VAERS 2021 Database www.vaers.hhs.gov

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

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

COVID19 Lot Number

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

Incidents per State

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

ID: 1743787
Sex: M
Age:
State: NY

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Test Date: 20210726; Test Name: covid test Blood test; Test Result: Negative ; Test Date: 20210426; Test Name: Blood test; Result Unstructured Data: Test Result:showed that he had an old Lyme disease infection (; Comments: showed that he had an old Lyme disease infection (probably a year old).; Test Date: 2021; Test Name: full MRI of the spinal column; Result Unstructured Data: Test Result:Normal; Comments: All of the tests came back normal.; Test Date: 2021; Test Name: MRI of brain; Result Unstructured Data: Test Result:Normal; Comments: All of the tests came back normal.; Test Date: 20210826; Test Name: PCR; Test Result: Negative ; Comments: Nasal Swab

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: neuropathy in my hands and feet; had an old Lyme disease infection(probably a year old); general ache and pain; joint stiffness; fatigue; headache; This is a spontaneous report from a contactable consumer (patient). A 52-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration on 09Apr2021 (at age of 52 years old, Lot Number: ER8729) as a single dose for covid-19 immunization. The patient medical history was not reported. No known allergies. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient's concomitant medications were not reported. The patient previously took the first dos of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), on 19Mar2021 (at age of 52 years old, Lot Number: ER6201) for covid-19 immunization. After getting the second dose of the COVID-19 vaccine, on 10Apr2021 the patient experienced general ache and pain, joint stiffness, fatigue, headache, and neuropathy in his hands and feet, which, per the guidelines, were normal side effects of the vaccine. However, when these symptoms still did not disappear after two weeks, he went to the Urgent Care on 26Apr2021. Blood test taken at the Urgent Care showed that he had an old Lyme disease infection (probably a year old). He was treated with Doxycycline for 3 weeks, but his condition never improved and the symptoms persists to this day. Since the Urgent Care visit, he had been evaluated by a neurologist, a hematologist/oncologist, an infectious disease specialist, a rheumatologist; none of them found any problem. He had done numerous blood tests and a full MRI of the spinal column and the brain. All of the tests came back normal. The patient underwent lab tests and procedures which included covid test type post vaccination, Blood test on 26Jul2021: Negative, Nasal Swab PCR on 26Aug2021: Negative. The patient was not received treatment (except Doxycycline for Lyme disease infection). The events result in Doctor or other healthcare professional office/clinic visit and Emergency room/department or urgent care. The outcome of the events was not recovered.

Other Meds:

Current Illness:

ID: 1743788
Sex: F
Age:
State: OH

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: paralyzed feeding tube, pitch tube; This is a spontaneous report from a contactable consumer. A 12-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE solution for injection, batch/lot number and expiry date: not reported), via an unspecified route of administration on an unspecified date as dose number unknown, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. on an unspecified date, the patient experienced paralyzed feeding tube, pitch tube (paralysis). The reporter reported that, paralyzed, feeding tube, pitch tube. Pfizer said it was anxiety and tried to have her committed to a mental hospital and Pfizer is censoring her story. Pfizer destroyed her and her family, this is destroying our country and our children. The patient had Bell's Palsy from another vaccine. Out come of the event was unknown. Follow-up attempts are completed. No further information is expected. Batch/lot number not available for BNT162B2

Other Meds:

Current Illness:

ID: 1743789
Sex: F
Age:
State:

Vax Date: 09/07/2021
Onset Date: 09/01/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: typical headache; center of my chest discomfort; a little tightening; back pain; chest pain; pain between my shoulder blades; This is a spontaneous report from a contactable consumer (patient herself). A 48-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, formulation: Solution for injection, Lot number was not reported), via an unspecified route of administration on 07Sep2021 (at the age of 48-years-old ) as dose 1, single for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On 07Sep2021, within few hours after vaccination the patient experienced typical headache, center of my chest discomfort, a little tightening, it would be intermittent on and off and she had that for few days and then started with a back pain, pain between shoulder blades and about 6th day her chest pain was really bad almost went to the ER, and then on the 6-7th day back pain was constant, now back pain not often, comes and goes. Patient stated that she was very concerned with getting a second dose because she would not want to go through the same or possibly something worse. Caller stated that she is trying to get the antibody test, stated that she may have had COVID before the vaccine but she is not 100% sure because testing was not available through her doctors office so she could not do that. As noted in the fact sheet for recipients, patient should not get the Pfizer-BioNTech COVID-19 vaccine if patient had a severe allergic reaction after a previous dose of the vaccine or if she had a severe allergic reaction to any ingredient of the vaccine. The decision to receive the second dose for any other reason cannot be made by Pfizer. They refer patient to speak to her healthcare provider about the risks of the vaccine compared to the risks of potentially not being fully protected against COVID-19 infection. Patient healthcare provider knows her health situation and has access to information that can better help inform this decision. Seriousness of the events reported as non-serious. The outcome of the events was unknown. The lot number for the vaccine [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1743790
Sex: F
Age:
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/29/2021
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: developed a few hives and a hour later those faded and then two more locations of hives appeared around 3 pm and they are fading again; She got a booster dose today; she got a booster dose today; This is a spontaneous report from a contactable consumer or other non-hcp (patient herself). A 62-year-old female patient received bnt162b2 (BNT162B2, Formulation: Solution for injection, Lot number: not reported, Expiry date: Unknown) via an unspecified route of administration on 22Sep2021 as dose 3, single (at the age of 62-year-old) for COVID-19 immunisation. The patient's medical history and concomitant medications were not reported. Patient previously received first dose of Pfizer COVID vaccine on 16Mar2021 and the second dose on 06Apr2021 for COVID-19 immunisation. On 22Sep2021, the patient had booster dose today and she got a booster dose today and 35-40 minutes afterwards she developed a few hives and a hour later those faded and then two more locations of hives appeared around 3 pm and they are fading again, on an unspecified date in Sep2021, experienced she would be dead already. Caller stated she feels as though this was related to the vaccine and wants to know if she should not get any booster doses in the future. Caller states that she was assuming that the reaction was not severe because if it was, she would be dead already, so she wants to know if hives has been reported as a reaction. The outcome of the event hives was recovered on Sep2021, she would be dead and patient had booster dose today was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

Date Died:

ID: 1743791
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: One of my family members had no medical history she took the vaccine now she's dead.; This is a spontaneous report from a contactable consumer or other non hcp. A female patient of an unspecified age received BNT162B2 (COMIRNATY, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on an unspecified as dose number unknown, single for COVID-19 immunisation. The patient medical history was reported as none. The concomitant medications were not reported. The reporter stated that so many side effects had not been listed on the Pfizer website. Many people experience death, stroke and other problems. Reporter stated that one of the reporter's family members had no medical history she took the vaccine now she's dead on an unspecified date. Reporter stated to have seen so many people dying after receiving the vaccine. People who had no medical history get sick after the vaccine. The patient died on an unspecified date. It was not reported if an autopsy was performed. Follow-up attempts are completed. No further information is expected. Batch/lot number not available for BNT162B2.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101253587 same reporter/product, different patient / event.; Reported Cause(s) of Death: One of my family members had no medical history she took the vaccine now she's dead.

Other Meds:

Current Illness:

ID: 1743792
Sex: F
Age:
State: SC

Vax Date: 07/23/2021
Onset Date: 07/01/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Test Date: 2021; Test Name: heart rate; Result Unstructured Data: Test Result:went up to 120 beats per minute

Allergies:

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

Symptoms: it is hard for me to breath.; I can feel the palpitations/bad palpitations and I can hear the palpitations /my heart is racing.; my heart rate went up to 120 beats per minute; it's very uncomfortable; it's hard for me to sleep; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 67-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID -19 VACCINE, Solution for injection, Lot Number: FA6780, Expiry date: unknown) via an unspecified route of administration on 23Jul2021 (age at vaccination is 67-years) as dose 2, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient previously received bnt162b2 (PFIZER-BIONTECH COVID -19 VACCINE, Solution for injection, Lot Number: FA6780, Expiry date: unknown) via an unspecified route of administration on 02Jul2021 as dose 1, single for COVID-19 immunization (age at vaccination is 67-years). On 23Jul2021 the patient experienced my heart rate went up to 120 beats per minute (medically significant). On 25Jul2021 the patient experienced my heart is racing, I can feel the palpitations/bad palpitations and I can hear the palpitations, it is hard for me to breath. All these events are recorded in physician office visit. On unspecific date in Jul2021 the patient experienced it's very uncomfortable and it's hard for me to sleep. She already been to the cardiologist and had to wear a Halter monitor for 5 days. Informed she will go back to the cardiologist in next week, Monday 27Sep2021. She had one of those (pulse) oximeter they put on fingers, and on one time occasion her heart rate went up to 120 beats per minute. The patient underwent lab tests and procedures which included heart rate: went up to 120 beats per minute on an unknown date in 2021. The outcome of the events was reported as not recovered. Follow-up activities closed: No follow-up attempts are possible.

Other Meds:

Current Illness:

Date Died:

ID: 1743793
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: 4 funerals of people who have died 3 to four days after getting the COVID-19 vaccine; This is a spontaneous report from a contactable consumer via Pfizer-sponsored program. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection; 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. Reporter stated that he had personally gone to 4 funerals of people who have died 3 to four days after getting the COVID-19 vaccine, but states he doesn't know whether they are moderna or Pfizer or Johnson and Johnson and he doesn't know one person who has died from the actual virus. He just wanted information. The patient died on an unspecified date. Autopsy performed was unknown and cause of death was not reported. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: 4 funerals of people who have died 3 to four days after getting the COVID-19 vaccine

Other Meds:

Current Illness:

Date Died:

ID: 1743794
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: 4 funerals of people who have died 3 to four days after getting the COVID-19 vaccine; This is a spontaneous report from a Pfizer-sponsored program via a contactable consumer or other non-healthcare professional. This case split for third patient. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot number was not reported), via an unspecified route of administration on an unspecified date as dose number unknown, single for covid-19 immunisation.The patient medical history and concomitant medications were not reported. On an unspecified date, the patient had gone to 4 funerals of people who have died 3 to four days after getting the covid-19 vaccine. The reporter wanted to know now that the Pfizer COVID-19 vaccine was fully approved and enquired if he took the vaccine and had adverse side effects from it who was going to pay for his bills. The reporter stated that he had been doing some research on the amount of people who have died from taking the COVID-19 vaccine and what adverse events they have had after receiving the vaccine. He stated that he had personally gone to 4 funerals of people who have died 3 to four days after getting the COVID-19 vaccine, but stated he doesn't know whether they are moderna or Pfizer or Johnson and Johnson and he doesn't know one person who has died from the actual virus. He just wanted information. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death

Other Meds:

Current Illness:

ID: 1743795
Sex: F
Age: 54
State: MA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: 8/19/21 X-Ray of Shoulder - Diagnosed with SIRVA. 8/19/21 Outpatient Visit with Doctor 8/30/21 - Physical Therapist : Eval, Manual Therapy 9/8/21 - Physical Therapy 9/22/21 - Physical Therapy 9/29/21 - Physical Therapy

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: After receiving my 1st shot, my shoulder pain did not go away. I waited, hoping it would get better but it did not. I went to an orthopedic doctor and I was told it was SIRVA, injury from the shot administered in the wrong location. When I reach using my right arm, I experience great pain. I am currently in physical therapy. I have been doing physical therapy for 4 weeks. I still am unable to reach with my right arm without pain.

Other Meds: None

Current Illness: None

ID: 1743796
Sex: U
Age:
State: MT

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

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

Lab Data: none

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Very sore injection site on left arm approximately 12 hours after injection. Fever, chills, nausea, vomiting, headache ending approximately 24 hours after injection

Other Meds:

Current Illness:

ID: 1743797
Sex: F
Age: 83
State: CT

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies: Walnuts

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

Symptoms: Fatigue

Other Meds: Metoprolol, statin

Current Illness:

Date Died:

ID: 1743798
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: 4 funerals of people who have died 3 to four days after getting the COVID-19 vaccine; This is a spontaneous report from a contactable consumer via a Pfizer-sponsored program. A patient of unspecified age and gender received 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 an unspecified date as dose number unknown, single for COVID-19 immunisation. The patient medical history was not reported. The patient's concomitant medications were not reported. Caller stated that he was been doing some research on the amount of people who have died from taking the COVID-19 vaccine and what adverse events they have had after receiving the vaccine. He stated that he had personally gone to 4 funerals of people who have died 3 to four days after getting the COVID-19 vaccine, but stated he did not knew whether they were moderna or Pfizer or Johnson and Johnson and he did not knew one person who had died from the actual virus. He just wanted information. Caller wanted to know that the Pfizer COVID-19 vaccine was fully approved if he took the vaccine and had adverse side effects from it who was going to pay for his bills. The patient died on an unspecified date. It was not reported if an autopsy was performed and cause of death was not reported. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: 4 funerals of people who have died 3 to four days after getting the COVID-19 vaccine

Other Meds:

Current Illness:

ID: 1743799
Sex: M
Age: 27
State: NY

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/29/2021
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: Systemic: Body Aches Generalized-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Weakness-Medium, Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1743800
Sex: F
Age: 55
State: FL

Vax Date: 09/18/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: Site: Pain at Injection Site-Mild, Systemic: Body Aches Generalized-Medium, Systemic: Joint Pain-Medium, Additional Details: started 10 days after getting shot, has very significant body and joint pain

Other Meds:

Current Illness:

ID: 1743801
Sex: F
Age: 23
State: TN

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/29/2021
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: Systemic: Headache-Severe, Additional Details: Patient experienced extreme migraines from first COVID pfizer shot at her work at her senoir living facility. Could not get the lot number before she left but I believe she has it on her card

Other Meds:

Current Illness:

ID: 1743802
Sex: F
Age: 21
State: RI

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

Date Died:

ID: 1743803
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: the patient died after getting the Pfizer BioNtech Covid vaccine; This is a spontaneous report from a Pfizer Sponsored Program. A non-contactable consumer reporting same event under the same suspect product for 6 patients. This is one of 6 reports. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history and the patient's concomitant medications were not reported. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101275697 same reporter, same vaccine, same adverse event, different patient;US-PFIZER INC-202101276043 same reporter, same vaccine, same adverse event, different patient; Reported Cause(s) of Death: unknown cause of death

Other Meds:

Current Illness:

ID: 1743804
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: there other leg, there same shot and same day they got shot on numb for about week; This is a spontaneous report from a contactable consumer. This consumer reported for a patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: Unknown), via an unspecified route of administration on an unspecified date as dose number unknown, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced that their other leg, there same shot and same day they got shot on numb for about week on an unspecified date. The 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: 1743805
Sex: F
Age:
State: KS

Vax Date: 08/01/2021
Onset Date:
Rec V Date: 09/29/2021
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: Pain; Lump; This is a spontaneous report received from a contactable consumer or other non-health care professional (patient reported for herself). A 61-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: Unknown), via an unspecified route of administration on Aug2021 (at the age of 61-years-old) as dose 1, single for COVID-19 immunisation. The patient medical history was and concomitant medications were not reported. Patient had both doses of the vaccine, 1st dose was on Aug2021 and 2nd dose on 10Sep2021, and after 1st dose she only experienced pain and lump (did not mention the specific body part) in 2021. And after 2nd dose, she experienced leg pain within 24 hours, Legs were hurting, feet were burning and really had bad pain. patient had massage to ease the pain, it was hard to sleep and never had this before. She did not take any pain medication or any other drugs in the past. Asked if has anybody reported like leg pain after getting the shot of the Pfizer COVID 19 vaccine. The outcome of the events was reported as unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1743806
Sex: F
Age:
State: AL

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Test Name: blood pressure; Result Unstructured Data: Test Result:184; Test Name: blood pressure; Result Unstructured Data: Test Result:It goes up and down; Test Date: 202107; Test Name: Covid test; Test Result: Negative

Allergies:

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

Symptoms: She was sick and thought she was dying for three days.; she had high blood pressure/ It was extremely high; Whole body shakes; feels like heart is racing out of chest; They were pretty sure it was from anxiety or whatever was causing the jitters.; They were pretty sure it was from anxiety or whatever was causing the jitters.; After getting the vaccine she wound up having heart issues.; she could not breathe; she is still very tired; She had lost sense of taste and smell; She had lost sense of taste and smell; She had body aches; slept a lot.; She was initially diagnosed with Upper Respiratory Sinusitis; This is a spontaneous report from a contactable consumer or other non hcp. A 62-years-old female patient received bnt162b2 (BNT162B2, Formulation: Solution for injection, Lot number: ER8732, Expiry date: Jul2021) via an unspecified route of administration, administered in Arm Left on 26Apr2021 14:30 (at the age of 62-year-old) as DOSE 2, SINGLE for covid-19 immunisation. Historical vaccine include BNT162B2 dose 1 (Lot Number: EN6205, Expiry date: Jun2021) administered in left arm on 22Mar2021. Medical history included ongoing anxiety: Situational anxiety, ongoing migraine, Sinus infections from an unknown date and unknown if ongoing. Concomitant medications included diphenhydramine, paracetamol (EXTRA STRENGTH TYLENOL PM), She took Extra Strength Tylenol 30 minutes before getting the second shot because she was told to do so. Historical vaccine included BNT162B2 (COVID-19 MRNA VACCINE BIONTECH, Formulation: Solution for injection, Lot Number: EN6205, Expiry Date: Jun2021), administered in arm Left on 22Mar2021 (at the age of 62-year-old), as dose 1, single for covid-19 immunization. Vaccination facility Type hospital. On 26Apr2021 she was sick and thought she was dying for three days, she had high blood pressure, it was extremely high and her whole body shakes, feels like heart is racing out of chest, They were pretty sure it was from anxiety or whatever was causing the jitters, After getting the vaccine she wound up having heart issues, she could not breathe, she is still very tired, She had lost sense of taste and smell, She had lost sense of taste and smell, She had lost sense of taste and smell, slept a lot, She was initially diagnosed with Upper Respiratory Sinusitis. It was reported that the high blood pressure and shaking in body is driving her insane. Extremely high blood pressure: When probed for outcome she stated It varies her a little bit. It goes up and down. She has never had issues with her high blood pressure. After getting the vaccine she wound up having heart issues. She went to see the cardiologist and they are checking for all sorts of things due to issues experiencing. Whole body shakes: It does not matter what environment she is in. She could be sitting at home watching a movie or sitting on the lake and her heart will start fluttering and her whole body shakes in the inside. It is debilitating to her. When it starts and kicks up in her body it is rampant and the shaking is every single day. It is to the point where it's a nuisance. She cannot hold a pen to write, it's ridiculous. It all started the day got the second shot. The whole body shaking is the same as heart racing in her chest. It is like her heart is racing in her body. Everything is quivering from head to toe. Metoprolol- 25mg take tablet by mouth twice daily. She was prescribed this in the Emergency room and she is still taking it. Her blood pressure was 184/something. However, she is not taking twice a day, but once a day because she does not want to bottom out. It's located in a pharmacy filled bottle. She does not have lot/exp on it. She was hoping everything got better and did not. Her doctor continued to prescribe the Metoprolol to take the stress off her heart. These things are ridiculous and she has never experienced this. She added, last year she had lost a grandson and she would have thought this feeling would happen then, but it did not, no lasting issues. These events started probably 3-4 hours after receiving the vaccination. She got scared and called her daughter to come over and spend the night. She was terrified about having the headaches because she was prone to having migraine headaches. Her blood pressure spiked that day. She did go to the Emergency room and it was 184 over something. They were pretty sure it was from anxiety or whatever was causing the jitters. She had never had these issues before. She had no heart issues or problems before. These are things she has never had or experienced before. She commented she knows other people have had the same issues and things happen. She has been going to the doctors and talking to the nurses and even went to the Emergency Room because it got bad one day where she could not breathe. She felt like she was having a heart attack and went to the Emergency room and they were well aware of this happening. They referred to it as the jitters. She took Extra Strength Tylenol 30 minutes before getting the second shot because she was told to do so. The nurse when she got the first shot told her she should take it 30 minutes before getting the shot. When she got the first shot she had not taken it before shot and was told to take immediately and to make sure to take it 30 minutes before getting the second one. Prior to getting the vaccine she was healthy and had no signs of high blood pressure. It had always been low. She was always very active. While providing details she added, she is still very tired and stated she would up with COVID in Jul2021. Treatment/Intervention: She stated she went to the doctor, but her PCP was not available. She saw the Nurse Practitioner at the doctor's office. This Nurse Practitioner did not do a covid test on her. It was not until two weeks later that she went to see her PCP and by that time when a covid test it was negative. She had lost sense of taste and smell. She was sick and thought she was dying for three days. She clarified she was sick for like two weeks, but thought was dying for three days. She had body aches and slept a lot. The COVID test that was done was one that was sent out and came out negative. The Nurse Practitioner did not do the Covid test or test for it. She was initially diagnosed with Upper Respiratory Sinusitis. The Covid test was on 28 or 29Jul2021 and it was negative when went back to the doctor. Investigations included she is now being referred to neurologist. The Cardiologist was checking things. She was told she has RBBD and was told she would be referred to neurologist because it is unknown how to treat thing. Everyone is at lost for this. They are trying to rule out any true illness or whatever. While capturing details for Supplemental Form, caller added, she went to the Emergency Room after she had the COVID shot three times. She felt like she was having a heart attack and thought it would go away as easily as it came. They are very aware of this happening and called it the jitters. They gave her some medicine while in the Emergency Room because she was also nauseated. They wondered if could be due to being nauseated and the anxiety. This was either in Jun2021 or Jul2021 when she went. She cannot remember. She added, she went to the Doctor again recently and the doctor added medicine for anxiety because that is what it feels like. She is having constant anxiety. The medication has helped, but it does not git rid of it. It has not gotten rid of the shakes that accompanies this in her body. She can barely work. She provided the names of the medications the doctor prescribed as Lexapro, later clarified to be the Generic Lexapro, Escitalopram and Klonopin. Escitalopram - 10mg once daily. Located in pharmacy filled bottle. Did not see lot/exp/NDC to provide. Klonopin- Once daily as needed, 0.5mg. Located in pharmacy filled bottle. Did not see lot/exp to provide. She commented this, clarified as the vaccine, has affected her memory. She cannot remember things. Her brain is scattered and amess. It is like covid fog from having covid. She later clarified he doctor prescribed blood pressure pills. She was prescribe this in the

Other Meds: Pfizer, Inc. EUA 027034

Current Illness: Migraine (Verbatim: Migraine); Situational anxiety (Verbatim: Situational anxiety)

ID: 1743807
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

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

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743808
Sex: M
Age:
State: WI

Vax Date:
Onset Date: 09/23/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Test Date: 20210918; Test Name: PCR; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20210923; Test Name: PCR; Test Result: Positive ; Comments: nasal swab

Allergies:

Symptom List: Unevaluable event

Symptoms: tested positive for a COVID 19 infection; tested positive for a COVID 19 infection; Loss of smell; This is a spontaneous report from a contactable consumer (patient). A 40-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in left arm on an unspecified date (Lot Number: EP6955) as dose 2, single, via an unspecified route of administration, administered in left arm on 01Mar2021 (Lot Number: EL3248) as dose 1, single for COVID-19 immunisation. Patient 's age at vaccination was 40-year-old. The patient medical history was not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. No concomitant medication was received. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any other medications within 2 weeks of vaccination. The patient previously took cefaclor (CECLOR) and experienced allergy to CECLOR. The patient experienced loss of smell on 23Sep2021. On the evening of 23Sep2021, he tested positive for a COVID 19 infection. The events did not result in emergency room visit or physician office visit. No treatment was received for the events. Since the vaccination, the patient has been tested for COVID-19. The patient underwent lab tests and procedures which included PCR (polymerase chain reaction): negative (Nasal Swab) on 18Sep2021, polymerase chain reaction: positive (nasal swab) on 23Sep2021. The outcome of the event loss of smell was not recovered, outcome of event tested positive for a COVID 19 infection was recovered with lasting effects on an unspecified date.

Other Meds:

Current Illness:

ID: 1743809
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: She did not present her period; This is a spontaneous report from a contactable consumer or other non hcp (patient). A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection), dose 1 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose 1, single, dose 2 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose 2, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced she did not present her period. The outcome for 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: 1743810
Sex: M
Age:
State:

Vax Date: 01/12/2021
Onset Date: 08/22/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Transverse Myelitis; This is a spontaneous report from a contactable physician, the patient. A 66-years-old male patient received second dose of bnt162b2 (PFIZER BIONTECH COVID 19 VACCINE, formulation: solution for injection, lot number was not reported) via an unspecified route of administration on 12Jan2021 as dose 2, single for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient experienced transverse myelitis on 22Aug2021. The patient received first dose of bnt162b2 (PFIZER BIONTECH COVID 19 VACCINE, formulation: solution for injection, lot number was not reported) via an unspecified route of administration on 23Dec2020 as single for covid-19 immunization. The patient was asking if there had been reports of this diagnosis this far out from the Pfizer COvid-19 doses. He knew it can usually occur in the first few weeks to months after vaccination, from his understanding. The outcome of the event was unknown. The patient was advised by his neurologist as well as PCP and other physicians not to receive the booster dose of the Pfizer Covid-19 vaccine, but is wanting Pfizer's recommendation on this decision. The lot number for BNT162b2 was not provided and will be requested during follow up.; Sender's Comments: Based on the information currently available, a possible contributory role of the suspect vaccine BNT162B2 or comirnarty in triggering the onset of transverse myelitis cannot be excluded.The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds:

Current Illness:

ID: 1743811
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: she gave Covid to her 58 year old husband, who got the Pfizer vaccine; she gave Covid to her 58 year old husband, who got the Pfizer vaccine; This is a spontaneous report from a contactable consumer. A 58-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), 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. The patient's medical history and concomitant medications were not reported. The reporter asked if we can e-mail her a list of the ingredients for the Pfizer BioNTech COVID-19 vaccine Comirnaty and asked if the vaccine works to prevent getting Covid. She stated that she was not vaccinated, but she gave COVID to her 58 year old husband, who got the Pfizer vaccine. The outcome of the events was unknown. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow-up.

Other Meds:

Current Illness:

ID: 1743812
Sex: F
Age:
State:

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

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: she presented palpitations in the heart/her heart was thumping so hard; This is a spontaneous report from a contactable consumer. A 74-year-old female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 08Aug2021, as single dose (Batch/Lot number was not reported) for covid-19 immunisation. The patient stated she had the first dose and her heart was thumping so hard (reported as " palpitations in the heart") and she was in the hospital in 2021.The outcome of event was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1743813
Sex: F
Age:
State: PA

Vax Date: 09/20/2021
Onset Date: 09/23/2021
Rec V Date: 09/29/2021
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: Weakness; Thoughts are cloudy; Dizzy; Forgetfulness, she will do one thing and then forget what she did; This is a spontaneous report from a contactable other HCP (patient). A 44-year-old female other HCP (Patient) reported herself who received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, lot number: FF2588), via injection in left deltoid on 20Sep2021 at 20:30 (at the age of 44-year-old) as dose 1, single for covid-19 immunization at pharmacy facility. Vaccine administered at military facility was reported as no. Medical history included hypertension, asthma, chronic migraine, fibromyalgia and glaucoma (from unspecified date to ongoing). Family medical history relevant to events was reported as none. The patient's concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. Patient did not receive any other vaccine on the same day of BNT162B2 vaccine. The events reported prior to the vaccination was none. After 3 days of first vaccination, on 23Sep2021, patient developed weakness, dizzy, and her thoughts are cloudy as forgetfulness. Stated that she will do one thing and then forget what she did. Provided seriousness of being dizzy as not serious because she was not falling down. Patient was not hospitalized nor visited to emergency room or physician office, due to the events. Stated she was trying to figure out if she should go to urgent care or try to get an appointment at her doctor's office tomorrow, she was trying to figure out if that was normal. Therapeutic measure was reported as no. The outcome of the events was reported as not recovered.

Other Meds:

Current Illness: Asthma; Chronic migraine; Fibromyalgia; Glaucoma; Hypertension

ID: 1743814
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: reporter herself was not vaccinated but she gave COVID to her uncle, the patient who was vaccinated but unknown if Pfizer; reporter herself was not vaccinated but she gave COVID to her uncle, the patient who was vaccinated but unknown if Pfizer; This is a spontaneous report from a contactable consumer. A male patient (reporter's uncle) of an unspecified age received bnt162b2 (COVID-19 VACCINE - MANUFACTURER UNKNOWN), via an unspecified route of administration on an unspecified date (lot number was not reported) as dose number unknown, single for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The reporter asked if she can be emailed a list of the ingredients for the Pfizer BioNTech Covid 19 vaccine and Comirnaty and wanted to know if the vaccine works to prevent getting Covid. The reporter herself was not vaccinated but she gave COVID to her uncle, the patient, who was vaccinated but unknown if Pfizer on an unknown date. The 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: 1743815
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: Depression/Depression lessened before the second shot.; Brain fog presented; The patient brain fog contributed to a car accident.; This is a spontaneous report from a non-contactable consumer. This 38-year-old consumer (patient) of unknown gender communicated to a Pfizer sales representative that he/she received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: unknown) via an unspecified route of administration on an unspecified date as dose 1, single for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On an unknown date after the first shot the patient presented depression and brain fog. The patient's brain fog contributed to a car accident. It was mentioned that depression lessened before the second shot. The outcome of depression was recovering, the outcome of brain fog and car accident was unknown. The lot number for the vaccine, [BNT162B2], was not provided and would be requested during follow up.

Other Meds:

Current Illness:

ID: 1743816
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: This is a spontaneous report from a noncontactable consumer (patient). A 38-year-old patient, of an unspecified gender, received the 2nd dose of BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine, solution for injection, batch/lot# not reported), via an unspecified route of administration, on an unspecified date, single dose, for COVID-19 immunization. The patient's medical history and concomitant medications not reported. Patient previously received the 1st dose of BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine), via an unspecified route of administration, on an unspecified date, single dose, for COVID-19 immunization. After the first shot, patient experienced depression and brain fog (contributed to a car accident). On unspecified date, patient had lessened depression, then after he received second shot, depression and brain fog returned significantly worse. Anxiety also heightened. Patient still has large swelling at the injection site 3 days post-shot. Outcome of the events: not recovered. The lot number for the vaccine, (BNT162B2), not provided and will be requested during follow-up.

Other Meds:

Current Illness:

ID: 1743817
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

Symptom List: Injection site pain

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743818
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

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

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743819
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

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

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain location tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743820
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

Symptom List: Tremor

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743821
Sex: U
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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 Name: COVID-19 virus test; Test Result: Positive

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743822
Sex: U
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

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

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743823
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

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

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743824
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743825
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

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

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743826
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

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

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743827
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

Symptom List: Pain in extremity

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743828
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

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

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743829
Sex: U
Age:
State: GA

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

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

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

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

Symptoms: COVID-19; COVID-19; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for 28 patients. This is one of 28 reports. A patient of unspecified age and gender received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), 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. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced COVID-19 (medically significant) on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on unknown date. The reporter stated that 28 people from a certain University tested positive. The lot number for bnt162b2 was not provided and will be requested during follow-up.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101237061 Same reporter/product/events, different patient

Other Meds:

Current Illness:

ID: 1743830
Sex: F
Age:
State:

Vax Date: 09/10/2021
Onset Date: 09/14/2021
Rec V Date: 09/29/2021
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: 20210914; Test Name: COVID; Test Result: Positive

Allergies:

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

Symptoms: tested positive for COVID; This is a spontaneous report from a Pfizer-sponsored program. A contactable Nurse reported for a 13-year-old female patient (granddaughter) that she received her first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: Not reported) via an unspecified route of administration, administered on 10Sep2021 as DOSE 1, SINGLE for COVID-19 immunization. The patients medical history and concomitant medications were not reported. Caller Retired RN stated in behalf of her 13 year old granddaughter who received the 1st dose of the Pfizer COVID 19 vaccine- She had the 1st dose on 10Sep2021 and tested positive for COVID on 14Sep2021 - He wants to know if they need to have 90 day period wait before taking the 2nd dose - The patient will have her 2nd dose on 01Oct2021 - Caller also had COVID 19 before and he was advised to wait for 90 days before getting the 2nd dose. On 14Sep2021 the patient underwent for SARS-CoV-2 test and it was reported as positive .The outcome of the events was unknown. Information about lot/batch number cannot be obtained. No further information expected.

Other Meds:

Current Illness:

ID: 1743831
Sex: U
Age:
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: regarding a patient who had Shingles after receiving the Pfizer Covid-19; This is a spontaneous report received from a contactable consumer or other non hcp.A patient of unspecified age and gender received bnt162b2(Pfizer Covid 19-Vaccine,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.The patient experienced regarding a patient who had shingles after receiving the pfizer covid-19 on an unspecified date.Patient's information and gender was not written on the questionnaire/form. Unable to ask if the caller is HCP. Unable to transfer, the caller hung up while talking to the representative.The patient received no treatment for the event.The outcome of the events was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

Date Died:

ID: 1743832
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: the patient died after getting the Pfizer BioNtech Covid vaccine; This is a spontaneous report from a Pfizer Program. A non-contactable consumer reporting same event under the same suspect product for 6 patients. This is one of 6 reports. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history and the patient's concomitant medications were not reported. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101253281 same reporter/SD/AE, different patient; Reported Cause(s) of Death: unknown cause of death

Other Meds:

Current Illness:

Date Died:

ID: 1743833
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: the patient died after getting the Pfizer BioNtech Covid vaccine; This is a spontaneous report from a Pfizer Sponsored Program. A non-contactable consumer reporting same event under the same suspect product for 6 patients. This is one of 6 reports. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history and the patient's concomitant medications were not reported. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101253281 same reporter,same vaccine, same adverse event, different patient; Reported Cause(s) of Death: unknown cause of death

Other Meds:

Current Illness:

Date Died:

ID: 1743834
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: the patient died after getting the Pfizer BioNtech Covid vaccine; This is a spontaneous report from a Pfizer Sponsored Program. A non-contactable consumer reporting same event under the same suspect product for 6 patients. This is one of 6 reports. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history and the patient's concomitant medications were not reported. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101253281 same reporter,same vaccine, same adverse event, different patient; Reported Cause(s) of Death: unknown cause of death

Other Meds:

Current Illness:

Date Died:

ID: 1743835
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/29/2021
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: 6 kids in her neighborhood have died after getting the Pfizer BioNtech Covid vaccine; This is a spontaneous report from a Pfizer Sponsored Program. A non-contactable consumer reporting same event under the same suspect product for 6 patients. This is one of 6 reports. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history and the patient's concomitant medications were not reported. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101253281 same reporter,same vaccine, same adverse event, different patient; Reported Cause(s) of Death: unknown cause of death

Other Meds:

Current Illness:

Date Died:

ID: 1743836
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: 6 kids in her neighborhood have died after getting the Pfizer BioNtech Covid vaccine; This is a spontaneous report from a Pfizer Sponsored Program. A non-contactable consumer reporting same event under the same suspect product for 6 patients. This is one of 6 reports. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history and the patient's concomitant medications were not reported. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101253281 same reporter/SD/AE, different patient;US-PFIZER INC-202101253281 same reporter,same vaccine, same adverse event, different patient; Reported Cause(s) of Death: unknown cause of death

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am