First Reports for Bivalent C19 Vaccine in VAERS
By Craig Paardekooper (17th September 2022 1:31 am)

15% of cases are serious. Compare this to Pfizer EN series where 14.5% were serious.. See
symptomfrequency3.pdf (howbad.info)

Cardiac Symptoms

Guillain Barre Syndrome

Chest Pain

7 cases

Pericarditis

3 cases

Electrocardiogram abnormal 2 cases
Heart rate increased

2 cases

Palpitations

2 cases

Arrhythmia

1 caseCardiac arrest

1 caseCardiac discomfort

1 caseCardiac Flutter

1 caseElectrocardiogram

1 caseHeart rate abnormal

1 caseHeart rate irregularities

1 casePericardial drainage

1 casePulse absent

1 caseTroponin

1 caseTroponin increased

1 caseInfections
COVID-19

7 cases

Sars Cov 2 Test Positive

6 cases

COVID 19 Pneumonia

1 caseOral Herpes

1 caseInfluenza like illness

2 cases

MiscellaneousDeath

4 casesAcute Kidney Injury

2 cases

1 caseRespiratory
Acute Respiratory Failure

1 caseRespiratory Arrest

1 caseRespiratory Distress1 casePainful Respiration

1 caseDyspnea

3 cases

Hypoxia

2 cases

Clots
Thrombosis

1 caseRetinal Hemorrhage

1 caseVenous Thrombosis

1 caseAnticoagulant therapy

1 caseMuscularTremor3 casesMuscular spasms

1 caseMuscular weakness

1 caseFatigue

14 cases

Arthralgia

7 cases

Mobility Decreased

5 cases

Gait disturbance

4 cases

Myalgia

4 casesLethargy

3 cases

Malaise2 casesMusculoskeletal stiffness

2 cases

Arthritis

1 caseHere is a table showing the frequency of symptoms found in the 106 reports following administration of the bivalent
COVID 19 booster by Moderna and Pfizer. I have highlighted ones that I consider to be serious. I count at least 32
very serious symptoms. The full table is shown on the next page.
HeadachePain
Pyrexia
Fatigue
ChillsDizziness
Arthralgia
Chest pain
COVID-19
Incorrect dose
administered
Incorrect productformulation
administered
NauseaPain in extremity
SARS-CoV-2 test
positive
VertigoAnxietyConfusional state
Extra dose
administered
Mobility decreased
Death
Fall
Gait disturbanceHyperhidrosis
Myalgia
No adverse event
SyncopeWrong productadministered
Asthenia
Blood test
Burning sensation
Decreased appetite
Dyspnoea
Injection site
erythema
Injection site pain
Injection site
swelling
Laboratory test
abnormalLethargy
Loss ofconsciousness

20
15
15
14
12
10
7
7
7

18.87
14.15%
14.15%
13.21%
11.32%
9.43%
6.60%
6.60%
6.60%

7

6.60%

7

6.60%

7
6

6.60%
5.66%

6

5.66%

6
5
5

5.66%
4.72%
4.72%

5

4.72%

5
4
4
4
4
4
4
4

4.72%
3.77%
3.77%
3.77%
3.77%
3.77%
3.77%
3.77%

4

3.77%

3
3
3
3
3

2.83%
2.83%
2.83%
2.83%
2.83%

3

2.83%

3

2.83%

3

2.83%

3

2.83%

3

2.83%

3

2.83%

Pericarditis
Pruritus
Sleep disorder
Syringe issue
Tinnitus
TremorUnderdose
Vomiting
White blood cellcount increased
Abdominal pain
Acute kidney injury
Back pain
Computerised
tomogram
abdomen abnormal
Condition
aggravatedCough
Depression
Diarrhoea
Dysstasia
Echocardiogram
Electrocardiogram
abnormal
Erythema
Facial pain
Heart rateincreased
Hypoxia
Immediate postinjection reaction
Influenza like illness
Injection site
warmthInsomnia
Lymphadenopathy
Lymph node pain
Magnetic resonanceimaging
MalaiseMusculoskeletal
stiffness
Palpitations
Paraesthesia
T-cellprolymphocytic
leukaemia

3
3
3
3
3
3
3
3

2.83%
2.83%
2.83%
2.83%
2.83%
2.83%
2.83%
2.83%

3

2.83%

2
2
2

1.89%
1.89%
1.89%

2

1.89%

2

1.89%

2
2
2
2
2

1.89%
1.89%
1.89%
1.89%
1.89%

2

1.89%

2
2

1.89%
1.89%

2

1.89%

2

1.89%

2

1.89%

2

1.89%

2

1.89%

2
2
2

1.89%
1.89%
1.89%

2

1.89%

2

1.89%

2

1.89%

2
2

1.89%
1.89%

2

1.89%

Ultrasoundabdomen abnormal
Unevaluable event
Unresponsive tostimuli
Vision blurred
Walking aid userWrong technique inproduct usage
process
Acute respiratory
failureAdrenal adenoma
Affect lability
Alcohol use
Amenorrhoea
Amnesia
Anal incontinence
Angina pectoris
Angioedema
Anticoagulant
therapy
Appendix disorder
Arrhythmia
Arthritis
Biopsy bonemarrow
Biopsy site
unspecified
abnormal
Biopsy skinabnormal
Blood creatinine
increased
Blood disorder
Blood sodiumincreased
Blood test
abnormalBody temperature
increased
Bone pain
Breast cancer
femaleC-reactive protein
Caffeine allergy
Cardiac arrest
Cardiac discomfort
Cardiac flutter
Cardiac stress test
Central venous
catheterisation

2

1.89%

2

1.89%

2

1.89%

2
2

1.89%
1.89%

2

1.89%

1

0.94%

1
1
1
1
1
1
1
1

0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%

1

0.94%

1
1
1

0.94%
0.94%
0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1
1
1
1
1
1

0.94%
0.94%
0.94%
0.94%
0.94%
0.94%

1

0.94%

Chest tube insertion
Chest X-ray
Choking
Cold sweat
Computerised
tomogram
COVID-19
pneumonia
Delusion
Device connection
issue
Disorientation
Drain placement
Drain removal
Dysphagia
Electrocardiogram
Electromyogram
Embolism venous
Emotional distress
Endotracheal
intubation
Epistaxis
Ex-alcohol user
Exercise tolerance
decreased
Eye movement
disorderEye pain
Fear
Feeling abnormal
Feeling cold
Feeling drunk
Feeling hot
Full blood countGait inability
Guillain-Barre
syndrome
Haematochezia
Haemodialysis
Haemodynamic
instability
HangoverHeart rateabnormalHeart rate irregularHepatic cyst
Hepatorenal
syndrome
Hot flush
Hypernatraemia
Hyperthyroidism
Hypoacusis

1
1
1
1

0.94%
0.94%
0.94%
0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1
1
1
1
1
1
1
1

0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%

1

0.94%

1
1

0.94%
0.94%

1

0.94%

1

0.94%

1
1
1
1
1
1
1
1

0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%

1

0.94%

1
1

0.94%
0.94%

1

0.94%

1

0.94%

1

0.94%

1
1

0.94%
0.94%

1

0.94%

1
1
1
1

0.94%
0.94%
0.94%
0.94%

Hypoaesthesia
Hypophagia
Impaired driving
ability
Impaired work
ability
Incorrect route ofproduct
administration
Induration
Influenza
Injection site
induration
Intensive careInterchange ofvaccine productsIntermenstrual
bleeding
Irritability
Limb discomfort
LipaseLip swelling
Loss of personal
independence indaily activities
Magnetic resonanceimaging heart
Mechanicalventilation
Menstruation
irregular
Mental statuschanges
Metabolic function
test
Migraine
Monoplegia
Muscle spasms
Muscular weakness
Mydriasis
Nasal congestion
Nasopharyngitis
Neuralgia
Obsessive thoughts
Oedema peripheral
Oral herpes
Oropharyngeal pain
Oxygen saturation
decreased
Painful respiration
Pain in jaw
Pallor

1
1

0.94%
0.94%

1

0.94%

1

0.94%

1

0.94%

1
1

0.94%
0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1
1
1
1

0.94%
0.94%
0.94%
0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1
1
1
1
1
1
1
1
1
1
1
1

0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%

1

0.94%

1
1
1

0.94%
0.94%
0.94%

Pancreatitis
Paranasal sinus
discomfort
Paranoia
Pericardial drainage
Peripheral swelling
Peroneal nerve
palsy
Photophobia
Platelet countPneumothorax
Posture abnormal
Product
administered topatient of
inappropriate age
Pulse absent
Pupil fixed
Rash
Rash erythematous
Rash macular
Respiratory arrest
Respiratory distressRespiratory tract
congestion
Retinalhaemorrhage
Rhinorrhoea
SARS-CoV-2
antibody test
SARS-CoV-2
antibody test
positive
SARS-CoV-2 test
negative
Secretion discharge
SeizureSensation of foreignbody
SepsisSexual dysfunction
Skin disorder
Skin lesion
Skin warm
Staphylococcal
bacteraemia
Swelling
Swollen tongue
T-lymphocyte countincreased
Tension headache
Thirst

1

0.94%

1

0.94%

1
1
1

0.94%
0.94%
0.94%

1

0.94%

1
1
1
1

0.94%
0.94%
0.94%
0.94%

1

0.94%

1
1
1
1
1
1
1

0.94%
0.94%
0.94%
0.94%
0.94%
0.94%
0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1

0.94%

1
1

0.94%
0.94%

1

0.94%

1
1
1
1
1

0.94%
0.94%
0.94%
0.94%
0.94%

1

0.94%

1
1

0.94%
0.94%

1

0.94%

1
1

0.94%
0.94%

Thrombocytopenia
Thrombosis
Tongue disorder
Trigeminal
neuralgia
Troponin
Troponin increased
UltrasoundabdomenUltrasound Doppler
Ultrasound kidney
Urine analysis
Urticaria
Venous thrombosis
Weight bearing
difficulty
Weight decreased
Wheelchair user
X-ray limb
abnormal

1
1
1

0.94%
0.94%
0.94%

1

0.94%

1
1

0.94%
0.94%

1

0.94%

1
1
1
1
1

0.94%
0.94%
0.94%
0.94%
0.94%

1

0.94%

1
1

0.94%
0.94%

1

0.94%

16 Serious Cases
VAERS ID:

2433664 (history)

Form:

Version 2.0

Age:

67.0

Sex:

FemaleLocation:

Michigan

Vaccinated:

2021-02-08

Onset:

2022-08-22

Days after vaccination: 560
Submitted:

0000-00-00

Entered:2022-09-08
Lot /
Dose

Site /Route

COVID19: COVID19 (COVID19(PFIZER-BIONTECH)) /PFIZER/BIONTECH

EL9269 /1-/-

COVID19: COVID19 (COVID19(PFIZER-BIONTECH)) /PFIZER/BIONTECH

EN6198/2-/-

COVID19: COVID19 (COVID19(PFIZER-BIONTECH)) /PFIZER/BIONTECH

FH8028/3-/-

COVID19-2: COVID19 (COVID19(PFIZER-BIONTECH BIVALENT)) /PFIZER/BIONTECH

FK9894/4-/-

Vaccination / Manufacturer

Administered by: Unknown
Purchased by: ?
Symptoms: COVID-19 pneumonia, Chest tube insertion,
Death, Dyspnoea, Endotracheal intubation,
Haemodynamic instability, Hypoxia, Mechanicalventilation, Oxygen saturation decreased, Pneumothorax,
Respiratory distress, SARS-CoV-2 antibody test, SARS-CoV2 antibody test positive
SMQs:, Anaphylactic reaction (broad), Angioedema(broad), Asthma/bronchospasm (broad), Acute central
respiratory depression (broad), Pulmonary hypertension(broad), Cardiomyopathy (broad), Eosinophilic pneumonia(broad), Hypersensitivity (broad), Respiratory failure(narrow), Drug reaction with eosinophilia and systemic
symptoms syndrome (broad), Infective pneumonia(narrow), Opportunistic infections (broad), COVID-19(narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2022-09-06
Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:Allergies:
Diagnostic Lab Data: 8/23/22 SARS-CoV-2 IgG (Anti-Spike)-- positive
CDC Split Type:
Write-up: 68y.o. female with PMH pertinent forseronegative RA on chronic prednisone recent COVID PNA
presented for worsening SOB. In the ER, patient was
hypoxic requiring HFNC 100% FiO2/50 L and anonrebreather maintaining SPO2 in the early 90s.
Significant increase in work of breathing. Patient was
intubated. On 8/28, the patient developed resp distress.
Patient had a needle decompression and then chest tube
placement for right sided tension pneumothorax. Patient
was unable to be weaned off ventilator and on 9/5 had adrop in SpO2 with increased WOB. Patient required
multiple pressors for hemodynamic instability. Patienttransitioned to comfort care, and passed peacefully thatevening.

VAERS ID: 2433672 (history)
Form:

Version 2.0

Age:

78.0

Sex:

Male

Location: Michigan
Vaccinated:

2021-02-13

Onset:

2022-08-23

Days after
vaccination:

556

Submitted:

0000-00-00

Entered:2022-09-08
Lot /
Dose

Site /Route

COVID19: COVID19(COVID19 (MODERNA)) /MODERNA

006M20A/1-/-

COVID19: COVID19(COVID19 (MODERNA)) /MODERNA

040A21A/2-/-

COVID19-2: COVID19(COVID19 (PFIZER-BIONTECH FF2593 /3
BIVALENT)) /PFIZER/BIONTECH-/-

Vaccination / Manufacturer

Administered by: Unknown
Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure,
Blood creatinine increased, Blood sodium increased, Body
temperature increased, COVID-19, Cardiac arrest,
Confusional state, Death, Embolism venous,
Hypernatraemia, Hypophagia, Laboratory test abnormal,
Mental status changes, Mydriasis, Pulse absent, Pupil
fixed, Respiratory arrest, SARS-CoV-2 test positive,
Staphylococcal bacteraemia, Troponin increased,
Unresponsive to stimuli, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad),
Rhabdomyolysis/myopathy (broad), Acute renal failure(narrow), Anaphylactic reaction (narrow),
Hyperglycaemia/new onset diabetes mellitus (broad),
Neuroleptic malignant syndrome (broad), Myocardial
infarction (narrow), Anticholinergic syndrome (broad),
Arrhythmia related investigations, signs and symptoms(broad), Retroperitoneal fibrosis (broad), Shockassociated circulatory or cardiac conditions (excl torsadede pointes) (narrow), Torsade de pointes, shockassociated conditions (broad), Hypovolaemic shockconditions (broad), Toxic-septic shock conditions (broad),Anaphylactic/anaphylactoid shock conditions (broad),
Hypoglycaemic and neurogenic shock conditions (broad),
Dementia (broad), Embolic and thrombotic events,
venous (narrow), Acute central respiratory depression(narrow), Guillain-Barre syndrome (broad), Noninfectious
encephalitis (broad), Noninfectious
encephalopathy/delirium (broad), Noninfectious
meningitis (broad), Cardiomyopathy (broad), Hypotonichyporesponsive episode (broad), Chronic kidney disease(broad), Hypersensitivity (broad), Tumour lysis syndrome(broad), Respiratory failure (narrow), Drug reaction witheosinophilia and systemic symptoms syndrome (narrow),
Hypoglycaemia (broad), Infective pneumonia (broad),
Dehydration (broad), Sepsis (broad), Opportunistic
infections (broad), COVID-19 (narrow), Noninfectious
myocarditis/pericarditis (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2022-08-31
Days after onset: 8Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:Allergies:
Diagnostic Lab Data: 8/23/22 SARS-COV-2 (COVID-19) by
NAA, Micro -- detected
CDC Split Type:
Write-up: 79y.o. male who presents with altered mental
status. Patient is a poor historian, majority of history istaken from wife over the phone. Patient tested positive
for covid on August 12, 2022 at his nursing home. Patient
has advanced dementia, not conversational at baseline.
He was living with his wife at home until August 1, 2022
when he moved into a nursing home. A few weeks ago,
he started having poor oral intake and worsening
confusion. In the EC, temp 102 degF, blood pressure
168/104, heart rate 134, respiratory rate 36, pulse ox 89%
on 6L nasal canula. Labs significant for sodium 162,
creatinine 3.07, troponin 0.11, WBC 19.6. COVID test
positive. Patient found to be in acute hypoxic respiratory
failure due to covid, MSSA bacteremia, VTE, AKI andhypernatremia. Family including wife and daughter,decided to transition patient to hospice care. Patient
assessed and unresponsive to verbal and tactile stimuli,
pulseless, respirations and heartsounds absent. Pupils
dilated, fixed, and unresponsive to light. Date and time ofdeath pronounced on 8/31/22 at 1600.

VAERS ID: 2427901 (history)
Form:

Version 2.0

Age:

51.0

Sex:

FemaleLocation: Unknown
Vaccinated:

2021-02-17

Onset:

2022-01-01

Days after
vaccination:

318

Submitted:

0000-00-00

Entered:2022-09-02

Vaccination / Manufacturer

Lot /
Dose

Site /Route

COVID19-2: COVID19(COVID19 (PFIZER-BIONTECHBIVALENT)) /PFIZER/BIONTECH

EN6200/2-/-

Administered by: Unknown
Purchased by: ?
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic
infections (broad), COVID-19 (narrow)Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2022-02-05
Days after onset: 35
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: pt passed away at home; she had a positive
COVID test on 1/27/22 from Lab.

VAERS ID: 2430015 (history)
Form:

Version 2.0

Age:

73.0

Sex:

Male

Location: Florida
Vaccinated:

2021-03-13

Onset:

2022-09-03

Days after
vaccination:

539

Submitted:

0000-00-00

Entered:2022-09-06
Vaccination / Manufacturer

Lot /
Dose

Site /Route

COVID19: COVID19(COVID19 (MODERNA)) /MODERNA

015M20 /- / IM
1

COVID19-2: COVID19(COVID19 (MODERNA
BIVALENT)) / MODERNA

030A21A/2

Administered by: Private
Purchased by: ?
Symptoms: Unevaluable event
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? Yes, 3 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Patient hospitalized.

- / IM

VAERS ID: 2433665 (history)
Form:

Version 2.0

Age:

59.0

Sex:

Male

Location: Michigan
Vaccinated:

2021-03-16

Onset:

2022-08-22

Days after
vaccination:

524

Submitted:

0000-00-00

Entered:2022-09-08

Vaccination / Manufacturer

Lot /
Dose

Site /Route

COVID19: COVID19 (COVID19(PFIZER-BIONTECH)) /PFIZER/BIONTECH

EP7534/1-/-

COVID19: COVID19 (COVID19(PFIZER-BIONTECH)) /PFIZER/BIONTECH

ER8729/2-/-

COVID19: COVID19 (COVID19(PFIZER-BIONTECH)) /PFIZER/BIONTECH

FF8839/3-/-

COVID19-2: COVID19(COVID19 (PFIZER-BIONTECHBIVALENT)) /PFIZER/BIONTECH

FJ9943/4-/-

Administered by: Unknown
Purchased by: ?
Symptoms: Acute kidney injury, Alcohol use, COVID-19,
Central venous catheterisation, Chest pain, Confusional
state, Dizziness, Ex-alcohol user, Haemodialysis,
Hepatorenal syndrome, Lethargy, SARS-CoV-2 test
positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal
failure (narrow), Hepatic failure, fibrosis and cirrhosis andother liver damage-related conditions (narrow),
Neuroleptic malignant syndrome (broad), Anticholinergic
syndrome (broad), Shock-associated circulatory or cardiac
conditions (excl torsade de pointes) (broad), Torsade depointes, shock-associated conditions (broad),
Hypovolaemic shock conditions (broad), Toxic-septic
shock conditions (broad), Anaphylactic/anaphylactoid
shock conditions (broad), Hypoglycaemic and neurogenic
shock conditions (broad), Dementia (broad), Embolic andthrombotic events, venous (narrow), Noninfectious
encephalitis (broad), Noninfectious
encephalopathy/delirium (broad), Noninfectious
meningitis (broad), Gastrointestinal nonspecificsymptoms and therapeutic procedures (broad),
Cardiomyopathy (broad), Vestibular disorders (broad),
Chronic kidney disease (narrow), Tumour lysis syndrome(broad), Drug reaction with eosinophilia and systemic
symptoms syndrome (broad), Hypoglycaemia (broad),
Infective pneumonia (broad), Dehydration (broad),
Opportunistic infections (broad), COVID-19 (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:
Current Illness:
Preexisting Conditions:Allergies:
Diagnostic Lab Data: 8/22/22 SARS-COV-2 (COVID-19) by
NAA, Micro -- detected
CDC Split Type:
Write-up: 61y.o. male who presents on 8/22 with historyof CABG, Hypertension, SBP, significant for alcoholic
cirrhosis complicated by ascites and hydrothorax, andend-stage renal disease requiring dialysis M W F,
presented to the ER from dialysis due to chest pain rightsided associated with dizziness. Found to be COVID
positive, no indication for Remdesivir. Remained inisolation for 10 days, isolation precautions are removed.
He reports that he began consuming alcohol in his 20s
until April 9, 2022, when he stopped consumption due tosymptoms. HRS with progressive AKI- initiated onhemodialysis July 8, 2022 -undergoing Intermittent HD 3 x
week MWF via RIJ permacath- under care of Dr Upon
exam, ptDiagnostic Lab Data: August 13 2021
CDC Split Type:
Write-up: I was rushed to hospital . Needed to be
operated on, I had pericarditis. They drained 1 litre ofwater from around my heart. I am still suffering on a daily
basis. Heart feels squeezed all the time. No breath, noenergy. Exhausted. Very stiff neck and lower back.

VAERS ID: 2433384 (history)
Form:

Version 2.0

Age:

68.0

Sex:

FemaleLocation: Unknown
Vaccinated:

2021-06-15

Onset:

2021-06-18

Days after
vaccination:

3

Submitted:

0000-00-00

Entered:2022-09-08

Vaccination / Manufacturer

Lot /
Dose

Site /Route

COVID19-2: COVID19(COVID19 (PFIZER-BIONTECHBIVALENT)) /PFIZER/BIONTECH

FA9093/ UNK-/-

Administered by: Unknown
Purchased by: ?
Symptoms: Asthenia, Cardiac discomfort, Dyspnoea,
Fatigue, Musculoskeletal stiffness, Pericardial drainage,
Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus
erythematosus (broad), Dystonia (broad), Parkinson-likeevents (broad), Acute central respiratory depression(broad), Pulmonary hypertension (broad), Guillain-Barre
syndrome (broad), Noninfectious encephalitis (broad),
Noninfectious meningitis (broad), Cardiomyopathy(broad), Chronic kidney disease (broad), Arthritis (broad),Drug reaction with eosinophilia and systemic symptoms
syndrome (broad), Immune-mediated/autoimmune
disorders (broad), Noninfectious myocarditis/pericarditis(narrow)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Crab

incidently when at emergency room at a local Hospital on
Oct. 20, 2021. Lab and blood tests showed blood counts
way off. White T cells extremely high. Oncologist gave myhusband the shocking news that day. Immunotherapy for
12 weeks via Hospital''s oncology clinic. Counts havebecome close to normal. Then, hopefully stem celltransplant in Oct if marrow biopsy he just had on Aug. 31
shows marrow is also now normal and healthy. Oct isplanned for mid Oct. He''ll be at the clinic for monrh thenmany followup and isolation at home to prevent infection
CDC Split Type:
Write-up: TPLL leukemia. Rare T cell blood disease

VAERS ID: 2428182 (history)
Form:

Version 2.0

Age:

72.0

Sex:

Male

Location: Rhode Island
Vaccinated:

2021-06-22

Onset:

2021-09-01

Days after
vaccination:

71

Submitted:

0000-00-00

Entered:2022-09-02

Vaccination / Manufacturer

Lot /
Dose

Site /Route

COVID19-2: COVID19(COVID19 (PFIZER-BIONTECHBIVALENT)) /PFIZER/BIONTECH

EW0181
/1

LA /
SYR

Administered by: Pharmacy
Purchased by: ?
Symptoms: Biopsy bone marrow, Blood disorder, Bloodtest abnormal, Laboratory test abnormal, T-cell
prolymphocytic leukaemia, T-lymphocyte countincreased, White blood cell count increased
SMQs:, Haematopoietic cytopenias affecting more than
one type of blood cell (broad), Neuroleptic malignant
syndrome (broad), Drug reaction with eosinophilia andsystemic symptoms syndrome (broad), Haematologicalmalignant tumours (narrow)Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omeprazole 20 mg tablets, tamsulisin.4 mg tablets, Centrum Silver, senna tabs, milk of
magnesia 1/8th cup at night, fiber tabs.
Current Illness: None
Preexisting Conditions: Acid reflux, enlarged prostate
Allergies: None
Diagnostic Lab Data: WBC severely elevated after 2 covid
shots to otherwise extremely healthy and fit 72 year old.
Husband worked out daily, ran Mike''s and achieved 2nd
degree black belt couple years ago. Leukemia discovered

and stress test.
CDC Split Type:
Write-up: Diagnosed with pericarditis. Intermittent chest
pain and a change in my EKG morphology led me to go
get seen by a cardiologist.

VAERS ID: 2431042 (history)
Form:

Version 2.0

Age:

25.0

Sex:

Male

Location: Arizona
Vaccinated:

2021-08-10

Onset:

2022-01-01

Days after
vaccination:

144

Submitted:

0000-00-00

Entered:2022-09-07

Vaccination / Manufacturer

Lot / Site /Dose Route

COVID19: COVID19 (COVID19(PFIZER-BIONTECH)) /PFIZER/BIONTECH

-/1

AR /
SYR

COVID19-2: COVID19 (COVID19(PFIZER-BIONTECH BIVALENT)) /PFIZER/BIONTECH

-/2

AR /
SYR

Administered by: Private
Purchased by: ?
Symptoms: Cardiac stress test, Chest pain,
Echocardiogram, Electrocardiogram abnormal,
Pericarditis
SMQs:, Systemic lupus erythematosus (broad),
Arrhythmia related investigations, signs and symptoms(broad), Gastrointestinal nonspecific symptoms andtherapeutic procedures (broad), Cardiomyopathy (broad),
Chronic kidney disease (broad), Drug reaction witheosinophilia and systemic symptoms syndrome (broad),
Immune-mediated/autoimmune disorders (broad),
Noninfectious myocarditis/pericarditis (narrow)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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: He had me do a 12 lead EKG, echo,

VAERS ID: 2434625 (history)
Form:

Version 2.0

Age:

65.0

Sex:

FemaleLocation: Michigan
Vaccinated:

2021-11-05

Onset:

0000-00-00

Submitted:

0000-00-00

Entered:2022-09-08

Vaccination / Manufacturer

Lot /
Dose

Site /Route

COVID19-2: COVID19 (COVID19 FF 8841,(PFIZER-BIONTECH BIVALENT)) FH 803 / - / IM
/ PFIZER/BIONTECH
2
Administered by: Pharmacy
Purchased by: ?
Symptoms: Adrenal adenoma, Fatigue, Hepatic cyst,
Magnetic resonance imaging, Myalgia, Platelet count,
Thrombocytopenia
SMQs:, Rhabdomyolysis/myopathy (broad), Liverneoplasms, benign (incl cysts and polyps) (narrow),
Haematopoietic thrombocytopenia (narrow), Systemic
lupus erythematosus (broad), Eosinophilic pneumonia(broad), Tendinopathies and ligament disorders (broad),Drug reaction with eosinophilia and systemic symptoms
syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications: Meloxicam, Levothyroxine , tumeric,norvasc, vitaminD3,
Current Illness: None
Preexisting Conditions: Osteo arthritis, hyptension,
hypothyroidism
Allergies: Demerol, iodine
Diagnostic Lab Data: July 2022, mRi, platelet count
CDC Split Type:
Write-up: Thrombocytopenia, liver cysts, adrenal
adenoma , severe fatigue since vax, muscle aches severe
since vax

VAERS ID: 2429558 (history)
Form:

Version 2.0

Age:

66.0

Sex:

Male

Location: Unknown
Vaccinated:

2021-11-28

Onset:

2022-02-03

Days after
vaccination:

67

Submitted:

0000-00-00

Entered:2022-09-06

Vaccination / Manufacturer

Lot /
Dose

COVID19-2: COVID19(COVID19 (PFIZER-BIONTECH 330308D/2
BIVALENT)) /PFIZER/BIONTECH

Site /
Route-/-

Administered by: Unknown
Purchased by: ?
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic
infections (broad), COVID-19 (narrow)Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2022-02-09
Days after onset: 6Permanent 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: pt had a positive COVID test on 2/3/22; pt diedat home; no medical records

Disease; Dystonia in Cervical Region
Allergies: Trees; Grass; Shrubs; Barium; Sudafed; Tylenol
with Codeine
Diagnostic Lab Data: Abdominal Ultra Sound, abnormal;
Blood panel
CDC Split Type: vsafe
Write-up: In January 2022 after the first booster I had ahead cold for about three weeks. I had a headache. I was
also exhausted and have been the same fatigue as oftoday. I also had back pain. In May I was in bed for threedays with back pain and abdominal pain. I went to the ER
and I learned it was my appendix. I was put into ICU
because I also had septicemia. They put drains in mybelly. They did not remove my appendix. I continued withdrainage tubes after returning home and had themremoved after about a week. I have been less functional
than normal since then. My knuckles hurt. My hip also
hurts so bad I can barely walk.

VAERS ID: 2433748 (history)
Form:

Version 2.0

Age:

53.0

Sex:

FemaleLocation: Oregon
Vaccinated:

2021-12-17

Onset:

2022-01-01

Days after
vaccination:

15

Submitted:

0000-00-00

Entered:2022-09-08
Lot /
Dose

Site /Route

COVID19-2: COVID19 (COVID19
2308D(PFIZER-BIONTECH BIVALENT))/3/ PFIZER/BIONTECH

RA /
IM

Vaccination / Manufacturer

Administered by: Pharmacy
Purchased by: ?
Symptoms: Abdominal pain, Appendix disorder,
Arthralgia, Back pain, Blood test, Drain placement, Drain
removal, Fatigue, Gait disturbance, Headache, Intensive
care, Loss of personal independence in daily activities,
Mobility decreased, Nasopharyngitis, Sepsis, Ultrasoundabdomen abnormal
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy(broad), Anticholinergic syndrome (broad),
Retroperitoneal fibrosis (broad), Dementia (broad),
Parkinson-like events (broad), Guillain-Barre syndrome(broad), Gastrointestinal nonspecific symptoms andtherapeutic procedures (narrow), Arthritis (broad),
Tendinopathies and ligament disorders (broad),
Hypoglycaemia (broad), Sepsis (narrow), Opportunistic
infections (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
Extended hospital stay? No
Previous Vaccinations: MMR, 12 years old, skin reaction,swelling in the face
Other Medications: Voltron; Flexeril; Zyrtec; Multi
Vitamin; Vitamin C; Afrin
Current Illness: N/A
Preexisting Conditions: Arthritis; Neurological Lyme

Diagnostic Lab Data:
CDC Split Type:
Write-up: Anxiety, Depression, Tingling sensation,
Emotional Distress, Loss of appetite, exercise, sex, weight
loss, Fatigue, inability to sleep, Blurry Vision, Chest pain,
Headache, & Migraines, unsteady when walking, worry,
intense fear, obsessive thoughts,

VAERS ID: 2433820 (history)
Form:

Version 2.0

Age:

66.0

Sex:

Male

Location: Unknown
Vaccinated:

2021-12-20

Onset:

2021-12-24

Days after
vaccination:

4

Submitted:

0000-00-00

Entered:2022-09-08
Vaccination / Manufacturer

Lot / Dose

Site /Route

COVID19-2: COVID19(COVID19 (PFIZERBIONTECH BIVALENT)) /PFIZER/BIONTECH

LOTFL3203
EXP 0 / UNK

LA /
SYR

Administered by: Pharmacy
Purchased by: ?
Symptoms: Anxiety, Chest pain, Decreased appetite,
Depression, Emotional distress, Exercise tolerance
decreased, Fatigue, Fear, Gait disturbance, Headache,
Insomnia, Migraine, Obsessive thoughts, Paraesthesia,
Sexual dysfunction, Vision blurred, Weight decreased
SMQs:, Peripheral neuropathy (broad),
Hyperglycaemia/new onset diabetes mellitus (broad),
Anticholinergic syndrome (broad), Parkinson-like events(broad), Guillain-Barre syndrome (broad), Gastrointestinal
nonspecific symptoms and therapeutic procedures(broad), Glaucoma (broad), Cardiomyopathy (broad), Lens
disorders (broad), Retinal disorders (broad), Depression(excl suicide and self injury) (narrow), Hypoglycaemia(broad), Sexual dysfunction (narrow)Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations:
Other Medications: METFORMIN PC, 500mg TAROSIMVASTATIN 20mg SDZ-TRAVOPROST OPHT 0.004%
Current Illness: Diabetic 2
Preexisting Conditions: No Chronic health conditions.
Allergies: Nothing Known

VAERS ID: 2434097 (history)
Form:

Version 2.0

Age:

70.0

Sex:

Male

Location: Pennsylvania
Vaccinated:2022-07-18

Onset:

2022-08-04

Days after
vaccination:

17

Submitted:

0000-00-00

Entered:2022-09-08

Vaccination / Manufacturer

Lot /
Dose

Site /Route

COVID19-2: COVID19(COVID19 (PFIZER-BIONTECHBIVALENT)) /PFIZER/BIONTECH

FM7553LA / IM/4

Administered by: Pharmacy
Purchased by: ?
Symptoms: Abdominal pain, Anal incontinence,
Anticoagulant therapy, Blood test, Computerised
tomogram abdomen abnormal, Confusional state, Fall,
Haematochezia, Hyperhidrosis, Pain, Thrombosis,
Ultrasound Doppler, Ultrasound abdomen abnormal,
Ultrasound kidney, Venous thrombosis
SMQs:, Acute pancreatitis (broad), Haemorrhage terms(excl laboratory terms) (narrow), Neuroleptic malignant
syndrome (broad), Anticholinergic syndrome (broad),
Retroperitoneal fibrosis (broad), Dementia (broad),
Embolic and thrombotic events, vessel type unspecified
and mixed arterial and venous (narrow), Embolic andthrombotic events, venous (narrow), Gastrointestinal
haemorrhage (narrow), Thrombophlebitis (broad),
Noninfectious encephalitis (broad), Noninfectious
encephalopathy/delirium (broad), Noninfectious
meningitis (broad), Accidents and injuries (narrow),
Gastrointestinal nonspecific symptoms and therapeutic
procedures (narrow), Ischaemic colitis (broad),
Noninfectious diarrhoea (broad), Hypoglycaemia (broad)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
Extended hospital stay? No

Previous Vaccinations:
Other Medications: Losartan; Potassium; Amlodipine;
Hydrochlorothiazide
Current Illness: N/A
Preexisting Conditions: High Blood Pressure
Allergies: N/A
Diagnostic Lab Data: CT Scan of abdomen, abnormal;
Ultrasound of Abdomen, Kidney, Aorta, unknown; Blood
Panel;CDC Split Type: vsafe
Write-up: I was on the golf course in August after playing
15 holes. I had been sweating but I was drinking plenty ofwater. I got to box 16 and fell to all fours. I was sweating
profusely. I asked to be helped back to the car so I could
get into the air condition. When we got to my car I
realized I was confused. I sat down on the ground for aminute. I lost control of my bowels. I cleaned up and got
into the car and cooled off and drove home. I got more
Gatorade and something to eat and I felt fine. I got home.
A few hours later I had another bowel movement that
was all blood. Another two hours went by and I went tobathroom again and it was all blood again. I went the ER
and the pain was so bad I was on all fours. It was
abdominal cramps. I had a CT scan and blood work. One
doctor told me I had diverticulosis. I was given Fentanyl
for pain. Went home and then I rested for a few hours
and then I had more abdominal pain and blood. I went
back to ER and was admitted. I had another scan and theyfound clots around my colon. They also saw a clot in avein from my heart to my liver. I have been a jogger all
my life.. They put me on Eliquis to prevent clots. I''ve
been fine ever since. I''ve been to several doctors and noone can tell me what caused the clots. I also saw agastroenterologist. I have an appointment with a vascular
doctor in a week or so as well as a hematologist. I also
saw an internal doctor at the hospital.

VAERS ID: 2433709 (history)
Form:

Version 2.0

Age:

60.0

Sex:

FemaleLocation: Florida
Vaccinated:2022-07-20

Onset:

2022-07-24

Days after
vaccination:

4

Submitted:

0000-00-00

Entered:2022-09-08

Vaccination / Manufacturer

COVID19-2: COVID19(COVID19 (PFIZER-BIONTECHBIVALENT)) /PFIZER/BIONTECH

Lot /
Dose

Site /
Route

hurt
Other Medications: Duloxitin, Cympalta, Sumatriptan,
Levothyroxin, Gabapentin
Current Illness: NO
Preexisting Conditions: Chronic Migranes, PTSD,
Depression, FIbromyalgia, Hypothyroid
Allergies: NO
Diagnostic Lab Data: EMG test, Blood work, MRI, CT scan
all done while I was admitted at the Clinic
CDC Split Type:
Write-up: It started fever imidiatley after vaccine, and 4days later I woke ip at 4 in the morning and my body wasjust numb, When I went to pull my legs over the side of
the bed I just fell straight to the floor. I had to crawl to myroommates door and can barely knot on his door for help.
EMS picked me up My right leg feels like a bag of cement
and pins and needles but my left leg is totally paralized
and now have dropped foot. Physical therapy gave a drop
foot support and can use a walker. I am trying to use acane but I can''t use a cane that well. I''m waiting to see if
i can get IgG injection done. I was admitted to the Clinic.
on 7/24/22 to 8/22/22 and diagnosed there by Dr. withGBS.

VAERS ID: 2429608 (history)
FJ4991LA / IM/3

Administered by: Pharmacy
Purchased by: ?
Symptoms: Blood test, Computerised tomogram,
Electromyogram, Fall, Gait inability, Guillain-Barre
syndrome, Hypoaesthesia, Immediate post-injection
reaction, Limb discomfort, Magnetic resonance imaging,
Mobility decreased, Monoplegia, Paraesthesia, Peroneal
nerve palsy, Pyrexia, Sleep disorder, Walking aid user
SMQs:, Peripheral neuropathy (narrow), Neuroleptic
malignant syndrome (broad), Anticholinergic syndrome(broad), Embolic and thrombotic events, vessel typeunspecified and mixed arterial and venous (narrow),
Dystonia (broad), Parkinson-like events (broad), GuillainBarre syndrome (narrow), Accidents and injuries(narrow), Demyelination (narrow), Conditions associatedwith central nervous system haemorrhages andcerebrovascular accidents (broad), Hypersensitivity(narrow), Tendinopathies and ligament disorders (broad),Drug reaction with eosinophilia and systemic symptoms
syndrome (broad), Immune-mediated/autoimmune
disorders (narrow), 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? Yes, 28 days
Extended hospital stay? No
Previous Vaccinations: flu shot malase and my arm would

Form:

Version 2.0

Age:

83.0

Sex:

FemaleLocation: Colorado
Vaccinated:2022-08-18

Onset:

2022-08-28

Days after
vaccination:

10

Submitted:

0000-00-00

Entered:2022-09-06

Vaccination / Manufacturer

Lot /
Dose

Site /Route

COVID19-2: COVID19(COVID19 (PFIZER-BIONTECHBIVALENT)) /PFIZER/BIONTECH

FP7139LA / IM/4

Administered by: Private
Purchased by: ?
Symptoms: Hypoxia
SMQs:, Asthma/bronchospasm (broad), Acute central
respiratory depression (broad), Pulmonary hypertension(broad), Eosinophilic pneumonia (broad), Respiratory
failure (broad), Infective pneumonia (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, 6 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Severe hypoxia requiring transfer back to
hospital.

Echocardiogram, CXR
CDC Split Type:
Write-up: Pericarditis, chest pain, fever, rigors, vomiting.
Treatment with NSAIDs. Cardiology consultation. Follow
up arranged with cardiology and Cardiac MRI

VAERS ID: 2428859 (history)
Form:

Version 2.0

Age:

20.0

Sex:

FemaleLocation: Washington
Vaccinated:2022-09-02

Onset:

2022-09-02

Days after
vaccination:

0

Submitted:

0000-00-00

Entered:2022-09-04
Vaccination / Manufacturer

COVID19-2: COVID19(COVID19 (MODERNA
BIVALENT)) / MODERNA

Lot /
Dose

Site /
Route051B22A/2- / IM

Administered by: Pharmacy
Purchased by: ?
Symptoms: C-reactive protein, Chest X-ray, Chest pain,
Chills, Echocardiogram, Electrocardiogram, Magnetic
resonance imaging heart, Pericarditis, Pyrexia, Troponin,
Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant
syndrome (broad), Systemic lupus erythematosus (broad),
Anticholinergic syndrome (broad), Gastrointestinal
nonspecific symptoms and therapeutic procedures(narrow), Cardiomyopathy (broad), Chronic kidneydisease (broad), Drug reaction with eosinophilia andsystemic symptoms syndrome (broad), Immunemediated/autoimmune disorders (broad), Noninfectious
myocarditis/pericarditis (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, 2 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications: Buspirone 15mg BID Divalproex
125mg BID Prazosin 2mg nightly
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Troponin, CRP, EKG,