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: 1294545
Sex: F
Age: 61
State: CA

Vax Date: 03/13/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital: Y

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

Lab Data:

Allergies: Penicilyn

Symptom List: Dysphagia, Epiglottitis

Symptoms: My left foot felt very heavy then my left lower leg started to get numb. We all 911 by the time the ambulance came my left arm was getting numb. I was transported in helicopter to regional Hospital I was having a stroke

Other Meds: None

Current Illness: None

ID: 1294546
Sex: F
Age: 70
State: GA

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: soaps/detergents, odors-smells-perfumes, eucalyptus, goldenrod

Symptom List: Anxiety, Dyspnoea

Symptoms: feeling bad & nauseous in morning during physical therapy. Asthma flared up. Used rescue inhaler AM, used again in 3 hours, then in two more hours used nebulizer. Eventually falling asleep for about an hour. Woke up and still needed rescue inhaler when trying to perform any tasks.

Other Meds: Valsartan HTCZ-320/25, Bystolic 10mg, ropinirole 4mg, montelukast 10mg, loratadine 10 mg, albuterol sulfate 90 mcg, fluticasone 50mcg, breo 200mcg/25mg, incruse62.5mcg, ipratropium bromide and albuterol sulfate inhalation solution

Current Illness:

ID: 1294547
Sex: M
Age: 37
State: FL

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 05/07/2021
Hospital: Y

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

Lab Data:

Allergies: No

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

Symptoms: Extreme Fatigue that led to multiple syncope. A police officer thought I had a heart attack and thus I ended up in the hospital. I did not have a heart attack but seemed to have fainted while walking or realizing it.

Other Meds: buprenorphine and naloxone

Current Illness: None

ID: 1294548
Sex: M
Age: 36
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Vomiting, dizziness, flushing/sweating, vitals wnl. Known h/o of anxiety and vomiting with vaccines.

Other Meds:

Current Illness:

ID: 1294549
Sex: M
Age: 71
State: LA

Vax Date: 01/13/2021
Onset Date: 01/16/2021
Rec V Date: 05/07/2021
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: IMDUR

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

Symptoms: Patient started with left sided weakness and slurring of speech the evening of 1/16. Symptoms improved after a little while so went to bed. The next am he woke up with worsened left arm and leg weakness, difficulty walking and slurred speech with drooling. He was diagnosed with a right middle cerebral artery stroke. Patient unable to return home due to dense left hemiparesis; was admitted to a nursing home for stroke rehab and PT/OT/ST. Thankfully he is very gradually improving

Other Meds: bisoprolol, asa, coumadin, gabapentin, protonix, pravastatin, venlafaxine, percocet

Current Illness: Patient was stable at the time. Told me "I was just fine before this happened"

ID: 1294550
Sex: F
Age: 36
State: OR

Vax Date: 04/29/2020
Onset Date: 04/28/2021
Rec V Date: 05/07/2021
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: None

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

Symptoms: My arm is swollen and a lump can be felt at the sight of the vaccine. Still very sore and tender a week later and lump seems bigger.

Other Meds: Suboxone Sertraline

Current Illness:

ID: 1294552
Sex: M
Age: 20
State:

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: NKA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt received J&J yesterday. Pt started having fever, bodyaches and chills. Pt was SOB last night, but not now.

Other Meds: UNK

Current Illness: N/A

ID: 1294553
Sex: F
Age: 49
State: CA

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: poison oak plants (the oil in the plants), and things that have directly touched poison oak plants, like dogs that have run through it. trace metals (like cheap jewelry) and I had hives ones to amoxicillin (antibiotic)

Symptom List: Pharyngeal swelling

Symptoms: After my 1st vaccine, about 12 to 36 hours later I slowly started noticing rashes and hives on parts of my body. I already had a poison oak rash, so the timeline is a little rough as to when I was sure it wasn't a new poison oak rash (on a new part of my body), and was truly hives or a new rash. Then it became more obvious by 36 plus hours, due to hives on hands, feet, and lower torso/upper thigh areas, and my week-old poison oak rash was getting much better.

Other Meds: I had a pretty severe case of poison oak rash at the time of my first vaccine, in the same arm as the vaccine shot. I get poison oak rashes every year, but this was my first big case this year. I don't take any medications for it, just top

Current Illness: zero

ID: 1294554
Sex: M
Age: 24
State:

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
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: Pt states he was vaccinated with J&J at 1500 yesterday. Pt c/o difficulty breathing, ha, body aches, and n/v. Pt went to sick call which referred him to ED.Pt is able to drink water w/o issue.

Other Meds: UNK

Current Illness: N/A

ID: 1294555
Sex: F
Age: 39
State:

Vax Date: 05/04/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: CODEINE

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 39-year-old female comes to the emergency room for flu-like symptoms after receiving the Johnson & Johnson vaccine. Patient states that she receive the vaccine at approximately noon yesterday. starting at 1730-1800 last night she began developing fatigue and muscle aches. Later in the evening the symptoms worsened and she developed a headache. Overnight the headache resolved but the fatigue and muscle aches continued to worsen. This morning she states that she was unable to make it to morning PT. Here in the emergency room she states she has continued fatigue and muscle aches. She denies any nausea, vomiting, diarrhea or abdominal pain. She denies any hematuria or dysuria. She denies any lightheadedness, diz

Other Meds: UNK

Current Illness: N/A

ID: 1294556
Sex: M
Age: 52
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Nausea, sweating, pallor. BPs 185/121 (pulse 110), 167/113 (pulse 80). Patient advised to take blood pressure medications.

Other Meds:

Current Illness:

ID: 1294557
Sex: M
Age: 51
State: AZ

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 05/07/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: I had the 2nd shot of Moderna vaccine Monday 5/3 at noon by 3 AM the next morning I had a fever measured 104.5 chills, headache, weak. I tool Tylenol as directed it would only reduce temps to 101 after 2 hours the fever 104 would return. This lasted until late morning the next day my temps started to fall off to 99. Tiredness and headaches still a problem been 3 days since the Moderna 2nd vaccine shot. I also feel some inner ear pressure like some inflammation in there. The headaches seem to be getting somewhat worse causing me to feel nauseated I took 500 MG of Ibuprofen seems to reduce the headaches. I also developed a cough dry but almost like a flu cough which seems to be resolving.

Other Meds: Vitamin D 1200 IU

Current Illness: Non

ID: 1294558
Sex: F
Age: 29
State:

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: 29-year-old female brought to the emergency room by EMS after syncopal episode at sick all this morning. Patient states that she receive the Johnson and Johnson coronavirus vaccine yesterday at approximately 1500. Throughout the evening and overnight she developed the expected side effects of myalgias, mild headache and fatigue. She states because she was not feeling well this morning she was instructed to give us a call. She is sick, she was sitting in a chair and when she was called to code forward she stood up, developed tunneling of her vision with spots in front of her eyes, felt dizzy and then passed out. When she woke up the dizziness had resolved. She states that she feels dizzy intermittently at basel

Other Meds: NKA

Current Illness: N/A

ID: 1294559
Sex: M
Age: 24
State:

Vax Date: 05/04/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: N/A

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

Symptoms: 24-year-old male brought in by EMS for multiple complaints. On arrival vital signs stable with mild tachycardia and fever. on exam heart regular rate and rhythm. Lungs clear to auscultation bilaterally. EKG without evidence of STEMI. Chest x-ray normal. Labs with no actual abdomen bowel is. Patient improved in ED with medications and pain control. Suspect vaccine reaction. Plan for discharge home with continued supportive care and follow up with primary care physician.

Other Meds: NKA

Current Illness: N/A

ID: 1294560
Sex: M
Age: 27
State:

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: NKA

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

Symptoms: Patient presents with chills and nausea without vomiting x 0230. Patient received J&J vaccine yesterday at 1630. Reports he took Tylenol at 0230. Patient also reports feeling achy to back but believes because he had ACFT yesterday.

Other Meds: UNK

Current Illness: N/A

ID: 1294562
Sex: M
Age: 32
State:

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: N/A

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

Symptoms: 32 yo M, no known chronic medical conditions, p/w FLS since getting the J&J vaccine yesterday. Sx are improving, but pt was feeling sick at work so his supervisor told him to come to ED for eval. Only sx pt currently has are severe fatigue, mild frontal HA, and mild nausea.

Other Meds: NKA

Current Illness: N/A

ID: 1294563
Sex: M
Age: 23
State:

Vax Date: 05/03/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: pt presents to the ED for migraines and blurred vision that began last night which he is concerned is a side effect from the J&J vaccine, pt received the vaccine on 5/3/21.

Other Meds: UNK

Current Illness: ADHD

ID: 1294564
Sex: M
Age: 19
State:

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt c/o headaches, feverish, bodyaches x2hrs. Pt received the J&J covid vaccine at 1330 today. Pt has not taken any meds. Denies additional s/s. Denies anybody in area with similar s/s.

Other Meds: NKA

Current Illness: N/A

ID: 1294565
Sex: F
Age: 24
State:

Vax Date: 05/05/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: pt presents to the ED for concerns of J&J vaccine reactions, states he received his vaccine on 5/5/21 and has had one episode of vomiting, nausea, headaches and chills, attempted to go to sick call yesterday but was unable

Other Meds: UNK

Current Illness: insomnia

ID: 1294566
Sex: M
Age: 20
State:

Vax Date: 05/05/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: pt presents to the ED for "cold sweats, fever, headaches and soreness, and eye pain" that began yesterday after receiving the J&J COVID vaccine, has not attempted to take tylenol or motrin for fever and headaches

Other Meds: UNK

Current Illness: N/A

ID: 1294567
Sex: F
Age: 28
State: MO

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: Benadryl

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

Symptoms: Seeing black, spotty eyesight, almost passing out but was able to make it back to bed to lay down twice. Cannot stand or walk for longer than a couple of minutes unassisted (holding onto something) without breathing becoming shallow and dizziness setting in. Intermittent dizziness and inability to focus eyesight occurred throughout the day even if sitting down. Issues have been consistent throughout entire day. Not sure if this is adverse but also started having circulation issues in toes/fingers turning white & numb when either standing, walking or lying down. Experienced chills but only until ceiling fan was turned off. Circulation slightly improved except in feet.

Other Meds: Amphetamine salts 30 mg, vitamin b super complex, vitamin d

Current Illness: N/A

ID: 1294568
Sex: F
Age: 20
State:

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Unevaluable event

Symptoms: pt presents to the ED for SOB/nasuea and dizziness that began yesterday evening after receiving the J&J vaccine on 5/6/21.

Other Meds: UNK

Current Illness: Depression

ID: 1294569
Sex: F
Age: 56
State: OR

Vax Date: 02/15/2021
Onset Date: 04/17/2021
Rec V Date: 05/07/2021
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: preservatives, mullosks, stone fruits

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

Symptoms: Started with tinnitus in both ears. Never had this before. It comes and goes. Keeps me awake at night.

Other Meds: None

Current Illness: None

ID: 1294571
Sex: M
Age: 53
State: NJ

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/07/2021
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: Amoxicillin Dipyrone Contrast media Moxofloxacin

Symptom List: Injection site pain, Pain

Symptoms: As a patient with Asthma, Aspirin is a medicine that makes me short of breath. I do not think it is an allergy as such, but a hypersensitivity to Acetylsalysilic Acid. 1 hour after the application of the vaccine, I felt the same symptoms as when I used any component that contains acetylsalysilic acid. In those cases I must apply inhaler. So I did, in 1 hour, I was already better. I didn't need to go to a doctor or hospital.

Other Meds: No

Current Illness: Asthma

ID: 1294572
Sex: M
Age: 21
State:

Vax Date: 05/03/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain, Menorrhagia

Symptoms: chest pain. Sharp, left sided CP with SOB x 3 hours; continuous, no radiation; mvmt increases pain, started while sitting today; HX PTX x 2 with VATS surgery 5 years ago.

Other Meds: UNK

Current Illness: Pneumothorax

ID: 1294574
Sex: F
Age: 63
State: CA

Vax Date: 03/20/2021
Onset Date: 03/25/2021
Rec V Date: 05/07/2021
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 known but have multiple food sensitivities including Dairy and Gluten.

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

Symptoms: Inflammation in ribs under left breast. Dr said it was costochondritis

Other Meds: Levothyroxine Multiple Vitamin Fish Oil Vitamin B12 Acidophilus Calcium Magnesium Andographis

Current Illness: None

ID: 1294575
Sex: M
Age: 40
State: OH

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Had a severe colonic seizure and stopped breathing. He said he felt funny after the shot, like he was light-headed and dizzy. Then out of nowhere I heard him moan and saw he was foaming at the mouth and violently convulsing and turning blue. I did cpr and the paramedics arrived and took him to the hospital. We are following up with a neurologist tomorrow.

Other Meds: Disulfiram Lamictil Lexapro Seroquil Wellbutrin *been on all of these for years

Current Illness: None

ID: 1294576
Sex: F
Age: 43
State: WI

Vax Date: 12/01/2020
Onset Date: 01/17/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: Nkda

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: First shot 12/23, 2nd 1/12/21. A week after #2 my menstrual cycles (which have been clockwork all of my life-I have 4 children and track it monthly) became much more frequent and heavy with excessive clotting. I thought perhaps I was going though early menopause (44) but then realized correlation with vaccine. My mood changed, I feel sad all of the time, I am dreading recommendation of additional shots.

Other Meds: Multivitamin, vit D3

Current Illness: None

ID: 1294577
Sex: F
Age: 18
State: CA

Vax Date: 04/24/2021
Onset Date: 05/04/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Extremely heavy period

Other Meds:

Current Illness:

ID: 1294579
Sex: F
Age: 48
State: CA

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: Denies

Symptom List: Nausea

Symptoms: Client received second dose COVID vaccine @ 10:10 am, complained of shortness of breath similar to asthma @ 10:23 am. Client had rescue inhaler in car, self administered albuterol 5 puffs. Observed and vital signs monitored. Client reported shortness of breath improved with use of inhaler, left observation area @ 10:46 am once her symptoms improved and left with her husband,

Other Meds: Lisinopril, Albuterol

Current Illness:

ID: 1294580
Sex: F
Age: 35
State: OR

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Injection site pain

Symptoms: Mild fever, chills, body aches, joint pain, nausea, headache.

Other Meds: Multivitamin, coq10, fish oil, GABA, zinc

Current Illness: None

ID: 1294581
Sex: F
Age: 46
State: CA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Vasovagal Syncope starting five minutes after injection lasting about 20 minutes. BP fluctuated. Heart rate and O2 were normal. Monitored for approximately 30 minutes and then released. Abdominal pain started 3 hours after vaccination. Pain worsened and became severe over several hours, peaking with other flu-like symptoms and decreased over the next several days as other symptoms decreased. Pain was worse on left side about half way up rib cage and lasted for 5 days. Abdominal pain was worse and sharpened when twisting, rolling or bending torso. I can still feel a pulling sensation under ribs on left side off and on. Also starting about 15 hours after vaccination I had brownish colored urine that lasted about 36 hours. Saw FNP 10 days after vaccination. CBC, liver & kidney function blood work & urine dip stick tests all normal. They could not feel any enlargement on physical examination, but suspect spleen issue

Other Meds: multi-vitamin, B-complex, D vitamins taken daily Echinacea taken off and on about every 7 to 10 days and last taken 5 days before vaccine

Current Illness: none

ID: 1294582
Sex: F
Age: 72
State: FL

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 05/07/2021
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: none

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

Symptoms: the day after the vaccine I had chest pains......never had them before......hope not to have them again.....very scarey

Other Meds: . Armour Thyroid 30 mg 2 times a day... 2. PREGIDHEA/T 150/30/2 mgRDT prescribed by doctor .....bioidentical hormones 3. E3/#2/P4 3/1/140 mg RDT prescribed by doctor.....bioidentical hormones compounded 4. Azelastine Hydrochloride Nasal S

Current Illness: none

ID: 1294583
Sex: F
Age: 37
State: AZ

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
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: None known

Symptom List: Tremor

Symptoms: Fever and chills first first 24 hours. Red, swollen, hot, itchy large circle developed after the first 24 hours. Painful, hot, very itchy and uncomfortable.

Other Meds: Levothyroxine, Wellbutrin

Current Illness: None

ID: 1294584
Sex: F
Age: 54
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
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: Flushing/sweating, vitals wnl. C/o hypoglycemia. Given 3 cups juice, 2 graham crackers.

Other Meds:

Current Illness:

ID: 1294585
Sex: M
Age: 50
State: NY

Vax Date: 04/17/2021
Onset Date: 04/18/2021
Rec V Date: 05/07/2021
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: None.

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

Symptoms: Tremors; shortness of breath; Fever; Chills; profuse sweating. Headaches.

Other Meds: Simvastatin.

Current Illness: None.

ID: 1294587
Sex: F
Age: 17
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
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: Vomiting. BPs 87/54 (pulse 95), 98/63 (pulse 71).

Other Meds:

Current Illness:

ID: 1294588
Sex: F
Age: 52
State: WA

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 05/07/2021
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: Yeast, mold, pollen, hazelnuts

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: headache, fever(48 hours), stomach pain with constant burping, body aches, fatigue (still continues a week+ from onset)

Other Meds: Vit D, Rauwolfia, hawthorn, B vitamins, CoQ10

Current Illness: none

ID: 1294589
Sex: M
Age: 67
State: KY

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 05/07/2021
Hospital: Y

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

Lab Data:

Allergies: Tylenol, Chantix, Paxil

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

Symptoms: Malaise beginning ~10 hours after injection. Finally able to sleep at 8:00 next morning. Woke at 11:00 disoriented, blurred vision. EMT took me to stroke center. They determined probably not a stroke, sent me to the Hospital (cardiac) area. I was told the MRI there showed no evidence of stroke. I do not know the results of the other scans/tests. Felt better after 24 hours. Mostly recovered after 72 hours. Now (28 days later), have some residual problems with right eye, become out of breath after moderate exertion (%SpO2 95 or above). Health Department administers vaccinations at a local convention center but has no permanent offices/staff there.

Other Meds: Carvedilol, Lisinopril, Spironolactone, Furosemide, Tamsulosin, Vitamin D supplements

Current Illness: None

ID: 1294655
Sex: M
Age:
State: GA

Vax Date:
Onset Date: 05/01/2021
Rec V Date: 05/07/2021
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: CHILLS; HEADACHE; MUSCLE ACHES; This spontaneous report received from a patient concerned a male of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 03-MAY-2021 for prophylactic vaccination. Batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On MAY-2021, the subject experienced chills. On MAY-2021, the subject experienced headache. On MAY-2021, the subject experienced muscle aches. The action taken with covid-19 vaccine was not applicable. The outcome of the headache, chills and muscle aches was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1294656
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 05/04/2021
Rec V Date: 05/07/2021
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: ITCHY HIVES; SWOLLEN LYMPH NODES NEAR THROAT; RED RASH ON LEG; This spontaneous report received from a patient concerned a 38 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included non-alcohol user, and non-smoker, and other pre-existing medical conditions included the patient had no known drug allergies.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 204A21A, and batch number: 204A21A expiry: 23-JUN-2021) dose was not reported, administered on 04-MAY-2021 13:00 for prophylactic vaccination. No concomitant medications were reported. On 04-MAY-2021, the subject experienced swollen lymph nodes near throat. On 04-MAY-2021, the subject experienced red rash on leg. Laboratory data included: Vital signs measurement (NR: not provided) not reported. On 04-MAY-2021 17:00, the subject experienced itchy hives. The action taken with covid-19 vaccine was not applicable. The patient recovered from itchy hives on 04-MAY-2021, was recovering from red rash on leg, and had not recovered from swollen lymph nodes near throat. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1294657
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: ALL JOINTS/MUSCLES ACHE; CANNOT WORK; FEELING OF WEAKNESS; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination .The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced all joints/muscles ache, cannot work, and feeling of weakness. The action taken with covid-19 vaccine was not applicable. The outcome of the all joints/muscles ache, cannot work and feeling of weakness was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1294658
Sex: M
Age:
State: PA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 05/07/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: On the 3rd day I also woke up with left side of my face feeling a slight but noticeable cold burn mainly above my left eyebrow and left cheek bone; Arm is still sore; palms of my hands feeling as if they were on fire. The back of my neck and upper back felt like they had a really bad sunburn 8 days post vaccine; parasthesia/pins and needles in my left arm and legs; Felt lightheaded for 4 full days after the shot beginning 20 hours after the shot; facial numbness/my left arm became numb/the numbness moved to various parts of my body; Constant electrical buzz and vibration in my body for the first week which made it impossible to sleep; impossible to sleep; This is a spontaneous report from a contactable consumer (reporting for himself). A 34-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 16Apr2021 at 11:30 (Batch/Lot Number: EP7533) as single dose for COVID-19 immunization. Medical history included allergy (cannot digest bananas or avocados). The patient's concomitant medications were not reported. On 17Apr2021 at 08:00, the patient felt very strong lightheaded for 4 full days, with some facial numbness, woke up with left side of his face feeling a slight but noticeable cold burn mainly above his left eyebrow and left cheek bone. After lightheadedness, his left arm became numb. The numbness moved to various parts of his body. It would leave the left arm, then move to my right arm, then it would move to my neck and throat (skin only). The patient had constant electrical buzz and vibration in my body for the first week which made it impossible to sleep. The electrical buzz in the front part of his head between his eyes. Along with the arm numbness (parasthesia), the patient woke up with palms of his hands feeling as if they were on fire. The back of his neck and upper back felt like they had a really bad sunburn on 24Apr2021 (reported as 8 days post vaccine). On an unspecified date, the patient's arm was still sore. The patient had doctor or other healthcare professional office/clinic visit. The patient also visited emergency room/department or urgent care. The patient was hospitalized for 1 day. The patient did not received treatment for the events. The patient was not diagnosed with COVID-19 prior to vaccination and has not been tested for COVID-19 since the vaccination. The outcome of the event cold burn was recovering while not recovered for the other events. Information about Lot/batch number was available. Further information has been requested.

Other Meds:

Current Illness:

ID: 1294659
Sex: M
Age:
State: SC

Vax Date: 12/30/2020
Onset Date: 01/15/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Cellulitis in the arm i received the shot; pain in my arm where i received the shot; This is a spontaneous report from a contactable other hcp. A 37-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE) (Batch/Lot Number: EL1284), dose 1, via an unspecified route of administration on 30Dec2020 (at the age of 37-years-old) as a single dose for covid-19 immunisation. Medical history included was reported as none and the patient reported no known allergies. There were no concomitant medications. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. No other medications were received within 2 weeks of the vaccination. On 15Jan2021, the patient reported he started having pain in his arm where he received the shot. He went to the doctor and was diagnosed with cellulitis in the arm he received the shot. Therapeutic measures taken included unspecified antibiotics. Clinical outcome of the events cellulitis and pain in the arm he received the shot was resolving. It was also reported that since the vaccination, the patient had not been tested for COVID-19.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events of cellulitis and pain in arm due to temporal relationship. There is limited information provided in this report. This case will be reassessed once additional 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:

Current Illness:

ID: 1294660
Sex: M
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 05/07/2021
Hospital: Y

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: kidney stones; infection; This is a spontaneous report received from a Pfizer-sponsored program. A 51-year-old male patient (husband) received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot number: unknown), single dose, dose 1 via an unspecified route of administration on an unspecified date for COVID--19 immunisation. The patient's medical history was not reported. The patient's concomitant medications were not reported. The patient was in the hospital for treatment of kidney stones on an unspecified date. Kidney stone symptoms started after his first dose. On an unknown date, he had a stent placed and had an infection. Treatment was received for kidney stones.The clinical outcome of kidney stones was unknown. Information about the Lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1294661
Sex: U
Age:
State: VA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 05/07/2021
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: Blood clots on my legs; tired; This is a spontaneous report from a contactable consumer (the patient). A 30-year-old patient of an unspecified gender received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Lot number ER8737), via an unspecified route of administration, on 07Apr2021 at 12:30 (at the age of 30 years old) as a single dose in he left arm for COVID-19 immunization. Medical history included COVID-19 from an unknown date and unknown if ongoing. The patient has no known allergies. The patient's concomitant medications were not reported. The patient had received no other vaccines within fourteen days prior to vaccination. The patient experienced "blood clots on my legs" on 07Apr2021 at 17:00 with outcome of unknown, and "feeling drained and tired for two weeks now" begining on 07Apr2021 at 17:00 with outcome of unknown. The patient has not been tested for COVID-19 since the vaccination .

Other Meds:

Current Illness:

ID: 1294662
Sex: F
Age:
State: WI

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: fever; High BP; headache; This is a spontaneous report from a non-contactable consumer (patient). This 64-year-old female patient received her first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: ER7030) via an unspecified route of administration on 24Mar2021 17:00 on Arm Left as single dose for COVID-19 immunisation. The patient medical history was not reported. Concomitant medication included lisinopril dihydrate (LISINOPRIL). On 24Mar2021 02:00, after receiving her first shot, that 1st night, she had a little bit of headache, and then she was fine, and high blood pressure (BP)/ blood pressure went up. On 25Mar2021, the second day, she had fever. Her fever was 101.2 degrees Fahrenheit and lasted a few hours. She ended up going to the doctor and they walked her to the Emergency Room and was treated. She had additional heart tests scheduled with a cardiologist. She had Covid-19 in Nov2020 which showed sars-cov-2 test positive and had antibodies present when drawn during BP episode and they were 214/101. She had an antibody test with her doctor. She has the results from the antibody test. She asked if there was a certain antibody number that would say she did not need the second dose. She enquired if she should wait to get her second vaccine dose and if it was needed to repeat both doses. She went to town for a new blood pressure cuff because with her old cuff, her blood pressure was going over 200. Her husband suggested there could be something wrong. She checked it the next morning, 25Mar2021, and it was still high. She called and went to the doctor. The doctor did an EKG and then walked her to the Emergency Department where she had a blood pressure of 214/101. Now, she has to go have a stress tests and heart tests scheduled for next week, the 29th. Her blood pressure was better the next day after being seen in the ER, clarified as 26Mar2021. She was prescribed Lisinopril 5mg, by mouth, once a day for her blood pressure in the ER and started taking from 25Mar2021. She is continuing to take this medication. She has to go to an appointment and has to continue monitoring her blood pressure. Her blood pressure is still up. She clarifies it is not as high as it was, but her blood pressure being high is still continuing. She is scheduled for her appointment for a NUC medical test, which has to do with her heart. There is a stress test with part of it which is scheduled for next Thursday. Then, once she is done with the first part, they schedule the second part where they will take pictures of her heart. The event blood pressure went up required a visit to Emergency Room and Physician Office. Outcome of blood pressure went up was not recovered. The patient was recovered from headache on 24Mar2021, and recovered from fever on 25Mar2021. The caller is scheduled for her second dose of the Covid-19 shot today at 14;00 central time. She had been trying to get a hold of someone. Of course, she is concerned about getting her second shot, if she should or not? She is concerned with getting the second dose after what happened the first time. The consumer considered the events as non-serious. No follow-up attempts are needed; information about lot/batch number cannot be obtained. Follow-up (21Apr2021): New information from a contactable consumer included: patient age, event information, lab data, lot#/location/time of BNT162B2. The case was upgraded to serious. No follow-up attempts are needed. No further information is expected.

Other Meds: LISINOPRIL [LISINOPRIL DIHYDRATE]

Current Illness:

ID: 1294663
Sex: F
Age:
State: FL

Vax Date: 01/03/2021
Onset Date: 01/01/2021
Rec V Date: 05/07/2021
Hospital: Y

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: Diagnosed with organized pneumonia; This is a spontaneous report from a contactable consumer (patient). A 75-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; solution for injection; Lot Number: E1274) via an unspecified route of administration in the left arm on 03Jan2021 between 10:00 and 11:00 (at the age of 75-years-old) as a single dose for COVID-19 immunization. Medical history including any illness at time of vaccination was reported as none. Adverse events following prior vaccinations were reported as none. Family medical history relevant to the adverse event was reported as none. Concomitant medications were reported as none. The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine or on the same day as the COVID-19. On an unspecified date in Jan2021 (two weeks after dose 1 of the vaccine), the patient was diagnosed with organized pneumonia. The patient called to report that she received her first COVID-19 vaccine shot on 03Jan2021 and two weeks later she was diagnosed with pneumonia. As per the patient, the pneumonia progressively got worse and she was hospitalized for it for a total of three times. She stated that at her third hospitalization they performed a lung biopsy to determine the type of pneumonia she had. The biopsy diagnosed her with "oxidizing pneumonia" (also reported as organized pneumonia). The patient stated that it was a rare form of pneumonia. The patient stated that she received her second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; solution for injection; Lot Number: L9269) via an unspecified route of administration in the left arm on 14Feb2021 (at the age of 75-years-old) as a single dose for COVID-19 immunization. She stated that she missed her original second dose appointment because she was in the hospital at the time of that appointment. She stated that her pneumonia was still bad at that time. The patient stated that she was hospitalized once in Jan2021; about 2 weeks after receiving the first vaccine. She was then hospitalized for a second time for pneumonia at the end of January or the beginning of February and her third hospitalization was at the end of February or beginning of March. During the third hospitalization was when they did the biopsy and diagnosed her type of pneumonia. The patient stated that they could not treat it with antibiotics, so she had to go on steroids. The patient stated that she was still taking the steroid medication. Otherwise, the patient denied any medications, medical conditions, labs, or treatments relevant to the adverse event. The patient stated that her internist wanted her to call and to report her adverse event. The patient inquired if anyone else had reported this or had a similar diagnosis after having received the COVID-19 vaccine. The clinical outcome of the event organized pneumonia was unknown.

Other Meds:

Current Illness:

ID: 1294664
Sex: F
Age:
State: MI

Vax Date: 03/30/2021
Onset Date: 04/01/2021
Rec V Date: 05/07/2021
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: I was hospitalized with covid; I was hospitalized with covid; kind of weak; tired; This is a spontaneous report from a contactable consumer (patient). A 74-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration on 30Mar2021 (at the age of 74-years-old) as a single dose for COVID-19 immunisation. Medical history included chronic obstructive pulmonary disease (COPD) from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. Last week (unspecified date), she was hospitalized with COVID, just came home after a week in the hospital, just came home last night. She was asking whether she can get the second dose and if there is any guidance on timing of the second dose. She was in the hospital 2 weeks ago and they tested her, and she was negative and last Monday she didn't feel good and went to the hospital and she has COPD and she tested positive on Monday and they kept her. She already has 1 shot and is supposed to get the 2nd on the 24th and she doesn't know if she should wait 14 days. Stated she was kind of weak. She was starting to get tired and not able to complete report. Clarified it was the Pfizer Covid vaccine and she got the 1st dose 30Mar2021 and was due for the 2nd dose 24Apr2021. The patient underwent lab tests and procedures which included SARS-COV-2 test: negative on Apr2021 then positive on Apr2021. The outcome of the events was unknown. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1294665
Sex: M
Age:
State: MO

Vax Date: 03/06/2021
Onset Date: 03/09/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: three smallest toes on both feet (left/right) feel swollen; discomfort in wearing shoes and sleeping at night; balance is affected; nerve damage; discoloration; blood clots; This is a spontaneous report from a contactable consumer (patient). A 57-years-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiry date: unknown), via an unspecified route of administration, administered in Arm Left on 06Mar2021 11:00 as single dose for COVID-19 immunization. The patient had no medical history and known allergies. Patient did not have COVID prior vaccination. Patient was not tested for COVID post vaccination. Concomitant medications were not reported. It was reported that patient had three smallest toes on both feet (left/right) feel swollen. He had discomfort in wearing shoes and sleeping at night. He had movement of the toes but balance is affected. Just really troubling as nothing like this was affecting him before. He had been told it was COVID toe. He first thought it is was nerve damage. Could be blood clots small based on reading information. He never got sick. He was attempting to set a doctors appointment. There is a small amount of discoloration. He was hopeful with time this will get better. Events started on 09Mar2021 14:00 with outcome of not recovered. No treatment received. Events resulted in Doctor or other healthcare professional office/clinic visit, Disability or permanent damage. Events were reported as serious due to disability. Patient had second dose of bnt162b2 (lot no.: ER2613) on 27Mar2021 on Left Arm. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm