|
| VAERS ID: |
902906 (history) |
| Form: |
Version 2.0 |
| Age: |
31.0 |
| Sex: |
Male |
| Location: |
Connecticut |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / UNK |
LA / SYR |
Administered by: Private Purchased by: ?
Symptoms: Arthralgia,
Chills,
Fatigue,
Headache,
Injection site pain,
Myalgia,
Nausea,
Pyrexia,
Respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: History of transposition of great vessels at birth
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:
Write-up: Chills approx 6 hours after receiving shot Injection site tenderness (no redness or swelling noted) Muscle aches and joint pain at 8 hours At 12 hours, fatigue, nausea (20 minutes), headache, congestion, low grade temp 99.5, malaise Hour 17 fever to 100.5 took 800 mg Advil and 1000 mg Tylenol. Hour 24 all symptoms completely resolved only very mild injection site tenderness. Felt at baseline. Afebrile. |
|
| VAERS ID: |
902908 (history) |
| Form: |
Version 2.0 |
| Age: |
44.0 |
| Sex: |
Male |
| Location: |
Oklahoma |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
LA / IM |
Administered by: Work Purchased by: ?
Symptoms: Arthralgia,
Fatigue,
Feeling hot,
Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ambien, Dyazide, Celecoxib, Allegra
Current Illness: None
Preexisting Conditions: Migraines, asthma
Allergies: Cherry, almonds, sulfa drugs
Diagnostic Lab Data: None
CDC Split Type:
Write-up: Extreme fatigue, felt very warm all over body for 14 - 16 hours, exceptional pruritus on head and back, all joints are exceptionally achey |
|
| VAERS ID: |
902919 (history) |
| Form: |
Version 2.0 |
| Age: |
41.0 |
| Sex: |
Female |
| Location: |
Florida |
| Vaccinated: | 2020-12-17 |
| Onset: | 2020-12-17 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Chest discomfort,
Cold sweat,
Dyspnoea,
Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, zolpidem, ibuprofen, Loestrin
Current Illness: None
Preexisting Conditions: Anxiety
Allergies: No known allergies
Diagnostic Lab Data: 12/17/2020: blood pressure via automatic cuff
CDC Split Type:
Write-up: Patient left the vaccine clinic after waiting 15 minutes. While driving home, she began to feel clammy with a tightness in her chest and throat. She reports that it felt harder for her to breathe. She describes the onset as 20-30 minutes after vaccine was administered. She returned to the vaccine clinic where she was given diphenhydramine 25 mg PO, and her blood pressure was ~130/100 mmHg. She reports that she is usually normotensive. Patient was observed for 30-45 minutes, and she reports feeling better. |
|
| VAERS ID: |
902923 (history) |
| Form: |
Version 2.0 |
| Age: |
34.0 |
| Sex: |
Female |
| Location: |
Arkansas |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-17 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
- / - |
Administered by: Unknown Purchased by: ?
Symptoms: Asthenia,
Chills,
Myalgia,
Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: NAUSEA, CHILLS, MUSCLE PAIN, WEAKNESS |
|
| VAERS ID: |
902925 (history) |
| Form: |
Version 2.0 |
| Age: |
35.0 |
| Sex: |
Female |
| Location: |
Texas |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Atelectasis,
Chest X-ray abnormal,
Chest pain,
Computerised tomogram thorax normal,
Dizziness,
Electrocardiogram normal,
Fatigue,
Headache,
Heart rate increased,
Laboratory test normal,
Lung hyperinflation,
Nausea,
Pain,
Pyrexia,
Vomiting
SMQs:, Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, Vitamin D, Fish Oil, Singular 10 MG, Panelor 30mg, Maxalt 10mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Iodine
Diagnostic Lab Data: CT Chest -- normal, EKG -- normal, Lab test-- normal. Xray Chest results -- basilar atelectasis, Hyperinflation of lungs.
CDC Split Type:
Write-up: 02:45 PM walking , dizzy, rapid heart rate, mild chest pain. Directed to ER in hospital, CT Chest -- normal, EKG -- normal, Lab test-- normal. Xray Chest results -- basilar atelectasis, Hyperinflation of lungs. Blood pressure 171/109. No treatment given in ER -- f/u with PCP 12/18/20. 08:00PM nausea, headache, vomit 1x. 10:00PM fever 104.00; Tylenol extra strength dose. 12/17/20 6:00am temp 99.00, Tylenol dose extra strength; body aches, fatigue, mild headache. |
|
| VAERS ID: |
902926 (history) |
| Form: |
Version 2.0 |
| Age: |
44.0 |
| Sex: |
Female |
| Location: |
Texas |
| Vaccinated: | 2020-12-17 |
| Onset: | 2020-12-17 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
UN / IM |
Administered by: Private Purchased by: ?
Symptoms: Erythema,
Flushing,
Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: caller reported Flushing, redness around face and nauseous. Advised that Number for IMT (Incident management Team)will be activated. Caller declined. Advised to return to observation room where shot was given. Caller stated she would. Called her 5 minutes and left a message to call back if symptoms also persist or worsens |
|
| VAERS ID: |
902927 (history) |
| Form: |
Version 2.0 |
| Age: |
29.0 |
| Sex: |
Male |
| Location: |
Ohio |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-15 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Injection site pain,
Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Injection Site pain/swelling
Other Medications: Fluticasone nasal spray
Current Illness: No
Preexisting Conditions: Allergic rhinitis
Allergies: No
Diagnostic Lab Data:
CDC Split Type:
Write-up: Injection site swelling and pain |
|
| VAERS ID: |
902928 (history) |
| Form: |
Version 2.0 |
| Age: |
64.0 |
| Sex: |
Male |
| Location: |
Unknown |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
- / - |
Administered by: Unknown Purchased by: ?
Symptoms: Abdominal pain upper,
Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Stomach crump & vomiting |
|
| VAERS ID: |
902929 (history) |
| Form: |
Version 2.0 |
| Age: |
56.0 |
| Sex: |
Female |
| Location: |
Illinois |
| Vaccinated: | 2020-12-17 |
| Onset: | 2020-12-17 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EK5730 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Blood pressure increased,
Dizziness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: DIZZY, SLIGHTLY EVEVATED BLOOD PRESSURE |
|
| VAERS ID: |
902930 (history) |
| Form: |
Version 2.0 |
| Age: |
26.0 |
| Sex: |
Female |
| Location: |
South Carolina |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-17 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
LA / SYR |
Administered by: School Purchased by: ?
Symptoms: Pain in extremity,
Tenderness
SMQs:, Tendinopathies and ligament 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? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Iron deficiency
Allergies: none
Diagnostic Lab Data:
CDC Split Type:
Write-up: left arm soreness/pain tender to touch/palpation |
|
