|
VAERS ID: |
1873071 (history) |
Form: |
Version 2.0 |
Age: |
10.0 |
Sex: |
Female |
Location: |
Northern Mariana Islands |
Vaccinated: | 2021-11-11 |
Onset: | 2021-11-16 |
Days after vaccination: | 5 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
- / IM |
Administered by: Private Purchased by: ? Symptoms: Contusion,
Full blood count abnormal,
Petechiae,
Platelet count decreased,
Rash,
Thrombocytopenia SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No Previous Vaccinations: Other Medications: diphenhydramine Current Illness: Intermittent rhinorrhea for two weeks. Also with unexplained bruising on arms two weeks ago. Preexisting Conditions: Attention deficit-hyperactivity disorder, post-traumatic stress disorder Allergies: Mom reports pt is allergic to Campbell''s condensed chicken noodle soup. Diagnostic Lab Data: Patient received her first COVID-19 vaccine on 11/11/21. Presented to our clinic on 11/16/21 for bruising and rash. Rash subsequently identified as petechiae. CBC showed thrombocytopenia, with platelets of 27,000. Repeat CBC showed platelet count of 15,000. CDC Split Type:
Write-up: Patient received her first COVID-19 vaccine on 11/11/21. Presented to our clinic on 11/16/21 for bruising and rash. Rash subsequently identified as petechiae. CBC showed thrombocytopenia, with platelets of 27,000. Repeat CBC showed platelet count of 15,000. |
|
VAERS ID: |
1874374 (history) |
Form: |
Version 2.0 |
Age: |
9.0 |
Sex: |
Female |
Location: |
Washington |
Vaccinated: | 2021-11-06 |
Onset: | 2021-11-07 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
- / IM |
Administered by: Private Purchased by: ? Symptoms: Petechiae,
Vomiting SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: None Current Illness: None Preexisting Conditions: Dyslexia Allergies: None Diagnostic Lab Data: None CDC Split Type:
Write-up: Developed emesis (5+ many episodes), petechia of eyes and face thought due to vomiting the next day. |
|
VAERS ID: |
1889915 (history) |
Form: |
Version 2.0 |
Age: |
9.0 |
Sex: |
Male |
Location: |
Kansas |
Vaccinated: | 2021-11-12 |
Onset: | 2021-11-18 |
Days after vaccination: | 6 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-22 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
LA / SYR |
Administered by: Pharmacy Purchased by: ? Symptoms: Vasculitis SMQs:, Vasculitis (narrow), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: None Current Illness: None Preexisting Conditions: None Allergies: Penicillian Diagnostic Lab Data: CDC Split Type:
Write-up: Vascuularitis in both feet, worse in left. Steroid and antibiotic were prescribed 11/22/21 |
|
VAERS ID: |
1894497 (history) |
Form: |
Version 2.0 |
Age: |
11.0 |
Sex: |
Female |
Location: |
New York |
Vaccinated: | 2021-11-08 |
Onset: | 2021-11-13 |
Days after vaccination: | 5 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Blood urine present,
C-reactive protein normal,
Full blood count normal,
Haematocrit normal,
Haematuria,
Haemoglobin normal,
Henoch-Schonlein purpura,
Lymphadenopathy,
Metabolic function test,
Platelet count normal,
Protein urine absent,
Purpura,
Rash papular,
Urine analysis abnormal,
White blood cell count normal SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Vasculitis (narrow), Hypersensitivity (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: none Current Illness: none Preexisting Conditions: intermittent asthma Allergies: none Diagnostic Lab Data: 11/15/21 CBC--WBC 5.82 H/H 12.3/36.9 plt 339, CRP 0.7 11/22/21 CBC--WBC 6.02 H/H 12/36 plt 301, UA trace blood, microscopic 11-20 WBC, neg protein CDC Split Type:
Write-up: Patient developed R inguinal adenopathy (1cm x 2) on 11/13/21. On 11/14/21 she developed an erythematous papular rash on the R lower extremity and a few similar lesions on her chest and back. Was seen by urgent care and told rash were bites. Was seen at on 11/15 CBC, BMP, CRP drawn, all WNL. The lesions on her legs became purpuric on 11/19/21. Seen again at on 11/22, inguinal adenopathy decreasing in size, labs repeated including UA which showed microscopic hematuria. At no time did she have fever. No abdominal pain, no joint pain, no headache, no itching. BP 93/62--normal Given lower extremity rash and microscopic hematuria, we are calling this HSP but it is a very soft diagnosis. The feeling is that this is vaccine related, whether it be HSP or just a purpuric rash. |
|
VAERS ID: |
1894734 (history) |
Form: |
Version 2.0 |
Age: |
6.0 |
Sex: |
Male |
Location: |
Massachusetts |
Vaccinated: | 2021-11-09 |
Onset: | 2021-11-14 |
Days after vaccination: | 5 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / 1 |
LA / SYR |
Administered by: Private Purchased by: ? Symptoms: Flushing,
Petechiae,
Rash SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: olly kids multivitamin Current Illness: Preexisting Conditions: Autism, absence type seizures Allergies: Certain animal hair (bunnies), causes hives and eczema Diagnostic Lab Data: None yet. Consulted with pediatricians office and requested a further appointment. CDC Split Type:
Write-up: Five days after his vaccination experienced petechiae rash above his lip and underneath his nose. It gave the appearance of a mustache. It appeared with flush cheeks and lasted for about two days before resolving. |
|
VAERS ID: |
1906298 (history) |
Form: |
Version 2.0 |
Age: |
6.0 |
Sex: |
Female |
Location: |
California |
Vaccinated: | 2021-11-06 |
Onset: | 2021-11-20 |
Days after vaccination: | 14 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-29 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: C-reactive protein increased,
Coagulation test normal,
Henoch-Schonlein purpura,
Pain in extremity,
Pharyngitis streptococcal,
Platelet count increased,
Purpura,
Renal function test normal,
Viral myositis,
White blood cell count increased,
X-ray limb normal SMQs:, Agranulocytosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal infections (narrow), Vasculitis (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: none Current Illness: none Preexisting Conditions: none Allergies: none Diagnostic Lab Data: Elevated CRP, elevated WBC and platelets, normal coagulation factors, normal renal studies, normal x-rays of legs CDC Split Type:
Write-up: Patient developed severe leg pain on 11/20, was seen at ER, diagnosed with viral myositis. then developed purpuric rash, returned to ER 11/25, diagnosed with Henoch Schonlein Purpura and Strep pharyngitis. ER visit only, no inpatient hospitalization, treated with Tylenol and Ibuprofen |
|
VAERS ID: |
1917861 (history) |
Form: |
Version 2.0 |
Age: |
8.0 |
Sex: |
Female |
Location: |
New York |
Vaccinated: | 2021-11-29 |
Onset: | 2021-11-30 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2021-12-02 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / UNK |
- / IM |
Administered by: Unknown Purchased by: ? Symptoms: C-reactive protein increased,
Protein urine present,
Purpura,
Rash SMQs:, Acute renal failure (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Keflex and Amoxicillin Diagnostic Lab Data: elevated CRP on 12/1/21 to 10.9, and small protein in her urine. CDC Split Type:
Write-up: The following day she developed a painful purpuric rash on her lower extremities. |
|
VAERS ID: |
1925375 (history) |
Form: |
Version 2.0 |
Age: |
10.0 |
Sex: |
Female |
Location: |
Texas |
Vaccinated: | 2021-11-09 |
Onset: | 2021-11-13 |
Days after vaccination: | 4 |
Submitted: |
0000-00-00 |
Entered: |
2021-12-06 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FL0007 / 2 |
LA / SYR |
Administered by: Pharmacy Purchased by: ? Symptoms: Arthralgia,
Blood test normal,
Gait disturbance,
Inflammatory marker test,
Joint swelling,
Pain in extremity,
Peripheral swelling,
Purpura,
Rash,
Urine analysis normal SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: none Current Illness: none Preexisting Conditions: none Allergies: none Diagnostic Lab Data: urine analysis normal blood pressure normal blood work normal inflammation level on the higher end of normal CDC Split Type:
Write-up: After the 1st shot she developed a rash below her waistline. it covered all the way across the front of her lower body a d wrapped around her bottom. she also suffered from stiff fingers like joint pain. after a phone call to the doctor they didn?t think the rash was covid shot related. she got the 2nd shot and 8 hours after injection she had joint pain behind her left knee. she she woke up the following morning she was unable to walk normal. that followed with swollen ankles, joint pain in both legs, purpura all over the lower legs. bruise like. difficult walking. rash has continued to her upper thighs. feet still swollen after 8 days. |
|
VAERS ID: |
1932239 (history) |
Form: |
Version 2.0 |
Age: |
9.0 |
Sex: |
Female |
Location: |
Connecticut |
Vaccinated: | 2021-12-02 |
Onset: | 2021-12-03 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2021-12-08 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / 2 |
LA / IM |
Administered by: Pharmacy Purchased by: ? Symptoms: Joint swelling,
Peripheral swelling,
Purpura,
Urticaria SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: POSSIBLE COVID EXPOSURE ON 11/24/2021 Preexisting Conditions: BRUGADA SYNDROME Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: PURPURIC RASH, URTICARIA, SWELLING OF ANKLES, FEET AND HANDS PATIENT REFERRED TO CCMC INFECTIOUS DISEASE, CARDIOLOGY AND RHEUMATOLOGY IF NEEDED |
|
VAERS ID: |
1935139 (history) |
Form: |
Version 2.0 |
Age: |
11.0 |
Sex: |
Female |
Location: |
Florida |
Vaccinated: | 2021-11-07 |
Onset: | 2021-11-01 |
Submitted: |
0000-00-00 |
Entered: |
2021-12-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
F65127 / 1 |
LA / - |
Administered by: Pharmacy Purchased by: ? Symptoms: COVID-19,
Drug ineffective,
Dysmenorrhoea,
Heavy menstrual bleeding,
Menstruation irregular,
Nodule,
Pain in extremity,
Peripheral swelling,
Pyrexia,
SARS-CoV-2 test,
Thrombosis SMQs:, Cardiac failure (broad), Angioedema (broad), Lack of efficacy/effect (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Fertility disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None, Comment: Patient History: No Allergies: Diagnostic Lab Data: Test Date: 20211123; Test Name: fever; Result Unstructured Data: Test Result:102.8; Test Date: 20211123; Test Name: fever; Result Unstructured Data: Test Result:101; Test Date: 20211125; Test Name: fever; Result Unstructured Data: Test Result:99; Test Date: 20211123; Test Name: COVID-19 PCR test; Test Result: Positive ; Test Date: 20211124; Test Name: COVID-19 rapid test; Test Result: Positive CDC Split Type: USPFIZER INC202101689667
Write-up: giant clots / clots are sizes of a large pickle; has tested positive for Covid; has tested positive for Covid; really heavy period; irregular period, really heavy 12-13 days after the end of her period; arm hurting /sore arm; arm swelled up; lump; bad cramps; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP) from medical information team and product quality group. The reporter is the parent. A 11 year-old female patient received bnt162b2 (COMIRNATY), administered in arm left, administration date 07Nov2021 (Lot number: F65127) at the age of 11 years as dose 1, single for covid-19 immunisation; influenza vaccine (FLU), administered in arm left, administration date 10Nov2021 (Batch/Lot number: unknown) for immunisation. The patient had no relevant medical history. The patient''s relevant medical history and concomitant medications were not reported. The following information was reported: THROMBOSIS (medically significant) with onset 23Nov2021 21:00, outcome "not recovered", described as "giant clots / clots are sizes of a large pickle"; DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant) all with onset 23Nov2021, outcome "unknown" and all described as "has tested positive for Covid"; MENSTRUATION IRREGULAR (non-serious) with onset 22Nov2021, outcome "unknown", described as "irregular period, really heavy 12-13 days after the end of her period"; HEAVY MENSTRUAL BLEEDING (non-serious) with onset 22Nov2021 23:30, outcome "not recovered", described as "really heavy period"; DYSMENORRHOEA (non-serious) with onset Nov2021, outcome "unknown", described as "bad cramps"; PAIN IN EXTREMITY (non-serious) with onset 10Nov2021, outcome "recovered" (Nov2021), described as "arm hurting /sore arm"; PERIPHERAL SWELLING (non-serious) with onset 10Nov2021, outcome "recovered" (Nov2021), described as "arm swelled up"; NODULE (non-serious) with onset 10Nov2021, outcome "recovered" (Nov2021), described as "lump". The events "giant clots / clots are sizes of a large pickle", "irregular period, really heavy 12-13 days after the end of her period", "really heavy period" and "bad cramps" were evaluated at the physician office visit. The patient underwent the following laboratory tests and procedures: pyrexia: (23Nov2021) 102.8; (23Nov2021) 101; (25Nov2021) 99; sars-cov-2 test: (23Nov2021) positive; (24Nov2021) positive. Therapeutic measures were taken as a result of thrombosis, covid-19, menstruation irregular, heavy menstrual bleeding, dysmenorrhoea. Vaccination Facility Type was reported as Pharmacy. No vaccine was received 4 weeks prior to the first administration date of the suspect vaccine, flu vaccine was administered 3 days afterwards. The patient had no relevant family medical history. It was reported that, no predisposing factors involved. The patient had her period a couple of times, she just got it in on an unspecified date in Aug2021. The caller was giving her daughter ibuprofen either 200 mg or 400 mg and Tylenol 500 mg for the fever and for the cramps. Caller says that the ibuprofen is not handy at the moment. The pediatrician gave her a birth control pill, Provera, to stop the bleeding, which it did. When she had started the Provera she continued to have clots until Friday. On first day that the Provera had started working and takes the Provera at 19:15 and she will wake up and her pad was much, much better and ever since the clots started getting better, at 2:00 she gets horrible cramps and has the heavy bleeding again. So then for about 5 to 6 hours it was worse. The patient had nasal swabs performed. No follow-up attempts are possible. No?further?information?is expected. |
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