|
| VAERS ID: |
903147 (history) |
| Form: |
Version 2.0 |
| Age: |
38.0 |
| Sex: |
Female |
| Location: |
Puerto Rico |
| 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,
Injection site pain,
Ocular discomfort,
Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: Printec (anticonceptional)
Current Illness: None
Preexisting Conditions: Asthmatic
Allergies: seafood, red meat, milk and dairy products, fish
Diagnostic Lab Data: None
CDC Split Type: vsafe
Write-up: Pain at the injection site and the whole arm felt sore. Felt like a pressure behind my eyes, very tired, extreme fatigue. |
|
| VAERS ID: |
903149 (history) |
| Form: |
Version 2.0 |
| Age: |
29.0 |
| Sex: |
Female |
| Location: |
Colorado |
| 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 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Diarrhoea,
Dizziness,
Faeces discoloured,
Feeling cold,
Hyperhidrosis,
Injection site pain,
Nausea,
Poor quality sleep,
Pyrexia,
Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Adderall, spironalactone, vitamin D supplement
Current Illness: none
Preexisting Conditions: none
Allergies: mangoes
Diagnostic Lab Data:
CDC Split Type:
Write-up: 1215 pm on 12/16/2020: pfizer covid vac in left arm Poor nights sleep with left arm pain at injection site 500am on 12/17/2020: stood up to get ready and immediately started to dizzy. Then immediately threw up and had darker green diarrhea. Once that finished I had the sweats and felt cold with a subjective fever until around 9 am with continued nausea. Symptoms resolved 11:40 AM. |
|
| VAERS ID: |
903150 (history) |
| Form: |
Version 2.0 |
| Age: |
51.0 |
| Sex: |
Female |
| Location: |
Kansas |
| 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: Other Purchased by: ?
Symptoms: Feeling hot
SMQs:
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: medication for seizures, Lisinopril, Atrovastatin, eye drops
Current Illness: no
Preexisting Conditions: seizure disorder, hypertension, Cholesterol, dry eyes
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:
Write-up: Patient state, one hour after vaccination, "I got the warm feeling, I got hot" Temp taken at 2 hour, no temp. Temp taken 4 hours later, no temp. |
|
| VAERS ID: |
903151 (history) |
| Form: |
Version 2.0 |
| Age: |
21.0 |
| Sex: |
Female |
| Location: |
Maryland |
| 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 |
EH9899 / 1 |
LA / IM |
Administered by: Military Purchased by: ?
Symptoms: Chills,
Injection site induration,
Pain
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: Medical Nexplon Birth Control
Current Illness: Na
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: n/a
CDC Split Type: vsafe
Write-up: Chills, Body Ache, Hard around the injection |
|
| VAERS ID: |
903152 (history) |
| Form: |
Version 2.0 |
| Age: |
42.0 |
| Sex: |
Female |
| Location: |
Puerto Rico |
| 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 / SYR |
Administered by: Private Purchased by: ?
Symptoms: Chills,
Fatigue,
Headache,
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: Cynthroid
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe
Write-up: 12/15/2020 I was tired, body chills, pain in left arm but was all very light until 12/16/2020 headache was more severe |
|
| VAERS ID: |
903153 (history) |
| Form: |
Version 2.0 |
| Age: |
29.0 |
| Sex: |
Female |
| Location: |
New Mexico |
| 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 / 1 |
LA / IM |
Administered by: Private Purchased by: ?
Symptoms: Body temperature increased,
Erythema,
Feeling abnormal,
Hypoaesthesia,
Immediate post-injection reaction,
Pharyngeal hypoaesthesia,
Pruritus,
Throat irritation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: tylenol
Current Illness: na
Preexisting Conditions: arthritis in joints
Allergies: Sulfate, morphine, pecans, latex, bee stings, powered milk and the entire "cillin" family (ect... penicillin, amoxicilin)
Diagnostic Lab Data: NA
CDC Split Type: vsafe
Write-up: Immediately after the injection the tips of my finger began to go numb my hand started itching my throat started to go numb and itch and I got 25mg of Benedryl symptoms got worse so they had to give me in IV injection of benedryl which made the symptoms a litter better. I was released and when I got home I went to sleep. When I woke up my body felt like I had been run over by a big truck. I took my temp and it was 99.8. I laid back down and decided to sleep it off and woke up this morning not feeling any worse but not any better. My hands got red from the rash and is still a little red. |
|
| VAERS ID: |
903154 (history) |
| Form: |
Version 2.0 |
| Age: |
24.0 |
| Sex: |
Female |
| Location: |
Oklahoma |
| 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 / SYR |
Administered by: Private Purchased by: ?
Symptoms: Chest discomfort,
Dizziness,
Flushing,
Palpitations
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (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: No
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: After receiving the injection, patient felt flushed and lightheaded. Began to feel like heart was racing and chest tightness. The patient''s heart rate was checked, the patient was provided with Tylenol and water, and observed for an additional 15 minutes. Symptoms resolved during this time. |
|
| VAERS ID: |
903155 (history) |
| Form: |
Version 2.0 |
| Age: |
57.0 |
| Sex: |
Female |
| Location: |
Florida |
| 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: Private Purchased by: ?
Symptoms: Palatal oedema,
Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: metformin 1000mg PO BID
Current Illness: unknown
Preexisting Conditions: diabetes
Allergies: iodine-severe (undocumented reaction)
Diagnostic Lab Data:
CDC Split Type:
Write-up: At 11:15am, patient received first dose of SARS-CoV-2 vaccine. At 12:00pm, patient began to develop a rash and had mild edema noted in the uvula. She did not have difficulty breathing/swallowing/speaking. She was given prednisone 50mg x 1 and diphenhydramine 50mg x 1 in the ED. |
|
| VAERS ID: |
903156 (history) |
| Form: |
Version 2.0 |
| Age: |
60.0 |
| Sex: |
Female |
| Location: |
Arkansas |
| 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 |
- / UNK |
RA / IM |
Administered by: Public Purchased by: ?
Symptoms: Fatigue,
Head discomfort,
Headache,
Nasal congestion,
Pain,
Paraesthesia,
Rhinorrhoea,
SARS-CoV-2 test
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), COVID-19 (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: Buspar, effexor XL, metoprolol, lipitor, co10,
Current Illness: None
Preexisting Conditions: Hypertension, pre-diabetes, anxiety, panic attacks & depression
Allergies: Sulfa drugs: rash, Crestor: muscle weakness
Diagnostic Lab Data: COVID BD Veritor Rapid & PCR
CDC Split Type:
Write-up: States after vaccine, reported tingling/electrical feelings in legs & arms. Four hours after, rhinorrhea reported. States at 48 hours, started having nasal and head congestion. States experienced body aches x 12 hours but have improved at 48 hours. States is feeling better with body aches now. States is also having headaches x 24 hours. States is having them "moderately now." States is also noticing fatigue. States starting noticing fatigue at 12 hours after injection and still present now. |
|
| VAERS ID: |
903157 (history) |
| Form: |
Version 2.0 |
| Age: |
23.0 |
| 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 |
RA / IM |
| UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER |
- / 1 |
- / - |
Administered by: Work 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: None
Current Illness: Slight sniffles, and congestion but I did have two negative Covid test
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:
Write-up: Headache |
|
