VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1551235
Sex: F
Age: 69
State:

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: sore arm; sleepy; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 01-Feb-2021 and was forwarded to Moderna on 02-Feb-2021. This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of PAIN IN EXTREMITY (sore arm) and SOMNOLENCE (sleepy) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. No Medical History information was reported. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Jan-2021, the patient experienced PAIN IN EXTREMITY (sore arm) and SOMNOLENCE (sleepy). On 29-Jan-2021, PAIN IN EXTREMITY (sore arm) and SOMNOLENCE (sleepy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was reported. The treatment information was unknown. This case was linked to MOD-2021-022538 (E2B Linked Report). Most recent FOLLOW-UP information incorporated above includes: On 05-May-2021: Updated reporter and patient info. Dr listed in Initial SD is not primary reporter or husband; Sender's Comments: MOD-2021-022538:cross linked to "patient 2" (husband)

Other Meds:

Current Illness:

ID: 1551236
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: adverse reaction; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE REACTION (adverse reaction) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ADVERSE REACTION (adverse reaction). At the time of the report, ADVERSE REACTION (adverse reaction) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information was not provided. Concomitant medication was not provided. Reporter wife was fine. No major issues even after getting the second shot.

Other Meds:

Current Illness:

ID: 1551237
Sex: F
Age: 71
State: MS

Vax Date: 01/25/2021
Onset Date: 02/02/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of INJECTION SITE PAIN (injection site started hurting), ERYTHEMA (got red), SWELLING (swollen), PRURITUS (itchy) and INJECTION SITE INJURY (seems worse this morning) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 062G20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included LOSARTAN for an unknown indication. On 25-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, the patient experienced INJECTION SITE PAIN (injection site started hurting), ERYTHEMA (got red), SWELLING (swollen) and PRURITUS (itchy). On 03-Feb-2021, the patient experienced INJECTION SITE INJURY (seems worse this morning). At the time of the report, INJECTION SITE PAIN (injection site started hurting), ERYTHEMA (got red), SWELLING (swollen), PRURITUS (itchy) and INJECTION SITE INJURY (seems worse this morning) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment information was not provided. Concomitant medication includes OTC supplements.

Other Meds: LOSARTAN

Current Illness:

ID: 1551238
Sex: F
Age:
State: OH

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of RASH (Rash that covers torso of body/Rash that covers scalped), RASH PRURITIC (rash that itches) and HYPOACUSIS (Difficulty in hearing.) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. No medical history is provided and concomitant drugs are provided. Concomitant products included BISOPROLOL FUMARATE, HYDROCHLOROTHIAZIDE (BISOPROLOL HCT), CALCIUM and VITAMINS NOS for an unknown indication. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, the patient experienced RASH (Rash that covers torso of body/Rash that covers scalped), RASH PRURITIC (rash that itchies) and HYPOACUSIS (Difficulty in hearing.). At the time of the report, RASH (Rash that covers torso of body/Rash that covers scalped), RASH PRURITIC (rash that itchies) and HYPOACUSIS (Difficulty in hearing.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient took 2 Benadryl at 3 o?clock in the morning.

Other Meds: BISOPROLOL HCT; CALCIUM; VITAMINS NOS

Current Illness:

ID: 1551239
Sex: F
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Neckache; little dots on and around injection site 2-4 inches around; Aches; A spontaneous report was received from a Consumer concerning a 23-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events little dots on and around injection site 2-4 inches around(Injection site reaction), neckache(neck pain), aches(pain). The patient's medical history was not provided. No relevant concomitant medications were reported. On unknown date, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot batch: unknown) for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the events little dots on and around injection site 2-4 inches around . On an unknown date, the patient experienced the events neckache . On an unknown date, the patient experienced the events aches. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. On an unknown date the outcome of events include, little dots on and around injection site 2-4 inches around, neckache, aches was not reported.

Other Meds:

Current Illness:

ID: 1551240
Sex: U
Age: 63
State: FL

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: Nausea; fatigue; fever; pain at injection site; Headache; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (fatigue), PYREXIA (fever), VACCINATION SITE PAIN (pain at injection site), HEADACHE (Headache) and NAUSEA (Nausea) in a 63-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. No Medical History information was reported. On 20-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Jan-2021, the patient experienced FATIGUE (fatigue), PYREXIA (fever), VACCINATION SITE PAIN (pain at injection site) and HEADACHE (Headache). On 27-Jan-2021, the patient experienced NAUSEA (Nausea). On 23-Jan-2021, FATIGUE (fatigue) and PYREXIA (fever) had resolved. On 27-Jan-2021, HEADACHE (Headache) had resolved. On 29-Jan-2021, VACCINATION SITE PAIN (pain at injection site) had resolved. At the time of the report, NAUSEA (Nausea) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 26-Mar-2020, Coronavirus test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1551241
Sex: F
Age: 21
State: PA

Vax Date: 01/03/2021
Onset Date: 01/05/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: sore arm the next day; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm the next day) in a 21-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026L20A and 012M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported). On 03-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 05-Jan-2021, the patient experienced PAIN IN EXTREMITY (sore arm the next day). At the time of the report, PAIN IN EXTREMITY (sore arm the next day) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication was not provided. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1551242
Sex: F
Age:
State: CA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Pain in lower pelvis pain and crotch pain area worsened; Non-specific report of reaction to vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Pain in lower pelvis pain and crotch pain area worsened) and VACCINATION COMPLICATION (Non-specific report of reaction to vaccine) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025L20A) for COVID-19 vaccination. Concurrent medical conditions included Pelvic pain (Experiencing lower pelvic pain and crotch pain.) and Gallstones. Concomitant products included ACETYLSALICYLIC ACID, CAFFEINE, PARACETAMOL (EXCEDRIN [ACETYLSALICYLIC ACID;CAFFEINE;PARACETAMOL]), MULTIVITAMIN [VITAMINS NOS], CALCIUM and NAPROXEN for an unknown indication. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, the patient experienced PAIN (Pain in lower pelvis pain and crotch pain area worsened) and VACCINATION COMPLICATION (Non-specific report of reaction to vaccine). At the time of the report, PAIN (Pain in lower pelvis pain and crotch pain area worsened) and VACCINATION COMPLICATION (Non-specific report of reaction to vaccine) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Most recent FOLLOW-UP information incorporated above includes: On 21-Apr-2021:

Other Meds: EXCEDRIN [ACETYLSALICYLIC ACID;CAFFEINE;PARACETAMOL]; MULTIVITAMIN [VITAMINS NOS]; CALCIUM; NAPROXEN

Current Illness: Gallstones; Pelvic pain (Experiencing lower pelvic pain and crotch pain.)

ID: 1551243
Sex: F
Age:
State: MS

Vax Date: 01/15/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Tested positive for covid after receiving the first dose of the vaccine; This spontaneous case was reported by a pharmacist (subsequently medically confirmed) and describes the occurrence of SARS-COV-2 TEST POSITIVE (Tested positive for covid after receiving the first dose of the vaccine) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 immunisation. No Medical History information was reported. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced SARS-COV-2 TEST POSITIVE (Tested positive for covid after receiving the first dose of the vaccine). At the time of the report, SARS-COV-2 TEST POSITIVE (Tested positive for covid after receiving the first dose of the vaccine) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. This case was linked to MOD-2021-016742 (Patient Link).

Other Meds:

Current Illness:

ID: 1551244
Sex: F
Age: 25
State: OH

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: pain in her arm; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 03-Feb-2021 and was forwarded to Moderna on 03-Feb-2021. This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (pain in her arm) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) for COVID-19 vaccination. The patient's past medical history included No adverse reaction (No medical history reported.). Concomitant products included BISOPROLOL FUMARATE (ZEBETA) for an unknown indication. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Jan-2021, the patient experienced INJECTION SITE PAIN (pain in her arm). On 14-Jan-2021, INJECTION SITE PAIN (pain in her arm) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Jan-2021, COVID-19: positive positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.

Other Meds: ZEBETA

Current Illness:

ID: 1551245
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 01/27/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: 2 blotches 1.5 inches and a dime size; Tender to touch; Itching sensation; Burning sensation; paresthesia in both the hand and wrist in the opposing hand from injectionP; Arthritic pain awaken; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 31-Jan-2021 and was forwarded to Moderna on 01-Feb-2021. This spontaneous case was reported by a consumer and describes the occurrence of RASH MACULAR (2 blotches 1.5 inches and a dime size), TENDERNESS (Tender to touch), PRURITUS (Itching sensation), BURNING SENSATION (Burning sensation) and PARAESTHESIA (paresthesia in both the hand and wrist in the opposing hand from injectionP) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029K20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse event. On 30-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 27-Jan-2021, the patient experienced RASH MACULAR (2 blotches 1.5 inches and a dime size), TENDERNESS (Tender to touch), PRURITUS (Itching sensation), BURNING SENSATION (Burning sensation), PARAESTHESIA (paresthesia in both the hand and wrist in the opposing hand from injectionP) and ARTHRALGIA (Arthritic pain awaken). At the time of the report, RASH MACULAR (2 blotches 1.5 inches and a dime size), TENDERNESS (Tender to touch), PRURITUS (Itching sensation), BURNING SENSATION (Burning sensation), PARAESTHESIA (paresthesia in both the hand and wrist in the opposing hand from injectionP) and ARTHRALGIA (Arthritic pain awaken) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) and mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. Concomitant medication was not provided.

Other Meds:

Current Illness:

ID: 1551246
Sex: F
Age: 80
State: GA

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: fatigue; slowest down her brain again, hit her down/ it was not a dizziness, could hardly think; had to go to bed and could not get up that night; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of FEELING ABNORMAL (slowest down her brain again, hit her down/ it was not a dizziness, could hardly think), HYPERSOMNIA (had to go to bed and could not get up that night) and FATIGUE (fatigue) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026LC0A) for COVID-19 vaccination. The patient's past medical history included COVID-19 (had a very bad time, had to be hospitalized for 10 days because the virus affected her brain; she felt she could not think, or operate.) in July 2020. Concomitant products included PARACETAMOL (TYLENOL) for Arthritis, ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) and LEVOTHYROXINE SODIUM (SYNTHROID) for an unknown indication. On 20-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Jan-2021, the patient experienced FEELING ABNORMAL (slowest down her brain again, hit her down/ it was not a dizziness, could hardly think) and HYPERSOMNIA (had to go to bed and could not get up that night). On 23-Jan-2021, the patient experienced FATIGUE (fatigue). On 23-Jan-2021, FEELING ABNORMAL (slowest down her brain again, hit her down/ it was not a dizziness, could hardly think) outcome was unknown. At the time of the report, HYPERSOMNIA (had to go to bed and could not get up that night) and FATIGUE (fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications also included blood pressure medications and medication for bedtime. No treatment information was provided.

Other Meds: TYLENOL; ASPIRIN (E.C.); SYNTHROID

Current Illness:

ID: 1551247
Sex: F
Age: 83
State: MD

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: extreme weakness, almost fainted; severe nausea; intestinal episode, run to the bathroom; redness at the injection site; itching at the injection site; a little bit of soreness at the injection site; swelling at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (extreme weakness, almost fainted), NAUSEA (severe nausea), FUNCTIONAL GASTROINTESTINAL DISORDER (intestinal episode, run to the bathroom), VACCINATION SITE ERYTHEMA (redness at the injection site) and VACCINATION SITE SWELLING (swelling at the injection site) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025J20A and 030M/20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Hyperlipidemia in 1990. Concurrent medical conditions included Osteopenia in 1990, Joint pain in 1970 and Osteoarthritis. Concomitant products included CELECOXIB for Hyperlipidemia, PRAVASTATIN for Joint pain, CALCIUM CITRATE for Osteopenia, ACETYLSALICYLIC ACID (BABY ASPIRIN) and CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000) for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 22-Jan-2021, the patient experienced VACCINATION SITE SWELLING (swelling at the injection site) and VACCINATION SITE PAIN (a little bit of soreness at the injection site). On 29-Jan-2021, the patient experienced ASTHENIA (extreme weakness, almost fainted), NAUSEA (severe nausea), FUNCTIONAL GASTROINTESTINAL DISORDER (intestinal episode, run to the bathroom), VACCINATION SITE ERYTHEMA (redness at the injection site) and VACCINATION SITE PRURITUS (itching at the injection site). On 23-Jan-2021, VACCINATION SITE PAIN (a little bit of soreness at the injection site) had resolved. On 29-Jan-2021, ASTHENIA (extreme weakness, almost fainted), NAUSEA (severe nausea) and FUNCTIONAL GASTROINTESTINAL DISORDER (intestinal episode, run to the bathroom) had resolved. On 02-Feb-2021, VACCINATION SITE SWELLING (swelling at the injection site) and VACCINATION SITE PRURITUS (itching at the injection site) had resolved. At the time of the report, VACCINATION SITE ERYTHEMA (redness at the injection site) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Immediately following administration of the first dose of the Moderna Covid-19 vaccine on January 22, 2021, the patient experienced no signifiant symptoms - only minimal soreness and redness at the injection site which abated within 24 hours. One week later, at between 8:45 am and 9:00 am on the morning of January 29th , the patient experienced the first symptoms: intense itching, a circle of redness and induration/swelling that was "sore"/painful to touch around the vaccination site on my left arm. The red swollen area increased in size and by the end of the day encircled my upper arm. The itching, redness and swelling gradually diminished and by January 31st there was just a pale red area around the vaccination site which disappeared in a few more days. By about 10 am on the morning of January 29th I experienced other symptoms - I suddenly felt so weak as if I was about to faint and lay down to avoid falling. The patient remained lying there for about an hour when I felt my strength had returned. Within that hour I experienced intense nausea which abated by the time I felt strong enough/back to normal and resumed my normal activities as if nothing had happened. I had no other symptoms after that. I self administered benedryl topical ointment to the red itching area, but did not not seek medical attention at the time. The patient had a video appointent a few days laterwith my internist to describe what had happened. The patient was concerned whether the patient might have a more adverse reaction with the 2nd vaccine administration. She consulted with others and told me to go ahead with the 2nd vaccination. She prescribed EpiPen for me to have ready after my second vaccinatio appointment and advised that the patient wait longer than the prescribed 15 minutes, but the second Covid 19 vaccination was uneventful. Most recent FOLLOW-UP information incorporated above includes: On 21-Apr-2021: Medical history, concomitant medication and narrative had been updated.

Other Meds: PRAVASTATIN; CELECOXIB; BABY ASPIRIN; VITAMIN D 2000; CALCIUM CITRATE

Current Illness: Osteoarthritis

ID: 1551248
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: 2-week delayed reaction of extreme chiills; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (2-week delayed reaction of extreme chiills) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced CHILLS (2-week delayed reaction of extreme chiills). At the time of the report, CHILLS (2-week delayed reaction of extreme chiills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment and concomitant medications were not provided by reporter.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the onset date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1551249
Sex: F
Age:
State: NJ

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of DIZZINESS (lightheaded), TREMOR (uncontrollable shakiness), DECREASED APPETITE (loss of appetite), ABDOMINAL PAIN UPPER (stomach ache) and ARTHRALGIA (Arthritic pain and her joints were painful) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 26-Jan-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Jan-2021, the patient experienced DIZZINESS (lightheaded), TREMOR (uncontrollable shakiness), DECREASED APPETITE (loss of appetite), CHILLS (Chills) and NAUSEA (Nauseated). On 29-Jan-2021, the patient experienced ABDOMINAL PAIN UPPER (stomach ache), ARTHRALGIA (Arthritic pain and her joints were painful) and FATIGUE (tired). The patient was treated with IBUPROFEN at an unspecified dose and frequency. At the time of the report, DIZZINESS (lightheaded), TREMOR (uncontrollable shakiness), DECREASED APPETITE (loss of appetite), ABDOMINAL PAIN UPPER (stomach ache), ARTHRALGIA (Arthritic pain and her joints were painful), CHILLS (Chills), FATIGUE (tired) and NAUSEA (Nauseated) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment details included Ibuprofen. No relevant concomitant medications reported. Action taken with mRNA-1273 in response to the events was not applicable.

Other Meds:

Current Illness:

ID: 1551250
Sex: F
Age: 58
State: KS

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: face turned really red; lightheadedness on rising; see stars on rising; I had severe tremors; fatigue; A spontaneous report was received from a nurse concerning a 58-year-old, female patient who experienced the events of my face turned really red, fatigue, tremor, and lightheadedness on rising, I see stars on rising. The patient's medical history was not provided. Concomitant product use was not provided/unknown by the reporter. On 28 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (lot/batch: 043L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. Details of first dose of mRNA vaccine was not reported. On 28 Jan 2021, the patient experienced the events erythema, fatigue, dizziness, and tremor. The patient reported that her face and cheeks turned red, felt fatigue, felt lightheadedness on rising and had severe tremors in the night for 2 hours. Action taken with mRNA-1273 in response to the events was not applicable. The outcome of the events erythema, fatigue, dizziness, and tremor was resolved.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1551251
Sex: F
Age: 55
State: NY

Vax Date: 01/25/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Fever that went to 101F; Became tired; Shortness of breath; Pain from her head to her toes; Swelling below the injection site; A spontaneous report was received from a Healthcare Professional concerning a female patient who received Moderna's COVID-19 vaccine (mRNA-1273). The patient's medical history was not provided. No relevant concomitant medications were reported. On 25 Jan 2021, prior to the onset of the events the patient received their second of two planned doses of mRNA-1273 (lot/batch: 013L20A) intramuscularly in the left deltoid for prophylaxis of COVID-19 infection. On 25 Jan 2021, post vaccination over few days, she was tired, had fever that went up to 101 F and pain from her head to her toes, self treated with Tylenol and Motrin. She had an episode of shortness of breath and used two puffs of albuterol. She noticed swelling below the injection site around 10 cm x 5 cm. She reported no problems to her first shot. Action taken with mRNA-1273 in response to the events is not applicable. The outcome of events were not reported.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1551252
Sex: M
Age: 65
State: TX

Vax Date: 01/01/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Painful lymph nodes; lymph nodes are enlarged/swollen lymph nodes; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of LYMPH NODE PAIN (Painful lymph nodes) and LYMPHADENOPATHY (lymph nodes are enlarged/swollen lymph nodes) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced LYMPH NODE PAIN (Painful lymph nodes) and LYMPHADENOPATHY (lymph nodes are enlarged/swollen lymph nodes). At the time of the report, LYMPH NODE PAIN (Painful lymph nodes) and LYMPHADENOPATHY (lymph nodes are enlarged/swollen lymph nodes) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient noticed swelling under his arm on the second week after receiving the vaccine. Patient stated he visited a health care provider for the events, who confirmed swollen lymph nodes. Patient was then prescribed Levocet (levocetirizine) for treatment of events.

Other Meds:

Current Illness:

ID: 1551253
Sex: F
Age:
State: VA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: flu-llike symptoms; chills are uncontrollable; body is so sore; chills; muscle pain; aches; headache; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 27-Jan-2021 and was forwarded to Moderna on 01-Feb-2021. This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (chills), MYALGIA (muscle pain), PAIN (aches), HEADACHE (headache) and INFLUENZA LIKE ILLNESS (flu-llike symptoms) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for an unknown indication. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse event since an unknown date. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Jan-2021, the patient experienced CHILLS (chills), MYALGIA (muscle pain), PAIN (aches) and HEADACHE (headache). On 28-Jan-2021, the patient experienced INFLUENZA LIKE ILLNESS (flu-llike symptoms), CHILLS (chills are uncontrollable) and PAIN (body is so sore). At the time of the report, CHILLS (chills), MYALGIA (muscle pain), PAIN (aches), HEADACHE (headache), INFLUENZA LIKE ILLNESS (flu-llike symptoms), CHILLS (chills are uncontrollable) and PAIN (body is so sore) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Treatment information was not provided. Concomitant medication was not provided.

Other Meds:

Current Illness: No adverse event

ID: 1551254
Sex: M
Age: 96
State: TN

Vax Date: 01/02/2021
Onset Date: 02/01/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: 30 min of vertigo episode; Couldn't barely get to bed without falling/Felt like something was pulling him backwards; Arm was a little sore; Didn't sleep relaxed; This spontaneous case was reported by a consumer and describes the occurrence of VERTIGO (30 min of vertigo episode), ASTHENIA (Couldn't barely get to bed without falling/Felt like something was pulling him backwards), SLEEP DISORDER DUE TO GENERAL MEDICAL CONDITION, INSOMNIA TYPE (Didn't sleep relaxed) and VACCINATION SITE PAIN (Arm was a little sore) in a 96-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030L20A and 011G28) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure. Concomitant products included BENAZEPRIL HYDROCHLORIDE, HYDROCHLOROTHIAZIDE (BENAZEPRIL/HCTZ) for Blood pressure abnormal, METOPROLOL for an unknown indication. On 02-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 01-Feb-2021, the patient experienced SLEEP DISORDER DUE TO GENERAL MEDICAL CONDITION, INSOMNIA TYPE (Didn't sleep relaxed). On 02-Feb-2021, the patient experienced VERTIGO (30 min of vertigo episode), ASTHENIA (Couldn't barely get to bed without falling/Felt like something was pulling him backwards) and VACCINATION SITE PAIN (Arm was a little sore). On 03-Feb-2021, VACCINATION SITE PAIN (Arm was a little sore) had resolved. At the time of the report, VERTIGO (30 min of vertigo episode), ASTHENIA (Couldn't barely get to bed without falling/Felt like something was pulling him backwards) and SLEEP DISORDER DUE TO GENERAL MEDICAL CONDITION, INSOMNIA TYPE (Didn't sleep relaxed) outcome was unknown. No treatment medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 21-Apr-2021: The patient height, weight, concomitant medication was provided.

Other Meds: BENAZEPRIL/HCTZ; METOPROLOL

Current Illness: Blood pressure

ID: 1551255
Sex: F
Age:
State: NY

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: dry eyes; dry mouth; injection site is pink and hot; total lethargy; injection site is pink and hot; Headache; temperature of 101.5; This spontaneous case was reported by a consumer and describes the occurrence of DRY EYE (dry eyes), DRY MOUTH (dry mouth), VACCINATION SITE WARMTH (injection site is pink and hot), LETHARGY (total lethargy) and VACCINATION SITE ERYTHEMA (injection site is pink and hot) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included LISINOPRIL and PRAVASTATIN for an unknown indication. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Jan-2021, the patient experienced DRY EYE (dry eyes), DRY MOUTH (dry mouth), VACCINATION SITE WARMTH (injection site is pink and hot), LETHARGY (total lethargy), VACCINATION SITE ERYTHEMA (injection site is pink and hot), HEADACHE (Headache) and PYREXIA (temperature of 101.5). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, DRY EYE (dry eyes), DRY MOUTH (dry mouth), VACCINATION SITE WARMTH (injection site is pink and hot), LETHARGY (total lethargy), VACCINATION SITE ERYTHEMA (injection site is pink and hot) and HEADACHE (Headache) outcome was unknown and PYREXIA (temperature of 101.5) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 28-Jan-2021, Body temperature: 101.5 temperature of 101.5. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment details included Tylenol, Ice pack.

Other Meds: LISINOPRIL; PRAVASTATIN

Current Illness:

ID: 1551256
Sex: F
Age: 49
State: IL

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Neck pain; Elbow pain,Shoulder pain; This spontaneous case was reported by a consumer and describes the occurrence of NECK PAIN (Neck pain) and ARTHRALGIA (Elbow pain,Shoulder pain) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, the patient experienced NECK PAIN (Neck pain) and ARTHRALGIA (Elbow pain,Shoulder pain). At the time of the report, NECK PAIN (Neck pain) and ARTHRALGIA (Elbow pain,Shoulder pain) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitants or treatment medications were reported.

Other Meds:

Current Illness:

ID: 1551257
Sex: F
Age: 76
State:

Vax Date: 01/20/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm), VOMITING (vomiting), CHILLS (chills), NAUSEA (nausea) and HEADACHE (headache) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included ATORVASTATIN CALCIUM (LIPITOR) and VITAMINS NOS (DAILY VITAMINS) for an unknown indication. On 20-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (sore arm), VOMITING (vomiting), CHILLS (chills), NAUSEA (nausea) and HEADACHE (headache). At the time of the report, PAIN IN EXTREMITY (sore arm) had resolved and VOMITING (vomiting), CHILLS (chills), NAUSEA (nausea) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medications were reported.

Other Meds: LIPITOR; DAILY VITAMINS

Current Illness:

ID: 1551258
Sex: F
Age: 78
State: GA

Vax Date: 01/19/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Soreness; Migraine headaches; Dizziness; Panic attack; pain at the injection; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Soreness), MIGRAINE (Migraine headaches), DIZZINESS (Dizziness), PANIC ATTACK (Panic attack) and VACCINATION SITE PAIN (pain at the injection) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) for COVID-19 vaccination. The patient's past medical history included Panic attacks and Surgery (Minor surgery) on 18-Jan-2021. Concurrent medical conditions included Chronic migraine and Allergy (Allergic to nickel due to metal implant in heart). On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN (Soreness), MIGRAINE (Migraine headaches), DIZZINESS (Dizziness), PANIC ATTACK (Panic attack) and VACCINATION SITE PAIN (pain at the injection). At the time of the report, PAIN (Soreness) and VACCINATION SITE PAIN (pain at the injection) had resolved and MIGRAINE (Migraine headaches), DIZZINESS (Dizziness) and PANIC ATTACK (Panic attack) outcome was unknown. Unknown The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 04-Feb-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1551259
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: covid arm; I had a tennis-ball-sized circle a few inches below the injection; This spontaneous case was reported by a consumer and describes the occurrence of LIMB DISCOMFORT (covid arm) and INJECTION SITE REACTION (I had a tennis-ball-sized circle a few inches below the injection) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On an unknown date, the patient experienced LIMB DISCOMFORT (covid arm) and INJECTION SITE REACTION (I had a tennis-ball-sized circle a few inches below the injection). At the time of the report, LIMB DISCOMFORT (covid arm) and INJECTION SITE REACTION (I had a tennis-ball-sized circle a few inches below the injection) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1551260
Sex: F
Age: 56
State: CT

Vax Date: 01/30/2021
Onset Date: 02/01/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Stomach and Back has a red rash; It is itching; It is sore; This spontaneous case was reported by a consumer and describes the occurrence of RASH ERYTHEMATOUS (Stomach and Back has a red rash), PRURITUS (It is itching) and PAIN (It is sore) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 30-Jan-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Feb-2021, the patient experienced RASH ERYTHEMATOUS (Stomach and Back has a red rash), PRURITUS (It is itching) and PAIN (It is sore). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, RASH ERYTHEMATOUS (Stomach and Back has a red rash), PRURITUS (It is itching) and PAIN (It is sore) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No relevant concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1551261
Sex: F
Age: 70
State: VA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Sore arm; Stuffed-up nose, felt like it was full of cement; Throat was very dry; She felt like she was choking; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm), NASAL CONGESTION (Stuffed-up nose, felt like it was full of cement), DRY THROAT (Throat was very dry) and CHOKING SENSATION (She felt like she was choking) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. The patient's past medical history included Seasonal allergy. Concomitant products included METOPROLOL, AMLODIPINE BESILATE (NORVASC) and B & FOLIC for an unknown indication. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced PAIN IN EXTREMITY (Sore arm), NASAL CONGESTION (Stuffed-up nose, felt like it was full of cement), DRY THROAT (Throat was very dry) and CHOKING SENSATION (She felt like she was choking). At the time of the report, PAIN IN EXTREMITY (Sore arm), NASAL CONGESTION (Stuffed-up nose, felt like it was full of cement), DRY THROAT (Throat was very dry) and CHOKING SENSATION (She felt like she was choking) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds: METOPROLOL; NORVASC; B & FOLIC

Current Illness:

ID: 1551262
Sex: F
Age:
State: TX

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Tingling down her arm, in her finger and palm; Swelling; Redness; This spontaneous case was reported by a health care professional and describes the occurrence of PARAESTHESIA (Tingling down her arm, in her finger and palm), VACCINATION SITE SWELLING (Swelling) and VACCINATION SITE ERYTHEMA (Redness) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Jan-2021, the patient experienced VACCINATION SITE SWELLING (Swelling) and VACCINATION SITE ERYTHEMA (Redness). On 09-Jan-2021, the patient experienced PARAESTHESIA (Tingling down her arm, in her finger and palm). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event following immunisation, at an unspecified dose and frequency. On 23-Jan-2021, VACCINATION SITE SWELLING (Swelling) and VACCINATION SITE ERYTHEMA (Redness) had resolved. At the time of the report, PARAESTHESIA (Tingling down her arm, in her finger and palm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1551263
Sex: M
Age: 78
State: GA

Vax Date: 01/12/2021
Onset Date: 01/19/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: blood in nose; FEVER; arm hurt; Husband felt heart thump thump; This spontaneous case was reported by a consumer and describes the occurrence of EPISTAXIS (blood in nose), PYREXIA (FEVER), PAIN IN EXTREMITY (arm hurt) and HEART RATE INCREASED (Husband felt heart thump thump) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 (hospitalized and got pneumonia ,had blood clot) in November 2020. On 12-Jan-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) at an unspecified dose. On 19-Jan-2021, the patient experienced EPISTAXIS (blood in nose), PYREXIA (FEVER), PAIN IN EXTREMITY (arm hurt) and HEART RATE INCREASED (Husband felt heart thump thump). The patient was treated with CALCIUM CARBONATE (ANTACID [CALCIUM CARBONATE]) at an unspecified dose and frequency. At the time of the report, EPISTAXIS (blood in nose), PYREXIA (FEVER) and PAIN IN EXTREMITY (arm hurt) outcome was unknown and HEART RATE INCREASED (Husband felt heart thump thump) was resolving. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications was not reported . Patient took antacid and felt better.

Other Meds:

Current Illness:

ID: 1551264
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Reaction; A spontaneous report was received from a consumer concerning a female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced reaction. The patient's medical history was not provided. No relevant concomitant medications were reported. On unknown date, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot/batch: not reported) unknown route for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced a reaction. No treatment information was provided. Action taken with mRNA-1273 in response to the events was unknown. The outcome of event(s), reaction, was unknown.; Reporter's Comments: Very limited information regarding this event has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1551265
Sex: F
Age: 84
State: OH

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: has a huge circle on her arm 3 1/2 inches; itching; worm; red; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (worm), CONTUSION (has a huge circle on her arm 3 1/2 inches), VACCINATION SITE ERYTHEMA (red) and INJECTION SITE PRURITUS (itching) in an 84-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. No Medical History information was reported. On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Jan-2021, the patient experienced VACCINATION SITE WARMTH (worm) and VACCINATION SITE ERYTHEMA (red). On 31-Jan-2021, the patient experienced INJECTION SITE PRURITUS (itching). On an unknown date, the patient experienced CONTUSION (has a huge circle on her arm 3 1/2 inches). On 24-Jan-2021, VACCINATION SITE WARMTH (worm) had resolved. At the time of the report, CONTUSION (has a huge circle on her arm 3 1/2 inches) outcome was unknown and VACCINATION SITE ERYTHEMA (red) and INJECTION SITE PRURITUS (itching) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant medications was reported. No treatment information was provided

Other Meds:

Current Illness:

ID: 1551266
Sex: F
Age:
State: GA

Vax Date: 01/23/2021
Onset Date: 01/31/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: rash at the injection site; swelling; soreness; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (rash at the injection site), VACCINATION SITE SWELLING (swelling) and VACCINATION SITE PAIN (soreness) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030L20A and 030L20A) for COVID-19 vaccination. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID) and SIMVASTATIN for an unknown indication. On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Jan-2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 31-Jan-2021, the patient experienced VACCINATION SITE RASH (rash at the injection site), VACCINATION SITE SWELLING (swelling) and VACCINATION SITE PAIN (soreness). At the time of the report, VACCINATION SITE RASH (rash at the injection site), VACCINATION SITE SWELLING (swelling) and VACCINATION SITE PAIN (soreness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment details included Ice, Cortisone Cream

Other Meds: SYNTHROID; SIMVASTATIN

Current Illness:

ID: 1551267
Sex: M
Age: 78
State: GA

Vax Date: 01/12/2021
Onset Date: 01/19/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: A week later both had some blood in nose, fever, and arm hurt; A week later both had some blood in nose, fever, and arm hurt; A week later both had some blood in nose, fever, and arm hurt; Husband felt heart thump thump-took antacid felt better; This spontaneous case was reported by a consumer and describes the occurrence of EPISTAXIS (A week later both had some blood in nose, fever, and arm hurt), PAIN IN EXTREMITY (A week later both had some blood in nose, fever, and arm hurt), PYREXIA (A week later both had some blood in nose, fever, and arm hurt) and PALPITATIONS (Husband felt heart thump thump-took antacid felt better) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 and Pneumonia. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jan-2021, the patient experienced EPISTAXIS (A week later both had some blood in nose, fever, and arm hurt), PAIN IN EXTREMITY (A week later both had some blood in nose, fever, and arm hurt), PYREXIA (A week later both had some blood in nose, fever, and arm hurt) and PALPITATIONS (Husband felt heart thump thump-took antacid felt better). The patient was treated with CALCIUM CARBONATE (ANTACID [CALCIUM CARBONATE]) at a dose of UNK dosage form. At the time of the report, EPISTAXIS (A week later both had some blood in nose, fever, and arm hurt), PAIN IN EXTREMITY (A week later both had some blood in nose, fever, and arm hurt) and PYREXIA (A week later both had some blood in nose, fever, and arm hurt) outcome was unknown and PALPITATIONS (Husband felt heart thump thump-took antacid felt better) was resolving. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Had Covid-19 in November-was hospitalized- got pneumonia, had a blood clot. .

Other Meds:

Current Illness:

ID: 1551268
Sex: F
Age:
State: AL

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: warm; Swollen on the injection site (left arm); red (on the injection site); aching (on the injection site); This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (warm), VACCINATION SITE SWELLING (Swollen on the injection site (left arm)), VACCINATION SITE ERYTHEMA (red (on the injection site)) and VACCINATION SITE PAIN (aching (on the injection site)) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0113J0A) for COVID-19 vaccination. Concurrent medical conditions included AFib. Concomitant products included APIXABAN (ELIQUIS) for Atrial fibrillation. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Jan-2021, the patient experienced VACCINATION SITE WARMTH (warm), VACCINATION SITE SWELLING (Swollen on the injection site (left arm)), VACCINATION SITE ERYTHEMA (red (on the injection site)) and VACCINATION SITE PAIN (aching (on the injection site)). The patient was treated with KETOROLAC TROMETHAMINE (TORADOL) for Pain, at a dose of 1 dosage form. At the time of the report, VACCINATION SITE WARMTH (warm), VACCINATION SITE SWELLING (Swollen on the injection site (left arm)), VACCINATION SITE ERYTHEMA (red (on the injection site)) and VACCINATION SITE PAIN (aching (on the injection site)) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient was schedule 2nd dose on February 4 Treatment medication information included Antibiotics Most recent FOLLOW-UP information incorporated above includes: On 29-Jun-2021: TCR received contains No new Information; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds: ELIQUIS

Current Illness: AFib

ID: 1551269
Sex: F
Age:
State: TX

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: on/ off Jitteriness; injection site was hot; Injection site was sore, painful, tender; Fatigue; nausea but no vomiting; This spontaneous case was reported by a consumer and describes the occurrence of FEELING JITTERY (on/ off Jitteriness), INJECTION SITE WARMTH (injection site was hot), INJECTION SITE PAIN (Injection site was sore, painful, tender), FATIGUE (Fatigue) and NAUSEA (nausea but no vomiting) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, the patient experienced FEELING JITTERY (on/ off Jitteriness), INJECTION SITE WARMTH (injection site was hot), INJECTION SITE PAIN (Injection site was sore, painful, tender), FATIGUE (Fatigue) and NAUSEA (nausea but no vomiting). At the time of the report, FEELING JITTERY (on/ off Jitteriness), INJECTION SITE WARMTH (injection site was hot), INJECTION SITE PAIN (Injection site was sore, painful, tender), FATIGUE (Fatigue) and NAUSEA (nausea but no vomiting) outcome was unknown. No concomitant medications were provided. No treatment medication was provided.

Other Meds:

Current Illness:

ID: 1551270
Sex: F
Age:
State:

Vax Date: 02/02/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: strange side effect after her second dose; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE EVENT FOLLOWING IMMUNISATION (strange side effect after her second dose) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ADVERSE EVENT FOLLOWING IMMUNISATION (strange side effect after her second dose). At the time of the report, ADVERSE EVENT FOLLOWING IMMUNISATION (strange side effect after her second dose) outcome was unknown. No concomitants or treatment medications were reported.

Other Meds:

Current Illness:

ID: 1551271
Sex: F
Age: 73
State: OH

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Stomach Ache; Headache; Fatigue; pain in the injection site; chills; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (Stomach Ache), HEADACHE (Headache), FATIGUE (Fatigue), INJECTION SITE PAIN (pain in the injection site) and CHILLS (chills) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M2OA) for COVID-19 vaccination. No Medical History information was reported. On 01-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach Ache), HEADACHE (Headache), FATIGUE (Fatigue), INJECTION SITE PAIN (pain in the injection site) and CHILLS (chills). At the time of the report, ABDOMINAL PAIN UPPER (Stomach Ache), HEADACHE (Headache), FATIGUE (Fatigue), INJECTION SITE PAIN (pain in the injection site) and CHILLS (chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported by investigator No treatment medications provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 19-Apr-2021: Follow up received on 19apr2021, No new information

Other Meds:

Current Illness:

ID: 1551272
Sex: M
Age: 79
State: PA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe muscle weakness couldn't move arms nor legs; Loose palm movement; He has a super pubic tube and the bag wasn't very clean; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULAR WEAKNESS (Severe muscle weakness couldn't move arms nor legs), HYPOKINESIA (Loose palm movement) and CATHETER MANAGEMENT (He has a super pubic tube and the bag wasn't very clean) in a 79-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Jan-2021, the patient experienced MUSCULAR WEAKNESS (Severe muscle weakness couldn't move arms nor legs), HYPOKINESIA (Loose palm movement) and CATHETER MANAGEMENT (He has a super pubic tube and the bag wasn't very clean). On 30-Jan-2021, MUSCULAR WEAKNESS (Severe muscle weakness couldn't move arms nor legs) and HYPOKINESIA (Loose palm movement) had resolved. At the time of the report, CATHETER MANAGEMENT (He has a super pubic tube and the bag wasn't very clean) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Computerised tomogram: unknown (Inconclusive) Inconclusive. On an unknown date, Magnetic resonance imaging head: negative (Negative) Negative. On an unknown date, Magnetic resonance imaging heart: negative (Negative) Negative. On an unknown date, X-ray: unknown (Inconclusive) Inconclusive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication details was reported. No treatment medication details was reported. Most recent FOLLOW-UP information incorporated above includes: On 22-Apr-2021: NNI

Other Meds:

Current Illness:

ID: 1551273
Sex: F
Age: 93
State: WV

Vax Date: 01/01/2021
Onset Date: 01/02/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: went to bed early; woke up with severe diarrhea; nauseous; This spontaneous case was reported by a consumer and describes the occurrence of SLEEP DISORDER (went to bed early), DIARRHOEA (woke up with severe diarrhea) and NAUSEA (nauseous) in a 93-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012M20a and 023L20A) for COVID-19 vaccination. No Medical History information was reported. On 01-Jan-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form(s). On 02-Jan-2021, the patient experienced NAUSEA (nauseous). On an unknown date, the patient experienced SLEEP DISORDER (went to bed early) and DIARRHOEA (woke up with severe diarrhea). The patient was treated with LOPERAMIDE HYDROCHLORIDE (IMODIUM) ongoing since an unknown date for Diarrhea, at a dose of UNK dosage form. At the time of the report, SLEEP DISORDER (went to bed early), DIARRHOEA (woke up with severe diarrhea) and NAUSEA (nauseous) outcome was unknown. No concomitant medications were reported. Treatment medication included 2 doses of Immodium. Action taken with mRNA-1273 in response to the events was not applicable. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1551274
Sex: F
Age:
State: CA

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: fast breathing; fatigue; arm sorennes; left eyelid irritated; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm sorennes), EYELID IRRITATION (left eyelid irritated), RESPIRATORY RATE INCREASED (fast breathing) and FATIGUE (fatigue) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. No Medical History information was reported. On 31-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, the patient experienced PAIN IN EXTREMITY (arm sorennes), EYELID IRRITATION (left eyelid irritated) and FATIGUE (fatigue). On 02-Feb-2021, the patient experienced RESPIRATORY RATE INCREASED (fast breathing). At the time of the report, PAIN IN EXTREMITY (arm sorennes), EYELID IRRITATION (left eyelid irritated), RESPIRATORY RATE INCREASED (fast breathing) and FATIGUE (fatigue) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. concominant and treatment drugs were not provided. lab data and historical conditions were also not provided

Other Meds:

Current Illness:

ID: 1551275
Sex: M
Age: 78
State: CO

Vax Date: 01/22/2021
Onset Date: 01/27/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: red spot as big as a half dollar; itchy; swelling; redness at the site; This spontaneous case was reported by a consumer and describes the occurrence of RASH MACULAR (red spot as big as a half dollar), VACCINATION SITE PRURITUS (itchy), VACCINATION SITE ERYTHEMA (redness at the site) and VACCINATION SITE SWELLING (swelling) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. Concurrent medical conditions included Diabetes, Cholesterol and Arthritis. Concomitant products included ALLOPURINOL for Arthritis, ATORVASTATIN for Cholesterol, INSULIN DETEMIR (LEVEMIR) and SITAGLIPTIN PHOSPHATE (JANVIA) for Diabetes mellitus, CALCIUM and MULTIVITAMINS [VITAMINS NOS] for Supplementation therapy, HCTZ for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Jan-2021, the patient experienced VACCINATION SITE ERYTHEMA (redness at the site). On 30-Jan-2021, the patient experienced RASH MACULAR (red spot as big as a half dollar), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE SWELLING (swelling). The patient was treated with HYDROCORTISONE at a dose of UNK, tid. On 28-Jan-2021, VACCINATION SITE ERYTHEMA (redness at the site) had resolved. At the time of the report, RASH MACULAR (red spot as big as a half dollar), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE SWELLING (swelling) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: LEVEMIR; JANVIA; ATORVASTATIN; CALCIUM; MULTIVITAMINS [VITAMINS NOS]; ALLOPURINOL; HCTZ

Current Illness: Arthritis; Cholesterol; Diabetes

ID: 1551276
Sex: F
Age:
State: FL

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Headache/ shooting pains in head; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache/ shooting pains in head) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included PARACETAMOL (TYLENOL) for an unknown indication. On 03-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Feb-2021, the patient experienced HEADACHE (Headache/ shooting pains in head). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, HEADACHE (Headache/ shooting pains in head) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown.

Other Meds: TYLENOL

Current Illness:

ID: 1551277
Sex: F
Age: 65
State: TX

Vax Date: 01/03/2021
Onset Date: 01/11/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Warm to touch at the injection site; Itching at the injection site; Redness at the injection site; Muscle soreness at the injection site; This spontaneous case was reported by a nurse (subsequently medically confirmed) and describes the occurrence of VACCINATION SITE PRURITUS (Itching at the injection site), VACCINATION SITE WARMTH (Warm to touch at the injection site), VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE PAIN (Muscle soreness at the injection site) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 043L20A) for COVID-19 vaccination. No Medical History information was reported. On 03-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Jan-2021, the patient experienced VACCINATION SITE PRURITUS (Itching at the injection site), VACCINATION SITE WARMTH (Warm to touch at the injection site), VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE PAIN (Muscle soreness at the injection site). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) at a dose of UNK dosage form (used for first two days). At the time of the report, VACCINATION SITE PRURITUS (Itching at the injection site), VACCINATION SITE WARMTH (Warm to touch at the injection site), VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE PAIN (Muscle soreness at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication was not reported. The patient took Advil for the first two days.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1551278
Sex: M
Age: 76
State: OH

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Sweating; weakness; Chills; Low blood pressure of 100/51; This spontaneous case was reported by a consumer and describes the occurrence of HYPOTENSION (Low blood pressure of 100/51), HYPERHIDROSIS (Sweating), ASTHENIA (weakness) and CHILLS (Chills) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. The patient's past medical history included Hyperlipidemia in 1995 and Stroke (2 strokes) in 2010. Concurrent medical conditions included Blood pressure high since 1998, Diabetes since 2008, Benign prostatic hyperplasia (chronic condition worsening) since 1990 and Neuropathy (chronic condition worsening) since 2008. Concomitant products included TAMSULOSIN from 1990 to an unknown date, LISINOPRIL from 1998 to an unknown date, PRAVASTATIN SODIUM, GLIPIZIDE from 2008 to an unknown date, CARVEDILOL from 1998 to an unknown date, METFORMIN, CLOPIDOGREL, AMLODIPINE BESYLATE and CHONDROITIN SULFATE, GLUCOSAMINE (GLUCOSAMINE CHONDROITIN [CHONDROITIN SULFATE;GLUCOSAMINE]) for an unknown indication. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Jan-2021, the patient experienced HYPOTENSION (Low blood pressure of 100/51). On 30-Jan-2021, the patient experienced HYPERHIDROSIS (Sweating), ASTHENIA (weakness) and CHILLS (Chills). On 01-Feb-2021, HYPOTENSION (Low blood pressure of 100/51) had resolved. At the time of the report, HYPERHIDROSIS (Sweating), ASTHENIA (weakness) and CHILLS (Chills) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 29-Jan-2021, Blood glucose: 188 (Inconclusive) 188. On 29-Jan-2021, Blood pressure measurement: 100/51 (Low) 100/51 blood pressure has been going high and low and has not taken his BP medicines.. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. No treatment medication was taken. Patient stated that she didn't take blood pressure medication at that night. This case was linked to MOD-2021-082574 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 19-Apr-2021: Follow-up received on 19-Apr-2021. The patient provided his Race as White and Ethnicity as Not Hispanic or Latino. The patient provided Medical history details with High blood pressure and Diabetes as ongoing, Hyperlipidemia as no recent change in status of chronic condition, Benign Prostatic hyperplasia and Neuropathy as in worsening status of chronic condition and the patient also had 2 strokes in the past. The patient provided the second dose details. The patient also provided several concomitant medication details. The adverse event outcome of Low BP after first dose and second dose was recovered.

Other Meds: TAMSULOSIN; LISINOPRIL; PRAVASTATIN SODIUM; GLIPIZIDE; CARVEDILOL; METFORMIN; CLOPIDOGREL; AMLODIPINE BESYLATE; GLUCOSAMINE CHONDROITIN [CHONDROITIN SULFATE;GLUCOSAMINE]

Current Illness: Benign prostatic hyperplasia (chronic condition worsening); Blood pressure high; Diabetes; Neuropathy (chronic condition worsening)

ID: 1551279
Sex: F
Age: 120
State:

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: sore arm, even more today; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm, even more today) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. Concurrent medical conditions included Thyroid disorder and . Concomitant products included NICOTINIC ACID for an unknown indication. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, the patient experienced PAIN IN EXTREMITY (sore arm, even more today). At the time of the report, PAIN IN EXTREMITY (sore arm, even more today) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood cholesterol: not provided Not provided. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information not provided. Other Concomitant medications included Thyroid medicine and Cholesterol medicine.

Other Meds: NICOTINIC ACID

Current Illness: Thyroid disorder

ID: 1551280
Sex: F
Age: 44
State: OH

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: This spontaneous case was reported by a health care professional (subsequently medically confirmed) and describes the occurrence of HYPERHIDROSIS (insane sweating (No fever)), DIZZINESS (dizzy), PYREXIA (fever), CHILLS (chills) and HEADACHE (headache) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026L20A and 028L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No adverse event reported). On 01-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Feb-2021, the patient experienced DIZZINESS (dizzy) and PYREXIA (fever). On 03-Feb-2021, the patient experienced HYPERHIDROSIS (insane sweating (No fever)), CHILLS (chills) and HEADACHE (headache). At the time of the report, HYPERHIDROSIS (insane sweating (No fever)), DIZZINESS (dizzy), PYREXIA (fever), CHILLS (chills) and HEADACHE (headache) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1551281
Sex: M
Age: 65
State: TX

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: dizziness; body pains; fatigue; nausea; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizziness), FATIGUE (fatigue), PAIN (body pains) and NAUSEA (nausea) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 043l20a) for COVID-19 vaccination. No Medical History information was reported. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced DIZZINESS (dizziness), FATIGUE (fatigue), PAIN (body pains) and NAUSEA (nausea). At the time of the report, DIZZINESS (dizziness), FATIGUE (fatigue), PAIN (body pains) and NAUSEA (nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Treatment medication included advil.

Other Meds:

Current Illness:

ID: 1551282
Sex: F
Age:
State: FL

Vax Date: 01/05/2021
Onset Date: 02/03/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: ache; felt without energy; fever (101.2 F); This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever (101.2 F)), PAIN (ache) and ASTHENIA (felt without energy) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011L20A and 011L20A) for COVID-19 vaccination. Concurrent medical conditions included Cholesterol (No reported adverse event). On 05-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Feb-2021, the patient experienced PYREXIA (fever (101.2 F)), PAIN (ache) and ASTHENIA (felt without energy). At the time of the report, PYREXIA (fever (101.2 F)), PAIN (ache) and ASTHENIA (felt without energy) outcome was unknown. Concomitant medication included blood thinner medicine.. Treatment medication included Aspirin. Action taken with mRNA-1273 in response to the events was not applicable.

Other Meds:

Current Illness:

ID: 1551283
Sex: F
Age: 75
State: AZ

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: pain in opposite arm (right)/sore arm; disoriented; sweating; lethargy; headache; I had fatigue; chills; joint pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in opposite arm (right)/sore arm), DISORIENTATION (disoriented), HYPERHIDROSIS (sweating), LETHARGY (lethargy) and HEADACHE (headache) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Jan-2021, the patient experienced PAIN IN EXTREMITY (pain in opposite arm (right)/sore arm), DISORIENTATION (disoriented), HYPERHIDROSIS (sweating), LETHARGY (lethargy), HEADACHE (headache), FATIGUE (I had fatigue), CHILLS (chills) and ARTHRALGIA (joint pain). At the time of the report, PAIN IN EXTREMITY (pain in opposite arm (right)/sore arm), DISORIENTATION (disoriented), HYPERHIDROSIS (sweating), LETHARGY (lethargy), HEADACHE (headache), FATIGUE (I had fatigue), CHILLS (chills) and ARTHRALGIA (joint pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1551284
Sex: F
Age:
State: MA

Vax Date:
Onset Date:
Rec V Date: 08/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: she is extremely sick; abdominal pain/sharp pain; has severe headaches; nausea; got chills; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (she is extremely sick), ABDOMINAL PAIN (abdominal pain/sharp pain), HEADACHE (has severe headaches), NAUSEA (nausea) and CHILLS (got chills) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ILLNESS (she is extremely sick), ABDOMINAL PAIN (abdominal pain/sharp pain), HEADACHE (has severe headaches), NAUSEA (nausea) and CHILLS (got chills). At the time of the report, ILLNESS (she is extremely sick), ABDOMINAL PAIN (abdominal pain/sharp pain), HEADACHE (has severe headaches), NAUSEA (nausea) and CHILLS (got chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm