|
| VAERS ID: |
902597 (history) |
| Form: |
Version 2.0 |
| Age: |
36.0 |
| Sex: |
Female |
| Location: |
Virginia |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Lip swelling,
Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zoloft
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:
Write-up: Right sided facial/lip swelling. Started about 0200 on 12/16/20. Patient sometimes gets angioedema, so unsure if this is related but wanted to report |
|
| VAERS ID: |
902621 (history) |
| Form: |
Version 2.0 |
| Age: |
27.0 |
| Sex: |
Male |
| Location: |
Kansas |
| Vaccinated: | 2020-12-14 |
| Onset: | 2020-12-14 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / UNK |
RA / IM |
Administered by: Private Purchased by: ?
Symptoms: Chills,
Fatigue,
Feeling of body temperature change,
Headache,
Nausea,
Pyrexia,
Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Patient received shot around 1pm later that night he started to experience chills, hot/cold, nausea, headache, extreme fatigue, low grade temp (99.1) Associate vomited several times the early the next morning. By the next day, day patient was vomiting less and was able to keep food down. Patient is feeling better the second day, experiencing some nausea. |
|
| VAERS ID: |
902648 (history) |
| Form: |
Version 2.0 |
| Age: |
26.0 |
| Sex: |
Female |
| Location: |
California |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
RA / IM |
Administered by: Private Purchased by: ?
Symptoms: Feeling hot,
Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), 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: Sprintec, Flonase, Loratadine
Current Illness:
Preexisting Conditions: Environmental allergies, low back herniated disc
Allergies: Dust, mold, grass, trees
Diagnostic Lab Data:
CDC Split Type:
Write-up: diffuse rash at anterior and right lateral neck associated with feeling of warmth |
|
| VAERS ID: |
902650 (history) |
| Form: |
Version 2.0 |
| Age: |
34.0 |
| Sex: |
Female |
| Location: |
Missouri |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Patient received shot and sat for 15 minutes, left and came back and reported she felt woozy. She felt dizzy. Patient stated she felt dizzy off and on while she was in clinic getting shot, patient left. |
|
| VAERS ID: |
902655 (history) |
| Form: |
Version 2.0 |
| Age: |
28.0 |
| Sex: |
Male |
| Location: |
Texas |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EK5730 / 1 |
LA / IM |
Administered by: Work Purchased by: ?
Symptoms: Chills,
Headache,
Pain
SMQs:
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: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:
Write-up: chills - 0730 body ache, headache - 1000 headache significantly worse - 1110 |
|
| VAERS ID: |
902656 (history) |
| Form: |
Version 2.0 |
| Age: |
54.0 |
| Sex: |
Female |
| Location: |
New York |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
- / IM |
Administered by: Private Purchased by: ?
Symptoms: Dizziness,
Headache,
Oropharyngeal pain
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular 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: Synthroid
Current Illness: unknown
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Sent for COVID 19 PCR testing
CDC Split Type:
Write-up: sore throat, headache, lightheadedness |
|
| VAERS ID: |
902665 (history) |
| Form: |
Version 2.0 |
| Age: |
42.0 |
| Sex: |
Female |
| Location: |
Michigan |
| Vaccinated: | 2020-12-16 |
| Onset: | 2020-12-16 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EZ5730 / 1 |
- / IM |
Administered by: Private Purchased by: ?
Symptoms: Chest discomfort,
Cold sweat,
Condition aggravated,
Dizziness,
Panic attack,
Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (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 Lipitor calcium with vitamin d cyanocobalamin Lisinopril fish oil loratadine
Current Illness: denies
Preexisting Conditions: high cholesterol hypertension panic attacks IgA nephropathy
Allergies: mucinex cough (dizziness) Surgical tape
Diagnostic Lab Data:
CDC Split Type:
Write-up: Pt. became lightheaded, and clammy. noted heart rate to be 51, oxygen saturation 100%. after sitting for a few minutes, she felt better, but then became dizzy and had some chest tightness and bilateral hand tingling. Pt. noted to have respiratory rate 22-26 with deep breath, but other vital signs were stable. (Blood pressures 108-138/70''s to 80''s) Heart rate remained stable in the 70-90''s range, lungs remained clear to auscultation through out. No rash or swelling noted anywhere. No itching, no throat tightness. Pt. repeatedly stated "I think I am having a panic attack". Due to the continued complaint of chest tightness, pt. sent to the emergency department for evaluation. |
|
| VAERS ID: |
902666 (history) |
| Form: |
Version 2.0 |
| Age: |
32.0 |
| Sex: |
Female |
| Location: |
Maryland |
| Vaccinated: | 2020-12-14 |
| Onset: | 2020-12-14 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Abdominal pain upper,
Chills,
Decreased appetite,
Dyspnoea,
Headache,
Injection site erythema,
Pain,
Pyrexia,
Retching
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: Daily 60mg Prozac, Vitamin D Supplement, Tylenol 6mg melatonin
Current Illness: None
Preexisting Conditions: None
Allergies: Morphine
Diagnostic Lab Data: n/a
CDC Split Type: vsafe
Write-up: redness around the injection spot, fever chills, Stomach Ache, Body Ache, Short of breath (walking up stairs ), Headaches no appetite, Dry heating . |
|
| VAERS ID: |
902667 (history) |
| Form: |
Version 2.0 |
| Age: |
44.0 |
| Sex: |
Female |
| Location: |
Colorado |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-15 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / N/A |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Injection site erythema,
Injection site induration,
Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (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: After patient received vaccine had localized reaction in left deltoid. Redness and firm to touch. Patient observed for additional time frame and redness lessened. Patient released home. |
|
| VAERS ID: |
902668 (history) |
| Form: |
Version 2.0 |
| Age: |
35.0 |
| Sex: |
Female |
| Location: |
Louisiana |
| Vaccinated: | 2020-12-14 |
| Onset: | 2020-12-15 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
PH9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Chills,
Fatigue,
Injection site pain,
Pain,
Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: Levotiroxin, vioral, baby aspirin, valerium capsules, multi vitamins
Current Illness: Seasonal allergies
Preexisting Conditions: Colitis (IBS), ranards, hypotyroidism
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe
Write-up: About 12 hours after the injection woke up and body was hurting all over, chills, body aches, felt feverish, temperature was 100.3F and really tired and hurting all over. Took Tylenol and returned to sleep. Woke up some hours later and took an Ibuprofen. rested for the rest of the day and now the only side effects is a little soreness on her injection mark. No other symptoms. Only the first 24 hours after the shot. |
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