongoing. The patient's concomitant medications were not provided. Post-vaccination on an unknown date, the patient experienced numbness on her face. It was reported that she experienced these AEs post-vaccination of her 1st dose, caller decided not to get her 2nd dose. In line with this, caller would like to know if, if she decides to get her 2nd dose , in terms of efficacy, does she need to restart her whole 2 dose series or can she proceed in getting her 2nd dose as is. The patient decided not to get her second dose and she want to know if she decides to get her second dose, in terms of efficacy, does she need to restart her whole 2 dose series or she proceed in getting her second dose. The outcome of event was unknown. The batch number is not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected.

Other Meds:

Current Illness:

ID: 1721851
Sex: M
Age:
State: PA

Vax Date: 08/05/2021
Onset Date: 08/01/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pain in the injection site in his left arm/shoulder; This is a spontaneous report from a contactable consumer or other non-health care professional. A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) via an unspecified route of administration, administered in left arm on 05Aug2021 (at the age of 73-year-old) as dose 1, single for covid-19 immunisation. The patient's medical history and concomitant medications were not reported. On an unspecified date in Aug2021, the patient experienced pain in his left shoulder at the injection site and asked if it was normal to feel this pain. Among the Pfizer-BioNTech COVID-19 Vaccine recipients, mild-to-moderate pain at the injection site within 7 days after an injection was the most commonly reported local reaction", that approximately 84% of clinical trial recipients experienced pain at the injection site as well. Patient wanted to know why was that he still felt the pain in the injection site in his left arm/shoulder in his first dose. Outcome of the event was not resolved. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up. This follow-up is being submitted to notify that the batch number is not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected.

Other Meds:

Current Illness:

ID: 1721852
Sex: F
Age:
State:

Vax Date: 04/01/2021
Onset Date:
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: headache that would come and go; a little bit of chest pain; This is a spontaneous report from a contactable consumer. A female patient of an unspecified age received second 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 Apr2021 as dose 2, single for covid-19 immunisation. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient previously took 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 Apr2021 as dose 1, single for covid-19 immunisation and experienced headache. On an unspecified date in 2021, the patient experienced headache and chest pain. It was reported that after shot 1 Patient experienced headache that would come and go After shot 2 Patient also experienced a headache that would come and go and a little bit of chest pain after the second shot. Event took place after use of product. She received both shots in Apr2021. The outcome of the event headache was not recovered while the outcome of the other event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1721853
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/22/2021
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: No longer lactose intolerant; This is a spontaneous report from a contactable consumer or other non hcp (patient). A patient of unspecified age and gender received unspecified dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, formulation: solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunization. The patient's medical history included lactose intolerance from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. The patient was no longer lactose intolerant after receiving COVID-19 vaccine. The outcome of the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up. Follow-up (17Sep2021): Follow-up attempts completed. information about lot/batch number cannot be obtained. No further information expected.

Other Meds:

Current Illness:

ID: 1721854
Sex: F
Age:
State: NY

Vax Date: 01/01/2021
Onset Date:
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: her heart was racing and she was having an anxiety attack and started shaking; her heart was racing and she was having an anxiety attack and started shaking; her heart was racing and she was having an anxiety attack and started shaking; This is a spontaneous report from Pfizer-sponsored program from a contactable female consumer (patient). A female patient of over 65-year of age (exact age: not specified) received first dose of bnt162b2 (Pfizer BioNtech Covid 19 vaccine, Solution for injection, Batch/lot number: Not Provided, Expiry date: Not provided), via an unspecified route on an unspecified date in Jan2021 and second dose of bnt162b2 (Pfizer BioNtech Covid 19 vaccine, Solution for injection, Batch/lot number: Not Provided, Expiry date: Not provided), via an unspecified route on an unspecified date in Feb2021, both as a single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. On an unknown date, patient heart was racing, and she was having an anxiety attack and started shaking. Her question was that she wanted to make sure she was fully vaccinated, and it was still effective after so much time had passed or if she needed to be revaccinated. The clinical outcome of the events was unknown. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1721855
Sex: F
Age:
State:

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 09/22/2021
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 Name: Temperature; Result Unstructured Data: Test Result: 101.1; Comments: temperature keeps goes up and up; right now it is 101.1.

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: experiencing a fever that is continually rising and is up to 101.1 degrees Fahrenheit; Feels bad; hard to talk because of the fever; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 64-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number and Expiry date: not reported), via an unspecified route of administration on 09Aug2021 as dose 1, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced, a fever that was continually rising and is up to 101.1 degrees Fahrenheit, hard to talk because of fever, and feels bad on an unspecified date in 2021. She reported that, since 4 AM today, she had been experiencing a fever that was continually rising, and was up to 101.1 degrees Fahrenheit. She also reported it was hard to talk because of the fever. Referred caller to HCP (healthcare professional) for treatment. The patient was seeking information about this side effect. Yesterday she got her 1st injection of the Pfizer BioNtech Covid Vaccine (09Aug2021). Today (10Aug2021) her temperature kept going up and up, right now it was 101.1. Caller began to say something about her head but did not complete the sentence. Stated only that she felt bad. The patient underwent lab tests and procedures which included body temperature increased 101.1 on an unspecified date temperature keeps goes up and up, right now it is 101.1. Reason for no lot number of Pfizer BioNtech Covid Vaccine. Caller unwilling to complete the report. The outcome of the events was not recovered at the time of this report. No follow-up attempts are possible, information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1721856
Sex: F
Age:
State: PA

Vax Date:
Onset Date: 08/04/2021
Rec V Date: 09/22/2021
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: redness on the injection site and soreness in the arm where she got the shot; redness on the injection site and soreness in the arm where she got the shot; Redness and soreness in left arm; This is a spontaneous report from a contactable consumer or other non-Health Care Professional from a Pfizer sponsored program. A 63-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number and Expiry date: Unknown), dose 2 via an unspecified route of administration, administered in Arm Left on an unspecified date at the age of 63-years-old as DOSE 2, SINGLE for covid-19 immunization. The patient medical history was not reported.There were no concomitant medications. The patient did not receive any other vaccines within 4 weeks prior to the Covid vaccine. On 04Aug2021 the patient experienced redness on the injection site and soreness in the arm where she got the shot, redness and soreness in left arm.The outcome of events was unknown. Information on lot/ batch number has been requested.

Other Meds:

Current Illness:

ID: 1721857
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 09/22/2021
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: Had a bruise for 7 days and it hurt a lot for several days; Had a bruise for 7 days and it hurt a lot for several days; swelling on the arm; The first time it was only purple/purple stain on her arm; This is a spontaneous report from a contactable consumer (patient) reported for herself. A female patient of an unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number: unknown, Expiration date: unknown) via an unspecified route of administration, administered in arm on an unspecified date in 2021 (age at vaccination was unknown) as dose 1, single for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient stated that she had the first vaccine three or four months ago, 4 hours later she had a bruise for 7 days and it hurt a lot for several days not where the vaccine was applied but in the middle of the injection arm on an unspecified date in 2021. Had like a bruise, purple stain on her arm. It was very hard. The first time it was only purple on an unspecified date in 2021. All around the arm there was swelling on the arm on an unspecified date in 2021. The patient stated that the swelling was not too much. It was the color purple. It was on the middle. The patient stated that it was just after the first dose. It was not where the vaccine was applied, it is in the middle of the injection arm. The patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number: unknown, Expiration date: unknown) via an unspecified route of administration, administered in arm on an unspecified date in 2021 (age at vaccination was unknown) as dose 2, single for COVID-19 immunization. The case was assessed as non-serious. The outcome of the events had a bruise for 7 days and it hurt a lot for several days was resolved on an unspecified date in 2021. The outcome of the other 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: 1721858
Sex: F
Age:
State: NY

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 09/22/2021
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: didn't have any side effects except at most a sore arm for a few days; This is a spontaneous report from a contactable consumer (patient). A 73-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on 15Jan2021 (at the age of 73 years old) as dose 1, single for COVID-19 immunisation. Medical history included smoking for 50 years and was up to two packs a day, spot on her lung. Concomitant medication(s) included varenicline tartrate (CHANTIX) taken for smoking cessation therapy from 01Jul2021 to 20Jul2021. Historical vaccine included FLU on an unspecified date for immunisation and experienced sore arm. Patient got her second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 05Feb2021 for COVID-19 immunisation. The patient experienced as, "didn't have any side effects except at most a sore arm for a few days" on 15Jan2021. Reported as, she got the Pfizer COVID vaccine and all of her friends did, and they all did great with no side effects. At most they had sore arms like a flu shot. Outcome of the event was recovered on 16Jul2021. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds: CHANTIX

Current Illness:

ID: 1721859
Sex: F
Age:
State:

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

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

Lab Data: Test Name: WBC; Result Unstructured Data: Test Result:Low

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: WBC was low; felt lethargic; This is a spontaneous report from a contactable consumer. This 61-year-old female consumer (patient) reported for herself. A 61-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; solution for injection, Lot Number: UNKNOWN), dose 1 via an unspecified route of administration on an unspecified date as a single dose for covid-19 immunization. The patient's medical history and concomitant medications were not reported. Patient reported she is taking 125mg tablets for two weeks on followed by two week off, then starting Ibrance 100mg after September 1st due to chronically low WBC count. Reported after her first Covid vaccine, her WBC was low and she felt lethargic, but it did not occur with 2nd vaccine. Outcome of the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1721860
Sex: F
Age:
State: GA

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 09/22/2021
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: she had soreness to her arm like the first, which she had gotten in her right arm; This is a spontaneous report from a contactable consumer. This consumer reported for 26-year-old female patient. A 26-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, formulation: Solution for injection, Batch/Lot Number: unknown) via unknown route of administration, administered in right arm on unspecified date in Jul2021, as dose 1, single for COVID-19 immunisation. The patient medical history was not reported. The concomitant medications included Products ascorbic acid, herbal nos, levoglutamide, lysine, magnesium, manganese, retinol, riboflavin, selenium, tocopherol, zinc (AIRBORNE), colecalciferol (VITAMIN D), ascorbic acid, biotin, calcium pantothenate, cyanocobalamin, folic acid, nicotinic acid, pyridoxine hydrochloride, riboflavin, thiamine hydrochloride, tocopheryl acetate (MULTIVITAMIN), sambucus nigra (ELDERBERRY) on unspecified date and took two Tylenol two days ago for her cycle, because she was aching from her cycle. It was reported patient received her first dose was in July, it was like a two-week period between them, so she thought it was on 30Jul or 26Jul. She reported that the ache or tired like feeling just started around 3:30PM, afternoon. She reported she kept checking on her yesterday and last night to make sure she was not feverish or feeling bad, and morning she had soreness to her arm like the first, which she had gotten in her right arm, then got the second in her left arm since they told her she couldn't take both shots in same arm. She said her daughter was fine when she left here outside of the soreness of the arm and redness at the injection site and complaining of hurting. An hour ago, she had aching to the bend of her knee like a tired feeling like she has been walking too much. She said her daughter had not treated the ache or tired feeling because it just started about an hour ago. At the time of this report the outcome of the events was unknown. The lot number for the vaccine was not provided and would be requested during follow up.

Other Meds: AIRBORNE; VITAMIN D [COLECALCIFEROL]; MULTIVITAMIN [ASCORBIC ACID;BIOTIN;CALCIUM PANTOTHENATE;CYANOCOBALAMIN;FOLIC ACID;NICOTINIC ACID;PYR; ELDERBERRY [SAMBUCUS NIGRA]

Current Illness:

ID: 1721861
Sex: F
Age:
State: CO

Vax Date: 07/25/2021
Onset Date: 08/02/2021
Rec V Date: 09/22/2021
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: A bump at the injection site; large round welt appeared at the injection site raised red hot to the touch and sore; large round welt appeared at the injection site raised red hot to the touch and sore; large round welt appeared at the injection site raised red hot to the touch and sore; This is a spontaneous report from a contactable consumer (patient herself). A 46-years-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; Batch/Lot number was not reported), via an unspecified route of administration, administered in left arm on 25Jul2021 14:00 (age at vaccination: 46 years) as DOSE 1, SINGLE for covid-19 immunisation. The patient's medical history included giant cell tumour of tendon sheath, PVNS in my right knee, knee arthroplasty and high blood pressure. Concomitant medication(s) included olmesartan. The patient had no known allergies. The patient had covid prior to vaccination. On 02Aug2021 19:00, slightly over 24 hours of receiving the vaccination, the patient started to have a bump at the injection site, large round welt appeared at the injection site raised red hot to the touch and sore. On 03Aug2021 at around 11AM (Tuesday morning) a large round welt appeared at the injection site raised red. The patient did not receive any treatment for the adverse event. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The adverse events resulted in physician's office visit. The patient was not diagnosed with covi-19 prior to vaccination nor was tested since vaccination. The outcome of all the events was unknown. The device date was 10Aug2021. The lot number for the vaccine was not provided and will be requested during follow up.

Other Meds: OLMESARTAN

Current Illness:

ID: 1721862
Sex: M
Age:
State: AZ

Vax Date: 08/06/2021
Onset Date: 08/01/2021
Rec V Date: 09/22/2021
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: sore and swollen arm for three days; sore and swollen arm for three days; severe headaches; clammy skin; blood pressure has been low; has no appetite; vertigo; having sweating; dizziness; This is a spontaneous report from a contactable consumer (patient mother) or other non-healthcare professional. A 47-year-old male patient received BNT162B2 (COMIRNATY; Solution for injection; Lot number, Expiry date: Unknown), via an unspecified route of administration on 06Aug2021 (at the age of 47-year-old) as dose 1 single for covid-19 immunization. The patient medical history and concomitant medications were not reported. On an unknown date in Aug2021 the patient experienced severe headaches, clammy skin, vertigo, his blood pressure has been low and has no appetite. The patient received the first dose of the vaccine Pfizer since the patient been experiencing sweating and having headache and something that did not realize dizziness, the patient had dizziness where he's spinning the room is not spinning it is preventing him from going to work because he drives, now is this a possible side effect of the medication. Initially the patient experienced a sore and swollen arm for three days but that has now (at the time of report) subsided. The patient received Tylenol, 500 MG each, two tablets (twice a day) as a therapeutic measure for the events. The patient did not receive any treatment Prior Vaccination. The event sore and swollen arm was recovered, the events severe headaches, clammy skin, vertigo, his blood pressure has been low and has no appetite was not recovered and outcome of the events sweating, dizziness was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1721863
Sex: F
Age:
State: LA

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

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

Lab Data:

Allergies:

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

Symptoms: She wanted to know if she can take over-the-counter medications for her symptoms. (like Tamiflu and cough medications); She wanted to know if she can take over-the-counter medications for her symptoms. (like Tamiflu and cough medications); This is a spontaneous report from a contactable consumer (patient). A female patient of an unspecified age received first dose of bnt162b2 (Pfizer-BioNTech COVID-19 Vaccine, Solution for injection, Batch/Lot number was not reported, Expiry date was not reported), dose 1 via an unspecified route of administration on an unspecified date as dose 1, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced she wanted to know if she can take over-the-counter medications for her symptoms (like tamiflu and cough medications). The clinical outcome of the events was unknown. The lot number for the vaccine was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1721864
Sex: F
Age:
State: NC

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 09/22/2021
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: Nauseous; throwing up; little bit of diarrhea; I am going on a week of feeling awful.; really run down/ tired; This is a spontaneous report from a contactable consumer (patient). A 26-year-old-female (patient) reported herself that she received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in arm left on 04Aug2021 (Batch/Lot number was not reported) as dose 1, single for (at the age of 26-year-old) covid-19 immunisation. The patient medical history and was not reported. The patient was on other medication (Birth control). Consumer stated, she got her first shot a week ago last Wednesday (04Aug2021) and she felt pretty good on Wednesday just like tired and 'out a bit' which was excepted. She woke up last Thursday morning (05Aug2021), super nauseous and throwing up and little bit of diarrhea and then and she have been nauseous ever since last Thursday. So, she was going on a week of feeling awful. Therapeutic measures were taken as a result of nauseous, she had taken over the counter nausea medicine Zofran. The clinical outcome of events nauseous and feeling awful were not recovered, events really run down/ tired, throwing up and little bit of diarrhea were unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1721865
Sex: U
Age:
State: NY

Vax Date: 05/01/2021
Onset Date: 07/01/2021
Rec V Date: 09/22/2021
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: extreme fatigue; aching nerve pain in hands and calves; aching nerve pain in hands and calves; This is a spontaneous report from a Pfizer sponsored program. A contactable consumer or other non hcp reported that a patient of unspecified age and gender received bnt162b2 (BNT162B2, solution for injection), dose 2 via an unspecified route of administration in May2021 as DOSE 2, SINGLE for covid-19 immunisation. The patient medical history was not reported. The patient previously received first dose of bnt162b2, via an unspecified route of administration, administered on an unspecified date as dose 1, single for covid-19 immunisation. The patient's concomitant medications were not reported. The patient experienced extreme fatigue, aching nerve pain in hands and calves on Jul2021. It was stated that, had pfizer second shot in may. Now since July extreme fatigue and aching nerve pain in hands and calves. Outcome of the events was not recovered. Information about lot/batch number cannot be obtained. No further information expected.

Other Meds:

Current Illness:

ID: 1721866
Sex: M
Age:
State: CO

Vax Date: 08/06/2021
Onset Date: 08/08/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data: Test Date: 202106; Test Name: Nasal Swab; Test Result: Negative

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Itchy hives developed near my lower part body near leg and but tuck 24-32 hours after vaccine. I woke up 4 AM due to itch, and took zyrtec for the hives. Hives went away in the morning when I woke up; Itchy hives developed near my lower part body near leg and but tuck 24-32 hours after vaccine. I woke up 4 AM due to itch, and took zyrtec for the hives. Hives went away in the morning when I woke up; started to notice tinnitus or ringing in my ear as well.; This is a spontaneous report from a contactable consumer or other non-health care professional (Patient). A 42-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot number was not reported) via an unspecified route of administration, administered in Arm Right on 06Aug2021 11:45 AM (at the age of 41-years-old) as dose 1, single for covid-19 immunization at Doctor's office/urgent care. Medical history included known allergies to pollen, dust mite, tumble weeds, cat, dog all from an unknown date to unknown if ongoing and No spleen and only one kidney due to an accident, single functional kidney. Concomitant medications included colecalciferol (VITAMIN D [COLECALCIFEROL]), tocopherol (VITAMIN E [TOCOPHEROL]), vitamin c [ascorbic acid] (VITAMIN C [ASCORBIC ACID]), ubidecarenone (COQ10 [UBIDECARENONE]), turmeric [curcuma longa rhizome] (TURMERIC [CURCUMA LONGA RHIZOME]) all were taken for an unspecified indication, start and stop date were not reported. Patient did not receive other vaccines within four weeks of vaccination. Patient had no covid prior vaccination and has been tested for covid post vaccination. On 08Aug2021, at 02:00Am patient developed Itchy hives near his lower part body near leg and but tuck 24-32 hours after vaccine. He woke up 4 AM due to itch and took zyrtec for the hives. Hives went away in the morning when he woke up. And also started to notice tinnitus or ringing in his ear as well, it was developed a day after vaccine, and he still have it so patient reporting the side effects. Not sure if tinnitus going to go away. That was the two side effects that are obvious to him so far. The patient underwent lab tests and procedures which included sars-cov-2 Nasal Swab test results negative for Covid-19 on an unknown date in Jun2021. Patient did not receive any treatment for the events itchy and Tinnitus and took Zyrtec for Hives. Outcome of the event hives was recovered on an unknown date in Aug2021 and not recovered for Itchy and Tinnitus. No follow-up attempts are possible; Information about lot/batch number cannot be obtained. No further information is expected.

Other Meds: VITAMIN D [COLECALCIFEROL]; VITAMIN E [TOCOPHEROL]; VITAMIN C [ASCORBIC ACID]; COQ10 [UBIDECARENONE]; FIBER; TURMERIC [CURCUMA LONGA RHIZOME]

Current Illness:

ID: 1721867
Sex: M
Age:
State:

Vax Date: 08/10/2021
Onset Date:
Rec V Date: 09/22/2021
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: Weird metal taste that I have been having in my mouth; This is a spontaneous report from a contactable consumer (patient). A 45-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: Unknown; Expiry Date: Unknown), via an unspecified route of administration, administered in Arm Left on 10Aug2021 (at the age of 45-years-old) as dose number unknown, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient did not receive any Other Products. The patient experienced "weird metal taste that i have been having in my mouth" on an unspecified date. The patient reported that he was just calling, the list of side effects that they listed, one of the side effect he had experienced, he found online, it was saying it was rare and he figured out to call in and report it, it was not dangerous but it was just weird metal taste that he has been having in his mouth since yesterday when he got the vaccination. The patient reported that he does annual exams but did not specify and said June this year not that long ago. He reported that he did not get any kind of treatment since the COVID shot, no. Outcome of the event was unknown. Information on the Lot/batch number has been requested. Follow-up activities closed. Batch/lot number not available for [Vaccine, BNT162B2]

Other Meds:

Current Illness:

ID: 1721868
Sex: F
Age:
State: CA

Vax Date: 03/29/2021
Onset Date:
Rec V Date: 09/22/2021
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: rash on buttocks; rash on back, elbows, thighs and parts of her legs; rash itches; slashes down her legs; This is a spontaneous report from a contactable consumer (patient). A 91-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: Unknown), via an unspecified route of administration in left arm on 29Mar2021 (at the age of 90-year-old) as dose 2, single for COVID-19 immunisation at vaccination facility type. Medical history included high blood pressure from an unknown date and unknown if ongoing (Has had high blood pressure since she was 65 years old), had pain in her head and had to go to the doctor from an unknown date and unknown if ongoing. Concomitant medications included levothyroxine sodium taken for headache from an unspecified start date and ongoing (Has been taking at least 2 years because not only did they she has to be taken care of, but she got a little hardware in her head. She was fine and it did not affect her cognitive skills and the patient took because of pain in her head and had to go to the doctor); atorvastatin taken for an unspecified indication from an unspecified start date and ongoing (Has been taking a very long, she does not when she started. Every time she goes to the doctor, she was given another pill. She states the main name was Lipitor, and indication was unknown); losartan potassium taken for hypertension from an unspecified start date and ongoing (Believes it would be her blood pressure medication); carvedilol taken for an unspecified indication from an unspecified start date and ongoing (the tablets are tiny little things. You could lose them if not careful, they are so small); amlodipine besylate taken for hypertension from an unspecified start date and ongoing; vitamin d nos taken for an unspecified indication from an unspecified start date and ongoing. The patient previously took bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EN6205, Expiration date: Jun2021), via an unspecified route of administration in left arm on 08Mar2021 (at the age of 90-year-old) as dose 1, single for COVID-19 immunisation. Caller stated since she had these 2 shots a month apart in Apr2021, she has come down with a rash on her behind. When it started, she went to see her doctor who gave her a cream and it did not work. It was really bad all over. She went to the emergency room and saw 2 doctors and a third doctor who was a dermatologist. The dermatologist said that it reminded them of a baby's diaper rash but bigger. Stated that it looked very sore, and caller stated that it was. He gave her an antibiotic and some more cream. She cannot see her doctor for another week or 2 because all of the appointments have been taken. The rash was now into her back on her elbows and thighs and part of her legs. No one knows what it was. She cannot believe it. Never in her life has she had this before. It came into her life after the first and second Pfizer shots. What was she to do? She called her insurance company, and they gave her this number to call to report it and to the centre for disease control, the CDC or something, whatever that means. She cannot go online because she was 91 years old. She was not an older looking lady, but all she has was a house phone and a cellular phone. She was never gone online and never had a reason to get a smart phone or computer. She had the shots in Apr2021, and that it was 08Apr2021 and 29Apr2021. Caller asked why they would give double to somebody? she was told that it was double the amount in the second shot. When she took the first one, people were saying that you get a double dose for the second shot. Stated that her doctor told her to get the shots because she was in the danger zone because of her age. She lives alone and was doing fine, with not a cold and not even a sniffle. The doctor told her she should take it and she did what she was told, and now looked what happened to her. She thought maybe we could help her. She was still driving and getting around. She was currently 91 years old, but she had the rash before her birthday in April. She was 90 then and was 91 now. She went to all these doctors and no one could tell her what was in the vaccine and no one knows what the rash was. The caller stated since the rash was on her backside, when she goes to sit down or lie down in bed, if she was on her back, that hurts. Stated that we can call her to make an appointment. Gave permission to contact her as long as it was about her rash. The food and drug administration has not put the ok in it. A doctor she had 30 years ago, who has since passed away, was a doctor in the Air Force. He told her all of his patients, if the government ever puts anything out that was countrywide, do not take it. Whatever you do, do not take it. if you get sick, they will go to the hospitals and they will be taken care of. This was 30 or 40 years ago. Not one person in the armed forces has been vaccinated as of this day, she looked it up. Said they were never taking it because of the government. Cannot go anywhere if you do not have a card with the vaccination. She just got off the phone with the insurance company and the registered nurse said that all they do was give out these numbers that Pfizer was who are taking down complaints from people are coming down with everything. Started 2 to 3 weeks after the shot when the stuff got into her system. It was red and sore all over on her behind. The rash now has like a dryness to it. She compares her skin feeling like if you took a piece of paper and squeezed it and it was all wrinkled down-that was what her skin was like. Her skin was not firm like it was, it was all dry and wrinkly. When she touches, it was rough. The rash was all over her back now. The rash was on her buttocks, but not as far wide as it was but it was on both of her hips and elbows. When she bends her elbows, it was there. There was also some on her upper legs. The one that bothers her was when she sits, it was really sore, and the pressure goes up into it. The rash has gotten worse. It was just on her buttocks and now it has travelled up her back. She took the mirror on her door to the one she looked through, and she could see these red slashes all the way down and she could feel them. She lives alone and does not have anyone that can look at it. That was within the last month or so. Caller read the diagnosis from her paper was dermatitis (L-30-9), from the allergist. The spelling of dermatitis was captured as provided by the caller. The allergist states she was allergic to penicillin. She was in her 60's, when she all of a sudden got a reaction to the penicillin. She ended up in the hospital with 2 other people going through the same thing. The caller confirms she does not have any NDC, Lot or expiry date for the Penicillin. Provided names of medication from list form her emergency room visit. Clotrimazole topic 1 application given to her on 08Jul2021, and she sees the number, 142200PDT beside this medication on her paper. Spelling of product name captured as provided by the caller. Azithromycin, 250mg, oral given on 08Jul2021 and provided the number, 142400PDT that she saw on her paper. She states she went to pick these prescriptions up from the pharmacy. She confirmed she was not still currently taking these medications. These prescriptions did not last very long. The cream was only 1 ounce. She was using it twice a day and it did not last very long, and that was just her buttocks at that time. The oral medication, she took 2 the evening of picking up the medication and then 3 the next 3 nights. Before, the rash was just her buttocks. After she went to him, it started working its way up the back. Her daughter in law who was training to be a registered nurse asked her if the rash itches and she said that it did, a lot on the back. She told her to take Benadryl. The last 2 days she did, she only took 1 pill yesterday and 1 pill today. If she was not to take it, she will stop it. Will it harm her or was it okay for her to take it? She states the "PRIVACY" helps w

Other Meds: LEVOTHYROXINE SODIUM; ATORVASTATIN; LOSARTAN POTASSIUM; CARVEDILOL; AMLODIPINE BESYLATE; VITAMIN D NOS

Current Illness:

ID: 1721869
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: a bad rash; This is a spontaneous report from a contactable pharmacist. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 2021 as dose 1, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On an unspecified date in 2021, the patient experienced a bad rash. Reporter stated that the doctor recommended not to get the 2nd dose and restart the vaccination series, but others advised the patient to go ahead and get the 2nd dose. The outcome of the event was unknown. Information about lot/batch number cannot be obtained. No further information expected.

Other Meds:

Current Illness:

ID: 1721870
Sex: U
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 09/22/2021
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: We only had a sore arm from the second shot; This is a spontaneous report from a contactable consumer (patient). A 70-year-old patient of an unspecified gender received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection, Lot number and expiration date was not reported) via an unspecified route of administration on an unspecified date as dose 2, single for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. Patient historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection, Lot number and expiration date was not reported) via an unspecified route of administration on an unspecified date for COVID-19 immunization (at the age of 70-year-old) and no adverse reaction was reported. The patient experienced we only had a sore arm from the second shot on an unspecified date. It was reported that, they could help to get more to get vaccinated. Patient only had a sore arm from the second shot and this would give data on any possible side effects so when a booster was recommended, would have this data ready for those who would be hesitant. The outcome of the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up. No follow-up attempts are needed; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101042090 same reporter/drug/AE, different patients

Other Meds:

Current Illness:

ID: 1721871
Sex: M
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 09/22/2021
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: We only had a sore arm from the second shot; This is a Spontaneous report from a contactable consumer. This contactable Consumer(reporter's wife) reported for a 76-year-old patient(husband) that who received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: Not reported) on an unknown date via an unspecified route of administration, as SINGLE for COVID-19 immunization. The patients medical history and concomitant medications were not reported. Historical vaccine included received his first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: Not reported) on an unknown date via an unspecified route of administration, as SINGLE for COVID-19 immunization. On an unknown date the patient reported as had a sore arm from the second shot. Outcome of the events was unknown. Lot/batch number is not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101042067 same reporter/drug/AE, different patients

Other Meds:

Current Illness:

ID: 1721872
Sex: M
Age:
State: KY

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: violent diarrhea; Sweating; chills; This is a spontaneous report from a contactable consumer (patient, self reported). A 52-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number and expiry date was not reported), via an unspecified route of administration, in Arm right, on 12Aug2021 at 02:00 PM (Age at vaccination: 52 years), as a Dose 2, single for COVID-19 immunization. Historical vaccine included first dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number and expiry date were not reported), via an unspecified route of administration, in Arm right, on 22Jul2021 at 10:00AM (Age at vaccination: 52 years), as a Dose 1, single for COVID-19 immunization. The medical history was not reported and patient did not had any known allergies. Concomitant medication included clomiphene citrate (Clomiphene). The patient did not receive other vaccine in four weeks. The patient was not diagnosed with COVID prior vaccination. The patient was not tested for COVID post vaccination. On 12Aug2021 at 6:00PM, the patient experienced violent diarrhea, Sweating and chills. It was unknown that the patient received treatment for the events. Outcome of the events were not recovered. No follow-up attempts are possible. No further information is expected.

Other Meds: CLOMIPHENE CITRATE

Current Illness:

ID: 1721873
Sex: U
Age:
State: VA

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

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

Lab Data: Test Date: 2021; Test Name: Blood test; Result Unstructured Data: Test Result:my blood test came out no disease; Comments: my blood test came out no disease

Allergies:

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

Symptoms: I had my vaccines and suddenly after two weeks approximately felt the tick symptoms disappear/After the covid vaccine my blood test came out no disease; 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), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose 2, single for covid-19 immunisation. Medical history included tick disease (serious tick disease for 3 years). The concomitant medications of the patient were not reported. The patient reported that after taking her second covid vaccine a strange event occurred. She has a serious tick disease for 3 years, and it reoccurs around the same months. She could feel it coming back. Then she had her vaccines and suddenly after two weeks approximately felt the tick symptoms disappeared. She had been having blood test every 3 months for 3 years to check the titers level. The disease was always present at different levels. After the covid vaccine her blood test came out no disease. The patient underwent lab tests and procedures which included blood test: blood test came out no disease on an unspecified date of 2021. The outcome of event was unknown. Information about lot/batch number cannot be obtained. No further information expected.

Other Meds:

Current Illness:

ID: 1721874
Sex: U
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 09/22/2021
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: eczema; This is a spontaneous report from a contactable pharmacist. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Solution for injection, Lot number and Expiration date was 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 was not reported. Concomitant medications included dupilumab (DUPIXENT) taken for eczema, start and stop date were not reported. The patient experienced eczema on an unspecified date. It was reported that for a patient who got the COVID 19 vaccine on Monday. The patient's mom was called that the patient was on Dupixent for eczema, an injection every 14 days. She wanted to know if it was ok to get the injections tomorrow since having the vaccine on Monday. The outcome of the event was unknown. No follow-up attempts are possible, information about lot/batch number cannot obtained. No further information is excepted.

Other Meds: DUPIXENT

Current Illness:

ID: 1721875
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/22/2021
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: extreme immune response to the vaccine; back ache; inflammation; This is a spontaneous report from a contactable other HCP via medical information team. Other HCP reported for a 5-decade-old (Age: 40's) male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), dose 1 via an unspecified route of administration on an unspecified date as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced extreme immune response to the vaccine, back ache and inflammation on an unspecified date. The outcome of events was unknown. Information on the lot/ batch number has been requested.

Other Meds:

Current Illness:

ID: 1721876
Sex: M
Age:
State: CA

Vax Date: 08/05/2021
Onset Date: 08/09/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data: Test Date: 20210813; Test Name: COVID-19 Test; Test Result: Negative ; Comments: Nasal Swab

Allergies:

Symptom List: Vomiting

Symptoms: shortness of breath; tightness of chest; mild chest pains; This is a spontaneous report from a contactable consumer (Patient). A 27-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number: EW0167), via an unspecified route of administration, on 05Aug2021 at 14:30 (at the age of 27-year-old), as dose 1, single in left arm for COVID-19 immunisation at Pharmacy/Drug Store. The patient's medical history included pre-diabetic, alcoholism, and severe dust mite allergy. Concomitant medications were not reported. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 09Aug2021, after first dose of vaccine, the patient experienced shortness of breath, tightness of chest, and mild chest pains. Patient did not receive treatment for the adverse events. Adverse events resulted in Physician office visit. The patient had no COVID prior vaccination and was tested COVID post vaccination. The patient underwent lab test and procedure which included SARS-CoV-2 test (nasal swab): negative, on 13Aug2021. The clinical outcome of all events was not recovered. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1721877
Sex: F
Age:
State: NC

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

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Met the worst case, purple bumps all over your body; dealing with it through tears and pain and itching; Met the worst case, purple bumps all over your body; dealing with it through tears and pain and itching; Met the worst case, purple bumps all over your body; dealing with it through tears and pain and itching; Met the worst case, purple bumps all over your body; dealing with it through tears and pain and itching; This is a spontaneous report received from a contactable consumer. This consumer reported for a Female patient (Daughter in Law). This is the first case out of 3 split cases. A female patient of an unspecified age received bnt162b2 (Pfizer-BioNTech COVID-19 Vaccine, solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunisation. Medical history included auto immune condition from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. Reporter stated, My daughter in law has an auto immune condition, and after she took the shot, the vaccine (Pfizer COVID 19 Vaccine) she has met the worst case ever as I complaint this which was that where you get these purple bumps all over your body. So, I just wanted to report that, she was dealing with it through tears and pain and itching. But I really would recommend that something needs to be said prior to getting that shot. If you have an auto-immune condition that really needs to be truly discussed with their doctor because anyone with the auto-immune condition is sounds like to me they are having some trouble. It is just breaking in my heart (general sentence) So, I just wanted to report that, it is horrible. Reporter further stated, What strange was, I have met two other people that have developed the same condition So, anyway I really think a warning or just say you know kind of deal. You know, something that the person administrating the vaccine could share. But anyway, you know just like they should not take the Flu Vaccine So, it is the way that the body responding to some kind of, chemical in the vaccine (not appropriately clarified hence not captured as event). But anyway, I just wanted to report that. The outcome of the events 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-202101050810 same reporter/drug/event, different patient;US-PFIZER INC-202101051050 same report/drug/AE, different patients

Other Meds:

Current Illness:

ID: 1721878
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: I got red bumps on my skin; my hands went numb; hands went numb but it was like an episode but different/it keeps changing hands went numb; Turned purple and I had all sort of stuffs and it lasted almost a week; tingling and it lasted about 20 minutes and then they came back to normal; its excruciating, I mean it's painful; This is a spontaneous report from a contactable consumer or other non-health care professional (pa-tient). A patient of unspecified age and gender received dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration 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 un-specified date on 2021, the patient experienced i got red bumps on my skin, my hands went numb; hands went numb but it was like an episode but different/it keeps changing hands went numb, turned purple and i had all sort of stuffs and it lasted almost a week, a tingling and it lasted about 20 minutes and then they came back to normal and its excruciating, i mean it's painful. It was further stated as consumer stated that this was the 2nd phone call I made the 1st one was all chopped off I can hear you but with a big echo. Consumer stated that I have a question, so I went to get the vaccine and then I went to a drug store. I had the vaccine and I have side-effects, I wanted to know if they are normal. Consumer stated, no, how long was that supposed to last, I wanted to know because everybody says it lasts like 1 day, it was gone but it has been a week and I got red bumps on my skin, my hands went numb, turned purple and I had all sort of stuffs and it lasted almost a week. So, is that normal? Did anybody report these. I am keeping bed rest today but still I got the red spots on my skin. So, I wanted to report this but also I wanted to ask, may be a few people reported this same, I do not know. Yeah, the hands went numb but it was like an episode but different, it keeps changing hands went numb, went purple and a tingling and it lasted about 20 minutes and then they came back to normal. Consumer further stated, you know, just give them the number and they can call me, give them my number, they can call me. I was not able to be on the phone all day. I have things to do. Do you know how many of you. I have to go through to talk to you, its excruciating, I mean it's painful. You know it was impossible, it was a quick question. Consumer in response stated, I get it you were saying that you can not answer but they can so, I have to call them and have to be in phone for 1 hour, another hour on the phone just to able to talk to somebody about a quick question, which means I need a hour to talk to some-body and then the communication is chopped up and then you ask to call again, you throw the millennials again until I talk to somebody else. Consumer stated, right, Customer service was key specially for medical stuff, the person before you were all chopped off, it was very bad communication. This is horrible for a pharmaceutical company. The clinical outcome of the event I got red bumps on my skin was reported as unknown while for the events my hands went numb; hands went numb but it was like an episode but different/it keeps changing hands went numb, went purple and a tingling and it lasted about 20 minutes and then they came back to normal, Turned purple and I had all sort of stuffs and it lasted almost a week, it keeps changing hands went numb, went purple and a tingling and it lasted about 20 minutes and then they came back to normal, its excruciating, I mean it's painful was reported as recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1721879
Sex: U
Age:
State: NC

Vax Date:
Onset Date:
Rec V Date: 09/22/2021
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: Purple bumps all over your body; Dealing with it through tears and pain and itching; Dealing with it through tears and pain and itching; Dealing with it through tears and pain and itching; Dealing with it through tears and pain and itching; This is a spontaneous report from a contactable consumer. This consumer reported for an Unknown patient. This is the third case out of 3 split cases. A patient of an unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number: Not Provided) 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. Reporter stated, his daughter in law had an auto immune condition, and after she took the shot, the vaccine (Pfizer COVID 19 Vaccine) she had met the worst case ever as the reporter complaint this which was that where you get these purple bumps all over your body. So, reporter just wanted to report that, she was dealing with it through tears and pain and itching. But the reporter really would recommend that something need to be said prior to getting that shot. If patients have an auto-immune condition that really need to be truly discussed with their doctor because anyone with the auto-immune condition was sounds like to reporter, they are having some trouble. It was just breaking in the report's heart (general sentence) So, the reporter just wanted to report that, it was horrible. Reporter further stated, the strange was, the reporter have met two other people that have developed the same condition So, anyway reporter really thought a warning or just said Pfizer know kind of deal. Pfizer knew, something that the person administrating the vaccine could share. But anyway, Pfizer knew just like they should not take the Flu Vaccine So, it was the way that the body responding to some kind of, chemical in the vaccine (not appropriately clarified hence not captured as event). But anyway, reporter just wanted to report that. Only limited information was reported. The outcome of the events 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-202101050518 same reporter/drug/event, different patient;US-PFIZER INC-202101051050 same report/drug/AE, different patients

Other Meds:

Current Illness:

ID: 1721880
Sex: F
Age:
State: MN

Vax Date:
Onset Date:
Rec V Date: 09/22/2021
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: headache; This is a spontaneous report from a contactable consumer. A female patient of unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EN6204, Expiry date, NDC number: not provided), via an unspecified route of administration on an unspecified date as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The reporter reporting adverse event for Pfizer Covid 19 vaccine and states the person that administered the shot, it was the same gal. The patient said had a headache first time on an unspecified date and nothing the second time. The patient confirms she received the Pfizer Covid 19 Vaccine. Outcome of the event was unknown. The lot number for the vaccine, was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1721881
Sex: M
Age:
State: CA

Vax Date: 06/12/2021
Onset Date: 07/23/2021
Rec V Date: 09/22/2021
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 Name: Covid test/Nasal Swab; Result Unstructured Data: Test Result:Pending

Allergies:

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

Symptoms: Eczema like skin rash; Eczema like skin rash; This is a spontaneous report from a contactable consumer (patient). A 17-year-old male patient received bnt162b2 (PFIZER-BIONTECH covid-19 vaccine, formulation: solution for injection and batch no: not reported/lot number: Ew0181) via an unspecified route of administration, in left arm on 12Jun2021 (at the age of 17-years-old) as dose 2, single for covid-19 immunization at Pharmacy or Drug Store. Patient was allergic to penicillin. Concomitant medication within 2 weeks of vaccination included naproxen. Historical vaccine included as patient received her first dose of bnt162b2 (PFIZER-BIONTECH covid-19 vaccine, formulation: solution for injection, batch no: not reported/lot number: Ew0178) via an unspecified route of administration, in left arm on 22May2021 as dose 1, single for covid-19 immunization. The patient had not received any other vaccines within 4 weeks prior to the covid vaccine. Prior to vaccination, the patient was not diagnosed with covid-19 and since the vaccination. The patient experienced eczema like skin rash on 23Jul2021. Patient had no treatment for events. The patient underwent lab tests and procedures which included sars-cov-2 test and results were pending. Outcome of the events was unknown.

Other Meds: NAPROXEN

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am