VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1227224
Sex: F
Age: 52
State: WA

Vax Date: 04/09/2021
Onset Date: 04/15/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Itchy skin and 4 inch raised red lesion that started at the site of the injection and is moving toward my hand. Currently right above my elbow. Appeared about 5 days after vaccine and is worsening.

Other Meds: Multi-vitamin Iron Progesterone

Current Illness:

ID: 1227226
Sex: F
Age: 21
State: MI

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever, headache, nausea, chills, loss of appetite, achy right knee, soreness at injection site, exhaustion

Other Meds:

Current Illness:

ID: 1227227
Sex: M
Age: 24
State:

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: non contiguous papular rash on back and back of arms; excoriated and healing well without any s/sx of infection; no weeping; some early papules developing; pruritic; will treat with prednisone taper;

Other Meds: none

Current Illness: none

ID: 1227228
Sex: F
Age: 36
State:

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Shaking chills, body aches, head ache, pain upper left arm (injection site), nausea, feelings of panic and paranoia.

Other Meds: Orthomicron

Current Illness: No

ID: 1227229
Sex: F
Age: 62
State: MA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Conjunctivitis

Other Meds: Claritin 12 hour

Current Illness:

ID: 1227230
Sex: F
Age: 36
State: MA

Vax Date: 04/08/2021
Onset Date: 04/12/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Tylenol

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

Symptoms: Ocular migraine day 5 Tension headaches day 5-9 Dizzy spells day 6-9 Sinus pressure (but no sinus issues) day 5-9 On day 9 today and symptoms are waning/waxing

Other Meds: None

Current Illness: None

ID: 1227231
Sex: F
Age:
State: PA

Vax Date: 03/25/2021
Onset Date: 03/28/2021
Rec V Date: 04/18/2021
Hospital: Y

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: cerebral venous sinus thrombosis; CT scan that revealed the clot; horrible headache after intercourse; vomiting; This is a spontaneous report from a contactable consumer (patient). A 29-years-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: EP7534), second dose via an unspecified route of administration, administered in left arm on 25Mar2021 09:45 as single dose for COVID-19 immunisation. Patient was 29 year old at the time of vaccination. Medical history included asthma, gastrooesophageal reflux disease, peanut and treenut allergy, all from an unknown date. Patient had estrogen allergy. Patient was not diagnosed with COVID-19 Prior to or after the vaccination. Concomitant medications included cetirizine hydrochloride (ZYRTEC ALLERGY), medroxyprogesterone acetate (DEPO PROGESTIN), beclometasone dipropionate (QVAR), OMEPRAZOLE, SERTRALINE HYDROCHLORIDE, all taken on an unspecified date and for unknown indication. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient had her first dose of bnt162b2 on 04Mar20210 at 9:45 am in left arm for COVID-19 immunisation. On 28Mar2021 at 09:45 the patient was diagnosed with cerebral venous sinus thrombosis a few days after receiving the second dose of the vaccine. She had a horrible headache after intercourse, went to the ER after vomiting, and had a CT scan that revealed the clot. The patient was hospitalized for cerebral venous sinus thrombosis. The patient underwent lab tests and procedures which included computerised tomogram: revealed the clot. Patient received Heparin and Eliquis as treatment for the events. Outcome of the events was recovering. No follow-up attempts needed. No further information expected.

Other Meds: ZYRTEC ALLERGY; DEPO PROGESTIN; QVAR; OMEPRAZOLE; SERTRALINE HYDROCHLORIDE

Current Illness:

ID: 1227232
Sex: F
Age: 51
State: MI

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: 24 hour headache Painful joints for about 2 days Fatigue about 2 days Insomnia for two nights Took Tylenol and that helped a bit

Other Meds: None

Current Illness: None

ID: 1227233
Sex: F
Age: 70
State: FL

Vax Date: 04/07/2021
Onset Date: 04/13/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: nka

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Severe vertigo , fatigue , nausea with movement

Other Meds: synthroid 100 mcg once a day

Current Illness: none

ID: 1227234
Sex: M
Age: 38
State: LA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Below the injection site, I have a large red circle on my arm and the area is hard.

Other Meds: None

Current Illness: None

ID: 1227235
Sex: F
Age: 49
State: AZ

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

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

Lab Data:

Allergies: Sulfa ,Penicillin.

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

Symptoms: Large lump about the size of a ping pong ball at the injection site. Hot to the touch, painful and very itchy.

Other Meds: Allegra , vitamin C, vitamin D3

Current Illness: No

ID: 1227236
Sex: F
Age: 48
State: MN

Vax Date: 03/05/2021
Onset Date: 04/12/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Penicillin's

Symptom List: Rash, Urticaria

Symptoms: Patient had symptoms of a cough and congestion reported on 03/29/2021. Symptoms have been continuing since. Loss sense of taste and smell, cough, congestion, and shortness of breath.

Other Meds: Tessalon, Robitussin, trulicity, zithromax, Lantus, albuterol, claritin, lipitor, protonix, aspirin, ferosul, trandate, cozaar, triumeg, norvasc

Current Illness: Cough, congestion that started on 03/29/2021

ID: 1227237
Sex: M
Age:
State: IN

Vax Date: 03/03/2021
Onset Date: 03/17/2021
Rec V Date: 04/18/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: vertigo is debilitating. Caller wanted to know if there have been reports of vertigo; he could not drive. Caller stated he was ok when laying on the couch but when he got up he could not walk without falling down; vertigo is debilitating. Caller wanted to know if there have been reports of vertigo/Vertigo; staggering and unable to walk on his own without someone helping him; complain of being dizzy/slight dizziness/dizziness; This is a spontaneous report from a contactable consumer (wife) on behalf of a 77 years-old male patient. A 77-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number and Expiry Date: unknown), via an unspecified route of administration on arm Left on 3Mar2021 at single dose for COVID-19 immunization. The patient medical history included ongoing Peritoneal dialysis from 2018, ongoing Heart bypass from Jan2019. The patient concomitant medications were not reported. The patient did not receive any other vaccine within 4 weeks prior to the COVID vaccine. On 17mar2021 or 18Mar2021, the patient complained of being dizzy. By 20Mar2021 he was staggering and unable to walk on his own without someone helping him and ongoing vertigo from 20Mar 2021 and reported as vertigo worsened. By 21Mar2021 he could not drive. The patient was ok when laying on the couch but when he got up he could not walk without falling down. The patient had extreme vertigo that started about 2 weeks after the vaccine and is debilitating. The patient is just under 6 feet, he shrunk a little. The events dizziness resulted in hospitalization from an unspecified date. The event vertigo resulted in ER visit and hospitalized from 22Mar2021 to 28Mar2021. The lab test included CT scan and MRI, results: negative; He also had lab tests, but nothing showed a reason why he has the vertigo. No further details provided about lab work. The outcome of the events was unknown. Information on the lot/batch number has been requested. Follow-up attempts are completed. No further information is expected

Other Meds:

Current Illness: Peritoneal dialysis

ID: 1227238
Sex: M
Age: 56
State: VA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Augmentin Mollusks

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

Symptoms: Inflamation and pain on left side of the body, beginning in the arm/shoulder and spreading to neck and left tonsil. Tonsil swelling was quite pronounced by 2am (nearly twelve hours after the injection) and blocked the airway when head was turned to the left, necessitating a makeshift pillow brace to keep head turned to the right overnight. Tonsil swelling began to diminish by about 6am and only slight enlargement remains thirty hours after injection. Additionally, a low-grade fever began at about 10 pm (~7 hours after injection) and reached a maximum of 100.5 degrees F approximately twenty-four hours after the injection. By twenty-eight hours, temperature was within normal limits (though still nearly a degree higher than typical for this patient). As of this writing, some thirty hours after the injection, headache, neck ache, and eye-ache persist, but none is severe. Symptoms appear to be continuing their improvement. I (the patient/recipient) hope the second installment of the vaccine is no worse than this one. The only truly alarming symptom was the swollen tonsil and some thought was given to seeking medical attention, but the pillow brace seemed to do the trick for keeping the airway open, so no assistance was sought. I have no doubt that these short-lived symptoms are much better than actual disease and I will not hesitate to follow up with the second vaccine installment?but I will monitor the tonsil situation very carefully.

Other Meds: Vitamin D3 (4000 IU/daily)

Current Illness: None

ID: 1227239
Sex: F
Age: 33
State: CT

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Shot 2- 4/15/21- Thursday 6 hours after- nausea started 9 PM ? extremely nauseous, uncontrollable chills, 102 fever and skin hurt to touch (that didn?t last long) (Friday)Next morning- low-grade fever, mild headache, no appetite 2 pm- still no appetite, headache, neck pain and chills Bedtime- chills, low-grade fever Saturday- 4/17- woke up completely soaked- I?m thinking I must?ve spiked a fever during the night. I also woke up with sharp painful chest pain. Went to the ER my D dimer blood tests were slightly elevated so they did a CAT scan and didn?t find any evidence of blood clots. Saturday Evening- still no appetite, headache and neck pain Today -4/18- still no appetite,neck pain,headache and fatigue

Other Meds: One a day multi vitamin

Current Illness: None

ID: 1227240
Sex: F
Age: 56
State: CA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, bee stings, eurythromycin,

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Periods of tachycardia with puke going up to 189 and lasting for 10-15 minutes at a time Hypertensive crisis - blood pressures from 180/133 and for 8 days since 2nd shot BP has been vhigh averaging 135/108 with metoprolol and propranolol on board.

Other Meds: Ativan Metoprolol Atorvastatin Baby aspirin Wellbutrin Cytomel

Current Illness: None

ID: 1227242
Sex: M
Age: 31
State: CA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Albendazole

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: I felt numbness in my right leg, the numbness went up to my right arm and then I started slurring. This happened within a few minutes. I laid down and called a nurse adviser. I was recommended to go to ER, so my wife took me to ER. They did CT scan of my head, then CT scan of my head and neck with contrast, then MRI of my head, then MRI of my head and neck with contrast. It was confirmed that I had an ACUTE ISCHEMIC STROKE. It was decided to perform carotid endarterectomy surgery to remove a clot in the neck carotid artery. The clot was removed.

Other Meds: Vyvanse 50mg Adderal 10mg Zirtec Fish Oil 2000mg Vitamin D 5000 ZMA by Optimum Nutrition Melatonin Whey protein powder Creatine powder

Current Illness:

ID: 1227243
Sex: F
Age:
State:

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/18/2021
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: This is a spontaneous report from a contactable consumer (patient). A 64-year-old female patient received a second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number: unknown), via an unspecified route of administration on 06Apr2021 13:00 at single dose for covid-19 immunisation. Patient medical history and concomitant medications were not reported. Patient received the second dose of the Pfizer-BioNTech COVID-19 Vaccine yesterday, 06APR2021 at around 1PM. She woke up in the middle of night (she usually does so). When she woke up this morning and had a cup of tea, noticed that she was "somewhat sensitive to caffeine" which is unusual because she liked drinking coffee. On 07APR2021, her heart rate (HR) is 96 beats per minute (BPM), which is high because her usual HR is 60 BPM. Her oxygen levels are normal (98%). She asked about this possible side effect to the vaccine, aside from her sore arm. She asked if she could take Ibuprofen. The outcome of the events was unknown. No follow-up attempts are needed. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021389552 Same reporter/drug/AE, different patient

Other Meds:

Current Illness:

ID: 1227244
Sex: F
Age: 44
State: TX

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: High fever (103-104); body aches & nausea; lasted 2 days then felt absolutely fine

Other Meds: None

Current Illness: None

ID: 1227245
Sex: F
Age: 17
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 17 year old given MODERNA covid vaccine: 1st dose given 3/16/21, and given a 2nd dose of MODERNA covid vaccine on 4/13/21

Other Meds:

Current Illness:

ID: 1227246
Sex: M
Age: 51
State: MI

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Tinnitus

Other Meds: My rbetriq

Current Illness: None

ID: 1227247
Sex: F
Age: 20
State: OK

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Unevaluable event

Symptoms: Fever, headache, tightness in chest, body aches

Other Meds: N/A

Current Illness: N/A

ID: 1227248
Sex: F
Age:
State: TN

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

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: blood pressure went high for 223/106; This is a spontaneous report from a Pfizer-sponsored program, received from a contactable consumer (patient). A female patient of an unspecified age received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number was not reported), via an unspecified route of administration on 01Apr2021 as single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On 01Apr2021, it was reported that the patient was rushed to the emergency room, her blood pressure went high for 223/106 after receiving the 1st dose. The patient was reported as hospitalized. The patient wanted to know what's with the Covid19 vaccine that can cause her to have this reaction. The patient underwent lab tests and procedures which included blood pressure measurement: 223/106 (high) on 01Apr2021. The outcome of the event was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1227249
Sex: M
Age: 40
State: NY

Vax Date: 03/25/2021
Onset Date: 04/07/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Injection site pain, Pain

Symptoms: I was working at and, around 5:30 am when I felt some strong pain both side of my chest. Sonner I felt a slight headache and from time to time it intensified to become unsupportable. At that time though about a lack of oxygenation, because I wore mask for the whole time I was working. About 9:am when I drove to home, I saw everything foggy in front of me. When I get home I took some paracetamol and another painkiller, because at that time my entire body was so warm, and the headache was very bad. I slept for 5 hours, when I woke up I went to the mechanic to fix my car. While I got back during the time I saw the same foggy vision.

Other Meds: No

Current Illness: No

ID: 1227250
Sex: M
Age: 38
State: MI

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Milk, tuna fish (both minor)

Symptom List: Injection site pain, Menorrhagia

Symptoms: Slight fatigue after 8 hours, minor body aches after about 10 hours, chills and low grade temp after about 12 hours. Woke up with loud ringing ears at about 15 hours after vaccination. The following morning (21 hours after vaccination) ringing ears were less intense, no body aches or chills. Still low energy. 45 hours after vaccine noticed slight fever again. 60 hours after vaccine all symptoms gone except light ringing ears.

Other Meds: Took 2 ibuprofens about 12 hours after vaccination

Current Illness: None

ID: 1227251
Sex: F
Age: 58
State: IN

Vax Date: 03/26/2021
Onset Date: 04/09/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: April 9, lethargic in afternoon, seeing flashing light in left eyesight. Lasted 2-3 days. Lymph node in rt groin swollen and sore. Persisting still. April 17, feverish, 101.5 F, chills, no appetite. Still persists. Difficulty breathing, slight, comes and goes.

Other Meds: None

Current Illness: None

ID: 1227252
Sex: F
Age: 41
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: sore arm, could hardly lift it by the end of the night of the vaccine, hot and chilled all night, left arm pain, right neck pain, next day slight headache, very tired, weak, winded easily, improved by the end of the next day

Other Meds: Daily multi vitamin, glucosamine, fish oil

Current Illness:

ID: 1227253
Sex: F
Age: 75
State: OR

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: In the middle of the night after second innoculation found myself on the floor next to my bed. I have no idea how I got there and was not aware of who I has or how I got there. I don't remember how I got to the floor and didn't remember falling out of bed. The next morning my right hip was very sore, so I concluded I had been unconcious ancd fell out of bed I'm reporting this on the hope that cases ofothers who had similar cases can help me understand. I believe my case is unusual and severe, I live alone and I could have been fatally injured

Other Meds: atorvastatin. amlodipine. lithium. Quetiapine. timolol aspirin D3. calcium

Current Illness:

ID: 1227254
Sex: F
Age: 63
State: TX

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Hours after the second dose I became dizzy, nauseous, had a racing heartbeat, had severe body aches and headache, and ran a fever of 101. I began throwing up, even water, and this continued for 3 days. As of today, I have a very red and swollen arm, sore and itchy, and am still experiencing nausea, chills, vertigo, and intermittent body aches in my back, hips, knees, shoulders. I also developed diarrhea. My fever ended yesterday. I have also noticed loss of taste and tinnitus. I was so ill on Thursday and Friday that my partner was prepared to take me to the ER if I didn't improve by Saturday. Fortunately, I did begin to feel a bit better on Saturday, but as of this evening I am still far from recovered. I have taken photos of my injected arm daily. Based on my experience with this 2nd dose of Moderna, I will never voluntarily take another COVID-19 vaccine, no matter the manufacturer.

Other Meds: none

Current Illness: none

ID: 1227255
Sex: F
Age: 26
State:

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: I am not able to move my left arm without feeling strong pain. I felt nauseated, dizzy, and a headache. As if I was drunk.

Other Meds:

Current Illness:

ID: 1227256
Sex: F
Age: 29
State: NY

Vax Date: 04/09/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Covid arm - red, hot, itchy circle around injection site

Other Meds: Levothyroxine

Current Illness: None

ID: 1227257
Sex: F
Age:
State: VT

Vax Date: 03/23/2021
Onset Date: 04/02/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: the contractions and cramping sensation went trough out her entire chest region and her back (like heart attack symptoms); the contractions and cramping sensation went trough out her entire chest region and her back (like heart attack symptoms; in the left arm it was cold and tingling; in the left arm it was cold and tingling; experiencing contractions and cramping in her arm and the left side of her torso in the ribcage area that continued for 24 hours; diarrhea on the weekend; strong cramps in her stomach (stomach flu-like symptoms); This is a spontaneous report from a contactable consumer or other non hcp (patient). A 53-years-old female patient received bnt162b2 (BNT162B2, PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection) dose 1 via an unspecified route of administration in Arm Left on 23Mar2021 (Lot number and Expiry date was not reported) as single dose for covid-19 immunisation. Medical history included ischemic colitis in the past and she thinks that maybe the cramping started triggering it again. The patient's concomitant medications were not reported. On 02Apr2021 strong cramps in her stomach (stomach flu-like symptoms) and on an unspecified date, the patient experienced the contractions and cramping sensation went trough out her entire chest region and her back (like heart attack symptoms), in the left arm it was cold and tingling (vaccination site coldness), (paraesthesia), experiencing contractions and cramping in her arm and the left side of her torso in the ribcage area that continued for 24 hours (muscle spasms) and diarrhoea on the weekend. Her second dose is scheduled on 13Apr2021, she would like to know if there are recommendations for her second dose because she heard that with the second dose the side effects are worse, she would like to know if someone else has reported these symptoms. She would like to know if she should possibly receive the vaccine in her thigh instead of her arm and if that would be helpful. The outcome of the events diarrhoea was recovered on 05Apr2020 and outcome of contractions and cramping sensation went trough out her entire chest region and her back (like heart attack symptoms) was not recovered and rest of the events was unknown. Information on the Lot/Batch number has been requested

Other Meds:

Current Illness:

ID: 1227258
Sex: M
Age:
State: CA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: possible heart attack; High pain in left arm; This is a spontaneous report from a contactable consumer (patient). An 86-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), first dose via intramuscular, administered in left arm on 08Feb2021 13:00 (Batch/Lot Number: EL9264) as SINGLE DOSE for covid-19 immunisation. Medical history included atrial fibrillation from 2010 to an unknown date, hypertension from 1971 to an unknown date, both knees replace from May2011 to an unknown date, left shoulder replaced from Nov2011 to an unknown date, left eye cataract removal from Jun2013 to an unknown date, right eye cataract removal from Oct2013 to an unknown date, L4 & L5 disc repair from Aug2014 to an unknown date, Gall bladder removed from Sep2014 to an unknown date, Right shoulder, Kidney disorder, cramps, Virus fighter, Heart disorder, eye disorder, General Health, Blood thinner, R. shoulder pain, sleep disorder, constipation, Clear vessels. No any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient's concomitant medications were not reported. The patient experienced possible heart attack on 08Feb2021 with outcome of not recovered, high pain in left arm on 08Feb2021 with outcome of not recovered. High pain in left arm-possible heart attack on 08Feb2021. Reported it was not caused by shot, but result is possible pitched nerve- X-ray and CT scan Being done. AE required Scheduled X-Ray and then CT scan on neck. Treatment included the event did require the initiation of new medication/other treatment/procedure. Seriousness criteria reported as not serious. COVID-19 testing had not been conducted.; Sender's Comments: A contributory role of the vaccine BNT162B2 to the event possible heart attack cannot be fully excluded based on the temporal relationship. Patient's advanced age, underlying hypertension, atrial fibrillation, kidney disorder and other comorbidities provide alternate explanation for the event. Case will be reassessed if additional information is received. 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-2021277193 same patient, same product (second dose), similar events.

Other Meds:

Current Illness:

ID: 1227259
Sex: M
Age:
State: ID

Vax Date: 12/19/2020
Onset Date: 12/19/2020
Rec V Date: 04/18/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: in the NICU for respiratory support; preterm delivery after 2nd covid vaccine; first dose on 19Dec2020; This is a spontaneous report from a contactable physician (parent). This physician reported information for both mother and baby. This is the baby report. A fetal male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), first dose on 19Dec2020 (lot number: EL0140) and second dose on 08Jan2021; both transplacental as single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. The mother had a preterm delivery after second COVID vaccine. The patient (2-day old at the time of the report) was in the NICU for respiratory support; no infection and was breastfeeding well. The patient had no malformation/anomalies diagnosed. The reporter considered the events to be non-serious. The outcome of the events was unknown. Follow-up attempts are completed. No further information is expected.; Sender's Comments: A contributory role of vaccine BNT162B2 to reported events cannot be fully excluded based on temporal association. Case will be reassessed if 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. ,Linked Report(s) : US-PFIZER INC-2021015910 same drug, different event and patient

Other Meds:

Current Illness:

ID: 1227260
Sex: F
Age:
State: TX

Vax Date: 03/30/2021
Onset Date:
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Might have Guillain-Barre Syndrome; her mother's legs "went numb and weak"; her mother's legs "went numb and weak"; her speech started to slur; This is a spontaneous report from a contactable consumer. A 90-year-old female patient received BNT162B2 (Solution for injection) via an unspecified route of administration on 30Mar2021 (Batch/Lot number: unknown) at single dose for covid-19 immunisation. The patient's medical history and concomitant medications was not reported. It was reported that upon returning home after the vaccination, her mother was unable to get out of the car under her own power, with the caller reporting her mother's legs "went numb and weak". Later on that day, her speech started to slur. They had contacted their family physician who thinks her mother Might have Guillain-Barre Syndrome. The outcome of the events was unknown. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1227261
Sex: M
Age:
State: MO

Vax Date: 03/15/2021
Onset Date: 03/01/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: broke his hips; This is a spontaneous report from a contactable consumer (reported from himself) from a Pfizer sponsored program. A male patient of an unspecified age received first 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 15Mar2021 at a single dose for covid-19 immunization. The patient medical history was not reported. Concomitantly, the patient was taking unspecified blood thinners. The patient called in because he was scheduled to get his 2nd dose on Monday, 05Apr2021 He got his 1st dose on 15Mar2021 and 10 days ago from the time of the report (Mar2021) he said he broke his hips and had surgery. He said he was on blood thinners and asking if it is ok for him to take the 2nd dose on the scheduled date. The outcome of the event was unknown. Information on lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1227262
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Postural orthostatic tachycardia syndrome; Pain in arm; Joint pain; This is a solicited report from a contactable consumer (patient), via a non-Pfizer marketing program. A 23-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) intramuscularly on an unspecified date as single dose for COVID-19 immunization and adalimumab (HUMIRA), subcutaneously from an unspecified date at unspecified dose for moderate to severe adult crohn's disease. Medical history included hemorrhage of colon from 2018 and moderate to severe adult crohn's disease. The patient's concomitant medications were not reported. On an unspecified date, patient experienced postural orthostatic tachycardia syndrome, pain in arm and joint pain. The events were reported as serious, medically significant. The action taken in response to the events for adalimumab was unknown. Outcome of event pain in arm was unknown while for all other events was recovered on an unspecified date. Causality assessment for the drug Humira and the events Postural orthostatic tachycardia syndrome and Joint pain was reported as No reasonable possibility by the reporter and manufacturer while for the event Pain in arm was not reported by the reporter and No reasonable possibility by the manufacturer. Causality assessment for the drug BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) and the events postural orthostatic tachycardia syndrome, pain in arm and joint pain was not reported by the reporter. The reporter's assessment of the causal relationship of the events with the suspect product was not provided at the time of this report. Since no determination has been received, the case is managed based on the company causality assessment. No follow up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: A contributory role of the vaccine BNT162B2 to reported events cannot be fully excluded based on the presumed temporal relationship and since it is part of the product safety profile. Underlying hemorrhage of colon and moderate to severe adult Crohn's disease may be contributory to the event orthostatic tachycardia syndrome. Case will be reassessed if additional information is received 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: 1227263
Sex: M
Age:
State: MI

Vax Date: 03/01/2021
Onset Date:
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: prolonged arm pain after second COVID shot; lack of mobility; This is a spontaneous report received from a contactable consumer (patient). A 74-year old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; solution for injection; Lot Number: EN16202, pending clarification) intramuscularly on 01Mar2021 at 13:00 as a single dose in the right arm for COVID-19 immunisation. Medical history included heart disease from 31Jan2007 and ongoing, double bypass and aortic valve replacement on an unspecified date, 2-stents on 07Nov2007 and ongoing, 1-stent in Jan2009 and ongoing, 1-stent on 10Jun2009 and ongoing and 1 stent on 02Dec2013 and ongoing. Family medical history relevant to the adverse events was reported as diabetes type 2, high blood pressure and heart disease. Concomitant medications were not reported. It was reported that the patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; solution for injection; Lot Number: EL9264) intramuscularly on 08Feb2021 at 16:30 as a single dose in the right arm for COVID-19 immunisation. On unspecified dates the patient experienced prolonged arm pain after second COVID shot and lack of mobility. The clinical course was reported as follows: "I waited 3 weeks after 2nd shot to see doctor at a Hospital. He had assured me that my arm's pain and lack of mobility was not one to vaccine. I have pain if arm is raised above my shoulder and when moved side to side. (Example) it is difficult to move right arm to position to put on or take off a shirt. MD said the shot may have with a vein in my shoulder and had recommended physical therapy." The clinical outcomes of the events prolonged arm pain after second COVID shot and lack of mobility were both unknown. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness: Heart disease, unspecified; Stent placement

ID: 1227264
Sex: M
Age:
State: CO

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: tightness in chest; light headed; scalp and face became warm, and flushed; This is a spontaneous report from a contactable consumer reporting for himself. A 72-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) (lot number EL3247/expiration date: not provided), via intramuscular route of administration, on 05Feb2021 at 10:40 (at the age of 72 years old) as a single dose in the left arm for COVID-19 IMMUNIZATION. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) (lot number EK9231/expiration date: not provided), via intramuscular route of administration, on 15Jan2021 at 10:50 (at the age of 72 years old) as a single dose in the right arm for COVID-19 IMMUNIZATION and experienced flushed scalp and face, lightheadiness, and scratchy throat. Relevant medical history included kidney stones many on 04Apr2020 to 06Jun2020 and noted that the patient had 7 kidney stones in 14 years, bursitis RT: Hip ongoing since 10May2017, reflux ongoing since 23Oct2019, Sinusitis from 2014 to 01Mar2020, hypertension, and benign prostatic hyperplasia (BPH). Concomitant medications included ongoing spironolactone 25mg oral for hypertension, ongoing bisoprolol (ZEBETA) 2.5mg oral for hypertension, ongoing pantaprazole (PROTONIX) 20mg oral for reflux, ongoing tamsulosin (FLOMAX) 0.4 mg oral for BPH. On 05Feb2021 at 10:45, the patient experienced light headed, and scalp and face became warm, and flushed. On 05Feb2021 at 10:55, the patient experienced tightness in chest. The events were reported by the consumer as non-serious. The events required a physician visit and treatment was received which included diphenhydramine (BENADRYL) and was observed for an hour. The outcome of the events tightness in chest, light headed, and scalp and face became warm, and flushed was recovered on 05Feb2021.; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021123487 Same patient, reporter, drug, different AE/dose

Other Meds: SPIRONOLACTONE; ZEBETA; PROTONIX [PANTOPRAZOLE SODIUM SESQUIHYDRATE]; FLOMAX [TAMSULOSIN HYDROCHLORIDE]

Current Illness: Bursitis; Reflux gastritis

ID: 1227265
Sex: F
Age:
State: OH

Vax Date: 03/13/2021
Onset Date: 03/01/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fell several days ago and fractured her leg; Fell several days ago and fractured her leg; This is a spontaneous report from a Pfizer-sponsored program from a contactable consumer, the patient. A female patient of an unknown age received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Lot unknown, first dose) solution for injection intramuscular on 13Mar2021 (at an unknown age) as a single dose for COVID-19 vaccination. Medical history and concomitant medications were not reported. The patient received the first Pfizer vaccine on 13Mar2021 and was scheduled to receive second vaccine today (03Apr2021). The patient fell several days ago and fractured her leg in Mar2021, would like to reschedule. The outcome of the event fractured her leg and fell was unknown. Information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1227266
Sex: F
Age:
State:

Vax Date:
Onset Date: 02/01/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Gagging; Feels tired and sleepy all the time; Feels tired and sleepy all the time; Arm was really sore; Some choking; Anxiety; Cough during treatment; This is a solicited report (MARKETING PROGRAM NAME NOT AVAILABLE) based on the information received by Pfizer pharmacy. A contactable 75-year-old female consumer (patient)received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as SINGLE DOSE for COVID-19 immunisation; and treprostinil sodium, via inhalation from 12Feb2021 (Batch/Lot number was not reported) to an unspecified date and at 18-54 ug, 4x/day, via inhalation from an unspecified date (Batch/Lot number was not reported), at 36 ug, 4x/day for pulmonary arterial hypertension. Medical history included ongoing anxiety. The patient's concomitant medications were not reported. In Feb2021, the patient experienced event of cough during treatment. In 2021, the patient experienced event of gagging (retching). On 04Mar2021, the patient experienced event of anxiety; related it to going to the physician appointment. An additional dosage regimen of 36 ug (6 breaths), qid via IH route was added to Tyvaso. The patient reported that coughing (previously reported as cough) and gagging had improved after the treatment. The patient's current IH Tyvaso dose was 6 breaths four times a day. On 04 Mar 2021, 2 weeks 6 days after initiating IH Tyvaso, the patient had anxiety and related it to going to the physician appointment. The patient had reported ongoing anxiety since childhood. In 2021, the patient experienced the event of some choking. In 2021, the patient experienced the events of feels tired and sleepy all the time and arm was really sore (pain in extremity). The patient felt tired and sleepy all the time. Her arm was really sore and she was tired and sleepy. The outcome of the event cough and gagging was recovering while the outcome of the rest of the events was unknown. The action taken in response to treprostinil sodium for the events was unknown. An unspecified treatment was given to the patient for the event cough and gagging. The reporter assessed the causal relationship between the IH Tyvaso and the event of cough as possible. The reporter did not provide causality for the events of retching, choking, anxiety, fatigue, somnolence, and pain in extremity. No follow-up attempts are possible. No further information is expected; Sender's Comments: Based on the information currently available, a possible contributory role of the suspect vaccine BNT162B2 in triggering the onset of choking,cough,gagging,and other events cannot be excluded but also contributory effect from other suspect drug TREPOSTINIL SODIUM. consider also possible contributory effects from patient's medical history and concomitant medications. 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: Anxiety

ID: 1227267
Sex: F
Age:
State:

Vax Date:
Onset Date: 03/25/2021
Rec V Date: 04/18/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Chronic obstructive pulmonary disease exacerbation; hypertension; vaccination complication; really sick; nausea; headache; The patient had decreased breaths from 12 to 10 breaths; This is a solicited report received from pharmacy. A contactable other healthcare professional and a consumer (patient) reported that a 67-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (batch/lot number was not reported) as a single dose for COVID-19 immunization; treprostinil sodium (TYVASO, concentration of 0.6 mg/ml), resp inhalation (reported as via inhalation (IH) route) from 23Sep2020 (batch/lot number: 2101929; expiration date: 31Jan2022) to an unspecified date, delivered by Tyvaso inhalation device (TD-300/A) at 18-54 ug, QID (3-9 breaths), then via an unspecified route of administration from an unspecified date (batch/lot number was not reported) to an unspecified date, at 72 ug to 60 ug (12 to 10 breaths) for secondary pulmonary arterial hypertension. Medical history included ongoing secondary pulmonary arterial hypertension and ongoing chronic obstructive pulmonary disease. Concomitant medication included tadalafil taken for an unspecified indication, start and stop date were not reported. On 25Mar2021, the patient experienced events of chronic obstructive pulmonary disease exacerbation (chronic obstructive pulmonary disease, hospitalized), hypertension (hypertension, hospitalized) and reaction to COVID vaccine (vaccination complication, hospitalized). On an unreported date, the patient experienced events of really sick (illness), nausea (nausea) and headache (headache). On an unreported date, the patient had decreased breaths from 12 to 10 breaths (off label use). It was also reported that the patient had decreased breaths from 72 ug to 60 ug (12 to 10 breaths). The patient was really sick, nausea and headache. On 25Mar2021, 6 months and 3 days after initiating IH Tyvaso, the patient was hospitalized for reaction to coronavirus disease (COVID) vaccine, chronic obstructive pulmonary disease exacerbation, and hypertension. The patient was discharged from the hospital on 28Mar2021. The action taken in response to the events chronic obstructive pulmonary disease, hypertension and vaccination complication for treprostinil sodium was not reported, and dose was decreased due to the events illness, nausea and headache. At the time of reporting, the outcome of chronic obstructive pulmonary disease, hypertension, vaccination complication, illness, nausea and headache was unknown. The reporter did not provide causality for the events of chronic obstructive pulmonary disease, hypertension, and vaccination complication. The reporter's causality for the events illness, nausea and headache with IH treprostinil sodium was considered to be possibly related. Case Comment/Sender's Comment: The company has assessed the serious adverse event of chronic obstructive pulmonary disease, hypertension and vaccination complication as not related to IH treprostinil and TD-300/A device. Chronic obstructive pulmonary disease and hypertension were likely due to exacerbation of underlying COPD and Hypertension respectively. Vaccination complication was due to COVID vaccine. The reporter's assessment of the causal relationship of the events with the suspect product was not provided at the time of this report. Since no determination has been received, the case is based on the company causality assessment. Information on the lot/batch number has been requested.; Sender's Comments: As there is limited information in the case provided, the causal association between the event chronic obstructive pulmonary disease, hypertension, vaccination complication, illness, headache, nausea and the suspect drug BNT162B2 , TYVASO cannot be excluded. The case will be reassessed once new information is 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: TADALAFIL

Current Illness: Chronic obstructive pulmonary disease; Pulmonary arterial hypertension

ID: 1227268
Sex: M
Age:
State:

Vax Date: 04/03/2021
Onset Date:
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: he is bleeding a little; This is a spontaneous report from a Pfizer-sponsored program, received from a contactable consumer (patient). This male patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration on 03Apr2021 (Batch/Lot number was not reported) as a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient was bleeding a little on an unspecified date. Outcome of the event was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1227269
Sex: F
Age:
State: MI

Vax Date: 03/19/2021
Onset Date: 03/01/2021
Rec V Date: 04/18/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: possible pinched nerve; TIA; heart rate is low anyways from the medications but it dropped to 35 when she was in the hospital/heart rate dropped; her right arm, the right side of her face, and her right knee were numb/ she has numbness in her right finger and right thumb; face feels like its burning; her vision was kind of blurry; sensational loss in her right hand; caller's sclera looked like her eye was bleeding and her pupil started turning a different color.; caller's sclera looked like her eye was bleeding and her pupil started turning a different color.; eye was super red; rupture of a blood vessel in her eye; blood clot in eye; This is a spontaneous report from a contactable nurse (reported for herself). A 64-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Lot Number: ER2613, expiry date not reported), via an unspecified route of administration, administered in left arm on 19Mar2021 09:00 at a single dose for covid-19 immunisation. Medical history included ongoing hypertension from 1900 wherein blood pressure was high prior to her atrial fibrillation medications; A fib (atrial fibrillation) from 2016 and ongoing; and ongoing heartrate low. As a child the caller had the vaccine in the sugar cube (unspecified) and her mouth was swelling from it; and stated that patient's sister was hospitalized after receiving the same vaccine. Family medical history included mom has hypertension. Concomitant medications included apixaban (ELIQUIS) taken for A fib (atrial fibrillation) from an unspecified start date and ongoing at 5 mg twice a day; sotalol taken for A fib (atrial fibrillation) from an unspecified start date and ongoing at 80 mg, twice a day; and diltiazem taken for A fib (atrial fibrillation) from an unspecified start date and ongoing at 180 mg, once a day. The patient was a healthcare worker and she has had friends who have died from covid. The patient had no previous immunization with the Pfizer vaccine considered as suspect and no additional vaccines administered on same date of the Pfizer suspect. Patient had no prior vaccinations (within 4 weeks). The patient stated she had the first dose of the vaccine and had a TIA (Apr2021) and rupture of a blood vessel in her eye 20Mar2021. The TIA was on Monday (Apr2021) and she was supposed to have her second dose tomorrow (09Apr2021). She stated she may get it but she is not taking it tomorrow because she is still having residual symptoms. She asked what the length of time she can wait to get it before she has to restart. Patient reported that after she got her first vaccine she had a ruptured blood vessel in her eye the next day (20Mar2021). She put warm and cool compresses on her eye then the ruptured blood vessel subsided. The ruptured blood vessel came back again a few days later and this time it was the entire sclera. She developed blood clots in her eye and the doctor said it probably wasn't from the vaccine (Mar2021). She was supposed to get her second dose of the vaccine tomorrow 09Apr2021 but she was going to hold off for now. She then had a TIA (Mar2021) and became hospitalized because of it from 06Apr2021 to 07Apr2021. The patient has ongoing atrial fibrillation but has been taking her medication religiously. She believed that the TIA was from the vaccine as there was no explanation as to why it happened. Her heart rate was low anyways from the medications (dates unspecified) but it dropped to 35 when she was in the hospital (Apr2021). The patient's primary care provide was not the attending in the hospital when the caller was hospitalized. Furthermore, it was reported that on 21Mar2021, patient's eye was super red but only on one side of her left eye. On Tuesday, 22Mar2021, caller went to see her primary care provider and they told the patient to put a warm compress and no eye drops in her eye, that helped. Then that Friday, 25Mar2021, the patient's sclera looked like her eye was bleeding and her pupil started turning a different color. Then last Monday (Apr2021), the patient woke up and her right arm, the right side of her face, and her right knee were numb she got up and went to see if she had a facial droop and did not. The patient thought it was from her sleeping wrong, but these symptoms did not go away. The patient went to the Emergency Room where they did a CT of her head and neck, with and without contrast which was negative. The patient was admitted on 06Apr2021 to the observation unit where they did an MRI and ECHO, which were both negative and she was diagnosed with a TIA and possible pinched nerve (Apr2021). The patient denied any heavy lifting prior to this event other than normal day to day things. The patient was discharged on Wednesday 07Apr2021. The patient's face felt like its burning, she has numbness in her right finger and right thumb. Physical therapy and occupational therapy said the patient should be okay but to be careful with things that were hot because she was at risk of burning herself. The second time the patient's eye became red, her vision was kind of blurry (Apr2021) and she didn't know if the blood was in her pupil. The only deficit that the patient has now is sensational loss in her right hand (Apr2021) and that should improve per the occupational therapist at the hospital. The caller was supposed to get the second dose of the vaccine on 09Apr2021 but she doesn't want to take it while she is having these symptoms. Results of tests and procedures for investigation of the patient included: head ct with and without contrast: negative on 06Apr2021; MRI brain: negative on 06Apr2021; Echocardiogram: negative on 07Apr2021; speech evaluation: passed on 07Apr2021. The patient asked what the efficacy is after one dose and if a booster will be needed since she is only protected for 6 months. Patient asked if she needed to restart the series of vaccinations if she doesn't get the second vaccine tomorrow 09Apr2021. The events ruptured blood vessel in eye, blood clot in eye, sclera looked like her eye was bleeding, eye was super red were reported as serious medically significant, and heart rate dropped as life-threatening. As reported, the events required emergency room and physician's office visit. Therapeutic measures were taken as a result of the events rupture of a blood vessel in her eye, and eye was super red. The outcome of the events reported was unknown. As per reporter, the events ruptured blood vessel in eye, blood clot in eye, and heart rate dropped were related to the covid BioNTech vaccine.; Sender's Comments: Based on the temporal relationship, the association between the reported events with BNT162b2 use can not be fully 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: ELIQUIS; SOTALOL; DILTIAZEM

Current Illness: Atrial fibrillation; Heart rate low; Hypertension

ID: 1227270
Sex: M
Age:
State:

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: entire face was swollen; entire face was swollen (his lips, throat, tongue); entire face was swollen (his lips, throat, tongue); entire face was swollen (his lips, throat, tongue); he could not eat anything; This is a spontaneous report received from a contactable consumer reporting on behalf of her husband. A male patient of unspecified age received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 31Mar2021 (lot ER8727), for COVID-19 immunization. The first dose of the vaccine was given on an unspecified date in 2021. Medical history and concomitant medications were not reported. On 01Apr2021 morning the patient woke up and his entire face was swollen (meaning his lips, throat, tongue) and he could not eat anything. The reporter gave him diphenhydramine (BENADRYL) last night. Reporter added they got a nurse, she told them to go to urgent care. Reporter also stated she will rather for him to answer, he was gone to the urgent care and she was just calling to see if that was a normal thing. Events outcome was unknown. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1227271
Sex: M
Age:
State: FL

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: actually passed out slightly; Really dizzy; can't move and stand by; This is a spontaneous report from a contactable consumer (patient). A 55-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Dose 1) via an unspecified route of administration on 27Mar2021 (batch/lot number: ER8730) at 55 years old at a SINGLE DOSE for COVID-19 immunization. The patient's medical history included Type II diabetes, Thyroid inactive, and blood pressure management, all from an unknown date. Concomitant therapy included unspecified blood pressure medication. On 27Mar2021, the patient actually passed out slightly (loss of consciousness), got really dizzy (dizziness), and can't move and stand by (movement disorder). It was reported that about 5 minutes after vaccination, patient got really dizzy and actually passed out slightly and was dizzy for about that day; he was dizzy all day, he can't move and stand by. Patient stated that he actually got better but took five days. Patient further stated, "I just determine, because of the reaction, people say, second is worse and I don't know if its allergic reaction or is that normal. If they consider." Outcome of the events was recovering.

Other Meds:

Current Illness:

ID: 1227273
Sex: F
Age:
State: MA

Vax Date: 03/15/2021
Onset Date: 03/30/2021
Rec V Date: 04/18/2021
Hospital: Y

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: massive clots; Pulmonary Embolisms; Occluded Left Lung, Right Ventricle; Occluded Left Lung, Right Ventricle; This is a spontaneous report from a contactable consumer (parent). A 44-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date not reported) via an unspecified route of administration administered in the right arm on 15Mar2021 13:45 as a single dose for COVID-19 immunisation. Medical history included multiple sclerosis. The patient is not pregnant at the time of vaccination. The patient has no known allergies and has not had COVID prior to vaccination. Concomitant medications included gabapentin, carbamazepine (TEGRETOL), fluoxetine, colecalciferol (VITAMIN D), fish oil, and baclofen. The patient did not receive any other vaccine in 4 weeks prior to the COVID vaccine. On 30Mar2021 06:00, the patient experienced Pulmonary Embolisms, Occluded Left Lung, Right Ventricle and had emergency open heart surgery to remove massive clots. He coded for 4 minutes and was in ICU for 9 days. The patient was hospitalized due to the events on an unspecified date for 12 days. The events resulted in Emergency room/department or urgent care, Hospitalization, Life threatening illness (immediate risk of death from the event), and Disability or permanent damage. Treatment for the events included open heart surgery. The patient underwent COVID test post vaccination via nasal swab on an unspecified date with unknown results. The outcome of the events was recovered with sequelae on an unspecified date. Information about lot/batch number has been requested.

Other Meds: GABAPENTIN; TEGRETOL; FLUOXETINE; VITAMIN D [COLECALCIFEROL]; FISH OIL; BACLOFEN

Current Illness:

ID: 1227275
Sex: M
Age:
State: VA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: dizziness; Fatigue; Jaw pain; This is a spontaneous report from a contactable consumer (patient). A 33-year-old male patient received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration, administered in left arm on 08Apr2021 12:15 (Batch/Lot number was not reported) as single dose (at the age of 33-year-old) for COVID-19 immunsation, at workplace clinic. The patient medical history was not reported. No known allergies. The patient had not experienced Covid-19 prior vaccination. No known allergies. There were no concomitant medications in two weeks. The patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in left arm on 18Mar2021 09:30 AM (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. The patient had not received any other vaccines within 4 weeks prior to the BNT162B2 vaccine. The patient experienced dizziness, fatigue and jaw pain on 09Apr2021 12:00. Events resulted in: hospitalization, hospitalization prolongation, life threatening illness (immediate risk of death from the event), disability or permanent damage, congenital anomaly or birth defect (as reported). The patient received treatment for the events: Tylenol. COVID was not tested post vaccination. The with outcome of events was recovering. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1227276
Sex: M
Age:
State: KS

Vax Date: 03/21/2021
Onset Date: 04/01/2021
Rec V Date: 04/18/2021
Hospital: Y

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: suffering from a stroke; not being well; This is a spontaneous report from a contactable consumer. A 36-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration on 21Mar2021 (Batch/Lot number was not reported) as SINGLE DOSE for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient previously had first dose of BNT162B2 for COVID-19 immunization. The patient had symptoms of an illness (perhaps covid like symptoms) starting on 19Mar2020 (between his first and second dose of Pfizer BioNtech). The patient went ahead and got his second dose on 21Mar2021. He then went to see his DR in the last week (week of 05Apr2021) because of not being well. The primary care DR thought the patient had perhaps been exposed to COVID between the 1st & 2nd doses (due to symptoms that the DR thought seemed like body's over-reaction to COVID) but a COVID test was done and it was negative. Then the patient has been admitted to the hospital since suffering from a stroke on 08Apr2021. He still has not tested positive for COVID again but he is in ICU with stroke symptoms. The stroke resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care, hospitalization and was a life threatening illness (immediate risk of death from the event). The patient was in the hospital for four days. The facility where the COVID-19 vaccine was administered was in the Public Health Clinic/facility. It was unknown if the patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine or other medication in two weeks. Prior to vaccination, the patient was not diagnosed with COVID-19. The outcome of the events was not recovered. Treatment for the event stroke was given. The patient underwent lab tests and procedures which included COVID test: both negative on 18Mar2021 and 08Apr2021. Information on the Lot/Batch number has been requested.

Other Meds:

Current Illness:

ID: 1227277
Sex: M
Age:
State: KY

Vax Date: 03/17/2021
Onset Date: 03/25/2021
Rec V Date: 04/18/2021
Hospital: Y

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: Kidney Failure; This is a spontaneous report from a contactable consumer (patient). A 41-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 17Mar2021 at 14:30 (batch/lot number was not reported) as a single dose for COVID-19 immunisation. The patient has no medical history and no known allergies. The patient's concomitant medications were not reported. Facility type vaccine was other. No other vaccine in four weeks. The patient experienced kidney failure on 25Mar2021 at 06:30. The adverse event resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care, hospitalization, life threatening illness (immediate risk of death from the event), disability or permanent damage. The patient was hospitalized for kidney failure for 7 days. Treatment was received for the adverse event. The patient underwent lab tests and procedures which included Covid test nasal swab: negative on 25Mar2021 and negative on 07Apr2021. The outcome of the event was recovered with lasting effects. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm