VAERS 2021 Database www.vaers.hhs.gov

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

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

Incidents per State

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

ID: 1551685
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Vomiting; Body ache; Fever; Chills; Nausea; Headache; Joint pain; This spontaneous case was reported by a nurse and describes the occurrence of VOMITING (Vomiting), MYALGIA (Body ache), PYREXIA (Fever), CHILLS (Chills) and NAUSEA (Nausea) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 20-Jan-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In January 2021, the patient experienced VOMITING (Vomiting), MYALGIA (Body ache), PYREXIA (Fever), CHILLS (Chills), NAUSEA (Nausea), HEADACHE (Headache) and ARTHRALGIA (Joint pain). At the time of the report, VOMITING (Vomiting), MYALGIA (Body ache), NAUSEA (Nausea), HEADACHE (Headache) and ARTHRALGIA (Joint pain) outcome was unknown and PYREXIA (Fever) and CHILLS (Chills) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patient is a registered nurse who was reporting a "severe reaction to second dose". Concomitant product use was not provided. Approximately 8 hours after the second dose, the patient experienced the above mentioned events. The patient stated "I thought I was going to die." On unspecified dates, she tested negative numerous times for COVID-19, including a negative antibody. At the time of the report, 48 hours after the vaccine, the patient still had a low grade fever and chills but said "am feeling better." Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1551686
Sex: F
Age: 70
State: VA

Vax Date: 02/11/2021
Onset Date: 02/21/2021
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: Had redness on the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (Had redness on the injection site) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. No Medical History information was reported. On 11-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Feb-2021, the patient experienced VACCINATION SITE ERYTHEMA (Had redness on the injection site). At the time of the report, VACCINATION SITE ERYTHEMA (Had redness on the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1551687
Sex: F
Age: 56
State: NY

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: itching at the injection site; redness at the injection site; swelling at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (itching at the injection site), VACCINATION SITE ERYTHEMA (redness at the injection site) and VACCINATION SITE SWELLING (swelling at the injection site) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (itching at the injection site), VACCINATION SITE ERYTHEMA (redness at the injection site) and VACCINATION SITE SWELLING (swelling at the injection site). The patient was treated with CORTISONE ACETATE at an unspecified dose and frequency and ANTIBIOTICS at an unspecified dose and frequency. At the time of the report, VACCINATION SITE PRURITUS (itching at the injection site), VACCINATION SITE ERYTHEMA (redness at the injection site) and VACCINATION SITE SWELLING (swelling at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1551688
Sex: F
Age: 74
State: CA

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: She had a little reaction, little redness, and soreness and warmth, tenderness, (2 days) red rash 7 cm X 13 cm occurring at the injection site.; Red rash 7 cm X 13 cm occurring at the injection site; Tenderness at the injection site; Redness at the injection site/red at the injection site; Soreness at the at the injection site; This spontaneous case was reported by a health care professional (subsequently medically confirmed) and describes the occurrence of VACCINATION SITE WARMTH (She had a little reaction, little redness, and soreness and warmth, tenderness, (2 days) red rash 7 cm X 13 cm occurring at the injection site.), VACCINATION SITE ERYTHEMA (Redness at the injection site/red at the injection site), VACCINATION SITE PAIN (Soreness at the at the injection site), VACCINATION SITE RASH (Red rash 7 cm X 13 cm occurring at the injection site) and VACCINATION SITE PAIN (Tenderness at the injection site) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025J20-2A) for COVID-19 vaccination. Concurrent medical conditions included Allergy to insect sting (Sensitive to mosquito and flea bites). On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Jan-2021, the patient experienced VACCINATION SITE ERYTHEMA (Redness at the injection site/red at the injection site) and VACCINATION SITE PAIN (Soreness at the at the injection site). On 28-Jan-2021, the patient experienced VACCINATION SITE WARMTH (She had a little reaction, little redness, and soreness and warmth, tenderness, (2 days) red rash 7 cm X 13 cm occurring at the injection site.), VACCINATION SITE RASH (Red rash 7 cm X 13 cm occurring at the injection site) and VACCINATION SITE PAIN (Tenderness at the injection site). On 30-Jan-2021, VACCINATION SITE PAIN (Soreness at the at the injection site) and VACCINATION SITE PAIN (Tenderness at the injection site) had resolved. At the time of the report, VACCINATION SITE WARMTH (She had a little reaction, little redness, and soreness and warmth, tenderness, (2 days) red rash 7 cm X 13 cm occurring at the injection site.) had not resolved and VACCINATION SITE ERYTHEMA (Redness at the injection site/red at the injection site) and VACCINATION SITE RASH (Red rash 7 cm X 13 cm occurring at the injection site) was resolving. 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. The patient had a little reaction, little redness and soreness went away after a few days and 9 days later (28-Jan-2021) she had COVID arm: warmth, tenderness, (2 days) red rash 7 cm X 13 cm occurring at the injection site which had faded to a pink at the time of this report. Treatment information were not provided.; 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:

Current Illness: Allergy to insect sting (Sensitive to mosquito and flea bites)

ID: 1551689
Sex: M
Age: 69
State: WI

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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: Severe headache; Muscle pain; Fatigue; Stiffness in shoulder; Severe chills/was shaking for 4 hours; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULOSKELETAL STIFFNESS (Stiffness in shoulder), CHILLS (Severe chills/was shaking for 4 hours), HEADACHE (Severe headache), MYALGIA (Muscle pain) and FATIGUE (Fatigue) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in November 2020. Concomitant products included RIVAROXABAN (XARELTO) and ATORVASTATIN for an unknown indication. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, the patient experienced MUSCULOSKELETAL STIFFNESS (Stiffness in shoulder) and CHILLS (Severe chills/was shaking for 4 hours). On 19-Feb-2021, the patient experienced HEADACHE (Severe headache), MYALGIA (Muscle pain) and FATIGUE (Fatigue). At the time of the report, MUSCULOSKELETAL STIFFNESS (Stiffness in shoulder), CHILLS (Severe chills/was shaking for 4 hours), HEADACHE (Severe headache), MYALGIA (Muscle pain) and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment medications were not provided by reporter.

Other Meds: XARELTO; ATORVASTATIN

Current Illness:

ID: 1551690
Sex: F
Age: 78
State: TX

Vax Date: 01/27/2021
Onset Date: 02/16/2021
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: Shingles; A spontaneous report was received from a consumer concerning a 79-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events shingles. The patient's medical history was not provided. No relevant concomitant medications were reported. On 27 Jan 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 025L20A) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On 16 Feb 2021, the patient experienced the event(s) shingles. Treatment details included valacyclovir. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), shingles was unknown.

Other Meds:

Current Illness:

ID: 1551691
Sex: F
Age:
State: LA

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

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Red spot; it itched alot; This spontaneous case was reported by a pharmacist and describes the occurrence of RASH MACULAR (Red spot) and PRURITUS (it itched alot) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027L20A) for COVID-19 vaccination. No Medical History information was reported. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Jan-2021, the patient experienced RASH MACULAR (Red spot) and PRURITUS (it itched alot). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) on 07-Jan-2021 for Vaccination site reaction, at an unspecified dose and frequency. At the time of the report, RASH MACULAR (Red spot) and PRURITUS (it itched alot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1551692
Sex: F
Age: 77
State: NJ

Vax Date: 02/03/2021
Onset Date: 02/05/2021
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: left arm hurts; peed with a strange smell and left some pink in the toilet; patient peed with a strange smell; This spontaneous case was reported by a patient family member or friend and describes the occurrence of PAIN IN EXTREMITY (left arm hurts), CHROMATURIA (peed with a strange smell and left some pink in the toilet) and URINE ODOUR ABNORMAL (patient peed with a strange smell) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension, Cholesterol and Hemorrhoids. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021, the patient experienced CHROMATURIA (peed with a strange smell and left some pink in the toilet) and URINE ODOUR ABNORMAL (patient peed with a strange smell). On an unknown date, the patient experienced PAIN IN EXTREMITY (left arm hurts). At the time of the report, PAIN IN EXTREMITY (left arm hurts), CHROMATURIA (peed with a strange smell and left some pink in the toilet) and URINE ODOUR ABNORMAL (patient peed with a strange smell) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. concomitant medications included: Blood pressure, cholesterol medication and unspecified medications. No treatment information was provided.

Other Meds:

Current Illness: Cholesterol; Hemorrhoids; Hypertension

ID: 1551693
Sex: F
Age: 83
State: MT

Vax Date: 02/19/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Arm was red from shoulder to elbow; Weakness; Lost her appetite; Pajamas were wet like she had a fever; Wart in between shoulder and arm; Dizziness; Arm was itching underneath; Joint pain; Little drowsy; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (Little drowsy), ERYTHEMA (Arm was red from shoulder to elbow), ASTHENIA (Weakness), DECREASED APPETITE (Lost her appetite) and HYPERHIDROSIS (Pajamas were wet like she had a fever) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 19-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, the patient experienced SOMNOLENCE (Little drowsy), PRURITUS (Arm was itching underneath) and ARTHRALGIA (Joint pain). On 20-Feb-2021, the patient experienced ERYTHEMA (Arm was red from shoulder to elbow), ASTHENIA (Weakness), DECREASED APPETITE (Lost her appetite), HYPERHIDROSIS (Pajamas were wet like she had a fever), SKIN PAPILLOMA (Wart in between shoulder and arm) and DIZZINESS (Dizziness). On 19-Feb-2021, SOMNOLENCE (Little drowsy) had resolved. On 20-Feb-2021, HYPERHIDROSIS (Pajamas were wet like she had a fever) had resolved. On 21-Feb-2021, DECREASED APPETITE (Lost her appetite) had resolved. At the time of the report, ERYTHEMA (Arm was red from shoulder to elbow), ASTHENIA (Weakness), SKIN PAPILLOMA (Wart in between shoulder and arm), DIZZINESS (Dizziness), PRURITUS (Arm was itching underneath) and ARTHRALGIA (Joint pain) outcome was unknown. Treatment and concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1551694
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Slightly sore arm 24 hours after getting the vaccine; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Slightly sore arm 24 hours after getting the vaccine) 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, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced VACCINATION SITE PAIN (Slightly sore arm 24 hours after getting the vaccine). At the time of the report, VACCINATION SITE PAIN (Slightly sore arm 24 hours after getting the vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The concomitant medications and treatment details were not provided. Most recent FOLLOW-UP information incorporated above includes: On 15-Apr-2021: Follow-up information received on 15-Apr-2021 included email ID, onset latency of the event slightly sore arm 24 hours after getting the vaccine.

Other Meds:

Current Illness:

ID: 1551695
Sex: F
Age:
State: NY

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: red bump; headache; Red; little bruise; swelled; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE BRUISING (little bruise), VACCINATION SITE MASS (red bump), HEADACHE (headache), VACCINATION SITE SWELLING (swelled) and VACCINATION SITE ERYTHEMA (Red) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. U06M20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Feb-2021, the patient experienced VACCINATION SITE BRUISING (little bruise) and VACCINATION SITE SWELLING (swelled). On 21-Feb-2021, the patient experienced VACCINATION SITE MASS (red bump), HEADACHE (headache) and VACCINATION SITE ERYTHEMA (Red). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form and BACITRACIN ZINC, NEOMYCIN SULFATE, POLYMYXIN B SULFATE, PRAMOCAINE HYDROCHLORIDE (NEOSPORIN + BURN RELIEF) at a dose of 1 dosage form. At the time of the report, VACCINATION SITE BRUISING (little bruise), VACCINATION SITE MASS (red bump), HEADACHE (headache), VACCINATION SITE SWELLING (swelled) and VACCINATION SITE ERYTHEMA (Red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1551696
Sex: F
Age: 79
State: FL

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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: Muscle Spasms; Really exhausted; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Really exhausted) and MUSCLE SPASMS (Muscle Spasms) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Feb-2021, the patient experienced FATIGUE (Really exhausted). On 20-Feb-2021, the patient experienced MUSCLE SPASMS (Muscle Spasms). On 20-Feb-2021, MUSCLE SPASMS (Muscle Spasms) had resolved. At the time of the report, FATIGUE (Really exhausted) outcome was unknown. Treatment and concomitant medications were not provided by reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1551697
Sex: F
Age: 70
State:

Vax Date: 02/15/2021
Onset Date: 02/15/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Hives all over the body; Itchy all over the body; Stayed in bed for 3 days; Fever; Headache; Vomits; Does not want to eat, does not have appetite; Is not able to sleep; Intense pain in the arm, from the thumb to the ears; Intense cold; Felt very dizzy; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Intense pain in the arm, from the thumb to the ears), FEELING COLD (Intense cold), DIZZINESS (Felt very dizzy), URTICARIA (Hives all over the body) and DECREASED APPETITE (Does not want to eat, does not have appetite) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History was provided by the reporter. Concurrent medical conditions included Asthma, Allergy to animal (Allergic to cats, dogs), Allergy (Allergy to pines) and Dust allergy. Concomitant products included FLUTICASONE PROPIONATE (FLOVENT) for Asthma, IBANDRONATE SODIUM (BONIVA), VITAMINS NOS, MAGNESIUM, POTASSIUM, FOLIC ACID and CALCIUM CITRATE, COLECALCIFEROL (CITRACAL + D3) 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 15-Feb-2021, the patient experienced PAIN IN EXTREMITY (Intense pain in the arm, from the thumb to the ears), FEELING COLD (Intense cold), DIZZINESS (Felt very dizzy), DECREASED APPETITE (Does not want to eat, does not have appetite), INSOMNIA (Is not able to sleep), ILLNESS (Stayed in bed for 3 days), PYREXIA (Fever), HEADACHE (Headache) and VOMITING (Vomits). On 16-Feb-2021, the patient experienced URTICARIA (Hives all over the body) and PRURITUS (Itchy all over the body). The patient was treated with IBUPROFEN (oral) on 15-Feb-2021 for Hives, at a dose of 1 dosage form; CLARITHROMYCIN (CLARITIN [CLARITHROMYCIN]) (oral) on 15-Feb-2021 for Hives, at an unspecified dose and frequency and PARACETAMOL (TYLENOL) on 15-Feb-2021 for Hives, at an unspecified dose and frequency. On 15-Feb-2021, VOMITING (Vomits) had resolved. On 17-Feb-2021, PAIN IN EXTREMITY (Intense pain in the arm, from the thumb to the ears), FEELING COLD (Intense cold), DIZZINESS (Felt very dizzy), URTICARIA (Hives all over the body), ILLNESS (Stayed in bed for 3 days), PYREXIA (Fever) and HEADACHE (Headache) had resolved. At the time of the report, DECREASED APPETITE (Does not want to eat, does not have appetite), INSOMNIA (Is not able to sleep) and PRURITUS (Itchy all over the body) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Feb-2021, Body temperature: 102 (High) Patient had fever of 102 F. On 16-Feb-2021, Body temperature: 101 (High) Patient had fever of 101?F.. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Most recent FOLLOW-UP information incorporated above includes: On 27-Apr-2021

Other Meds: BONIVA; VITAMINS NOS; MAGNESIUM; POTASSIUM; FOLIC ACID; CITRACAL + D3; FLOVENT

Current Illness: Allergy (Allergy to pines); Allergy to animal (Allergic to cats, dogs); Asthma; Dust allergy

ID: 1551698
Sex: F
Age: 90
State: FL

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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: loss of appetite; arm pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm pain) and DECREASED APPETITE (loss of appetite) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. Concurrent medical conditions included Diabetes. Concomitant products included CARBOHYDRATES NOS, CHOLESTEROL, FATS NOS, MINERALS NOS, POTASSIUM, PROTEIN, SODIUM, VITAMINS NOS (GLUCERNA ADVANCE) for Diabetes mellitus. On 09-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Feb-2021, the patient experienced PAIN IN EXTREMITY (arm pain). On 16-Feb-2021, the patient experienced DECREASED APPETITE (loss of appetite). On 10-Feb-2021, PAIN IN EXTREMITY (arm pain) had resolved. At the time of the report, DECREASED APPETITE (loss of appetite) outcome was unknown. Treatment medications were not provided by reporter.

Other Meds: GLUCERNA ADVANCE

Current Illness: Diabetes

ID: 1551699
Sex: M
Age:
State: NY

Vax Date: 01/16/2021
Onset Date: 02/16/2021
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: vertigo; dizziness; nausea; This spontaneous case was reported by a consumer and describes the occurrence of VERTIGO (vertigo), DIZZINESS (dizziness) and NAUSEA (nausea) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013L20A and 026L20A) for COVID-19 vaccination. No Medical History information was reported. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-Feb-2021, the patient experienced VERTIGO (vertigo), DIZZINESS (dizziness) and NAUSEA (nausea). On 17-Feb-2021, VERTIGO (vertigo), DIZZINESS (dizziness) and NAUSEA (nausea) had resolved. Treatment and concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1551700
Sex: F
Age: 72
State: MI

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: started itching at the injection site and around it; soreness at the injection site; swollen; redness; tenderness,if she lay down her arm it is tender; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (soreness at the injection site), VACCINATION SITE SWELLING (swollen), VACCINATION SITE ERYTHEMA (redness), VACCINATION SITE PAIN (tenderness,if she lay down her arm it is tender) and VACCINATION SITE PRURITUS (started itching at the injection site and around it) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. The patient's past medical history included Osteoporosis, Hypertension, Renal disease, Vitamin D deficiency, Chronic back pain, Lumbosacral (joint) (ligament) sprain and Constipation. Concomitant products included AMLODIPINE for Hypertension, METOPROLOL and CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000) for an unknown indication. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Feb-2021, the patient experienced VACCINATION SITE PAIN (soreness at the injection site), VACCINATION SITE SWELLING (swollen), VACCINATION SITE ERYTHEMA (redness) and VACCINATION SITE PAIN (tenderness,if she lay down her arm it is tender). On an unknown date, the patient experienced VACCINATION SITE PRURITUS (started itching at the injection site and around it). At the time of the report, VACCINATION SITE PAIN (soreness at the injection site), VACCINATION SITE SWELLING (swollen), VACCINATION SITE ERYTHEMA (redness), VACCINATION SITE PAIN (tenderness,if she lay down her arm it is tender) and VACCINATION SITE PRURITUS (started itching at the injection site and around it) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment medication included white alcohol.

Other Meds: METOPROLOL; VITAMIN D 2000; AMLODIPINE

Current Illness:

ID: 1551701
Sex: F
Age: 89
State: TX

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: Swelling; a little warm beneath; redness; The arm is a little sore; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE SWELLING (Swelling), VACCINATION SITE ERYTHEMA (redness), VACCINATION SITE WARMTH (a little warm beneath) and PAIN IN EXTREMITY (The arm is a little sore) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030M20A) for COVID-19 vaccination. The patient's past medical history included Stroke in 2003, Colitis, Osteoporosis, Cholesterol and Heart disease, unspecified. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Feb-2021, the patient experienced PAIN IN EXTREMITY (The arm is a little sore). On 12-Feb-2021, the patient experienced VACCINATION SITE ERYTHEMA (redness). On an unknown date, the patient experienced VACCINATION SITE SWELLING (Swelling) and VACCINATION SITE WARMTH (a little warm beneath). At the time of the report, VACCINATION SITE SWELLING (Swelling), VACCINATION SITE ERYTHEMA (redness), VACCINATION SITE WARMTH (a little warm beneath) and PAIN IN EXTREMITY (The arm is a little sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment medications were not provided by reporter. Concomitant medications reported were colitis medications,osteoporosis medications,cholesterol med,and heart medications.

Other Meds:

Current Illness:

ID: 1551702
Sex: F
Age: 65
State: DC

Vax Date: 01/19/2021
Onset Date: 01/19/2021
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: mild arm soreness; This spontaneous case was reported by a consumer and describes the occurrence of in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020L20A) for COVID-19 vaccination. no medical history was provided by the reporter. Concomitant products included ATORVASTATIN for Cholesterol, LISINOPRIL for Hypertension, LEVOTHYROXINE for Parathyroid tumour. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 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. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. treatment medication: tylenol Most recent FOLLOW-UP information incorporated above includes: On 28-Apr-2021: Caller returning call from Safety, concomitant medication was updated

Other Meds: LEVOTHYROXINE; LISINOPRIL; ATORVASTATIN

Current Illness:

ID: 1551703
Sex: M
Age:
State: FL

Vax Date:
Onset Date:
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 arm; Chills; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) and CHILLS (Chills) 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 an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm) and CHILLS (Chills). At the time of the report, PAIN IN EXTREMITY (Sore arm) and CHILLS (Chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1551704
Sex: F
Age: 90
State: CA

Vax Date: 02/10/2021
Onset Date:
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: rash at the site of injection; her arm started to itch; excessive sweat across stomach area; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE RASH (rash at the site of injection), PRURITUS (her arm started to itch) and HYPERHIDROSIS (excessive sweat across stomach area) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027L20A) 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) (unknown route) 1 dosage form. On an unknown date, the patient experienced INJECTION SITE RASH (rash at the site of injection), PRURITUS (her arm started to itch) and HYPERHIDROSIS (excessive sweat across stomach area). At the time of the report, INJECTION SITE RASH (rash at the site of injection), PRURITUS (her arm started to itch) and HYPERHIDROSIS (excessive sweat across stomach area) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment and concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1551705
Sex: F
Age:
State: PA

Vax Date: 02/12/2021
Onset Date:
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: postnasal drip; 2 ear aches; This spontaneous case was reported by a consumer and describes the occurrence of UPPER-AIRWAY COUGH SYNDROME (postnasal drip) and EAR PAIN (2 ear aches) 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 12-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 UPPER-AIRWAY COUGH SYNDROME (postnasal drip) and EAR PAIN (2 ear aches). The patient was treated with PREDNISOLONE at an unspecified dose and frequency. At the time of the report, UPPER-AIRWAY COUGH SYNDROME (postnasal drip) and EAR PAIN (2 ear aches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided by reporter.

Other Meds:

Current Illness:

ID: 1551706
Sex: F
Age:
State: WA

Vax Date: 01/16/2021
Onset Date: 01/17/2021
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: Unevaluable event

Symptoms: sore arm; injection site swelling, red about the size of a tennis ball- HCP dx cellulitis; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of PAIN IN EXTREMITY (sore arm) and VACCINATION SITE CELLULITIS (injection site swelling, red about the size of a tennis ball- HCP dx cellulitis) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Cellulitis (the patient had symptoms like cellulitis.) on 17-Jan-2021. Concomitant products included ROSUVASTATIN, METOPROLOL and LEVOTHYROXINE for an unknown indication. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Jan-2021, the patient experienced PAIN IN EXTREMITY (sore arm) and VACCINATION SITE CELLULITIS (injection site swelling, red about the size of a tennis ball- HCP dx cellulitis). The patient was treated with NEOMYCIN SULFATE, POLYMYXIN B SULFATE (ANTIBIOTIC [NEOMYCIN SULFATE;POLYMYXIN B SULFATE]) (oral) on 17-Jan-2021 for Cellulitis, at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (sore arm) and VACCINATION SITE CELLULITIS (injection site swelling, red about the size of a tennis ball- HCP dx cellulitis) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown.

Other Meds: ROSUVASTATIN; METOPROLOL; LEVOTHYROXINE

Current Illness:

ID: 1551707
Sex: F
Age: 80
State: MD

Vax Date: 01/25/2021
Onset Date: 02/19/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: slipped and broke her ankle; This spontaneous case was reported by a consumer and describes the occurrence of JOINT INJURY (slipped and broke her ankle) in an 80-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 19-Feb-2021, the patient experienced JOINT INJURY (slipped and broke her ankle). At the time of the report, JOINT INJURY (slipped and broke her ankle) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications provided. No treatment information provided. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 25-May-2021: Follow up received on 25-May-202 contains no significant information.

Other Meds:

Current Illness:

ID: 1551708
Sex: F
Age: 46
State: NJ

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Injection site is red; injection site itching; Headache; sore left arm; This spontaneous case was reported by an other health care professional and describes the occurrence of PAIN IN EXTREMITY (sore left arm), VACCINATION SITE PRURITUS (injection site itching), HEADACHE (Headache) and VACCINATION SITE ERYTHEMA (Injection site is red) in a 46-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) 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 left arm) and HEADACHE (Headache). On 26-Jan-2021, the patient experienced VACCINATION SITE PRURITUS (injection site itching). On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (Injection site is red). On 19-Jan-2021, HEADACHE (Headache) had resolved. On 20-Jan-2021, PAIN IN EXTREMITY (sore left arm) had resolved. At the time of the report, VACCINATION SITE PRURITUS (injection site itching) and VACCINATION SITE ERYTHEMA (Injection site is red) 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: 1551709
Sex: F
Age: 57
State: FL

Vax Date: 02/01/2021
Onset Date: 02/04/2021
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: Minor itchiness by the upper body; Pain going down from the side on my neck; Warm by the rash; Rash on the chest; Soreness at injection; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Minor itchiness by the upper body), NECK PAIN (Pain going down from the side on my neck), FEELING HOT (Warm by the rash), RASH (Rash on the chest) and VACCINATION SITE PAIN (Soreness at injection) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038K20A) for COVID-19 vaccination. no specified medical history was reported. Concomitant products included LISINOPRIL and VITAMINS NOS for an unknown indication. On 01-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced PRURITUS (Minor itchiness by the upper body), NECK PAIN (Pain going down from the side on my neck), FEELING HOT (Warm by the rash), RASH (Rash on the chest) and VACCINATION SITE PAIN (Soreness at injection). The patient was treated with LORATADINE, PSEUDOEPHEDRINE HYDROCHLORIDE (BENADRYL 24 D) at an unspecified dose and frequency. At the time of the report, PRURITUS (Minor itchiness by the upper body), NECK PAIN (Pain going down from the side on my neck), FEELING HOT (Warm by the rash), RASH (Rash on the chest) and VACCINATION SITE PAIN (Soreness at injection) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: LISINOPRIL; VITAMINS NOS

Current Illness:

ID: 1551710
Sex: M
Age:
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Irritable; Severe Headache; Extreme Fatigue; Muscle Aches; This spontaneous case was reported by a consumer and describes the occurrence of IRRITABILITY (Irritable), HEADACHE (Severe Headache), FATIGUE (Extreme Fatigue) and MYALGIA (Muscle Aches) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004M20A) for COVID-19 vaccination. Concomitant products included DOXYCYCLINE for Skin damage. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Feb-2021, the patient experienced IRRITABILITY (Irritable), HEADACHE (Severe Headache), FATIGUE (Extreme Fatigue) and MYALGIA (Muscle Aches). The patient was treated with IBUPROFEN at an unspecified dose and frequency. At the time of the report, IRRITABILITY (Irritable), HEADACHE (Severe Headache), FATIGUE (Extreme Fatigue) and MYALGIA (Muscle Aches) had not resolved. 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.

Other Meds: DOXYCYCLINE

Current Illness:

ID: 1551711
Sex: F
Age: 76
State: FL

Vax Date: 02/13/2021
Onset Date: 02/18/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Vertigo; Itchiness on arm; Rash from elbow the elbow to the shoulder (injection arm); This spontaneous case was reported by a consumer and describes the occurrence of VERTIGO (Vertigo), PRURITUS (Itchiness on arm) and RASH (Rash from elbow the elbow to the shoulder (injection arm)) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 015M20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 from November 2020 to December 2020. Concomitant products included ROSUVASTATIN for Cholesterol, CLOPIDOGREL, METOPROLOL SUCCINATE (METOPROLOL [METOPROLOL SUCCINATE]), LISINOPRIL, ALLOPURINOL, CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000) and COPD Inhaler for an unknown indication. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, the patient experienced PRURITUS (Itchiness on arm) and RASH (Rash from elbow the elbow to the shoulder (injection arm)). On 21-Feb-2021, the patient experienced VERTIGO (Vertigo). The patient was treated with LORATADINE, PSEUDOEPHEDRINE HYDROCHLORIDE (BENADRYL 24 D) at an unspecified dose and frequency and HYDROCORTISONE ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, VERTIGO (Vertigo), PRURITUS (Itchiness on arm) and RASH (Rash from elbow the elbow to the shoulder (injection arm)) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In November 2020, SARS-CoV-2 test: positive Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: CLOPIDOGREL; METOPROLOL [METOPROLOL SUCCINATE]; LISINOPRIL; ALLOPURINOL; ROSUVASTATIN; VITAMIN D 2000; COPD Inhaler

Current Illness:

ID: 1551712
Sex: F
Age:
State: NJ

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Knot in cubital fossa; This spontaneous case was reported by a consumer and describes the occurrence of JOINT SWELLING (Knot in cubital fossa) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, the patient experienced JOINT SWELLING (Knot in cubital fossa). At the time of the report, JOINT SWELLING (Knot in cubital fossa) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment was received by the patient. No concomitant medication was received by the patient. Most recent FOLLOW-UP information incorporated above includes: On 06-Jul-2021: Follow up was received on 06-JUL-2021: contains non significant information.

Other Meds:

Current Illness:

ID: 1551713
Sex: M
Age: 56
State: NY

Vax Date: 01/05/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Red, itchy,slightly tinted rash on his collar bone and the top of his sternum; Tingling sensation; Red, itchy,slightly tinted rash on his collar bone and the top of his sternum; Slightly tinted rash on his collar bone and the top of his sternum; The rash increasingly spread to his stomach with a lighter rash in places around his under arm but not in his arm pit, down his arm, and down the side of his torso; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Red, itchy,slightly tinted rash on his collar bone and the top of his sternum), PARAESTHESIA (Tingling sensation), ERYTHEMA (Red, itchy,slightly tinted rash on his collar bone and the top of his sternum), RASH (Slightly tinted rash on his collar bone and the top of his sternum) and RASH (The rash increasingly spread to his stomach with a lighter rash in places around his under arm but not in his arm pit, down his arm, and down the side of his torso) in a 56-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011L20A and 028L20A) for COVID-19 vaccination. No Medical History information was reported. On 05-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PRURITUS (Red, itchy,slightly tinted rash on his collar bone and the top of his sternum), PARAESTHESIA (Tingling sensation), ERYTHEMA (Red, itchy,slightly tinted rash on his collar bone and the top of his sternum), RASH (Slightly tinted rash on his collar bone and the top of his sternum) and RASH (The rash increasingly spread to his stomach with a lighter rash in places around his under arm but not in his arm pit, down his arm, and down the side of his torso). The patient was treated with HYDROCORTISONE ongoing since an unknown date for Rash, at an unspecified dose and frequency and LORATADINE (CLARITIN [LORATADINE]) ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, PRURITUS (Red, itchy,slightly tinted rash on his collar bone and the top of his sternum), PARAESTHESIA (Tingling sensation), ERYTHEMA (Red, itchy,slightly tinted rash on his collar bone and the top of his sternum), RASH (Slightly tinted rash on his collar bone and the top of his sternum) and RASH (The rash increasingly spread to his stomach with a lighter rash in places around his under arm but not in his arm pit, down his arm, and down the side of his torso) outcome was unknown. The concomitant medications were not provided. Treatment medication also included antifungal cream.

Other Meds:

Current Illness:

ID: 1551714
Sex: F
Age:
State: PA

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: arm swelled, big patch; broke out with all body rash; a lot of swelling at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (arm swelled, big patch), RASH (broke out with all body rash) and VACCINATION SITE SWELLING (a lot of swelling at the injection site) in a 63-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 an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PERIPHERAL SWELLING (arm swelled, big patch), RASH (broke out with all body rash) and VACCINATION SITE SWELLING (a lot of swelling at the injection site). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL A) at an unspecified dose and frequency. At the time of the report, PERIPHERAL SWELLING (arm swelled, big patch), RASH (broke out with all body rash) and VACCINATION SITE SWELLING (a lot of swelling at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1551715
Sex: F
Age: 73
State: PA

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Itching from head to toe; Tongue was very dry; A spontaneous report was received from a consumer concerning a 73-years-old patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events itching from head to toe, tongue was very dry. The patient's medical history was not provided. Concomitant medications reported were Blood pressure meds, Vitamin d 3, Baby aspirin, Calcium for drug use for unknown indication. On 29 Jan 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 012k20a) intramuscularly for prophylaxis of COVID-19 infection. On 29 Jan 2021, the patient experienced the event(s) itching from head to toe, tongue was very dry. Treatment details included Zyrtec. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), itching from head to toe, tongue was very dry was unknown.

Other Meds: Blood pressure meds; VITAMIN D 2000; BABY ASPIRIN; CALCIUM

Current Illness:

ID: 1551716
Sex: M
Age:
State: IL

Vax Date: 02/22/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: body aches; chills; light headache; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (body aches), CHILLS (chills) and HEADACHE (light headache) 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 22-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MYALGIA (body aches), CHILLS (chills) and HEADACHE (light headache). The patient was treated with IBUPROFEN at an unspecified dose and frequency and ACETAMINOPHEN ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, MYALGIA (body aches), CHILLS (chills) and HEADACHE (light headache) outcome was unknown. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1551717
Sex: F
Age:
State: PA

Vax Date:
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: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Red welt at injection site; Pain at injection site/Tenderness at injection site; Redness at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE SWELLING (Red welt at injection site), VACCINATION SITE PAIN (Pain at injection site/Tenderness at injection site) and VACCINATION SITE ERYTHEMA (Redness at injection site) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. no specified medical history was reported. Concomitant products included LISINOPRIL and PRAVASTATIN for an unknown indication. 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 SITE SWELLING (Red welt at injection site), VACCINATION SITE PAIN (Pain at injection site/Tenderness at injection site) and VACCINATION SITE ERYTHEMA (Redness at injection site). The patient was treated with NAPROXEN SODIUM (ALEVE) at an unspecified dose and frequency. At the time of the report, VACCINATION SITE SWELLING (Red welt at injection site), VACCINATION SITE PAIN (Pain at injection site/Tenderness at injection site) and VACCINATION SITE ERYTHEMA (Redness at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: LISINOPRIL; PRAVASTATIN

Current Illness:

ID: 1551718
Sex: F
Age: 59
State: MI

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Tingling on left side of the face; Weird thinking; Weird dreams; Heavy foot feeling; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of PARAESTHESIA (Tingling on left side of the face), FEELING ABNORMAL (Weird thinking), ABNORMAL DREAMS (Weird dreams) and LIMB DISCOMFORT (Heavy foot feeling) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. Concurrent medical conditions included Anxiety. Concomitant products included CLONAZEPAM (KLONOPIN) for Anxiety, LEVOTHYROXINE SODIUM (SYNTHROID), VENLAFAXINE HYDROCHLORIDE (EFFEXOR), AMLODIPINE BESILATE (NORVASC), LOSARTAN and OMEPRAZOLE MAGNESIUM (PRILOSEC [OMEPRAZOLE MAGNESIUM]) for an unknown indication. On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Jan-2021, the patient experienced PARAESTHESIA (Tingling on left side of the face), FEELING ABNORMAL (Weird thinking), ABNORMAL DREAMS (Weird dreams) and LIMB DISCOMFORT (Heavy foot feeling). The patient was treated with PARACETAMOL (TYLENOL) for product used for unkown indication, at an unspecified dose and frequency. On 25-Jan-2021, PARAESTHESIA (Tingling on left side of the face), FEELING ABNORMAL (Weird thinking) and ABNORMAL DREAMS (Weird dreams) had resolved. At the time of the report, LIMB DISCOMFORT (Heavy foot feeling) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. This case was linked to MOD-2021-021655 (Patient Link).

Other Meds: SYNTHROID; EFFEXOR; NORVASC; LOSARTAN; PRILOSEC [OMEPRAZOLE MAGNESIUM]; KLONOPIN

Current Illness: Anxiety

ID: 1551719
Sex: M
Age:
State: IL

Vax Date:
Onset Date:
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: tingling at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PARAESTHESIA (tingling at injection site) 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 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 SITE PARAESTHESIA (tingling at injection site). At the time of the report, VACCINATION SITE PARAESTHESIA (tingling at injection site) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications and treatment medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 16-Apr-2021: Follow-up received on 16-Apr-2021 included no new information.

Other Meds:

Current Illness:

ID: 1551720
Sex: F
Age: 74
State:

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

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

Lab Data:

Allergies:

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

Symptoms: swelling in the right arm; rash in the right arm; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of VACCINATION SITE SWELLING (swelling in the right arm) and VACCINATION SITE RASH (rash in the right arm) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013l20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 28-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 VACCINATION SITE SWELLING (swelling in the right arm) and VACCINATION SITE RASH (rash in the right arm). At the time of the report, VACCINATION SITE SWELLING (swelling in the right arm) and VACCINATION SITE RASH (rash in the right arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment: The patient was given antihistamine and cream as treatment.

Other Meds:

Current Illness:

ID: 1551721
Sex: F
Age:
State: TX

Vax Date: 12/23/2020
Onset Date: 12/24/2020
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: Covid19; This spontaneous case was reported by a pharmacist and describes the occurrence of COVID-19 (Covid19) 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 23-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Dec-2020, the patient experienced COVID-19 (Covid19). On 14-Jan-2021, COVID-19 (Covid19) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1551722
Sex: F
Age: 75
State: NY

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Concomitant products included PARACETAMOL (TYLENOL), TRAMADOL, ACETYLSALICYLIC ACID (BABY ASPIRIN), MULTIVITAMIN & MINERAL, ATORVASTATIN and METOPROLOL for an unknown indication. On 16-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to at an unspecified dose. On 16-Feb-2021, the patient experienced PAIN IN EXTREMITY (pain in my left arm). On an unknown date, the patient experienced MOBILITY DECREASED (trouble lifting my left arm/still have some limited use of my arm/still having complications with my arm.) and DISCOMFORT (No longer tolerate the pain and discomfort). The patient was treated with IBUPROFEN (ADVIL 12 HOUR) for Pain, at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (pain in my left arm) had not resolved and MOBILITY DECREASED (trouble lifting my left arm/still have some limited use of my arm/still having complications with my arm.) and DISCOMFORT (No longer tolerate the pain and discomfort) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No medical history provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 21-Jul-2021: Event outcome updated.

Other Meds: TYLENOL; TRAMADOL; BABY ASPIRIN; MULTIVITAMIN & MINERAL; ATORVASTATIN; METOPROLOL

Current Illness:

ID: 1551723
Sex: F
Age: 75
State: FL

Vax Date: 01/22/2021
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: blood pressure was 180/73; This spontaneous case was reported by a consumer and describes the occurrence of BLOOD PRESSURE SYSTOLIC INCREASED (blood pressure was 180/73) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high. Concomitant products included ANASTROZOLE and HYDRALAZINE for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced BLOOD PRESSURE SYSTOLIC INCREASED (blood pressure was 180/73). At the time of the report, BLOOD PRESSURE SYSTOLIC INCREASED (blood pressure was 180/73) had resolved. The patient reported that the reason her blood pressure had raised so high was a medication that she was recently put on around the time of the vaccination series, Anastrozole 1MG. Her physician prescribed her Hydralazine 50MG and her blood pressure was back to normal range. NO treatment medication information provided. This case was linked to MOD-2021-021868, MOD-2021-021868 (Patient Link). Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 28-Jul-2021: Concomitant medication added in the products tab. Event outcome updated.

Other Meds: ANASTROZOLE; HYDRALAZINE

Current Illness: Blood pressure high

ID: 1551724
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: pain from elbow to wrist; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (pain from elbow to wrist) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Arthritis. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN (pain from elbow to wrist). At the time of the report, PAIN (pain from elbow to wrist) outcome was unknown.

Other Meds:

Current Illness: Arthritis

ID: 1551725
Sex: F
Age: 56
State: NC

Vax Date: 01/14/2021
Onset Date: 01/27/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: extremely dry on areas of body,scaly on areas of body; Skin feels sore; swollen lymph node in left armpit like a shelled pecan which hurts; itching all over body; blisters (sores) on top of hands/Skin feels sore; redness around nose,red on areas of body; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (itching all over body), BLISTER (blisters (sores) on top of hands/Skin feels sore), ERYTHEMA (redness around nose,red on areas of body), DRY SKIN (extremely dry on areas of body,scaly on areas of body) and PAIN (Skin feels sore) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included GLIMEPIRIDE, METFORMIN HYDROCHLORIDE, SITAGLIPTIN PHOSPHATE MONOHYDRATE (JANUMET), AMLODIPINE BESILATE (NORVASC), APIXABAN (ELIQUIS), FUROSEMIDE (LASIX [FUROSEMIDE]), POTASSIUM, RANOLAZINE (RANEXA), ATORVASTATIN, CLONAZEPAM (CLONOPIN), FLUTICASONE PROPIONATE (FLONASE ALLERGY RELIEF), LISINOPRIL, MAGNESIUM CARBONATE (MAGENSIUM VITAFIT), DULOXETINE HYDROCHLORIDE (CYMBALTA), TIZANIDINE, CICLOSPORIN (RESTASIS) and CETIRIZINE HYDROCHLORIDE (ZYRTEC ALLERGY) 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 27-Jan-2021, the patient experienced PRURITUS (itching all over body), BLISTER (blisters (sores) on top of hands/Skin feels sore), ERYTHEMA (redness around nose,red on areas of body) and LYMPHADENOPATHY (swollen lymph node in left armpit like a shelled pecan which hurts). On an unknown date, the patient experienced DRY SKIN (extremely dry on areas of body,scaly on areas of body) and PAIN (Skin feels sore). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, PRURITUS (itching all over body), BLISTER (blisters (sores) on top of hands/Skin feels sore), ERYTHEMA (redness around nose,red on areas of body), DRY SKIN (extremely dry on areas of body,scaly on areas of body), PAIN (Skin feels sore) and LYMPHADENOPATHY (swollen lymph node in left armpit like a shelled pecan which hurts) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: GLIMEPIRIDE; JANUMET; NORVASC; ELIQUIS; LASIX [FUROSEMIDE]; POTASSIUM; RANEXA; ATORVASTATIN; CLONOPIN; FLONASE ALLERGY RELIEF; LISINOPRIL; MAGENSIUM VITAFIT; CYMBALTA; TIZANIDINE; RESTASIS; ZYRTEC ALLERGY

Current Illness:

ID: 1551726
Sex: M
Age: 72
State: FL

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

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

Lab Data:

Allergies:

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

Symptoms: Irregular heart beat; Short of breath; Sore arm; Low grade fever; Chills; Muscle ache; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE IRREGULAR (Irregular heart beat), DYSPNOEA (Short of breath), PAIN IN EXTREMITY (Sore arm), PYREXIA (Low grade fever) and CHILLS (Chills) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Open heart surgery. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Jan-2021, the patient experienced DYSPNOEA (Short of breath), PAIN IN EXTREMITY (Sore arm), PYREXIA (Low grade fever), CHILLS (Chills) and MYALGIA (Muscle ache). On 27-Jan-2021, the patient experienced HEART RATE IRREGULAR (Irregular heart beat). At the time of the report, HEART RATE IRREGULAR (Irregular heart beat), DYSPNOEA (Short of breath), PAIN IN EXTREMITY (Sore arm), PYREXIA (Low grade fever), CHILLS (Chills) and MYALGIA (Muscle ache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1551727
Sex: F
Age: 74
State: CT

Vax Date: 02/10/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Vaccination site rash; Vaccination site pruritus; Vaccination site rash; Vaccination site pruritus; This spontaneous case was reported by a consumer and describes the occurrence of the first episode of VACCINATION SITE RASH (Vaccination site rash), the second episode of VACCINATION SITE RASH (Vaccination site rash), the first episode of VACCINATION SITE PRURITUS (Vaccination site pruritus) and the second episode of VACCINATION SITE PRURITUS (Vaccination site pruritus) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030M20A and 044A21A) for COVID-19 vaccination. no specified medical history was reported. The patient's past medical history included Hives. Concurrent medical conditions included Chronic pain (back and leg pain) since 1989, Drug allergy (Augmentin), Drug allergy (Biaxin), Drug allergy (some anesthetics used for surgery), Drug allergy (Naperson), Dug allergy (Ibuprofen), Drug allergy (Indocin), Drug allergy (Feldene,), Hypersensitivity, Asthma and Hay fever. Concomitant products included OXYCODONE HYDROCHLORIDE, PARACETAMOL (PERCOCET [OXYCODONE HYDROCHLORIDE;PARACETAMOL]), GABAPENTIN, CETIRIZINE HYDROCHLORIDE (ZYRTEC R), ESTRADIOL (ESTROGEL), HCTZ, VITAMIN E NOS, FISH OIL, ACETYLSALICYLIC ACID (ASPIRIN (E.C.)), ATORVASTATIN, MAGNESIUM, BIOTIN and SALBUTAMOL (PROVENTIL [SALBUTAMOL]) for an unknown indication. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Mar-2021 at 11:30 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to at an unspecified dose. On 13-Feb-2021, the patient experienced the first episode of VACCINATION SITE RASH (Vaccination site rash) and the first episode of VACCINATION SITE PRURITUS (Vaccination site pruritus). On 15-Feb-2021, the patient experienced the second episode of VACCINATION SITE PRURITUS (Vaccination site pruritus). On 19-Feb-2021, the patient experienced the second episode of VACCINATION SITE RASH (Vaccination site rash). On 15-Feb-2021, last episode of VACCINATION SITE PRURITUS (Vaccination site pruritus) had resolved. At the time of the report, last episode of VACCINATION SITE RASH (Vaccination site rash) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient also uses unspecified fiber pill as a concomitant medication. No treatment information provided. Most recent FOLLOW-UP information incorporated above includes: On 21-Jun-2021: Follow-up received on 21-JUN-2021. Patient history added, concomitant medication information added.

Other Meds: PERCOCET [OXYCODONE HYDROCHLORIDE;PARACETAMOL]; GABAPENTIN; ZYRTEC R; ESTROGEL; HCTZ; VITAMIN E NOS; FISH OIL; ASPIRIN (E.C.); ATORVASTATIN; MAGNESIUM; BIOTIN; PROVENTIL [SALBUTAMOL]

Current Illness: Asthma; Chronic pain (back and leg pain); Drug allergy (some anesthetics used for surgery); Drug allergy (Naperson); Drug allergy (Indocin); Drug allergy (Feldene,); Drug allergy (Biaxin); Drug allergy (Augmentin); Hay fever; Hypersensitivity

ID: 1551728
Sex: F
Age:
State: AZ

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

Symptoms: Scalp started itching Scalp started itching and felt like wanting to pull the head off; This spontaneous case was reported by a consumer and describes the occurrence of SKIN IRRITATION (Scalp started itchingScalp started itching and felt like wanting to pull the head off) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. No Medical History information was reported. On 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 SKIN IRRITATION (Scalp started itchingScalp started itching and felt like wanting to pull the head off). On 21-Feb-2021, SKIN IRRITATION (Scalp started itchingScalp started itching and felt like wanting to pull the head off) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1551729
Sex: F
Age: 67
State: NJ

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Lump Opposite Arm; Large raised lump in legs; Orthopedic nerve pain; Burning pain in all over of body; This spontaneous case was reported by a consumer and describes the occurrence of MASS (Lump Opposite Arm), PERIPHERAL SWELLING (Large raised lump in legs), NEURALGIA (Orthopedic nerve pain) and PAIN (Burning pain in all over of body) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in August 2020. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Feb-2021, the patient experienced MASS (Lump Opposite Arm), PERIPHERAL SWELLING (Large raised lump in legs), NEURALGIA (Orthopedic nerve pain) and PAIN (Burning pain in all over of body). At the time of the report, MASS (Lump Opposite Arm), PERIPHERAL SWELLING (Large raised lump in legs), NEURALGIA (Orthopedic nerve pain) and PAIN (Burning pain in all over of body) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1551730
Sex: M
Age: 72
State: CA

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Some of the vaccine spilled out and not all of it went into arm; Some of the vaccine spilled out and not all of it went into arm; Arm hurts big time, sore; A spontaneous report was received from a consumer concerning a 72-year-old, male patient who experienced some of the vaccine spilled out and not all of it went into arm/underdose, device connection issue and arm hurts big time and is sore/injection site pain. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 20 Feb 2021, prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (lot number 043L20A) intramuscularly in the right upper arm for prophylaxis of COVID-19 infection. On 20FEB2021, the patient reported that he did not receive the full dose of the vaccine. He saw that the person dispensing it withdrew the needle with product still inside, which spilled out upon withdrawal. He also reported that his arm hurt big time and felt sore. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events, underdose and device connection issue were recovered/resolved. The outcome of the event, injection site pain was unknown.; Reporter's Comments: This report refers to a case of underdose and device connection issue for mRNA-1273 (lot # 043L20A) with associated AE reported as injection site pain.

Other Meds:

Current Illness:

ID: 1551731
Sex: U
Age: 48
State: DE

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

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

Lab Data:

Allergies:

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

Symptoms: emergency hernia surgery; arm pain at injection site; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (arm pain at injection site) and HERNIA (emergency hernia surgery) in a 49-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included LOSARTAN and AMOXICILLIN TRIHYDRATE, CLARITHROMYCIN, ESOMEPRAZOLE MAGNESIUM (NEXIUM 1-2-3) for an unknown indication. 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 INJECTION SITE PAIN (arm pain at injection site). On 02-Feb-2021, the patient experienced HERNIA (emergency hernia surgery). At the time of the report, INJECTION SITE PAIN (arm pain at injection site) and HERNIA (emergency hernia surgery) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: LOSARTAN; NEXIUM 1-2-3

Current Illness:

ID: 1551732
Sex: F
Age: 66
State: MN

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: arm was "killing her"; sore arm injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (sore arm injection site) and PAIN IN EXTREMITY (arm was "killing her") in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L2A) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Feb-2021, the patient experienced VACCINATION SITE PAIN (sore arm injection site). On 20-Feb-2021, the patient experienced PAIN IN EXTREMITY (arm was "killing her"). At the time of the report, VACCINATION SITE PAIN (sore arm injection site) and PAIN IN EXTREMITY (arm was "killing her") was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1551733
Sex: F
Age: 29
State: CT

Vax Date: 12/31/2020
Onset Date: 01/04/2021
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: Shingles; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HERPES ZOSTER (Shingles) in a 29-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026L20A) for COVID-19 vaccination. The patient's past medical history included Asthma (she used an albuterol inhaler as needed two years ago). On 31-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Jan-2021, the patient experienced HERPES ZOSTER (Shingles). The patient was treated with PREDNISONE at an unspecified dose and frequency and ACICLOVIR SODIUM (ACYCLOVIR ABBOTT VIAL) at an unspecified dose and frequency. At the time of the report, HERPES ZOSTER (Shingles) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. On 04-Jan-2021, the patient reported red bumps on her back. She went to a health care provider who purportedly misdiagnosed the area as poison oak/ivy and she was prescribed prednisone. She sought a second opinion and was diagnosed with Shingles by another health care provider who prescribed Acyclovir (three times a day), which she was still taking at the time of the report. At the time of the report (27-Jan-2021) she described the area as now being dried up, scabbed up and red. Most recent FOLLOW-UP information incorporated above includes: On 27-Apr-2021: Initial additional information.

Other Meds:

Current Illness:

ID: 1551734
Sex: F
Age:
State:

Vax Date: 02/12/2021
Onset Date:
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: shingle like hives; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (shingle like hives) 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 12-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 URTICARIA (shingle like hives). At the time of the report, URTICARIA (shingle like hives) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Reporter did not allow further contact

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm