|
VAERS ID: |
1141441 (history) |
Form: |
Version 2.0 |
Age: |
5.25 |
Sex: |
Male |
Location: |
Florida |
Vaccinated: |
2021-03-19 |
Onset: |
2021-03-25 |
Days after vaccination: |
6 |
Submitted: |
0000-00-00 |
Entered: |
2021-03-28 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
- / UNK |
- / - |
Administered by: Other Purchased by: ? Symptoms: Diplopia, Eye pain, Laboratory test, Ocular discomfort, Ophthalmological examination, VIth nerve paralysis, Vision blurred SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad) Life Threatening? No Birth Defect? No Died? No Permanent Disability? Yes Recovered? No Office Visit? Yes ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: escitalopram Current Illness: none Preexisting Conditions: none Allergies: none Diagnostic Lab Data: Several eye exams performed by the aforementioned O.D. CDC Split Type: Write-up: Approximately 5-6 days after my vaccination I began to experience blurred vision. There was a feellng of pressure coming from my eyes. When both eyes were open I had double vision. If one eye was closed vision was more normal. Overall, vision was blurred and there was pain/discomfort in the eyes. On March 27 I went to the eye doctor After examining me he concluded I had experienced cranial nerve palsy in the sixth abducent nerve. It was my left eye that was affected. In my past, i have had two incidences of bells palsy and one incident of an ?eye stroke''. I am not diabetic. My bp and cholesterol are good. I tested negative for Lymes disease 2 years ago. |
|
VAERS ID: |
1314766 (history) |
Form: |
Version 2.0 |
Age: |
5.92 |
Sex: |
Male |
Location: |
Washington |
Vaccinated: |
2021-02-28 |
Onset: |
0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
2021-05-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
00821BA / 2 |
RL / IM |
Administered by: Work Purchased by: ? Symptoms: Balance disorder, Condition aggravated, Hypoacusis, Meniere's disease, Tinnitus, Vertigo SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Vestibular disorders (narrow) Life Threatening? No Birth Defect? No Died? No Permanent Disability? Yes Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: ckd - dialysis patient Allergies: none Diagnostic Lab Data: CDC Split Type: Write-up: Pre-existing tenitus, Meneirs''s Disease. These problems greatly exacerbated with 2nd vaccination?and contune to worsen. New "noises" within a week of vaccine not before heard (sounds like a gas generator next door and a flock of birds chirping). Also, marked decrease in hearing?voices poorly heard and distorted. Marked development of vertigo?loss of balance is alarming at times. |
|
VAERS ID: |
1410928 (history) |
Form: |
Version 2.0 |
Age: |
6.0 |
Sex: |
Male |
Location: |
Georgia |
Vaccinated: |
2021-02-04 |
Onset: |
2021-06-15 |
Days after vaccination: |
131 |
Submitted: |
0000-00-00 |
Entered: |
2021-06-18 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 2 |
RA / IM |
Administered by: Private Purchased by: ? Symptoms: Blood test, Chest X-ray, Chest pain, Electrocardiogram SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad) Life Threatening? Yes Birth Defect? No Died? No Permanent Disability? No Recovered? Yes Office Visit? Yes ER Visit? No ER or Doctor Visit? Yes Hospitalized? Yes, 2 days Extended hospital stay? No Previous Vaccinations: Other Medications: entresto, Nexium. Current Illness: eye infection pursuant to cataract surgery (2) Preexisting Conditions: CHF after MI on 6/9/2014 Allergies: sulfa based drugs. Bidil, Effient Diagnostic Lab Data: EKG, blood test, chest X-ray, etc... CDC Split Type: Write-up: Severe chest pains, very reminiscent to MI 7 years ago |
|
VAERS ID: |
1446386 (history) |
Form: |
Version 2.0 |
Age: |
11.0 |
Sex: |
Male |
Location: |
Washington |
Vaccinated: |
2021-06-29 |
Onset: |
2021-07-02 |
Days after vaccination: |
3 |
Submitted: |
0000-00-00 |
Entered: |
2021-07-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EW0198 / 2 |
UN / IM |
Administered by: Pharmacy Purchased by: ? Symptoms: Abdominal pain upper, Blood creatine phosphokinase MB increased, C-reactive protein increased, Chest discomfort, Chest pain, Electrocardiogram normal, Fatigue, Headache, Laboratory test, Pyrexia, Troponin increased, Wheezing SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Noninfectious myocarditis/pericarditis (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? Yes, 2 days Extended hospital stay? No Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: Troponin 7.09 ng/ml (7/2)-$g 6.549-$g 5.571-$g5.699-$g7.210 (7/3)-$g 5.621, CK-MB 45.4 ng/ml-$g 37.7, CRP 4.8 mg/dl-2.6, ECG normal x2 CDC Split Type: Write-up: 12 year old male here with chest pain following his second COVID-19 vaccine. At around noon on 6/29 he received his second Pfizer COVID-19 vaccine. The following day he was tired, had a headache, and stomach ache. Thursday at 2 am he felt "wheezy" and had a subjective fever. He woke up this morning just after midnight with central chest pain, and pressure that was 7/10. He was given ibuprofen and it improved to 5/10. His mother then took him to ED where labs were done and notable for an elevated troponin to 7.09. He was then sent here for further care. He was given a dose of Toradol and his pain resolved. Troponins were trended and stayed below 10, so he was not given IVIG or steroids. He remained asymptomatic and labs improved so he was discharged the day after admission. |
|
VAERS ID: |
1696757 (history) |
Form: |
Version 2.0 |
Age: |
11.0 |
Sex: |
Female |
Location: |
Georgia |
Vaccinated: |
2021-09-14 |
Onset: |
0000-00-00 |
Submitted: |
0000-00-00 |
Entered: |
2021-09-14 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FA6780 / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Product administered to patient of inappropriate age SMQs:, Medication errors (narrow) Life Threatening? No Birth Defect? No Died? Yes
Date died: 0000-00-00 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: Patient was 11 years old and 8 months at the time of vaccine No side effects noted. |
|
VAERS ID: |
1835404 (history) |
Form: |
Version 2.0 |
Age: |
5.0 |
Sex: |
Male |
Location: |
Indiana |
Vaccinated: |
2021-10-04 |
Onset: |
2021-10-04 |
Days after vaccination: |
0 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-02 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
- / - |
Administered by: Pharmacy Purchased by: ? Symptoms: Adverse drug reaction, Cardiac disorder, Heart rate increased, Off label use, Pyrexia, Wrong product administered SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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? Yes, ? days Extended hospital stay? No Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Medical History/Concurrent Conditions: Tachycardia Allergies: Diagnostic Lab Data: Test Name: heartbeat increased; Result Unstructured Data: Test Result:rapid heartbeat out of proportion to age and level; Comments: rapid heartbeat out of proportion to age and level of exertion CDC Split Type: USPFIZER INC202101318718 Write-up: Heart Complications; dealing with some adverse symptoms; a rapid heartbeat out of proportion to age and level of exertion; fever; Went for their flu shot but instead got the Pfizer Covid vaccine; Went for their flu shot but instead got the Pfizer Covid vaccine; This is a spontaneous report from a contactable consumer (parent) and a Pfizer-sponsored program. A 5-year-old patient of an unspecified gender received BNT162B2 (COMIRNATY; Solution for injection; Lot number: Unknown), via an unspecified route of administration as DOSE 1, SINGLE on 04Oct2021 at afternoon time (at the age of 5-year-old) for COVID-19 immunisation at pharmacy. Patient''s medical History (including any illness at time of vaccination) included had patient tachycardia. There were no concomitant medications. No history of all previous immunization with the Pfizer vaccine considered as suspect. Caller was a 35-year-old male and wife (29 years old) with 2 children (4 years old male and 5 years old). Caller called because him, his wife, his 4-year-old, and his 5-year-old child all went to get the flu vaccine but were given doses of the Pfizer COVID-19 Vaccine instead on 04Oct2021. Their two children were mistakenly given the COVID-19 vaccine instead of a flu shot a week ago at their local pharmacy and they are now dealing with some adverse symptoms. a rapid heartbeat out of proportion to age and level of exertion. The children have been taken to a paediatric cardiologist, and the family was told both are showing signs of heart issues, since last week, the family now says the patient had developed a fever. Seriousness criteria was assessed as hospitalization for Heart Complications. The caller and his wife had already received both doses last Apr2021 of the Pfizer COVID-19 Vaccine before. Both children, were given full adult doses of the Pfizer COVID-19 Vaccine. Caller declined to provide initials, date of birth, sex, height, weight, or ethnicity of the patient and HCP information. Caller states his wife was better at keeping up with that information than he was. Stated that he just wanted to provide information on the other child due to the other child''s symptoms. Caller stated that he has been trying to get the Lot number from the pharmacy. The patient underwent lab tests and procedures which included Heart rate increased as rapid heartbeat out of proportion to age and level of exertion. Caller denied any other medications, medical conditions, labs, testing, or treatments relevant to report for this child. The outcome of events was reported as unknown. The lot number for (BNT162B2), was not provided and will be requested during follow-up. Follow-up (12Oct2021, 14Oct2021,18Oct2021): New information received from a contactable consumer. This consumer (Father) reported for a 5-year-old male patient that: Clinical course updated. New event fever was added. Medical history updated (tachycardia). lab tests added. |
|
VAERS ID: |
1849514 (history) |
Form: |
Version 2.0 |
Age: |
11.0 |
Sex: |
Female |
Location: |
Massachusetts |
Vaccinated: |
2021-11-06 |
Onset: |
2021-11-06 |
Days after vaccination: |
0 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-07 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / 1 |
RA / IM |
Administered by: Pharmacy Purchased by: ? Symptoms: Deafness, Fall, Fatigue, Hypoaesthesia, Loss of consciousness, Screaming, Seizure SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Sexual dysfunction (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? Yes, ? days Extended hospital stay? No Previous Vaccinations: UNKOWN, PARENT DID NOT SPECIFY Other Medications: UNKNOWN, NOT SPECIFIED BY PARENT Current Illness: NONE REPORTED BY PARENT Preexisting Conditions: NONE REPORTED BY PARENT Allergies: NONE REPORTED BY PARENT Diagnostic Lab Data: EMERGENCY SERVICE CALLED AND PT WAS HOSPITALIZED. CDC Split Type: Write-up: PATIENT COMPLAINED TO PARENT THAT SHE COULDN''T HEAR ANYTHING, THAT SHE COULDN''T "FEEL HER EARS" WITHIN 5 MIN AFTER BEING VACCINATED. PT SOON AFTER BECAME UNSCONSCIOUS AND FELL ON THE FLOOR. RPH WAS CALLED TO THE SITE AT THIS TIME. PT GAINED CONSCIOUSNESS ~2-5 MIN AFTER RPH WAS PRESENT. PT THEN HAD A SEIZURE THAT LASTED ABOUT 5 MIN; PT WAS SCREAMING, ASKING MOM "TO MAKE IT STOP." SHE LATER FELT BETTER BUT WAS FEELING TIRED. |
|
VAERS ID: |
1850103 (history) |
Form: |
Version 2.0 |
Age: |
8.0 |
Sex: |
Male |
Location: |
Unknown |
Vaccinated: |
2021-11-05 |
Onset: |
2021-11-05 |
Days after vaccination: |
0 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-08 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 1 |
AR / IM |
Administered by: Unknown Purchased by: ? Symptoms: Abdominal pain, Abdominal tenderness, Blood lactic acid, C-reactive protein normal, Carbon dioxide decreased, Computerised tomogram abdomen normal, Full blood count normal, Metabolic function test, Nausea, Ultrasound abdomen normal, Urine analysis normal SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (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? Yes, ? days Extended hospital stay? No Previous Vaccinations: Other Medications: Ritalin, Guanfacine Current Illness: None reported Preexisting Conditions: Failure to thrive with PEG tube, ADHD, acid reflux Allergies: NKA Diagnostic Lab Data: Ultrasound and CT abdomen without appendicitis or other acute abnormalities. CMP with CO2 of 18. Normal lactic acid, CRP, UA, CBC. CDC Split Type: Write-up: Severe abdominal pain that progressed over 2 days following vaccination. Periumbilical in location. Worse after any food or drinking. Associated with nausea but no vomiting. No fever. Fluctuating time course with pain free intervals lasting seconds to minutes with times of pain lasting seconds to minutes. Tender in umbilical region on exam without features of acute abdomen. |
|
VAERS ID: |
1854420 (history) |
Form: |
Version 2.0 |
Age: |
7.0 |
Sex: |
Female |
Location: |
California |
Vaccinated: |
2021-11-04 |
Onset: |
2021-11-05 |
Days after vaccination: |
1 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5127 / 1 |
RA / IM |
Administered by: Private Purchased by: ? Symptoms: Acute respiratory failure, Blood culture negative, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Cough, Culture negative, Echocardiogram normal, Endotracheal intubation, Enterovirus test positive, Human rhinovirus test positive, Hypoxia, Intensive care, Lung consolidation, Lung opacity, Mechanical ventilation, Productive cough, Respiratory tract congestion, Skin discolouration, Sputum discoloured, Unresponsive to stimuli SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad) 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: Took eucalyptus syrup the day after vaccine. None before Current Illness: None Preexisting Conditions: Autism Deafness Cochlear implant in place Allergies: None Diagnostic Lab Data: Respiratory panel + for rhinovirus/enterovirus. Cultures of blood and secretions are negative. CXRs with bilateral ground glass opacities and CT with consolidation (11/6). No evidence of pulmonary embolism. Echocardiogram normal (11/7). Patient has been seen by ID and Pulmonology Services. Testing for TB (quantiferon) and Coccidioidomycosis are pending. She will undergo bronchoscopy 11/9 for concern for alveolar hemorrhage. CDC Split Type: Write-up: Patient received vaccine in afternoon 11/4. At 2300 on 11/5, developed some congestion and an acute coughing episode productive of pinkish phlegm. Family gave some eucalyptus syrup which she was able to swallow. Cough suddenly stopped at which point patient became nonresponsive with color change. 911 called, brought to Medical Center. Noted to be hypoxic and have barking cough. Developed acute hypoxemic respiratory failure requiring emergency intubation and she was transferred to Medical Center where she has remained on a ventilator. |
|
VAERS ID: |
1861598 (history) |
Form: |
Version 2.0 |
Age: |
7.0 |
Sex: |
Male |
Location: |
Virginia |
Vaccinated: |
2021-11-09 |
Onset: |
2021-11-09 |
Days after vaccination: |
0 |
Submitted: |
0000-00-00 |
Entered: |
2021-11-11 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
FK5618 / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Aortic valve incompetence, Borrelia test negative, Cardiac valve disease, Cardiogenic shock, Echocardiogram, Echocardiogram abnormal, Ejection fraction decreased, Hypotension, Left ventricular dysfunction, Lung assist device therapy, Mitral valve incompetence, Pericardial effusion, Respiratory viral panel, SARS-CoV-2 antibody test negative, Systolic dysfunction, Tachycardia, Tricuspid valve incompetence, Viral test negative SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad), COVID-19 (broad), Noninfectious myocarditis/pericarditis (broad) Life Threatening? Yes Birth Defect? No Died? No Permanent Disability? No Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? Yes, 2 days Extended hospital stay? No Previous Vaccinations: Other Medications: Tylenol, motrin, zyrtec, zofran, miralax Current Illness: Yes, abdominal pain preceded the vaccination on 11/5 and diarrhea on 11/7. He had increased fatigue/lethargy prior to receiving the vaccine. Preexisting Conditions: none Allergies: None Diagnostic Lab Data: Initial TTE - 11/10/21 Summary * Structurally normal heart. * Moderate tricuspid regurgitation. * Moderate mitral regurgitation. * Normal RV pressures based on TR jet velocity and septal contour. * Normal LV size and wall thickness though moderately depressed systolic function (mmode SF 26%, mmode EF 49%, 2D EF 42%, Bullet EF 42%). * Trivial pericardial effusion posteriorly, along RV free wall. Echo 11/11/21 - Summary * Patient with history of ECMO placement (November 10, 2021). Transesophageal echocardiogram to evaluate ECMO cannulae. * Globally qualitatively severely depressed biventricular systolic function. * Aortic cannula tip is in mid ascending aorta. * Trivial+ aortic insufficiency. * Moderate mitral valve regurgitation from central coaptation defect. * Venous cannula tip in the RA and IVC junction. 11/10/21 - SARS-CoV-2 antibodies negative; Respiratory panel negative; Lyme screen negative CDC Split Type: Write-up: About 3 hours after receiving the vaccine, he presented in cardiogenic shock with tachycardia and hypotension. He was found to have severe LV dysfunction and is currently on ECMO. I would like to stress that he did have symptoms preceding receiving the vaccine, but felt that given the clinical decompensation that it should be reported and investigated. |
|