|
| VAERS ID: |
903043 (history) |
| Form: |
Version 2.0 |
| Age: |
31.0 |
| Sex: |
Female |
| Location: |
Massachusetts |
| 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 |
EH9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Asthenia,
Chills,
Fatigue,
Headache
SMQs:, Guillain-Barre 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: none
Current Illness: none, had Covid in April 2020
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: rest go home and take OTC Tylenol as directed
CDC Split Type:
Write-up: chills, headache, weakness, fatigue |
|
| VAERS ID: |
903044 (history) |
| Form: |
Version 2.0 |
| Age: |
58.0 |
| 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: Hypoaesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: stated her lips started to feel numb, like she was at the dentist. lips did not appear cyanotic. |
|
| VAERS ID: |
903045 (history) |
| Form: |
Version 2.0 |
| Age: |
47.0 |
| Sex: |
Female |
| Location: |
New York |
| 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 |
- / UNK |
- / IM |
Administered by: Work Purchased by: ?
Symptoms: Headache,
Hypoaesthesia,
Neck pain,
Pain,
Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (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: ibuprofen 600mg 1 tab 3 times a day Magnesium 500mg at bedtime, Topamax 50mg 1/2 tab twice a day Vit D 3 5000IU once a day
Current Illness: migraines, migraine variance, chiari malformation
Preexisting Conditions:
Allergies: Lamictal Darvocet, Succinycholine
Diagnostic Lab Data: none
CDC Split Type:
Write-up: about 1 1/2 hour after receiving it I felt a pain and numbness down left arm into pinky and ring finger. That only last about 2 minutes. Then the pain radiated to left side of neck and head and headache is still there at 1pm. |
|
| VAERS ID: |
903046 (history) |
| Form: |
Version 2.0 |
| Age: |
40.0 |
| Sex: |
Female |
| Location: |
Puerto Rico |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-16 |
| 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 |
9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament 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: None
Current Illness: None
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None
CDC Split Type: vsafe
Write-up: Caller had vaccine and at 12:30 at night caller had extreme paid in left arm and had to take Tylenol. Next day caller stated pain had subsided. |
|
| VAERS ID: |
903047 (history) |
| Form: |
Version 2.0 |
| Age: |
52.0 |
| Sex: |
Female |
| Location: |
New York |
| 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 |
AR / IM |
Administered by: Private Purchased by: ?
Symptoms: Circumstance or information capable of leading to medication error,
Dizziness,
Headache,
Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Medication errors (narrow), 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, Omeprazole
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:
Write-up: Employee states that there was confusion at the time of vaccine injection, and that she was possibly given a second injection right after the first. approximately 45 minutes later she experienced headache and dizziness and had an observed syncopal episode. She was taken to the ER, evaluated for MI. Was found to be stable and was discharged. |
|
| VAERS ID: |
903073 (history) |
| Form: |
Version 2.0 |
| Age: |
29.0 |
| Sex: |
Female |
| Location: |
Alabama |
| 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: Private Purchased by: ?
Symptoms: Diarrhoea,
Headache
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Write-up: I WOKE UP WITH DIARRHEA AND A CONSTANT HEADACHE THAT HASNT LEFT |
|
| VAERS ID: |
903074 (history) |
| Form: |
Version 2.0 |
| Age: |
29.0 |
| Sex: |
Male |
| Location: |
North Carolina |
| 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 / SYR |
Administered by: Private Purchased by: ?
Symptoms: Headache
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: Allegra, famotidine, omeprazole
Current Illness:
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:
Write-up: Headache at base of skull near spinal cord 3 hours after dose given |
|
| VAERS ID: |
903075 (history) |
| Form: |
Version 2.0 |
| Age: |
32.0 |
| 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 |
H9899 / 1 |
RA / SYR |
Administered by: School Purchased by: ?
Symptoms: Chills,
Myalgia,
Pyrexia,
SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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: Zoloft
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid tested 12/16/2020 and result was negative, nasal swab
CDC Split Type: vsafe
Write-up: 12/15/2020 I felt terrible with muscle aches, shivering, chills, fever was 102.8,I took tylenol and ibuprofen (alternated) 24 hours after initial fever I ceased meds and fever was still 101.5, this morning I was 98.6. The course of the fever was 36 hours total |
|
| VAERS ID: |
903079 (history) |
| Form: |
Version 2.0 |
| Age: |
26.0 |
| Sex: |
Female |
| Location: |
Rhode Island |
| 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 |
- / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Fatigue,
Headache,
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: Tylenol
Current Illness: NA
Preexisting Conditions: Na
Allergies: NKDA
Diagnostic Lab Data: NA
CDC Split Type: vsafe
Write-up: Around 630pm I began to have a really bad had a bad headache, feverish and body aching. Tenderness in the injection site area which eventually turned into full body aches and was tired. No vomiting or nausea. No redness at the site or injection site issues |
|
| VAERS ID: |
903081 (history) |
| Form: |
Version 2.0 |
| Age: |
35.0 |
| Sex: |
Female |
| Location: |
New York |
| 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: Confusional state,
Fatigue,
Headache,
Myalgia,
Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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: Fluoxetine 60mg, Dolovent, Junel, Klonopin
Current Illness: Acute migraine
Preexisting Conditions: Migraines, Depression
Allergies: Peanuts
Diagnostic Lab Data:
CDC Split Type:
Write-up: Muscle ache, fatigue, drowsiness, brief confusion, bilateral headache, onset 11 AM, duration 2-3 hours |
|
