VAERS 2021 Database www.vaers.hhs.gov

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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: 1551635
Sex: F
Age:
State: IN

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: broke out with itchy hives/hives on thighs, buttocks, legs, seat and back; broke out with itchy hives/hives on thighs, buttocks, legs, seat and back; This spontaneous case was reported by a nurse and describes the occurrence of URTICARIA (broke out with itchy hives/hives on thighs, buttocks, legs, seat and back) and PRURITUS (broke out with itchy hives/hives on thighs, buttocks, legs, seat and back) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. The patient's past medical history included Mononucleosis (At age 21 (broke out in a fine red rash).). Concurrent medical conditions included Penicillin allergy. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Jan-2021, the patient experienced URTICARIA (broke out with itchy hives/hives on thighs, buttocks, legs, seat and back). On an unknown date, the patient experienced PRURITUS (broke out with itchy hives/hives on thighs, buttocks, legs, seat and back). At the time of the report, URTICARIA (broke out with itchy hives/hives on thighs, buttocks, legs, seat and back) and PRURITUS (broke out with itchy hives/hives on thighs, buttocks, legs, seat and back) was resolving. 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 medications included topical calming cream. Most recent FOLLOW-UP information incorporated above includes: On 20-Apr-2021: Mailing address updated.

Other Meds: DULCOLAX [BISACODYL]

Current Illness: Penicillin allergy

ID: 1551636
Sex: F
Age:
State: MD

Vax Date: 01/25/2021
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: Pain in the arm; Pain in left side of the pelvis area; Pain in the hips joints and left side of pelvis area; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain in the arm), PELVIC PAIN (Pain in left side of the pelvis area) and ARTHRALGIA (Pain in the hips joints and left side of pelvis area) in an 84-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025520A) for COVID-19 vaccination. No Medical History information was reported. On 25-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 (Pain in the arm), PELVIC PAIN (Pain in left side of the pelvis area) and ARTHRALGIA (Pain in the hips joints and left side of pelvis area). At the time of the report, PAIN IN EXTREMITY (Pain in the arm) had resolved and PELVIC PAIN (Pain in left side of the pelvis area) and ARTHRALGIA (Pain in the hips joints and left side of pelvis area) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were provided by the reporter.

Other Meds:

Current Illness:

ID: 1551637
Sex: F
Age:
State:

Vax Date:
Onset Date:
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: Fever; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PYREXIA (Fever). At the time of the report, PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were provided by the reporter.

Other Meds:

Current Illness:

ID: 1551638
Sex: F
Age: 69
State:

Vax Date: 01/19/2021
Onset Date: 01/19/2021
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: Sore arm; This spontaneous case was reported by a nurse and describes the occurrence of PAIN IN EXTREMITY (Sore arm) in a 69-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 19-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 PAIN IN EXTREMITY (Sore arm). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. On 21-Jan-2021, PAIN IN EXTREMITY (Sore arm) had resolved. 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 relevant concomitant medications were reported. This case was linked to MOD-2021-020650 (Patient Link).

Other Meds:

Current Illness:

ID: 1551639
Sex: F
Age: 70
State: GA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: blood sugar level was 40 mg/dL; little soreness in the left arm; This spontaneous case was reported by a consumer and describes the occurrence of HYPOGLYCAEMIA (blood sugar level was 40 mg/dL) and VACCINATION SITE PAIN (little soreness in the left arm) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. Concurrent medical conditions included Addison's disease, Hashimoto's disease, Pernicious anemia and Juvenile diabetes. Concomitant products included HYDROCORTISONE (CORTEF [HYDROCORTISONE]) for Addison's disease, LEVOTHYROXINE SODIUM (SYNTHROID) for Hashimoto's disease, INSULIN DEGLUDEC (TRESIBA) and INSULIN ASPART (NOVOLOG) for Juvenile diabetes, Injectable B-12 for Pernicious anemia. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced VACCINATION SITE PAIN (little soreness in the left arm). On 05-Feb-2021, the patient experienced HYPOGLYCAEMIA (blood sugar level was 40 mg/dL). At the time of the report, HYPOGLYCAEMIA (blood sugar level was 40 mg/dL) outcome was unknown and VACCINATION SITE PAIN (little soreness in the left arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medications were reported.

Other Meds: TRESIBA; NOVOLOG; CORTEF [HYDROCORTISONE]; SYNTHROID; Injectable B-12

Current Illness: Addison's disease; Hashimoto's disease; Juvenile diabetes; Pernicious anemia

ID: 1551640
Sex: M
Age:
State: FL

Vax Date: 01/21/2021
Onset Date: 02/20/2021
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: cramps in stomach; Slept most of the day; bowel movement at 3am; felt nauseous; Very tired; had the chills; threw up; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (cramps in stomach), SOMNOLENCE (Slept most of the day), BOWEL MOVEMENT IRREGULARITY (bowel movement at 3am), NAUSEA (felt nauseous) and FATIGUE (Very tired) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012L20A and 010M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included PREDNISONE, THYROID (ARMOUR THYROID), RIVASTIGMINE, ZINC, FISH OIL (OMEGA3 JACK), DIOSMIN, HESPERIDIN (FLAVONID), MONTELUKAST SODIUM (ADKAST), DONEPEZIL and SIMVASTATIN for an unknown indication, ABC COMPLETE SENIOR 50+. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 20-Feb-2021, the patient experienced ABDOMINAL PAIN UPPER (cramps in stomach), SOMNOLENCE (Slept most of the day), BOWEL MOVEMENT IRREGULARITY (bowel movement at 3am), NAUSEA (felt nauseous), FATIGUE (Very tired), CHILLS (had the chills) and VOMITING (threw up). At the time of the report, ABDOMINAL PAIN UPPER (cramps in stomach), SOMNOLENCE (Slept most of the day), BOWEL MOVEMENT IRREGULARITY (bowel movement at 3am), NAUSEA (felt nauseous), FATIGUE (Very tired), CHILLS (had the chills) and VOMITING (threw up) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medications were provided by the reporter. This case was linked to MOD-2021-021461 (Patient Link).

Other Meds: PREDNISONE; ARMOUR THYROID; RIVASTIGMINE; ABC COMPLETE SENIOR 50+; ZINC; OMEGA3 JACK; FLAVONID; ADKAST; DONEPEZIL; SIMVASTATIN

Current Illness:

ID: 1551641
Sex: M
Age:
State: WA

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: mild case of diarrhea; pain at injection site; stomach ache; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (stomach ache), DIARRHOEA (mild case of diarrhea) and INJECTION SITE PAIN (pain at injection site) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 01M20A) for an unknown indication. Concomitant products included FLUOXETINE HYDROCHLORIDE (PROZAC) 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 ABDOMINAL PAIN UPPER (stomach ache). On an unknown date, the patient experienced DIARRHOEA (mild case of diarrhea) and INJECTION SITE PAIN (pain at injection site). The patient was treated with BISMUTH SUBSALICYLATE (PEPTO BISMOL [BISMUTH SUBSALICYLATE]) for Adverse event, at an unspecified dose and frequency and CHARCOAL ACTIVATED for Adverse event, at an unspecified dose and frequency. At the time of the report, ABDOMINAL PAIN UPPER (stomach ache), DIARRHOEA (mild case of diarrhea) and INJECTION SITE PAIN (pain at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Birth control medication was reported as concomitant.

Other Meds: PROZAC

Current Illness:

ID: 1551642
Sex: F
Age: 69
State: WA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
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: Not feeling good; Headache; Itchy arm; It was all red at injection site/an eight-inch red area at injection site.; Left arm was v sore; Swelled arm; Having difficulty walking due to muscle fatigue; She can barely lift it; Muscle fatigue; Slept all day; This spontaneous case was reported by a consumer and describes the occurrence of GAIT DISTURBANCE (Having difficulty walking due to muscle fatigue), LIMB DISCOMFORT (She can barely lift it), MUSCLE FATIGUE (Muscle fatigue), SOMNOLENCE (Slept all day) and MALAISE (Not feeling good) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced GAIT DISTURBANCE (Having difficulty walking due to muscle fatigue), LIMB DISCOMFORT (She can barely lift it), MUSCLE FATIGUE (Muscle fatigue), SOMNOLENCE (Slept all day), VACCINATION SITE SWELLING (Swelled arm) and VACCINATION SITE PAIN (Left arm was v sore). On 25-Jan-2021, the patient experienced VACCINATION SITE PRURITUS (Itchy arm) and VACCINATION SITE ERYTHEMA (It was all red at injection site/an eight-inch red area at injection site.). On an unknown date, the patient experienced MALAISE (Not feeling good) and HEADACHE (Headache). At the time of the report, GAIT DISTURBANCE (Having difficulty walking due to muscle fatigue), LIMB DISCOMFORT (She can barely lift it), MUSCLE FATIGUE (Muscle fatigue), SOMNOLENCE (Slept all day), VACCINATION SITE SWELLING (Swelled arm) and VACCINATION SITE PAIN (Left arm was v sore) had resolved, MALAISE (Not feeling good) and HEADACHE (Headache) outcome was unknown and VACCINATION SITE PRURITUS (Itchy arm) and VACCINATION SITE ERYTHEMA (It was all red at injection site/an eight-inch red area at injection site.) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient post receiving their first dose of vaccine 1st shot and on the next day their left arm was very sore and could barely lift it. The patient reported that they slept whole day, had muscle fatigue which lasted for a week due to which the patient was having difficulty in walking. The patient also experienced swelled arm which went away and on day 11, the patient had itchy arm and it was all red at injection site and was still not going away. On 24-Jun-2021 the patient reported that the patient had an eight-inch red area at the injection site. No Concomitant product use was reported. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 22-Apr-2021: Follow-up was received on 22-Apr-2021 and contains non significant information. On 24-Jun-2021: Follow-up was received on 24-Jun-2021. Updated the event verbatim of the event Vaccination site erythema.

Other Meds:

Current Illness:

ID: 1551643
Sex: F
Age: 67
State: FL

Vax Date: 01/28/2021
Onset Date: 01/29/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache; Nausea; Body aches; Chills; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache), MYALGIA (Body aches), CHILLS (Chills) and NAUSEA (Nausea) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. No Medical history information was provided by the reporter. Concomitant products included CALCIUM for Bone density increased, GABAPENTIN (NEURONTIN) for Headache, LEVOTHYROXINE, FISH OIL, COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) and VITAMIN B COMPLEX for an unknown indication. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jan-2021, the patient experienced MYALGIA (Body aches) and CHILLS (Chills). On 30-Jan-2021 at 2:30 AM, the patient experienced HEADACHE (Headache) and NAUSEA (Nausea). On 31-Jan-2021, HEADACHE (Headache), MYALGIA (Body aches) and CHILLS (Chills) had resolved. On 11-Apr-2021, NAUSEA (Nausea) had resolved. 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. Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: follow up received on 29-apr-2021:containes no new information On 06-May-2021: The follow up case received on 06-MAY-2021. Concomitant indications, dosage and start date were added. Lab test is added.

Other Meds: LEVOTHYROXINE; NEURONTIN; CALCIUM; FISH OIL; VITAMIN D [COLECALCIFEROL]; VITAMIN B COMPLEX

Current Illness:

ID: 1551644
Sex: F
Age: 69
State: FL

Vax Date: 01/28/2021
Onset Date: 02/04/2021
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: warm to the touch; felt very tired; little swelling and redness at the injection site; little swelling and redness at the injection site; Big rash which grew twice in size overnight.; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 22-Feb-2021 and was forwarded to Moderna on 23-Feb-2021. This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of VACCINATION SITE WARMTH (warm to the touch), VACCINATION SITE RASH (Big rash which grew twice in size overnight.), FATIGUE (felt very tired), VACCINATION SITE ERYTHEMA (little swelling and redness at the injection site) and VACCINATION SITE SWELLING (little swelling and redness at the injection site) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012M20A and 013M20A) for COVID-19 vaccination. Concurrent medical conditions included Bee sting. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Feb-2021, the patient experienced VACCINATION SITE RASH (Big rash which grew twice in size overnight.). On an unknown date, the patient experienced VACCINATION SITE WARMTH (warm to the touch), FATIGUE (felt very tired), VACCINATION SITE ERYTHEMA (little swelling and redness at the injection site) and VACCINATION SITE SWELLING (little swelling and redness at the injection site). The patient was treated with METHYLPREDNISOLONE for Rash, at a dose of 4 mg. On 16-Feb-2021, VACCINATION SITE RASH (Big rash which grew twice in size overnight.) had resolved. At the time of the report, VACCINATION SITE WARMTH (warm to the touch), FATIGUE (felt very tired), VACCINATION SITE ERYTHEMA (little swelling and redness at the injection site) and VACCINATION SITE SWELLING (little swelling and redness at the injection site) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) dosing remained unchanged. Concomitant product use was not provided. Most recent FOLLOW-UP information incorporated above includes: On 13-May-2021: Additional AEs, medication taken, pt initial, 2nd dose information added

Other Meds:

Current Illness: Bee sting

ID: 1551645
Sex: M
Age:
State:

Vax Date:
Onset Date: 02/03/2021
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: Bubbles of water pumping up in the hands and body; This spontaneous case was reported by a consumer and describes the occurrence of BLISTER (Bubbles of water pumping up in the hands and body) in a 39-year-old male patient 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) (Intramuscular) 1 dosage form. On 03-Feb-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced BLISTER (Bubbles of water pumping up in the hands and body). At the time of the report, BLISTER (Bubbles of water pumping up in the hands and body) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were provided by the reporter.

Other Meds:

Current Illness:

ID: 1551646
Sex: F
Age:
State: TX

Vax Date: 02/13/2021
Onset Date: 02/13/2021
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: body aches; severly tire; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (body aches) and FATIGUE (severly tire) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, the patient experienced PAIN (body aches) and FATIGUE (severly tire). The patient was treated with ACETAMINOPHEN for Adverse event, at an unspecified dose and frequency. At the time of the report, PAIN (body aches) and FATIGUE (severly tire) outcome was unknown. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1551647
Sex: F
Age:
State: SC

Vax Date: 02/10/2021
Onset Date: 02/17/2021
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: itchy rash; red splody rash; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE ERYTHEMA (red splody rash) and RASH PRURITIC (itchy rash) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029K20A) for COVID-19 vaccination. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID) for an unknown indication. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Feb-2021, the patient experienced INJECTION SITE ERYTHEMA (red splody rash). On 23-Feb-2021, the patient experienced RASH PRURITIC (itchy rash). The patient was treated with CORTISONE at a dose of cream. On 19-Feb-2021, INJECTION SITE ERYTHEMA (red splody rash) had resolved. At the time of the report, RASH PRURITIC (itchy rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medications included Ice.

Other Meds: SYNTHROID

Current Illness:

ID: 1551648
Sex: F
Age: 57
State: CA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Sweating; Body aches; chills; slight arm soreness; little fever/had low grade fever 100/102.7; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (Sweating), PYREXIA (little fever/had low grade fever 100/102.7), PAIN (Body aches), CHILLS (chills) and VACCINATION SITE PAIN (slight arm soreness) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029LL0A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included LISINOPRIL, LEVOTHYROXINE and ALENDRONATE SODIUM (ALENDRONATE) for an unknown indication. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Jan-2021, the patient experienced PYREXIA (little fever/had low grade fever 100/102.7) and VACCINATION SITE PAIN (slight arm soreness). On 22-Jan-2021, the patient experienced HYPERHIDROSIS (Sweating), PAIN (Body aches) and CHILLS (chills). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 23-Jan-2021, HYPERHIDROSIS (Sweating), PYREXIA (little fever/had low grade fever 100/102.7), PAIN (Body aches), CHILLS (chills) and VACCINATION SITE PAIN (slight arm soreness) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 22-Jan-2021, Body temperature: 100 (High) High and 102.7 (High) High. On 22-Jan-2021, COVID-19: positive (Positive) POSITIVE. 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.; Sender'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: Lisinopril; Levothyroxine; alendronate

Current Illness:

ID: 1551649
Sex: F
Age: 35
State: GA

Vax Date: 01/25/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Tingly in the arm; Warmness in the arm; Itching; Rash on the arm; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (Tingly in the arm), FEELING HOT (Warmness in the arm), PRURITUS (Itching) and RASH (Rash on the arm) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 25-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Feb-2021, the patient experienced PARAESTHESIA (Tingly in the arm), FEELING HOT (Warmness in the arm), PRURITUS (Itching) and RASH (Rash on the arm). At the time of the report, PARAESTHESIA (Tingly in the arm), FEELING HOT (Warmness in the arm), PRURITUS (Itching) and RASH (Rash on the arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1551650
Sex: F
Age: 91
State: MA

Vax Date: 02/03/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Sore arm; Large red rash with blister in the center; Large red rash with blister in the center; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm), RASH ERYTHEMATOUS (Large red rash with blister in the center) and RASH VESICULAR (Large red rash with blister in the center) in a 92-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030m20a) 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. In February 2021, the patient experienced PAIN IN EXTREMITY (Sore arm), RASH ERYTHEMATOUS (Large red rash with blister in the center) and RASH VESICULAR (Large red rash with blister in the center). At the time of the report, PAIN IN EXTREMITY (Sore arm), RASH ERYTHEMATOUS (Large red rash with blister in the center) and RASH VESICULAR (Large red rash with blister in the center) outcome was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. This case was linked to US-MODERNATX, INC.-MOD-2021-103611 (Linked Report). This case was linked to MOD-2021-103611 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 28-Apr-2021: Follow-up information received on 20-Apr-2021 included no new information.; Sender's Comments: US-MODERNATX, INC.-MOD-2021-103611:

Other Meds:

Current Illness:

ID: 1551651
Sex: F
Age: 76
State: NY

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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: little red pimple like rashes showing up and resolving; This spontaneous case was reported by a consumer and describes the occurrence of RASH (little red pimple like rashes showing up and resolving) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025J20A and 028L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included METOPROLOL TARTRATE (LOPRESSOR), ATORVASTATIN and LEVOTHYROXINE SODIUM (SYNTHROID) for an unknown indication. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 14-Jan-2021, the patient experienced RASH (little red pimple like rashes showing up and resolving). At the time of the report, RASH (little red pimple like rashes showing up and resolving) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: LOPRESSOR; ATORVASTATIN; SYNTHROID

Current Illness:

ID: 1551652
Sex: F
Age: 76
State:

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: soreness in the crease between left arm and back, soreness is about quarter inch/really hurts; injection site pain; aches; red; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (soreness in the crease between left arm and back, soreness is about quarter inch/really hurts), VACCINATION SITE PAIN (injection site pain), MYALGIA (aches) and VACCINATION SITE ERYTHEMA (red) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025J20-2A) for COVID-19 vaccination. No Medical History information was reported. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Jan-2021, the patient experienced VACCINATION COMPLICATION (soreness in the crease between left arm and back, soreness is about quarter inch/really hurts), VACCINATION SITE PAIN (injection site pain), MYALGIA (aches) and VACCINATION SITE ERYTHEMA (red). On 27-Jan-2021, VACCINATION SITE PAIN (injection site pain) and MYALGIA (aches) had resolved. At the time of the report, VACCINATION COMPLICATION (soreness in the crease between left arm and back, soreness is about quarter inch/really hurts) and VACCINATION SITE ERYTHEMA (red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. The treatment information was unknown.

Other Meds:

Current Illness:

ID: 1551653
Sex: F
Age: 78
State: MI

Vax Date: 02/10/2021
Onset Date: 02/13/2021
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: Sore to touch; Itchiness; Red mark/Small oval patch of redness and Increased its size until reached elbow/Outer part of arm was red; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itchiness), VACCINATION SITE ERYTHEMA (Red mark/Small oval patch of redness and Increased its size until reached elbow/Outer part of arm was red) and VACCINATION SITE PAIN (Sore to touch) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. Concurrent medical conditions included Hypothyroidism since 1994, Hypertension since 1994, Hypercholesterolemia since 1994 and Glaucoma since 2004. Concomitant products included LEVOTHYROXINE, TIMOLOL MALEATE, HYDROCHLOROTHIAZIDE, LISINOPRIL (LISINOPRIL HCTZ), ROSUVASTATIN CALCIUM (ROSUVASTIN), ROSUVASTATIN CALCIUM (CRESTOR), VITAMIN B12 NOS, CARTILAGE, HYALURONIC ACID (MOVE FREE ULTRA), VITAMIN D NOS, LACTOBACILLUS BREVIS, LACTOBACILLUS BUCHNERI (FLORA BALANCE), LINUM USITATISSIMUM SEED OIL (FLAX SEED OIL) and UBIDECARENONE (CO Q10) for an unknown indication. On 10-Feb-2021 at 5:25 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (Itchiness) and VACCINATION SITE ERYTHEMA (Red mark/Small oval patch of redness and Increased its size until reached elbow/Outer part of arm was red). On an unknown date, the patient experienced VACCINATION SITE PAIN (Sore to touch). At the time of the report, VACCINATION SITE PRURITUS (Itchiness) and VACCINATION SITE PAIN (Sore to touch) outcome was unknown and VACCINATION SITE ERYTHEMA (Red mark/Small oval patch of redness and Increased its size until reached elbow/Outer part of arm was red) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication included blood pressure pill, Advil as needed, Citracal as 1 tablet thrice a week, Vitamin C 100 milligram 1 tablet daily, Centrum silver 1 tablet once daily, Omega 3 1200milligram gel once per day. Treatment medication were not provided. Most recent FOLLOW-UP information incorporated above includes: On 06-Jul-2021: Follow-up received on 06-JUL-2021 contains no significant information On 16-Jul-2021: Added patients demographics, added patients medical history, added first and second dose details, added concomitant medication, updated event outcome

Other Meds: LEVOTHYROXINE; TIMOLOL MALEATE; LISINOPRIL HCTZ; ROSUVASTIN; CRESTOR; VITAMIN B12 NOS; MOVE FREE ULTRA; VITAMIN D NOS; FLORA BALANCE; FLAX SEED OIL; CO Q10

Current Illness: Glaucoma; Hypercholesterolemia; Hypertension; Hypothyroidism

ID: 1551654
Sex: F
Age: 70
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: Ears became itchy and hot; Ears became itchy and hot; Lips more swollen, red and burn?seemed to have a blister formation on inside lips; Tongue burns; Ears itchy; Still experiencing arm redness, swollen lip area; Rash; Arm became hot, very itchy and somewhat hard; Arm swollen and increased in size (4X3 in) hot, itchy; Arm slightly red/warm, but swelling is reducing?still a demarcation line; Lips still "burns" a little; Lips started to swell; Area below the injection site felt like it had been sunburned; Eyes became swollen; Eyes became hot; Area below injection site became swollen; Ears were swollen; Itching on her chest, arms, palms, ears, eyes, lips, below injection site; Soreness at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching on her chest, arms, palms, ears, eyes, lips, below injection site), EAR SWELLING (Ears were swollen), EYE SWELLING (Eyes became swollen), OCULAR DISCOMFORT (Eyes became hot) and PERIPHERAL SWELLING (Area below injection site became swollen) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Penicillin allergy (Generalized itching and hives. Have not taken since that time.) since 1970, Allergy (Red dye #27. Generalized itching and hives. Have not taken since that time.) since 1990 and Allergy (Raspberry and acai juice. Generalized itching and hives. Have not taken since that time.) since 1990. On 12-Feb-2021 at 2:30 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Feb-2021, the patient experienced PRURITUS (Itching on her chest, arms, palms, ears, eyes, lips, below injection site) and INJECTION SITE PAIN (Soreness at the injection site). On 18-Feb-2021, the patient experienced EAR SWELLING (Ears were swollen). On 19-Feb-2021, the patient experienced EYE SWELLING (Eyes became swollen), OCULAR DISCOMFORT (Eyes became hot) and PERIPHERAL SWELLING (Area below injection site became swollen). On 20-Feb-2021, the patient experienced FEELING HOT (Area below the injection site felt like it had been sunburned). On 21-Feb-2021, the patient experienced LIP SWELLING (Lips started to swell). On 22-Feb-2021, the patient experienced ORAL DISCOMFORT (Lips still "burns" a little). On an unknown date, the patient experienced EAR PRURITUS (Ears became itchy and hot), EAR DISCOMFORT (Ears became itchy and hot), LIP BLISTER (Lips more swollen, red and burn?seemed to have a blister formation on inside lips), TONGUE DISCOMFORT (Tongue burns; Ears itchy), PARAESTHESIA ORAL (Still experiencing arm redness, swollen lip area), RASH (Rash), INJECTION SITE INDURATION (Arm became hot, very itchy and somewhat hard), INJECTION SITE SWELLING (Arm swollen and increased in size (4X3 in) hot, itchy) and INJECTION SITE ERYTHEMA (Arm slightly red/warm, but swelling is reducing?still a demarcation line). On 14-Feb-2021, INJECTION SITE PAIN (Soreness at the injection site) had resolved. On 21-Feb-2021, PERIPHERAL SWELLING (Area below injection site became swollen) had resolved. At the time of the report, PRURITUS (Itching on her chest, arms, palms, ears, eyes, lips, below injection site), EAR SWELLING (Ears were swollen), EYE SWELLING (Eyes became swollen), OCULAR DISCOMFORT (Eyes became hot), FEELING HOT (Area below the injection site felt like it had been sunburned), ORAL DISCOMFORT (Lips still "burns" a little), EAR PRURITUS (Ears became itchy and hot), EAR DISCOMFORT (Ears became itchy and hot), LIP BLISTER (Lips more swollen, red and burn?seemed to have a blister formation on inside lips), TONGUE DISCOMFORT (Tongue burns; Ears itchy), PARAESTHESIA ORAL (Still experiencing arm redness, swollen lip area), RASH (Rash), INJECTION SITE INDURATION (Arm became hot, very itchy and somewhat hard), INJECTION SITE SWELLING (Arm swollen and increased in size (4X3 in) hot, itchy) and INJECTION SITE ERYTHEMA (Arm slightly red/warm, but swelling is reducing?still a demarcation line) outcome was unknown and LIP SWELLING (Lips started to swell) was resolving. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications include metoprolol succinate ER of 50 mg dose used for tachycardia, levothyroxine of 50 mcg dose for thyroid condition, lovastatin of 40 mg dose for cholesterol condition, calcium with vitamin D of 1000 mg/50 mcg for bone health, vitamin B12 of 1000mcg for vitamin support. Treatment information was not provided. This case was linked to MOD-2021-262895 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 28-Apr-2021: Follow up received on 28-Apr-2021 included no new information. On 20-Jul-2021: Events, concomitant medication, Patient demographics, allergies updated.

Other Meds:

Current Illness: Allergy (Red dye #27. Generalized itching and hives. Have not taken since that time.); Allergy (Raspberry and acai juice. Generalized itching and hives. Have not taken since that time.); Penicillin allergy (Generalized itching and hives. Have not taken since that time.)

ID: 1551655
Sex: F
Age: 52
State: NE

Vax Date: 01/22/2021
Onset Date: 02/20/2021
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: Joints all inflamed; Ears are bothering; Joints are hurting; Chills really bad; Horrible headache; Running mild temperature that got really high up to 102 F/On Sunday 21st the temperature got to 100 F/ On Monday 22nd still has temperature but not as high; Rash where the injection was; Started feeling really sick; Dizziness; Weakness; Shortness of breath; This spontaneous case was reported by an other health care professional and describes the occurrence of MALAISE (Started feeling really sick), DIZZINESS (Dizziness), ASTHENIA (Weakness), DYSPNOEA (Shortness of breath) and ARTHRITIS (Joints all inflamed) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031L20A and 042L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 20-Feb-2021, the patient experienced MALAISE (Started feeling really sick), HEADACHE (Horrible headache) and PYREXIA (Running mild temperature that got really high up to 102 F/On Sunday 21st the temperature got to 100 F/ On Monday 22nd still has temperature but not as high). 20-Feb-2021, the patient experienced DIZZINESS (Dizziness), ASTHENIA (Weakness), DYSPNOEA (Shortness of breath) and VACCINATION SITE RASH (Rash where the injection was). On an unknown date, the patient experienced ARTHRITIS (Joints all inflamed), EAR DISCOMFORT (Ears are bothering), ARTHRALGIA (Joints are hurting) and CHILLS (Chills really bad). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) at an unspecified dose and frequency. At the time of the report, MALAISE (Started feeling really sick), DIZZINESS (Dizziness), ASTHENIA (Weakness), DYSPNOEA (Shortness of breath), ARTHRITIS (Joints all inflamed), EAR DISCOMFORT (Ears are bothering), ARTHRALGIA (Joints are hurting), CHILLS (Chills really bad) and VACCINATION SITE RASH (Rash where the injection was) outcome was unknown, HEADACHE (Horrible headache) had not resolved and PYREXIA (Running mild temperature that got really high up to 102 F/On Sunday 21st the temperature got to 100 F/ On Monday 22nd still has temperature but not as high) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 20-Feb-2021, Body temperature increased: 102 (High) Got really high up to 102 F on Saturday night.. On 21-Feb-2021, Body temperature increased: 100 (Inconclusive) On Sunday 21st the temperature got to 100 F.. On 22-Feb-2021, Body temperature increased: (Inconclusive) Monday 22nd still has temperature but not as high.. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was provided.

Other Meds:

Current Illness:

ID: 1551656
Sex: M
Age: 21
State: TX

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: Vaccine-Drug interaction; This spontaneous case was reported by a consumer and describes the occurrence of DRUG INTERACTION (Vaccine-Drug interaction) in a 21-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025L20A) for COVID-19 vaccination. Previously administered products included for an unreported indication: STEROIDS (Patient mentioned that he has been taking steroids for the past week and today is the last day.). On 26-Jan-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Jan-2021, the patient experienced DRUG INTERACTION (Vaccine-Drug interaction). At the time of the report, DRUG INTERACTION (Vaccine-Drug interaction) outcome was unknown. No treatment information was provided. No concomitant medication was provided.

Other Meds:

Current Illness:

ID: 1551657
Sex: F
Age:
State: CA

Vax Date:
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: Flu like symptoms; Sweating; Chills; Tiredness; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu like symptoms), HYPERHIDROSIS (Sweating), CHILLS (Chills) and FATIGUE (Tiredness) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced INFLUENZA LIKE ILLNESS (Flu like symptoms), HYPERHIDROSIS (Sweating), CHILLS (Chills) and FATIGUE (Tiredness). At the time of the report, INFLUENZA LIKE ILLNESS (Flu like symptoms), HYPERHIDROSIS (Sweating), CHILLS (Chills) and FATIGUE (Tiredness) 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 provided No Treatment information provided This case was linked to MOD-2021-045543 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 16-Mar-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1551658
Sex: F
Age: 38
State: TX

Vax Date: 02/12/2021
Onset Date: 02/18/2021
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: a swollen lymph node on my collar bone; This spontaneous case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (a swollen lymph node on my collar bone) in a 38-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Feb-2021, the patient experienced LYMPHADENOPATHY (a swollen lymph node on my collar bone). At the time of the report, LYMPHADENOPATHY (a swollen lymph node on my collar bone) 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.

Other Meds:

Current Illness:

ID: 1551659
Sex: F
Age: 66
State: NC

Vax Date: 02/13/2021
Onset Date: 02/19/2021
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: Injection site pain, Menorrhagia

Symptoms: rash arm; itch; A Spontaneous report was received from consumer concerning a 66-year-old, female patient , who received first dose of Modern's COVID-19 vaccine(mRNA 1273) and experienced itching and rash. The patient medical history was not provided by the reporter. Concomitant medications were not provided not provided by the reporter. On 13-FEB-2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273(042L20A) , via intramuscular route and unknown anatomical location for prophylaxis of COVID-19 infection. After receiving the first dose ,patient experienced itching and rash. Patient had taken Antiitch-lotion to treat itching. Action taken with mRNA-1273 in response to the events was unknown. The outcome of the event rash ,itching were unknown.

Other Meds:

Current Illness:

ID: 1551660
Sex: F
Age: 76
State: NY

Vax Date: 01/14/2021
Onset Date: 02/11/2021
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: Red pimple rashes, some in clusters on different parts of the body including the legs and back; rashes are itchy, and her back is itching; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 22-Feb-2021 and was forwarded to Moderna on 22-Feb-2021. This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of RASH ERYTHEMATOUS (Red pimple rashes, some in clusters on different parts of the body including the legs and back) and RASH PRURITIC (rashes are itchy, and her back is itching) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 028L20A and 025J20A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension, High cholesterol and Hypothyroidism. Concomitant products included ATORVASTATIN for High cholesterol, METOPROLOL TARTRATE (LOPRESSOR) for Hypertension, LEVOTHYROXINE SODIUM (SYNTHROID) for Hypothyroidism. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 ml. On 11-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 11-Feb-2021, the patient experienced RASH ERYTHEMATOUS (Red pimple rashes, some in clusters on different parts of the body including the legs and back) and RASH PRURITIC (rashes are itchy, and her back is itching). At the time of the report, RASH ERYTHEMATOUS (Red pimple rashes, some in clusters on different parts of the body including the legs and back) and RASH PRURITIC (rashes are itchy, and her back is itching) had resolved. Treatment included cream to put on twice a day prescribed by a Dermatologist. This case was linked to MOD-2021-020646 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 27-Apr-2021: Received follow-up information. Events outcome has been updated from unknown to recovered and treatment information added.

Other Meds: LOPRESSOR; ATORVASTATIN; SYNTHROID

Current Illness: High cholesterol; Hypertension; Hypothyroidism

ID: 1551661
Sex: F
Age: 81
State: NV

Vax Date: 02/10/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: arm soreness; injection site redness; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm soreness) and VACCINATION SITE ERYTHEMA (injection site redness) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. No Medical History information was reported. On 10-Feb-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 (arm soreness) and VACCINATION SITE ERYTHEMA (injection site redness). At the time of the report, PAIN IN EXTREMITY (arm soreness) and VACCINATION SITE ERYTHEMA (injection site redness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. No concomitant medication was provided.

Other Meds:

Current Illness:

ID: 1551662
Sex: F
Age:
State: NY

Vax Date: 02/15/2021
Onset Date: 02/22/2021
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: foot pain; knee pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (foot pain) and ARTHRALGIA (knee pain) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. The patient's past medical history included Femur fracture (fractures in her femur from a fall) in 2014 and Foot surgery in 2014. Concurrent medical conditions included Knee arthritis. Concomitant products included MULTI VITAMINS & MINERALS for an unknown indication. On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Feb-2021, the patient experienced PAIN IN EXTREMITY (foot pain) and ARTHRALGIA (knee pain). At the time of the report, PAIN IN EXTREMITY (foot pain) and ARTHRALGIA (knee pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided.

Other Meds: MULTI VITAMINS & MINERALS

Current Illness: Knee arthritis

ID: 1551663
Sex: F
Age: 72
State: OH

Vax Date: 02/04/2021
Onset Date: 02/14/2021
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: COVID ARM; Red rash that lingers on for a while/ Red big rash; Itchy; Hurting; Headaches; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headaches) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011M20A) for COVID-19 vaccination. No Medical History information was reported. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Feb-2021, the patient experienced HEADACHE (Headaches). The patient was treated with PARACETAMOL (TYLENOL) for Headache, at an unspecified dose and frequency. At the time of the report, HEADACHE (Headaches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was provided. This case was linked to MOD-2021-094117 (Patient Link).

Other Meds:

Current Illness:

ID: 1551664
Sex: F
Age: 49
State: GA

Vax Date: 02/11/2021
Onset Date: 02/01/2021
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: Nausea

Symptoms: Shaking; Soreness; Small rash on buttocks; Headaches; Chills; This spontaneous case was reported by a consumer and describes the occurrence of 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 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. No concomitant medication was provided.

Other Meds:

Current Illness:

ID: 1551665
Sex: F
Age: 79
State: CA

Vax Date: 01/30/2021
Onset Date: 02/07/2021
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: low grade fever; Facial Swelling; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING FACE (Facial Swelling) and PYREXIA (low grade fever) in a 79-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 Eye laser surgery. Concomitant products included DEXAMETHASONE, NEOMYCIN SULFATE, POLYMYXIN B SULFATE (NEOMYCIN / POLY B / DEXAMETHASONE) for an unknown indication. On 30-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Feb-2021, the patient experienced SWELLING FACE (Facial Swelling). On an unknown date, the patient experienced PYREXIA (low grade fever). On 10-Feb-2021, SWELLING FACE (Facial Swelling) had resolved. At the time of the report, PYREXIA (low grade fever) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: Follow up was received on 14-Jul-2021, new event low grade fever was added.

Other Meds: NEOMYCIN / POLY B / DEXAMETHASONE

Current Illness:

ID: 1551666
Sex: M
Age: 73
State: MI

Vax Date: 01/01/2021
Onset Date: 01/01/2021
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: Itching on and off; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching on and off) in a 73-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In January 2021, the patient experienced PRURITUS (Itching on and off). At the time of the report, PRURITUS (Itching on and off) outcome was 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.

Other Meds:

Current Illness:

ID: 1551667
Sex: F
Age: 66
State:

Vax Date: 02/05/2021
Onset Date: 02/20/2021
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: Vaccination site rash; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (Vaccination site rash) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Feb-2021, the patient experienced VACCINATION SITE RASH (Vaccination site rash). At the time of the report, VACCINATION SITE RASH (Vaccination site rash) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Myocardial infarction: negative (Negative) Negative. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication use was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1551668
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Side-effects after vaccination; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Side-effects after vaccination) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Side-effects after vaccination). At the time of the report, VACCINATION COMPLICATION (Side-effects after vaccination) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. Treatment medications were unknown. Most recent FOLLOW-UP information incorporated above includes: On 20-Apr-2021: Follow-up received on 20-APR-2021 included: Event outcome changed from unknown to resolving.

Other Meds:

Current Illness:

ID: 1551669
Sex: M
Age: 61
State: TX

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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: Nauseous; Arm soreness; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm soreness) and NAUSEA (Nauseous) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Rheumatoid arthritis. Concurrent medical conditions included Hypertension and Hyperlipidemia. Concomitant products included ROSUVASTATIN CALCIUM (CRESTOR) for Hyperlipidemia, LISINOPRIL for Hypertension, TESTOSTERONE and CYANOCOBALAMIN (VITAMIN B 12 [CYANOCOBALAMIN]). On 20-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Feb-2021, the patient experienced PAIN IN EXTREMITY (Arm soreness). On 21-Feb-2021, the patient experienced NAUSEA (Nauseous). The patient was treated with IBUPROFEN at a dose of UNK dosage form. On 21-Feb-2021, NAUSEA (Nauseous) had resolved. At the time of the report, PAIN IN EXTREMITY (Arm soreness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: LISINOPRIL; CRESTOR; TESTOSTERONE; VITAMIN B 12 [CYANOCOBALAMIN]

Current Illness: Hyperlipidemia; Hypertension

ID: 1551670
Sex: F
Age: 74
State: AR

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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: Nausea; Chills; Low grade fever; Body ache; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (Nausea), CHILLS (Chills), PYREXIA (Low grade fever) and PAIN (Body ache) in a 74-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 20-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Feb-2021, the patient experienced NAUSEA (Nausea), CHILLS (Chills), PYREXIA (Low grade fever) and PAIN (Body ache). At the time of the report, NAUSEA (Nausea), CHILLS (Chills), PYREXIA (Low grade fever) and PAIN (Body ache) outcome was 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.

Other Meds:

Current Illness:

ID: 1551671
Sex: F
Age: 66
State: NC

Vax Date: 02/13/2021
Onset Date: 02/19/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Itching; Rash; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching) and RASH (Rash) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 vaccination. No Medical History information was reported. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, the patient experienced PRURITUS (Itching) and RASH (Rash). At the time of the report, PRURITUS (Itching) and RASH (Rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product used was not provided by the reporter. Treatment information was not provided. This case was linked to -MOD-2021-092534 (E2B Linked Report). Most recent FOLLOW-UP information incorporated above includes: On 27-Apr-2021: Follow-up received on 27-Apr-2021 included no new information.; Sender's Comments: -MOD-2021-092534:2nd dose case

Other Meds:

Current Illness:

ID: 1551672
Sex: F
Age:
State: NJ

Vax Date: 02/13/2021
Onset Date:
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: Swelling at vaccination site; my arm was sore; hotness where shot was given; red rash encircling the area where the shot was given; This spontaneous case was reported by a consumer and describes the occurrence of in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029l20a) for COVID-19 vaccination. Concurrent medical conditions included White blood cell abnormalities. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness: White blood cell abnormalities

ID: 1551673
Sex: F
Age: 42
State: MA

Vax Date: 02/13/2021
Onset Date:
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: Chills; Fever 102 ?F; nausea; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Chills), PYREXIA (Fever 102 ?F) and NAUSEA (nausea) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unk) for COVID-19 vaccination. No Medical History information was reported. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced CHILLS (Chills), PYREXIA (Fever 102 ?F) and NAUSEA (nausea). The patient was treated with PARACETAMOL (TYLENOL) at a dose of UNK dosage form. At the time of the report, CHILLS (Chills), PYREXIA (Fever 102 ?F) and NAUSEA (nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1551674
Sex: M
Age:
State: PA

Vax Date: 02/13/2021
Onset Date: 02/16/2021
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: sore throat; it hurts when he swallows; he had a lot of pain; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (sore throat), PHARYNGEAL SWELLING (it hurts when he swallows) and OROPHARYNGEAL PAIN (he had a lot of pain) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced OROPHARYNGEAL PAIN (sore throat), PHARYNGEAL SWELLING (it hurts when he swallows) and OROPHARYNGEAL PAIN (he had a lot of pain). The patient was treated with AMOXICILLIN TRIHYDRATE, CLAVULANATE POTASSIUM (AMOXICILLIN & CLAV. POTASSIUM) ongoing from 19-Feb-2021 at a dose of UNK dosage form. At the time of the report, OROPHARYNGEAL PAIN (sore throat), PHARYNGEAL SWELLING (it hurts when he swallows) and OROPHARYNGEAL PAIN (he had a lot of pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1551675
Sex: F
Age: 71
State: WI

Vax Date: 01/30/2021
Onset Date: 02/08/2021
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 skin scarring; Tenderness - Near Vaccination Site; Redness - NearVccination Site; Swelling - Near Vaccination Site; Hot to Touch Sensation - Near vaccination Site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Hot to Touch Sensation - Near vaccination Site), ERYTHEMA (Red skin scarring), TENDERNESS (Tenderness - Near Vaccination Site), VACCINATION SITE ERYTHEMA (Redness - NearVccination Site) and VACCINATION SITE SWELLING (Swelling - Near Vaccination Site) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. Concurrent medical conditions included Bigeminy, Hypertension, Type II diabetes mellitus, Shellfish allergy and Drug allergy. Concomitant products included HCTZ, METFORMIN, ATORVASTATIN CALCIUM (LIPITOR) and ATENOLOL for an unknown indication. On 30-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, the patient experienced VACCINATION SITE WARMTH (Hot to Touch Sensation - Near vaccination Site), TENDERNESS (Tenderness - Near Vaccination Site), VACCINATION SITE ERYTHEMA (Redness - NearVccination Site) and VACCINATION SITE SWELLING (Swelling - Near Vaccination Site). On 09-Feb-2021, the patient experienced ERYTHEMA (Red skin scarring). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) (oral) for Adverse event, at a dose of 1-2, prn and CEFALEXIN for Adverse event, at an unspecified dose and frequency. On 06-Mar-2021, VACCINATION SITE WARMTH (Hot to Touch Sensation - Near vaccination Site), ERYTHEMA (Red skin scarring), TENDERNESS (Tenderness - Near Vaccination Site), VACCINATION SITE ERYTHEMA (Redness - NearVccination Site) and VACCINATION SITE SWELLING (Swelling - Near Vaccination Site) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to MOD-2021-259356 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: Follow up received on 14-JUL-2021 contains patient demographic information, race information, medical history, concomitant drugs information.

Other Meds: HCTZ; METFORMIN; LIPITOR; ATENOLOL

Current Illness: Bigeminy; Drug allergy; Hypertension; Shellfish allergy; Type II diabetes mellitus

ID: 1551676
Sex: F
Age: 66
State: CO

Vax Date: 02/15/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: General body pain; Blurry vision; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (General body pain), NAUSEA (Nausea) and VISION BLURRED (Blurry vision) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030M20A) for COVID-19 vaccination. Concomitant products included METFORMIN for Blood pressure. On 15-Feb-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 (General body pain), NAUSEA (Nausea) and VISION BLURRED (Blurry vision). At the time of the report, PAIN (General body pain), NAUSEA (Nausea) and VISION BLURRED (Blurry vision) 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.

Other Meds: METFORMIN

Current Illness:

ID: 1551677
Sex: F
Age: 68
State: IL

Vax Date: 02/19/2021
Onset Date: 02/20/2021
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: Pain in arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain in arm) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. The patient's past medical history included Rheumatoid arthritis. Concomitant products included PARACETAMOL (TYLENOL) for Rheumatoid arthritis. On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Feb-2021, the patient experienced PAIN IN EXTREMITY (Pain in arm). On 21-Feb-2021, PAIN IN EXTREMITY (Pain in arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: TYLENOL

Current Illness:

ID: 1551678
Sex: M
Age: 77
State: MS

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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: tiredness; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (tiredness) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025L20A) for COVID-19 vaccination. No Medical History information was reported. On 11-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 FATIGUE (tiredness). The patient was treated with PARACETAMOL (TYLENOL) for Tiredness, at an unspecified dose and frequency. At the time of the report, FATIGUE (tiredness) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Patient reported that he received second dose of Pfizer and experienced adverse events.

Other Meds:

Current Illness:

ID: 1551679
Sex: M
Age:
State: GA

Vax Date: 02/18/2021
Onset Date:
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: Heart rate increased; Weakness; Ache; Pain in arm; Redness; Swelling arm; Dizziness; Chills; Throat tightness; Fever; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever), HEART RATE INCREASED (Heart rate increased), HEADACHE (Headache), ASTHENIA (Weakness) and PAIN (Ache) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031LZ0A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19 (Tested positive for antibodies in November 2020. Waited 90 days before receiving the vaccine. ) in October 2020. Concurrent medical conditions included Shellfish allergy. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PYREXIA (Fever), HEART RATE INCREASED (Heart rate increased), HEADACHE (Headache), ASTHENIA (Weakness), PAIN (Ache), PAIN IN EXTREMITY (Pain in arm), ERYTHEMA (Redness), PERIPHERAL SWELLING (Swelling arm), DIZZINESS (Dizziness), CHILLS (Chills) and THROAT TIGHTNESS (Throat tightness). The patient was treated with DIPHENHYDRAMINE, PARACETAMOL (EXTRA STRENGTH TYLENOL PM) at a dose of UNK dosage form. At the time of the report, PYREXIA (Fever), HEART RATE INCREASED (Heart rate increased), HEADACHE (Headache), ASTHENIA (Weakness), PAIN (Ache), PAIN IN EXTREMITY (Pain in arm), ERYTHEMA (Redness), PERIPHERAL SWELLING (Swelling arm), DIZZINESS (Dizziness), CHILLS (Chills) and THROAT TIGHTNESS (Throat tightness) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In November 2020, SARS-CoV-2 antibody test: positive (Positive) 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. No relevant concomitant medications were reported.

Other Meds:

Current Illness: Shellfish allergy

ID: 1551680
Sex: F
Age: 56
State: MA

Vax Date: 01/25/2021
Onset Date: 02/04/2021
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: Red rash around where the injection site; Red rash around where the injection site; A little painful; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (Red rash around where the injection site), VACCINATION SITE ERYTHEMA (Red rash around where the injection site) and VACCINATION SITE PAIN (A little painful) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. Concurrent medical conditions included Allergy (The patient takes nasal spray for allergy). Concomitant products included GABAPENTIN, LEVOTHYROXINE SODIUM (SYNTHROID), VITAMIN D3 and KALLIDINOGENASE (SOMAX) 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 04-Feb-2021, the patient experienced VACCINATION SITE RASH (Red rash around where the injection site), VACCINATION SITE ERYTHEMA (Red rash around where the injection site) and VACCINATION SITE PAIN (A little painful). At the time of the report, VACCINATION SITE RASH (Red rash around where the injection site), VACCINATION SITE ERYTHEMA (Red rash around where the injection site) and VACCINATION SITE PAIN (A little painful) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The concomitant medication also included antidepressants, nasal spray for allergy. Treatment medications were not provided. This case was linked to MOD-2021-082190 (E2B Linked Report).; Sender's Comments: MOD-2021-082190:Same patient (2nd dose)

Other Meds: GABAPENTIN; SYNTHROID; VITAMIN D3; SOMAX

Current Illness: Allergy (The patient takes nasal spray for allergy)

ID: 1551681
Sex: F
Age: 85
State: MD

Vax Date: 02/04/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Redness; Wheals; This spontaneous case was reported by a consumer and describes the occurrence of in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 04-Feb-2021, 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. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) and mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1551682
Sex: F
Age: 72
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/13/2021
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: redness extended down arm and around vaccination site; red itchy swollen endurated left arm; Injection site became hot to the touch; Injection site red/red itchy swollen endurated left arm; Injection site itchy/red itchy swollen endurated left arm; Injection site little swollen/red itchy swollen endurated left arm; covid arm; Arm was sore; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of PAIN IN EXTREMITY (Arm was sore), VACCINATION SITE WARMTH (Injection site became hot to the touch), VACCINATION SITE ERYTHEMA (Injection site red/red itchy swollen endurated left arm), VACCINATION SITE PRURITUS (Injection site itchy/red itchy swollen endurated left arm) and VACCINATION SITE SWELLING (Injection site little swollen/red itchy swollen endurated left arm) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Drug allergy (Iodine Epinephrine), Hypertension, Acid reflux (oesophageal) and Congenital adrenal hyperplasia. Concomitant products included SIMVASTATIN (ZOCOR), SPIRONOLACTONE, OMEPRAZOLE (PROTONIX [OMEPRAZOLE]), MULTIVITAMINS [VITAMINS NOS], PROBIOTICS NOS, GLUTEN, ASCORBIC ACID, BIOTIN, COPPER, RETINOL, ZINC (HAIR SKIN NAILS), TURMERIC [CURCUMA LONGA RHIZOME], TOCOPHEROL (VITAMIN E [TOCOPHEROL]) and MAGNESIUM for an unknown indication. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, the patient experienced PAIN IN EXTREMITY (Arm was sore). On 22-Feb-2021, the patient experienced VACCINATION SITE WARMTH (Injection site became hot to the touch), VACCINATION SITE ERYTHEMA (Injection site red/red itchy swollen endurated left arm), VACCINATION SITE PRURITUS (Injection site itchy/red itchy swollen endurated left arm), VACCINATION SITE SWELLING (Injection site little swollen/red itchy swollen endurated left arm) and ILL-DEFINED DISORDER (covid arm). On an unknown date, the patient experienced ERYTHEMA (redness extended down arm and around vaccination site) and VACCINATION SITE INDURATION (red itchy swollen endurated left arm). On 25-Feb-2021, ILL-DEFINED DISORDER (covid arm) had resolved. At the time of the report, PAIN IN EXTREMITY (Arm was sore), VACCINATION SITE WARMTH (Injection site became hot to the touch), VACCINATION SITE ERYTHEMA (Injection site red/red itchy swollen endurated left arm), VACCINATION SITE PRURITUS (Injection site itchy/red itchy swollen endurated left arm), VACCINATION SITE SWELLING (Injection site little swollen/red itchy swollen endurated left arm), ERYTHEMA (redness extended down arm and around vaccination site) and VACCINATION SITE INDURATION (red itchy swollen endurated left arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medication information was provided. This case was linked to MOD-2021-108760 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 30-Apr-2021: Follow-up received on 30-APR-2021. The reporter provided the Historical condition details. Adverse Events updated.

Other Meds: ZOCOR; SPIRONOLACTONE; PROTONIX [OMEPRAZOLE]; MULTIVITAMINS [VITAMINS NOS]; PROBIOTICS NOS; GLUTEN; HAIR SKIN NAILS; TURMERIC [CURCUMA LONGA RHIZOME]; VITAMIN E [TOCOPHEROL]; MAGNESIUM

Current Illness: Acid reflux (oesophageal); Congenital adrenal hyperplasia; Hypertension

ID: 1551683
Sex: F
Age: 85
State: CA

Vax Date: 01/18/2021
Onset Date: 01/28/2021
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: generalized pink discoloration near the injection site; covid arm; lump near the injection site; red patch on the injection upper arm; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE DISCOLOURATION (generalized pink discoloration near the injection site), TYPE IV HYPERSENSITIVITY REACTION (covid arm), INJECTION SITE SWELLING (lump near the injection site) and INJECTION SITE ERYTHEMA (red patch on the injection upper arm) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (NO historical condition reported.). On 18-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 2 dosage form. On 28-Jan-2021, the patient experienced INJECTION SITE ERYTHEMA (red patch on the injection upper arm). On 31-Jan-2021, the patient experienced INJECTION SITE DISCOLOURATION (generalized pink discoloration near the injection site), TYPE IV HYPERSENSITIVITY REACTION (covid arm) and INJECTION SITE SWELLING (lump near the injection site). At the time of the report, INJECTION SITE DISCOLOURATION (generalized pink discoloration near the injection site), TYPE IV HYPERSENSITIVITY REACTION (covid arm), INJECTION SITE SWELLING (lump near the injection site) and INJECTION SITE ERYTHEMA (red patch on the injection upper arm) outcome was unknown. Related Treatment details included Patient used Ice to treat the delayed injection site reaction. No relevant concomitant medications were reported For mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route), the reporter did not provide any causality assessments. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) was not applicable

Other Meds:

Current Illness:

ID: 1551684
Sex: M
Age:
State: TX

Vax Date: 02/12/2021
Onset Date: 02/21/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Hot at injection site; Red at injection site; Swollen at injection site; Itchy at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Hot at injection site), VACCINATION SITE ERYTHEMA (Red at injection site), VACCINATION SITE SWELLING (Swollen at injection site) and VACCINATION SITE PRURITUS (Itchy at injection site) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included FISH OIL, TURMERIC [CURCUMA LONGA RHIZOME], CUCURBITA PEPO SEED OIL, LYCOPENE, OENOTHERA BIENNIS OIL, SELENIUM, SERENOA REPENS, ZINC (SAW PALMETTO COMPLETE), CALCIUM, COLECALCIFEROL (VITAMIN D 3) and METHYLSULFONYLMETHANE (MSM COMPLETE) for an unknown indication. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Feb-2021, the patient experienced VACCINATION SITE WARMTH (Hot at injection site), VACCINATION SITE ERYTHEMA (Red at injection site), VACCINATION SITE SWELLING (Swollen at injection site) and VACCINATION SITE PRURITUS (Itchy at injection site). At the time of the report, VACCINATION SITE WARMTH (Hot at injection site), VACCINATION SITE ERYTHEMA (Red at injection site), VACCINATION SITE SWELLING (Swollen at injection site) and VACCINATION SITE PRURITUS (Itchy at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: FISH OIL; TURMERIC [CURCUMA LONGA RHIZOME]; SAW PALMETTO COMPLETE; CALCIUM; VITAMIN D 3; MSM COMPLETE

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm