|
VAERS ID: |
916428 (history) |
Form: |
Version 2.0 |
Age: |
16.0 |
Sex: |
Female |
Location: |
Texas |
Vaccinated: |
2020-12-30 |
Onset: |
2020-12-30 |
Days after vaccination: |
0 |
Submitted: |
0000-00-00 |
Entered: |
2020-12-31 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
037K20A / 1 |
LA / IM |
Administered by: Public Purchased by: ? Symptoms: Pruritus, Urticaria 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: Current Illness: Preexisting Conditions: migraines Allergies: Diagnostic Lab Data: N/A CDC Split Type: Write-up: hives and itching face after receiving the vaccination |
|
VAERS ID: |
921641 (history) |
Form: |
Version 2.0 |
Age: |
17.0 |
Sex: |
Female |
Location: |
New York |
Vaccinated: |
2021-01-04 |
Onset: |
2021-01-04 |
Days after vaccination: |
0 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-05 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EL0140 / 1 |
LA / IM |
Administered by: Senior Living Purchased by: ? Symptoms: Acute respiratory failure, COVID-19, Hypoxia, SARS-CoV-2 test positive SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow) Life Threatening? Yes Birth Defect? No Died? No Permanent Disability? No Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? Yes Hospitalized? Yes, ? days Extended hospital stay? No Previous Vaccinations: Other Medications: acetaminophen 160 mg/5 mL (5 mL) oral solution albuterol sulfate 2.5 mg/3 mL (0.083 %) solution for nebulization budesonide 0.5 mg/2 mL suspension for nebulization Certavite-Antioxidant 18 mg-400 mcg tablet ClearLax 17 gram/dose oral powder Current Illness: Right lung atelectasis/infiltrate with right mediastinal shift on chest x-ray (12/25) that was treated with steroids and antibiotics Preexisting Conditions: Chronic respiratory Failure Dependence on mechanical ventilation Seizure disorder Spastic quadriplegic cerebral palsy Encephalopathy Allergies: NKA Diagnostic Lab Data: 1/5/21 COVID PCR result: Positive CDC Split Type: Write-up: Administered first dose of COVID19 vaccine at 1:29pm on 1/4/21. At approximately 11:00pm resident exhibited acute respiratory decompensation with very limited air entry and hypoxemia. Patient received Benadryl, steroids, epinephrine, and Duoneb without improvement. Resident was referred to the emergency room and found to be COVID positive. No fever or rash were reported. |
|
VAERS ID: |
926611 (history) |
Form: |
Version 2.0 |
Age: |
16.0 |
Sex: |
Male |
Location: |
Missouri |
Vaccinated: |
2020-12-29 |
Onset: |
2021-01-06 |
Days after vaccination: |
8 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-07 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EL0140 / 1 |
RA / IM |
Administered by: Private Purchased by: ? Symptoms: Injection site rash, 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: Current Illness: Preexisting Conditions: Allergies: none Diagnostic Lab Data: CDC Split Type: Write-up: 1/6 a rash developed at the injection site and by 1/7 it had spread to the belly and chest. |
|
VAERS ID: |
930353 (history) |
Form: |
Version 2.0 |
Age: |
16.0 |
Sex: |
Female |
Location: |
Minnesota |
Vaccinated: |
2021-01-07 |
Onset: |
2021-01-08 |
Days after vaccination: |
1 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-08 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EK9231 / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Chest discomfort, Discomfort, Dyspnoea, Headache, Pain SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: Cardiac murmur LV non-compaction cardiomyopathy Allergies: Penicillin Diagnostic Lab Data: None ordered CDC Split Type: Write-up: Patient in clinic for chief complaint of possible side effect of the covid vaccine which she received yesterday. She states that she woke up at 0200 with chest tightness, achyness and headache. She rates the discomfort 7/10 last night and improved now to 5/10. She denies any worsening with any type of exertion and states that she can do simple things like take a shower, walk across the room, down the street or even stairs without any worsening. She denies any SOB or chest pain--just feels tight. Doesn''t feel like she can''t get a full breath or get the air out of her lungs either. She received her first of two doses of the Pfizer vaccine yesterday (4:23pm) and had no difficulty with the injection itself and then 9.5 hours later woke up from sleep with this chest tightness as well as achyness and headache. ?She states that she had the exact same symptoms when she had positive covid test back in August of this year with the addition of fatigue which lasted for 5 days. At that time it was not felt necessary to do any further testing nor treat with steroids according to cardiology. She does have history of LV non-compaction cardiomyopathy and her last visit with cardiology was about 2 years ago and she had a normal EKG and echo only showed "mild LV non compaction at the apex" at that time. He did not need to see her again until she is 18 unless she has problems. She states that she generally does very well and other than this tightness she does not have any other significant symptoms. |
|
VAERS ID: |
942502 (history) |
Form: |
Version 2.0 |
Age: |
17.0 |
Sex: |
Male |
Location: |
Oregon |
Vaccinated: |
2021-01-12 |
Onset: |
2021-01-13 |
Days after vaccination: |
1 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EL0142 / 1 |
LA / IM |
Administered by: Pharmacy Purchased by: ? Symptoms: Asthenia, Dizziness, Fatigue, Flushing, Hyperhidrosis SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (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: unknown Current Illness: none reported Preexisting Conditions: none reported Allergies: none reported Diagnostic Lab Data: n/a CDC Split Type: Write-up: Patient described rapid onset sweating and flushing. Said he felt light headed as well. Gave Benadryl 25 mg with continued observation for 30 minutes and he said he felt mostly better, but still tired and weak. Followed up next day and his mother said he was doing better. |
|
VAERS ID: |
946137 (history) |
Form: |
Version 2.0 |
Age: |
17.0 |
Sex: |
Male |
Location: |
California |
Vaccinated: |
2021-01-14 |
Onset: |
2021-01-14 |
Days after vaccination: |
0 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-14 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EL3302 / 1 |
LA / SYR |
Administered by: Private Purchased by: ? Symptoms: 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? Yes Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: HPV, 03/2015, fainted/vomited after hitting his head , 12 years old Other Medications: None Current Illness: None Preexisting Conditions: None Allergies: No allergies Tho a little milk sensitivity (lactose) Diagnostic Lab Data: None CDC Split Type: Write-up: Red rash appeared in both arms from shoulders to almost the elbows. No itching. Nurse gave Benadryl & Pepcid to slow symptoms. Rash went away within half an hour. No other symptoms. |
|
VAERS ID: |
950711 (history) |
Form: |
Version 2.0 |
Age: |
16.0 |
Sex: |
Female |
Location: |
California |
Vaccinated: |
2020-12-29 |
Onset: |
2021-01-15 |
Days after vaccination: |
17 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EL1284 / 1 |
- / SYR |
Administered by: Private Purchased by: ? Symptoms: Periorbital swelling, Pharyngeal swelling, Pruritus, Urticaria SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (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? No Hospitalized? No Previous Vaccinations: Other Medications: None Current Illness: None. Preexisting Conditions: None. Allergies: Yes, yesterday I broke into hives and right now my eyes are becoming puffy and my throat is swollen. The hives have disappeared when I woke up this morning. Diagnostic Lab Data: None. CDC Split Type: Write-up: Last night I broke out into a bunch of itchy spots that resemble hives all over my body. The hives went away in the morning. Just now, 3:57pm today, I have puffy eyes and a swollen throat. |
|
VAERS ID: |
950793 (history) |
Form: |
Version 2.0 |
Age: |
17.0 |
Sex: |
Male |
Location: |
New Mexico |
Vaccinated: |
2021-01-14 |
Onset: |
2021-01-16 |
Days after vaccination: |
2 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FFPHO / 1 |
LA / IM |
Administered by: School Purchased by: ? Symptoms: Axillary pain, Erythema, Nodule SMQs:, Anaphylactic reaction (broad), 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: None Current Illness: None Preexisting Conditions: None Allergies: None Diagnostic Lab Data: None CDC Split Type: Write-up: Red round bump under his left armpit that is painful to the touch Currently using Ibuprofen and ice packs to help |
|
VAERS ID: |
956925 (history) |
Form: |
Version 2.0 |
Age: |
14.0 |
Sex: |
Male |
Location: |
Georgia |
Vaccinated: |
2021-01-13 |
Onset: |
2021-01-19 |
Days after vaccination: |
6 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-19 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
026L20A / 1 |
RA / IM |
Administered by: Other Purchased by: ? Symptoms: Asthma, Chills, Pyrexia SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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? Yes ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Current Illness: none known at time of vaccine. Preexisting Conditions: Asthma. Allergies: none Diagnostic Lab Data: Chest X-ray showed congestion in the lungs. CDC Split Type: Write-up: The patient received the vaccine and did not have a reaction until Tuesdays the 19th. He had fever and chills. His grandfather signed the consent and told the nurse that he need to have the vaccine because he has asthma. The pediatrician increased his breathing treatment and prescribed antibiotics due to an upper respiratory infect that he had previously. He is now stable and remaining in the home. |
|
VAERS ID: |
968248 (history) |
Form: |
Version 2.0 |
Age: |
17.0 |
Sex: |
Male |
Location: |
New York |
Vaccinated: |
2021-01-21 |
Onset: |
2021-01-22 |
Days after vaccination: |
1 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EL3247 / 1 |
LA / IM |
Administered by: Public Purchased by: ? Symptoms: Eye pain, Eye swelling, Feeling abnormal SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Glaucoma (broad), 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: Abilify 20 mg Gabapentin Current Illness: NA Preexisting Conditions: NA Allergies: NA Diagnostic Lab Data: NA CDC Split Type: Write-up: At approximately 7:30 AM the following day, the patient woke up with the left eye being swollen and puffy as well as tender and slightly painful. Felt weird to blink but only in left eye. Took Acetaminophen 500mg and swelling decreased significantly around 2 hours later from the time it was first noticed. |
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