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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 1065137
Sex: U
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 03/02/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: strokes; This is a spontaneous report from a contactable physician. This physician reported similar events for two patients. This is 2nd of 2 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection, unknown lot number and expiration), via an unspecified route of administration on unspecified date at a single dose for COVID-19 immunization in a hospital. The patient's medical history was reported as none. Concomitant medications were not reported. The physician reported that there were two patients who came in with strokes with no underlying condition/health risks, but they had been recently vaccinated with the COVID vaccine on unspecified date. The outcome of the event was unknown. The event resulted in physician office visit. The event was assessed as serious (hospitalization). No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Sender's Comments: The information is limited and does not allow a full medical assessment. Considering temporal relationship, a possible contribution role of vaccination with BNT162B2 to the onset of stroke, cannot be fully excluded. The case will be reassessed should additional information become available. 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.,Linked Report(s) : US-PFIZER INC-2021163467 same reporter, product, event; different patient

Other Meds:

Current Illness:

ID: 1065138
Sex: F
Age:
State:

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: hard of hearing; rash; faint; being hot; short of breath; headache; was achy; extremely tired/extremely exhausted; This is a spontaneous report from a contactable nurse (reporting for mother). An 89-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, lot number and expiry date not reported), via an unspecified route of administration on 11Feb2021 at a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The first dose of BNT162B2 as COVID-19 immunization was received on an unknown date. Reporter was calling regarding side effects of the Pfizer COVID vaccine. Reporter stated that her mother (patient) is 89 years old and her mother was hard of hearing since an unknown date. Her mother got the second dose of the product 11Feb2021 and she was fine that Thursday, and by Friday (12Feb2021) her mother had a headache, was achy, and extremely tired. On Saturday, her mother felt a little bit better. On Sunday (14Feb2021), her mother had an episode of being hot and faint, and short of breath and extremely exhausted. This morning (15Feb2021), her mother was experiencing shortness of breath, and a rash and was exhausted. Reporter wa wondering if shortness of breath could be a side effect of the product. The outcome of the events headache, achy, and "extremely tired/extremely exhausted" was recovering, while for events hard of hearing, being hot, faint, short of breath and rash was unknown. Information about lot/batch number has been requested.; Sender's Comments: A possible contributory effect of suspect BNT162B2 on reported event syncope 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: 1065139
Sex: F
Age:
State: PA

Vax Date: 01/19/2021
Onset Date: 01/24/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: breast infection; left breast pain/breast became sore; breast became red, sore, warm and had a line traveling to my armpits; breast became red, sore, warm and had a line traveling to my armpits; breast became sore, warm and had a line traveling to my armpits; This is a spontaneous report from a contactable nurse (patient). A 39-year-old female patient received second single dose (BNT162B2, Pfizer, Solution for injection, lot number: EL3249, exp date not reported), via an unspecified route of administration (vaccine location: left arm) on 19Jan2021 06:00 for COVID-19 immunization. Facility where the most recent COVID-19 vaccine was administered: Hospital. The patient medical history was not reported. There were no known allergies to medications, food, or other products. Prior to vaccination, the patient was not diagnosed with COVID-19. There were no concomitant medications. There were no other medications received within 2 weeks of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously took BNT162B2 (Pfizer, lot number: EL1284) on 30Dec2020 06:00 (vaccine location: left arm). On 24Jan2021, the patient started to have left breast pain. Her breast became red, sore, warm and had a line traveling to the armpit. The doctor stated the red area felt full. The patient was treated for a breast infection. Treatment received for the adverse events included: Clindomycin. The events were considered non-serious by the reporter. The events resulted to doctor or other healthcare professional office/clinic visit. Since the vaccination, has the patient had not been tested for COVID-19. The events recovered on an unspecified date in 2021.; Sender's Comments: Based on temporal association, the causal relationship between BNT162B2and the event mastitis cannot be excluded. The information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once additional information becomes available. 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: 1065140
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: went into shock after she got it; This is a spontaneous report from a contactable consumer (daughter's friend) A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration on unknown date at single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The reporter stated that "a friend of her daughter's went into shock after she got it" on an unspecified date with outcome of unknown. Information on the lot/ batch number has been requested.

Other Meds:

Current Illness:

ID: 1065142
Sex: M
Age:
State: MA

Vax Date: 02/10/2021
Onset Date: 02/12/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: syncope; pleurisy; difficulty breathing; Flu-like symptoms; fever; chills; muscle and joint aches; muscle and joint aches; persistent headache; This is a spontaneous report from a contactable health care professional (patient). A 29-year-old male patient received the second dose of BNT162B2 (Pfizer-BioNTech COVID-19 vaccine, lot number: EK4176) in the hospital, via intramuscular route on 10Feb2021 at 10:30 at a single dose on the right arm for COVID-19 immunization. Medical history included Non-Hodgkin's lymphoma from 2010 to 2011 and allergies to penicillin on an unknown date and unknown if ongoing. Prior to vaccination, was the patient not diagnosed with COVID-19. The patient's concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any other medications within 2 weeks of vaccination. The patient received the first dose of BNT162B2 (lot number: H9899) in the hospital, via intramuscular route at 01:15 PM on the left arm for COVID-19 immunization. Since the vaccination the patient has not been tested for COVID-19. It was reported that on 12Feb2021 at 08:00 PM (also reported as '3 days after injection') the patient experienced flu-like symptoms that included fever, chills, muscle and joint aches, and a persistent headache. On 13Feb2021 (also reported as 'on the 4th day', the patient developed pleurisy and difficulty breathing and had 2 syncope events the morning of 14Feb2021 (also reported as 'on the 5th day'). The patient was taken by ambulance and admitted to ER for further testing. It was determined that all symptoms likely related to the second dose of the COVID-19 vaccine recently received. Pleurisy persists one week following vaccine dose. The patient went to the emergency room/department or urgent care due to the events. As treatment for the event, the patient was monitored and given IV fluids over 12 hour stay in CDU. The outcome of the events was recovered with sequelae (reported as recovered with lasting effects). The events were reported as non-serious.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship and current known drug safety profile. 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 RAs, Ethics Committees, and Investigators, as appropriate.

Other Meds:

Current Illness:

ID: 1065143
Sex: M
Age:
State: MI

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: may have gotten a double dose/ gave him shots in both arms/ thought they inadvertently gave him two doses of it/ unsure if he received two doses or if he only got one; both arms were sore; This is a spontaneous report from a contactable consumer (reported for himself). A male patient of an unspecified age (Age: 73; Unit: Unknown) received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number: en6200), via an unspecified route of administration on 17Feb2021 at single dose in arm for COVID-19 immunization. Medical history included Heart stents. The patient's concomitant medications were not reported. The patient previously took flu shot for immunization and experienced arms were sore. The patient reported that he may have gotten a double dose today (17Feb2021). They gave him shots in both arms, but said the first shot did not have any thing in it so they gave him another shot. He asked if a double dose was bad they said don't worry about it. Both arms were sore but not any worse than the flu shot. The consumer further reported that he got his first shot today and he thought they inadvertently gave him two doses of it. He got two shots, one in each arm and he was wondering if that's a bad thing. Caller stated they stuck him in one arm and she said "oh there was nothing in it, I'm going to give you another shot in another arm." Caller stated that he was unsure if he received two doses or if he only got one. Caller stated that the vaccination card he was provided only had one lot number and expiration date. Caller stated he was pretty sure he felt stuff go in each arm and both arms were sore, but its no more soreness than the flu shot. Caller asked if he was in danger and if he should watch out for side effects. No Covid prior vaccination. No Covid tested post vaccination. The event was non-serious per the reporter. The outcome of the events was unknown.

Other Meds:

Current Illness:

ID: 1065144
Sex: M
Age:
State: TN

Vax Date: 02/11/2021
Onset Date: 02/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: kidney infection; This is a spontaneous report from a Pfizer-sponsored program, Support. A contactable male consumer (patient) of unspecified age received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 11Feb2021, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on an unspecified date. Medical history and concomitant medications was not reported. On an unspecified date in Feb2021, after the second vaccination, the patient experienced kidney infection. His doctor prescribed antibiotics on 15Feb2021. The patient wanted to know if that will affect the efficacy of the vaccine. Event outcome was unknown.

Other Meds:

Current Illness:

ID: 1065145
Sex: F
Age:
State: TN

Vax Date: 02/08/2021
Onset Date: 02/12/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Test Date: 20210212; Test Name: COVID-19; Test Result: Positive

Allergies:

Symptoms: Friday 12th Feb was tested positive; This is a spontaneous report from a Pfizer-sponsored program COVAX US Support, received from a contactable consumer (patient). A female patient of an unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 08Feb2021 at a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient reported that she had her 1st dose of the vaccine on the 8th of Feb (2021), and Friday 12th Feb (2021) was tested positive. The outcome of the event was unknown. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1065146
Sex: F
Age:
State: MN

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

Lab Data:

Allergies:

Symptoms: Gastrointestinal? Bleeding; This is a spontaneous report from a contactable consumer (Patient's sister) via the Pfizer-sponsored program. A female patient of an unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot # UNKNOWN:), via an unspecified route of administration, on an unspecified date at a single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. It was reported that the patient received the first dose already and then had a GI (gastrointestinal) bleeding. The clinical outcome of gastrointestinal bleeding was unknown. Information about lot number has been requested.

Other Meds:

Current Illness:

ID: 1065147
Sex: M
Age:
State: FL

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Test Date: 20210212; Test Name: lab test; Test Result: Positive ; Test Date: 20210210; Test Name: rapid test; Test Result: Negative ; Test Date: 20210211; Test Name: rapid test; Test Result: Positive ; Test Date: 20210212; Test Name: rapid test; Test Result: Positive

Allergies:

Symptoms: tested positive on the 11th; This is a spontaneous report from a contactable consumer (patient) via a Pfizer-sponsored program. A male patient of an unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), via an unspecified route of administration on 03Feb2021 at a single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient received his first COVID shot last 03Feb2021. He tested negative on 10Feb2021 and tested positive on 11Feb2021 and 12Feb2021 for rapid test and lab test. On 14Feb2021, he had monoclonal antibody infusion. The patient wanted to know if he still needed to go to his second vaccine shot appointment that was scheduled on 24Feb2021. The outcome of the event was unknown. Information on lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1065148
Sex: F
Age:
State: AZ

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Altered State of Consciousness.; This is a spontaneous report from a contactable consumer (patient). This 74-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN5318), via an unspecified route of administration on 16Feb2021 16:30 at single dose on left arm for Covid-19 immunisation. Medical history included breast cancer with chemo in 2004. No known allergies. The patient did not have Covid prior vaccination. Concomitant medication included levothyroxine sodium (LEVOTHYROXIN). The patient did not have other vaccine in four weeks.The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL1283) via an unspecified route of administration on Jan2021 07:00 AM on left arm for Covid-19 immunisation. The patient experienced altered state of consciousness on 17Feb2021 at 07:00. The patient felt like she was standing beside herself, removed from herself. Lightheaded and remote from her thinking or what she was saying. As if on a psychedelic drug. No flu like symptoms at all. No treatment was received for the event. The outcome of the event altered state of consciousness was recovered in Feb2021. The patient did not have covid tested post vaccination.

Other Meds: LEVOTHYROXIN

Current Illness:

ID: 1065149
Sex: F
Age:
State:

Vax Date: 02/08/2021
Onset Date: 02/12/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: spure of neuropathy; This is a spontaneous report from a contactable consumer (Patient) via Pfizer-sponsored program. A female patient of an unspecified age received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 08Feb2021 at single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Previously, on an unspecified date, the patient took the first dose of the vaccine for COVID-19 immunization. On 12Feb2021 the patient experienced spure of neuropathy. Patient wanted to know if she can take prescribed "Metanx", that was prescribed before vaccine but not really taking this medication. The final outcome of the event was unknown. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1065150
Sex: M
Age:
State: GA

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

Lab Data:

Allergies:

Symptoms: Had kidney stones before/Developed kidney stone; Had kidney stones before/Developed kidney stone; This is a spontaneous report from a Pfizer-sponsored program. A contactable consumer (patient) reported that a male patient of an unspecified age 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 at a single dose for COVID-19 immunization. The patient's medical history included kidney stones. Concomitant medications were not reported. The patient developed kidney stones. She had kidney stones before. Outcome of the event was unknown. Information on batch/lot number was requested.

Other Meds:

Current Illness:

ID: 1065151
Sex: F
Age:
State: MT

Vax Date: 01/22/2021
Onset Date: 01/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Test Name: Blood test; Result Unstructured Data: Test Result:Good; Comments: looking for a UTI or infection and that came back good; Test Name: CT scan; Result Unstructured Data: Test Result:Good; Comments: it came back good

Allergies:

Symptoms: started acting strange, paranoid; started acting strange, paranoid; she forgets things; dementia; This is a spontaneous report from a contactable consumer (patient's daughter) An 82-year-old female patient received the 1st dose bnt162b2 (BNT162B2) at single dose in arm on 22Jan2021 for Covid-19 immunisation, administered a Clinic. Medical history included macular degeneration from Aug2020 and treated with Saffron and Eylea. The concomitant medications included: Saffron, an herb, started a few weeks before the vaccine was administered for macular degeneration, Eylea shot for the macular degeneration and she got a shot within a few weeks of getting one of the vaccines but this is not a new medication for her. No additional vaccines administered on same date of BNT162B2. No prior vaccinations within 4 weeks. The patient experienced dementia in Jan2021, started acting strange, paranoid on 24Jan2021, she forgets things in Jan2021. The events did not require a visit to Emergency Room or Physician Office. Course of events: About 2 days after the 1st shot she started acting strange, paranoid. Her mom lives with her daughter, son in law, and 21-year-old grandson. She though they were stealing from her, her daughter and grandson. Reporter explained she knew this sounded like classic dementia and she forgot things like everyone does but this was uncharacteristic and she was fine up until 3 days after the shot. They have called her primary care doctor who has done blood test looking for a UTI or infection and that came back good. The doctor also did a CT scan and it came back good. Caller explains that the event was about the same since it started. The outcome of dementia was unknown, of started acting strange, paranoid was not recovered. The patient received the 2nd dose of bnt162b2 (BNT162B2) at single dose in arm on 12Feb2021 for Covid-19 immunisation, administered a Clinic. Information on the lot/batch number has been requested.

Other Meds: SAFFRON; EYLEA

Current Illness:

ID: 1065152
Sex: U
Age:
State: NY

Vax Date: 01/01/2021
Onset Date:
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: had a bout of strep throat; This is a spontaneous report from a contactable pharmacist. A patient of unspecified age and gender received the 1st dose of bnt162b2 (BNT162B2) at single dose on an unspecified date in Jan2021 (3 weeks before this report) for Covid-19 immunisation, administered at a clinic as staff member. The patient medical history and concomitant medications were not reported. The patient experienced a bout of strep throat (mild) on an unspecified date after receiving the 1st dose and took an antibiotic in the past 24 hours. The outcome of events was unknown. The documentation stated still to give the vaccine. Information on batch/lot number was requested.; Sender's Comments: Based on the available information, the event "a bout of strep throat" is attributed to an intercurrent medical condition that was unrelated to BNT162B2 vaccine. 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: 1065153
Sex: M
Age:
State: AL

Vax Date: 01/26/2021
Onset Date: 01/29/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Heart arrhythmia; This is a spontaneous report from a contactable Other Health Professional. A 71-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EK9231), intramuscularly in Right arm on 26Jan2021 01:00 at single dose for COVID-19 immunisation. Medical history included HTN (hypertension), BPH (benign prostatic hyperplasia). Concomitant medication in two weeks included lisinopril, tamsulosin hydrochloride (TAMULOSIN), ergocalciferol (VIT D). Facility type vaccine: Public Health Clinic/Veterans Administration facility. If other vaccine in four weeks: No. The patient previously took naproxen and experienced allergies: Naproxen. If Covid prior vaccination: No. If Covid tested post vaccination: No. The patient experienced heart arrhythmia (medically significant) on 29Jan2021 12:00 with outcome of not recovered. Ae resulted in: Doctor or other healthcare professional office/clinic visit. AE treatment: Holter monitor.; Sender's Comments: Based on the temporal gap between the vaccination and the event onset, the event heart arrhythmia is considered as unrelated to suspect vaccine BNT162B2. The patient is most likely due to underlying cardiovascular conditions. 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: LISINOPRIL; TAMULOSIN; VIT D

Current Illness:

ID: 1065154
Sex: F
Age:
State: ND

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Test Name: Body temperature; Result Unstructured Data: Test Result:highest her temperature got was 100

Allergies:

Symptoms: Shrunk a little bit; really hot; Shivering; Tiredness; Fever; This is a spontaneous report from a contactable consumer. An 89-year-old female patient received the second dose of the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number: EN5318), via an unspecified route of administration in the left arm on 04Feb2021 at 89-year-old at a single dose for COVID-19 immunization. Medical history included macular degeneration from an unknown date and unknown if ongoing. There were no concomitant medications. The patient previously received the first dose of the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number: EL3249; left arm) for COVID-19 immunization on an unknown date. The patient experienced the following events and outcomes: shivering (non-serious) on 10Feb2021 with outcome of recovered on 11Feb2021, tiredness (non-serious) on 10Feb2021 with outcome of not recovered, fever (non-serious) on 10Feb2021 with outcome of recovered on 11Feb2021, shrunk a little bit (non-serious) on an unspecified date with outcome of unknown, really hot (non-serious) on 10Feb2021 with outcome of recovered on 11Feb2021. The patient underwent lab tests and procedures which included body temperature: highest her temperature got was 100 on an unspecified date. About six days after the patient had her second COVID shot, the patient experienced shivering and tiredness. It was reported that the patient had shrunk a little bit starting on an unspecified date. At the time of the report, over the last 3 days, the patient experienced the side effects. "It could be from something else. She could have gotten something. She did not know." The patient also had a fever a few times. The patient would go between shivering and really hot so she would take her temperature. The patient did not normally have a fever. When the shivering came on, she was trying to cook, and could not hold the spoon in her hand. The patient did not know what was wrong, but she was cold. All she wanted to do was sleep. The only symptom she still had was being tired. The night before the report, the patient woke up so warm and was sweating; her pajamas were damp. The patient could not sleep in them, so she had to go change. The patient has not shivered since then. The tiredness was persisting. The patient slept on and off all day today, but she was feeling better in general. The patient took her temperature every day. "The highest her temperature got was 100."

Other Meds:

Current Illness:

ID: 1065155
Sex: F
Age:
State: IL

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data: Test Date: 20210107; Test Name: Temperature; Result Unstructured Data: Test Result:didn't check her temperature but she is sure she h; Comments: didn't check her temperature but she is sure she had a fever; Test Date: 20210119; Test Name: Cardiac catheterization; Result Unstructured Data: Test Result:Results indicated myocarditis caused by a virus; Comments: heart attack because of myocarditis; Test Date: 20210119; Test Name: Echocardiogram; Result Unstructured Data: Test Result:Results indicated myocarditis caused by a virus; Comments: heart attack because of myocarditis; Test Date: 20210120; Test Name: Heart MRI with contrast; Result Unstructured Data: Test Result:Results indicated myocarditis caused by a virus

Allergies:

Symptoms: Heart attack; Myocarditis; Chills; didn't check her temperature but is sure she had one/She didn't check her temperature but she is sure she had a fever; was soaking wet when she woke up like her fever had broken and then she was fine/She woke up and was very sweaty; achy right side; Headache; This is a spontaneous report from a contactable consumer who reported for herself, a 60-year-old female patient who received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EL3246), via an unspecified route of administration in the right arm, on 06Jan2021 at 18:00 at the age of 60 years, at a single dose for Covid Prevention/COVID-19 immunization. The patient's medical history was not reported. There were no concomitant medications. The patient previously received the first dose of Covid-19 vaccine (Manufacturer: Pfizer, with Lot Number: EK5730) in the right arm, on 18Dec2020 at the age of 60 years for COVID-19 immunization. The patient reported that 13 days after the last dose of the vaccine, on 19Jan2021, she had a heart attack. She has no heart issues whatsoever. She had diagnostic testing such as a cardiac catherization, echocardiogram, both on 19Jan2021; and a heart MRI with contrast on 20Jan2021. The test results indicated that she had myocarditis caused by a virus. The cardiac catherization and echocardiogram also revealed heart attack because of myocarditis. She did not have any other issues with her heart. The patient asked if they would they let her know if anything comes up as far as information. The patient has recovered with lasting effects. She would be on medication for the next 3 years supposedly. The heart attack was caused by myocarditis which was caused by a virus. There were no other issues with her heart, arteries or anything. These events required a visit to the emergency room. She first went to a hospital in the city and was transferred via ambulance to another hospital in another city on the same day. Patient was hospitalized for the heart attack and myocarditis from 19Jan2021 to 22Jan2021. She had a lot of other symptoms the next day after receiving the vaccine on 07Jan2021. She also experienced chills. She didn't take her temperature but is sure she had one. She was achy on her whole right side and she had a headache. She started having chills at 1:30 PM (13:30) while at an eye doctors appointment. She laid down and was soaking wet when she woke up like her fever had broken and then she was fine. She didn't check her temperature but she is sure she had a fever. She woke up and was very sweaty. The outcome of the events heart attack and myocarditis was recovered with sequelae on Jan2021. The outcome of the remaining events was recovered on 07Jan2021.

Other Meds:

Current Illness:

ID: 1065156
Sex: M
Age:
State: GA

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

Lab Data:

Allergies:

Symptoms: Kidney stones; This is a spontaneous report from a contactable consumer (patient). A 78-year-old male patient received BNT162B2 (Pfizer-BIONTECH COVID-19 Vaccine; Batch/Lot number: EL3247), via an unspecified route of administration on an unspecified date as a single dose for COVID-19 immunisation. Medical history included nephrolithiasis (before getting the COVID shot). The patient's concomitant medications were not reported. The patient experienced kidney stones on an unspecified date. The patient explained that he was scheduled for the second COVID shot on Wednesday. He noted that he has developed a kidney stone and wanted to know if it was ok to get the second dose. It was confirmed that he was used to the pain and has had a bunch of them in the past; he has a history of kidney stones before getting the COVID shot. He stated that he wanted to go ahead and get the shot, the appointments were so hard to get. Outcome of the event was unknown.

Other Meds:

Current Illness:

ID: 1065157
Sex: F
Age:
State:

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data: Test Name: blood pressure; Result Unstructured Data: Test Result:178/122; Test Name: chest X-ray; Result Unstructured Data: Test Result:normal; Test Name: EKG; Result Unstructured Data: Test Result:normal; Test Name: heart rate; Result Unstructured Data: Test Result:102

Allergies:

Symptoms: overly dehydrated; high blood pressure/ blood pressure was 178/122; could not sleep entirely/she was in a semi-sleep state/having insomnia feeling like really bad; could not move or open her eyes; her head felt like exploding; her heart pounding/ heart rate 102; extreme fatigue; This is a spontaneous report from a contactable consumer (the patient). A female patient of an unspecified age received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot number not provided), via an unspecified route of administration on 12Jan2021 (age at vaccination unknown) as a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot number not provided), via an unspecified route of administration on an unspecified date (age at vaccination unknown) as a single dose for COVID-19 immunization, and experienced: arm soreness, nausea, and headache, on an unspecified date. After 1 hour 30 minutes of getting the second dose on 12Feb2021, the patient felt an extreme fatigue and went to sleep. She could not sleep entirely (from an unspecified date) and woke up and went to the bathroom several times after midnight and she tried to wake up at 4 am, but she was in a semi-sleep state half aware and could not move or open her eyes no matter how hard she tried. She described this state as she couldn't move and having insomnia feeling like really bad. When she managed to pull this up, she took her pulse and blood pressure and she was having high blood pressure, her head felt like exploding and also her heart pounding. Her blood pressure was 178/122 and her heart rate 102. She stated that her husband tried to call Pfizer that moment, but they could not get a hold of someone after 30 minutes, so they contacted 911. She was taken to the hospital, and her chest X-ray and EKG were normal (to discard a heart attack). Then they noted that she was overly dehydrated, so they prepared some IV (intravenous) solution for her. The clinical outcome of the events was unknown. Information on Lot /Batch Number has been requested.

Other Meds:

Current Illness:

Date Died: 01/28/2021

ID: 1065158
Sex: M
Age:
State: FL

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: death; severe headache; This is a spontaneous report from a non-contactable consumer from a Pfizer-sponsored program. A male patient of an unspecified age (Age: 83, unit: Unknown; as reported) received the first dose of the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number:EH9899), intramuscularly in the left arm on 20Jan2021 at a single dose for COVID-19 immunisation. The patient's medical history included sulfonamide allergy from an unknown date and unknown if ongoing. Concomitant medications were not reported. The patient previously took azithromycin [MANUFACTURER UNKNOWN] and experienced allergy on an unspecified date. On 22Jan2021, the patient experienced severe headache (non-serious). On 28Jan2021, the patient experienced death (death, medically significant); 8 days after receiving the vaccine. The patient died on 28Jan2021 due to unknown cause of death. It was unknown if an autopsy was performed. The clinical outcome of the event, death, was fatal. The clinical outcome of the event, severe headache, was not recovered. No follow-up attempts are possible. No further information is expected. ; Reported Cause(s) of Death: Unknown cause of death

Other Meds:

Current Illness:

ID: 1065159
Sex: F
Age:
State: MT

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data: Test Name: blood work; Result Unstructured Data: Test Result:Normal

Allergies:

Symptoms: Transverse myelitis; bowel and urine issues; bowel and urine issues; she can't walk; numbness from her toes up to her breast on the left side and numbness from her toes to her groin on the right side; This is a spontaneous report from a contactable consumer (patient). A 75-year-old female consumer received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 23Jan2021 at 13:00 at single dose into right arm for COVID-19 immunisation at the age of 75-year-old. Lot number was EL8982. Medical history was unknown and concomitant medications included blood pressure pills and cholesterol pills and vitamins. On 24Jan2021, the patient experienced transverse myelitis; the patient was hospitalized due to the event (hospitalization dates from 24Jan2021 to 7Feb2021; emergency room since 24Jan20211 noon). Consumer stated that when she was in the hospital, she was on heavy doses of steroids intravenous (IV) for 5 days. Blood work at the hospital was normal. Consumer left the hospital to go to the rehab facility on 30Jan2021, and then consumer left the rehab facility on 07Feb2021. Consumer stated that she could not walk. Consumer had complete numbness from her toes up to her breast on the left side and numbness from her toes to her groin on the right side. Consumer stated that she was still having issues with dragging her left leg, and with rehab, she was finally getting back some feeling, the numbness was still there but she was having bowel and urine issues. Consumer stated that her issues have somewhat improved with the help of rehab. The patient was recovering from the events.

Other Meds:

Current Illness:

ID: 1065160
Sex: F
Age:
State: TN

Vax Date: 02/10/2021
Onset Date: 02/13/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Stroke; This is a spontaneous report from a contactable consumer reporting on behalf of the mother. An approximately 81-year-old female patient received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EL9264) on 10Feb2021, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 23Jan2021 (Batch/lot number: EL3302). Medical history was not reported. Concomitant medications included two unspecified prescriptions. On 13Feb2021 the patient experienced stroke which required hospitalization on the same day. The reporter was not sure of the name but they did a 'CAT' where they went up and pull the clot out of the brain. Event outcome was unknown. The patient was still in the hospital at the time of report. No investigation was performed before the event.

Other Meds:

Current Illness:

ID: 1065161
Sex: F
Age:
State: OH

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: My mouth and tongue started itching; Skin broke out in a rash and became super itchy; Skin broke out in a rash and became super itchy; Have hives; This is a spontaneous report from a consumer reporting for herself. A 29-years-old female patient received the first dose of bnt162b2 (BNT162B2; Lot # em9809) vaccine , via an unspecified route of administration in the left arm on 24Feb2021 14:30 at single dose for covid-19 immunisation . Medical history included asthma , attention deficit hyperactivity disorder , polycystic ovaries , sleep apnoea syndrome, arthralgia , the patient was allergic to Albuterol, Penicillin, Cephalosporin, Iodine, Bees, all types of fish, all types of shellfish, peanuts, all types of tree nuts. Concomitant medication included cefixime (FLEXERIL), acetylcarnitine hydrochloride (NEUROTIN ), naproxen (MOTRIN). The patient experienced my mouth and tongue started itching on 24Feb2021 14:30 with outcome of not recovered , skin broke out in a rash and became super itchy on 24Feb2021 14:30 with outcome of not recovered , have hives on 24Feb2021 14:30 with outcome of not recovered. The reported events were considered Life Threatening. The patient received Benadryl, and got epi on hand as treatment. Follow up information has been requested.

Other Meds: FLEXERIL [CEFIXIME]; NEUROTIN [ACETYLCARNITINE HYDROCHLORIDE]; MOTRIN [NAPROXEN]

Current Illness:

ID: 1065162
Sex: M
Age:
State: OH

Vax Date:
Onset Date:
Rec V Date: 03/02/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: pneumonia; This is a spontaneous report from a contactable consumer reported for a patient (Husband) via a Pfizer-sponsored program. A male patient of an unspecified age received first dose of bnt162b2, via an unspecified route of administration on an unspecified date at a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient experienced pneumonia on an unspecified date which required hospitalization until now. The outcome of event was not recovered. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1065163
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Little lip swollen that looks like a classic symptom of little angioedema on her left side; Little lip swollen that looks like a classic symptom of little angioedema on her left side; This is a spontaneous report from contactable consumer. This consumer reported for a female patient (mother in law) of an unspecified age that received first dose of bnt162b2 (BNT162B2, lot number: EN6201) , via an unspecified route of administration on an unspecified date at single dose for covid-19 immunization. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced little lip swollen that looks like a classic symptom of little angioedema on her left side on an unspecified date with outcome of unknown. Reporter stated, "It is for my mother in law. Looks like she has a little angioedema on her lip. She did have the second shot today, Pfizer, 2nd shot (Unspecified Medication). It is not severe but she does have a little lip swollen that looks like a classic symptom of little angioedema on her left side. She had the shot on her right side. I just was not sure, I mean should she take Benadryl." Information on Lot/Batch number has been requested.

Other Meds:

Current Illness:

ID: 1065164
Sex: F
Age:
State: VA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: Test Date: 20210214; Test Name: Heart rate; Result Unstructured Data: Test Result:racing; Comments: Heart rate racing and in AFIB

Allergies:

Symptoms: sweating; Chills; AFIB; Heart rate racing; Lightheadedness and dizzy and felt like she would pass out.; Nausea; Muscle ache; Headache; Second dose arm hurt at injection site; compromised immune status; This is a spontaneous report from a contactable consumer (patient). A 74-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN6201), intramuscular at arm left on 13Feb2021 at 10:30 (at the age of 74 years) at single dose for COVID-19 immunization. Medical history included primary biliary cholangitis (PBC, autoimmune condition and was diagnosed 10 years ago), diagnosed allergies, compromised immune status, respiratory illness, genetic /chromosomal abnormalities, diabetes and obesity, all from an unknown date and unknown if ongoing. There were no concomitant medications. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN5318), intramuscular at arm left on 24Jan2021 and experienced sore arm. The patient experienced headache and arm hurt at injection site, both on 13Feb2021 at 19:00; heart rate racing, AFib, lightheadedness and dizzy and felt like she would pass out, all on 14Feb2021 at 07:30; nausea, muscle ache, both on 14Feb2021 at 03:00, chills on 14Feb2021 at 15:00 and sweating on 14Feb2021 at 16:00. The patient outcome of the events was recovering.

Other Meds:

Current Illness:

ID: 1065165
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Dtap/ipv portion was administered without reconstituting with the HIB portion/no AE; Initial information was received on 08-Dec-2020 regarding an unsolicited valid non-serious case from a other health professional. This case involves a patient (unknown demography) who had received DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL] in which DTAP/IPV portion was administered without reconstituting with the HIB portion (product preparation issue). Medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date, the patient received a dose of suspect DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE (lot number and expiry date not reported) via an unknown route in unknown administration site for prophylactic vaccination. It was case of an actual medication error due to inappropriate reconstitution technique. At the time of report, no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holders compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1065166
Sex: F
Age:
State: MO

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

Lab Data:

Allergies:

Symptoms: allergic reaction; Initial information received on 18-Feb-2021 regarding an unsolicited valid non-serious case from a consumer via Regulatory authority (under reference number: 00482313). This case involves female patient of unknown age who experienced allergic reaction (hypersensitivity), after receiving INFLUENZA USP TRIVAL A-B HIGH DOSE SUBVIRION VACCINE [FLUZONE HIGH DOSE]. The patient's past medical history, medical treatment(s), vaccination(s), concomitant medication(s) and family history were not provided. In 2010, the patient received a dose of suspect INFLUENZA USP TRIVAL A-B HIGH DOSE SUBVIRION VACCINE (lot number and expiration date not reported) via unknown route in unknown administration site for prophylactic vaccination. In 2010, the patient developed a non-serious allergic reaction (hypersensitivity), (approximately in the same year, exact latency unknown) following the administration of INFLUENZA USP TRIVAL A-B HIGH DOSE SUBVIRION VACCINE. No laboratory data reported. It was not reported if the patient received a corrective treatment. At the time of reporting, the outcome was not reported for the event hypersensitivity. Also reported that: Reporter wanted to know what were the components of that vaccine. Consumer was referred to her administering physician. Consumer stated she will check the website and she will call back tomorrow to speak to a supervisor. AE (adverse event) information not obtained due to long hold with consumer, and her main concern was just knowing the product composition of that FLUZONE HIGH-DOSE in 2010. Consumer was referred to the website and to her health care provider. She stated that she will call back tomorrow to speak to a supervisor. There will be no information on the batch number for this case.

Other Meds:

Current Illness:

ID: 1065167
Sex: M
Age: 38
State: MI

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: patient who received an expired dose of Tenivac, no AE; Initial information regarding an unsolicited valid non-serious case was received from a other health care professional via Medical Information (Reference number- 00482322) and transmitted to Sanofi on 18-Feb-2021. This case involves a 38 years male patient who received an expired 0.5 ml dose of DIPHTHERIA AND TETANUS TOXOIDS [Tenivac] (batch number C5578AA and expiration date:28-Jan-2021) via intramuscular route in the left deltoid for prophylactic vaccination (Expired product administered) on 29-Jan-2021. The patient's medical history, past medical treatment(s), vaccination(s), family history, risk factor were not provided. No concomitant medication were given to the patient. It was an actual medication error due to expired vaccine used (same day latency). Also reported that : MA (medical assistant) wants to know if the patient needs to be revaccinated The patient did not experience any side effects. No treatment provided. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds:

Current Illness:

ID: 1065168
Sex: F
Age: 72
State: NJ

Vax Date: 02/20/2021
Onset Date: 02/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: eye doctor gave eye antibiotics

Allergies: bee stings. mosquito bites penicillins bactrin

Symptoms: headache. right arm hard red swollen from shoulder to elbow painful fatigue neuralgia pains right eyelid swollen with chalazia

Other Meds: vitamin c vitamin d probiotics

Current Illness: none

ID: 1065169
Sex: F
Age: 54
State:

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Body Ache

Other Meds: none

Current Illness: none

ID: 1065326
Sex: F
Age: 70
State: GA

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: chills and 100.0 temp

Other Meds: trulicity, treseba,amlodipine-benaz, gilimepiride, levothyroxine, fluoxetine, simvastatin, florajen, vitamin d2, cramp defense

Current Illness:

ID: 1065327
Sex: F
Age: 57
State: SD

Vax Date: 02/23/2021
Onset Date: 03/02/2021
Rec V Date: 03/02/2021
Hospital: Y

Lab Data: CXR, EKG, Labs on admit 3/2/21

Allergies: Venofer

Symptoms: Developed acute respiratory distress with bilateral pulmonary infiltrates. Suspicious for pulmonary edema. CXR clear 2/6/21.

Other Meds: Outpatient Medications senna-docusate sodium (SENOKOT-S;PERICOLACE) 8.6-50 MG tablet Take 1 tablet by mouth 2 times a day ondansetron (ZOFRAN) 8 MG tablet Take 1 tablet (8 mg) by mouth 3 times a day as needed for nausea or vomiting cloNI

Current Illness: Constipation with stercoral ulcer with recent completion of Augmentin.

ID: 1065328
Sex: F
Age: 61
State: FL

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: PCN

Symptoms: Got vaccine on Friday evening. On Saturday developed low grade fever; fatigue; sore arm for several days.

Other Meds: Invokana; Janumet; Levothyroxine

Current Illness: NOne

ID: 1065329
Sex: F
Age: 64
State: VA

Vax Date: 01/28/2021
Onset Date: 02/06/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: Allergic to penicillin, erythromycin

Symptoms: I developed what is being called "Covid Vaccine Arm" a little more than a week after receiving the first dose of the Moderna vaccine in my right arm. The "rash" spread over my arm from the injection site almost to my elbow. It was somewhat red, raised, and hot and extremely itchy. It gradually faded and resolved after a week. I received my 2nd dose of the Moderna vaccine on February 26, 2021. This time--on the advice of my doctor--I got the injection in my left arm. I started developing a rash again, but this time the day after (2/27/21). While it does not itch as much as what I experienced previously, my arm has been far more sore and the area of redness (which is raised) is larger than the first time. I am primarily reporting the first incident, but want to include that it happened again, but more quickly.

Other Meds: No prescription medications, but take these vitamins & supplements: B-12, C, D3, K2, A, Magnesium, Zinc

Current Illness: None

ID: 1065330
Sex: F
Age: 85
State: NY

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: RHABDOMYLOSIS-Medium, Additional Details: AFTER RECEIVING THE VACCINE PATIENT HAD MUSCLE WEAKNESS AND FELL DOWN. PATIENT WAS TAKEN TO DOCTOR AND DIAGNOSED WITH RHABDOMYLOSIS

Other Meds:

Current Illness:

ID: 1065331
Sex: F
Age: 22
State: PA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Patient noted an anaphylactic response to hepatitis b as a baby. Was counseled to wait 30 minutes in pharmacy to be monitored after receiving a vaccine. Around 25 minutes later patient approached pharmacist stating felt tongue tingling. Patient drank some water stated she felt better but in next two minutes noted her throat felt obstructed. Technician called 911. Paramedics arrived within 3 minutes. No epipen was given. Paramedics and immunizing pharmacist both mentioned possible anxiety attack

Other Meds:

Current Illness:

ID: 1065332
Sex: M
Age: 59
State: VA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Muscle pain 102 Fever Sleepiness

Other Meds: Citalopram

Current Illness:

ID: 1065333
Sex: F
Age: 82
State: TX

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Weakness-Severe, Additional Details: patient was unresponsive and staring blankly later that evening after receiving the first dose of vaccine, she was not able to verbalize symptoms, however, she experienced weakness in legs requiring assistance to walk per her caregiver

Other Meds:

Current Illness:

ID: 1065334
Sex: F
Age: 42
State: MD

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: N/A

Allergies: Cipro, Acetaminophen

Symptoms: Red rash on neck, chest, abdomen, and back. Hot, but not very itchy. Present between 24 - 60 hours after vaccine, treated with Benadryl. Also, very intense pain in left arm, treated with ibuprofen. This began several hours after the vaccine and lasted about 48 hours.

Other Meds: None

Current Illness: None

ID: 1065335
Sex: F
Age: 95
State: NC

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Error: Wrong Patient (documentation in EMR)

Other Meds:

Current Illness:

ID: 1065336
Sex: F
Age: 66
State: DE

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

Lab Data:

Allergies:

Symptoms: Injection site is still swollen and painful 2 days after injection.

Other Meds:

Current Illness:

ID: 1065337
Sex: F
Age: 72
State: MA

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies: many antibiotics, sulfur drugs, sensitivity to -caine pain killers

Symptoms: I woke up at 11:30 pm with severe intestinal cramping. I have IBS so I used what normally worked - heat and a dicyclomine capsule. It got worse and worse to the point my whole body was shaking. I felt nauseous and thought I might throw up from the pain (I didn't). At 1:00 am I took a 5mg Oxycodone pill. I got a little relieft at about 1:45 am. The spasms started coming in waves. At 3:15 am I took another dicyclomine and again used the heating pad. At about 4:30 am, I was able to fall asleep. This is absolutely the worst spasming I have ever had.

Other Meds: Armour Thyroid, Liothyroxin, amitriptyline, tizanidine, Primal Defense probiotic, holy basil, Flonase nasal Spray, Boswellia with Bioprene, Raw B Complex, Tumeric Curcumin with bioprene, dicyclomine as needed, Oxicodone 5mg as needed for ch

Current Illness: none

ID: 1065339
Sex: F
Age: 76
State: NY

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data: None

Allergies: No food or allergies to other products Penicillin, aspirin, sulfa drugs, Macrodantin, Clarithromycin, Doxycycline

Symptoms: First: Vaccine was not given at Center. It was a drive-up at Drive Thru. Adverse general side effects that lasted from 3:00 a.m. 02/27/2021 through 03/01/2021: fatigue, headache, muscle pain, joint pain, chills, nausea, heart palpitations, loss of appetite. Considerably more pain than with Fibromyalgia, shaking chills even though wrapped in a quilt, more heart palpitations than usual.

Other Meds: Atenolol 50 mg day (heart) Levothyroxine 75 mcg day Meloxicam 7.5 mg day Prilosec OTC PRN Calcium day Vitamin D3 25 mcg day Atorvastatin 10 mg day Tylenol PRN

Current Illness: Fibromyalgia, heart arrhythmia (extra beats, past mitral and tricuspid prolapse diagnoses), varicose veins both legs, microscopic colitis

ID: 1065340
Sex: F
Age: 54
State: MI

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Site: Swelling at Injection Site-Mild, Systemic: reported \"heaviness\" in arm and shoulder, swelling of arm and neck area-Mild, Additional Details: no numbness, tingling, or decreased circulation. 25mg diphenhydramine given\r\nsymptoms occured 2+ hours after immunization administered, patient observed for 1 hour post reporting, no increase or worsening of condition

Other Meds:

Current Illness:

Date Died:

ID: 1065341
Sex: F
Age: 91
State: WA

Vax Date: 01/29/2021
Onset Date: 02/11/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Made aware of patient passing away on 3/1 per letter from Corporate legal team. Patient passed away on 2/14. Vaccine 1st dose given 1/29/21.-Severe

Other Meds:

Current Illness:

ID: 1065350
Sex: U
Age:
State: IL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional AE/PQC reported; Expired vaccine used; This spontaneous report was received from a medical director referring to a patient of unknown age and gender. The patient's pertinent medical history, concomitant drugs and drug allergies were not reported. On 04-FEB-2021, the patient was vaccinated with an expired dose of measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (recombinant human albumin (rHA)) (M-M-R II) (lot # R030806, expiration date was 24-OCT-2020, strength, frequency and route were not reported) for prophylaxis (expired vaccine used). No additional adverse event was reported.

Other Meds:

Current Illness: Prophylaxis

ID: 1065351
Sex: F
Age: 55
State: CA

Vax Date: 09/27/2002
Onset Date: 03/18/2003
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: no adverse reaction; vaccination date: 27-SEP-2002 and 18-MAR-2003; This spontaneous report has been received from a lawyer via a Plaintiff Fact Sheet referring to a 56 years old female patient. On 27-SEP-2002, the patient was vaccinated with hepatitis b vaccine (manufacture unknown) (strength, dose, route, lot #, expiration date not reported) for prophylaxis by a physician. On 18-MAR-2003, the patient received another dose of hepatitis b vaccine (manufacture unknown) (strength, dose, route, lot #, expiration date not reported) (inappropriate schedule of product administration). There were no adverse reactions or side effects experienced. This is one split report from a case in litigation (MARRS# 1907USA003404).; Sender's Comments: US-009507513-1907USA003404:

Other Meds:

Current Illness:

ID: 1065352
Sex: U
Age:
State: FL

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 03/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: no additional adverse event; he believes the child only got half dose; This spontaneous report has been received from a physician via company representative concerning a child patient of unknown gender. The patient's relevant medical history, drug reactions/allergies, concurrent conditions and concomitant therapies were not reported. On 16-FEB-2021, a nurse vaccinated the child with Measles (+) Mumps (+) Rubella (Wistar RA 27-3) Virus Vaccine, Live recombinant Human albumin (rHA) (MMR-II) (strength, dose, dose number, route of administration, anatomical location not provided) (lot number reported as T006165 and expiration date as 19-FEB-2022) for prophylaxis; however, she did not hold the child very well. Thus, the investigator believed the child only got half dose. There was no additional adverse event.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm