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: 1552686
Sex: F
Age: 70
State: GA

Vax Date: 01/18/2021
Onset Date: 01/29/2021
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: Itching near injection site; Rash near injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itching near injection site) and VACCINATION SITE RASH (Rash near injection site) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No adverse event history). Concomitant products included LISINOPRIL, ZINC, ASCORBIC ACID, ROSA CANINA FRUIT (VITAMIN C & ROSEHIP) and ATORVASTATIN CALCIUM (LIPITOR) for an unknown indication. On 18-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 VACCINATION SITE PRURITUS (Itching near injection site) and VACCINATION SITE RASH (Rash near injection site). At the time of the report, VACCINATION SITE PRURITUS (Itching near injection site) had resolved and VACCINATION SITE RASH (Rash near injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: LISINOPRIL; ZINC; VITAMIN C & ROSEHIP; LIPITOR

Current Illness:

ID: 1552687
Sex: F
Age: 20
State: FL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
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: Really tired; Pain on the injection site; Swelling on the injection site; This spontaneous case was reported by an other health care professional and describes the occurrence of VACCINATION SITE PAIN (Pain on the injection site), VACCINATION SITE SWELLING (Swelling on the injection site) and FATIGUE (Really tired) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced VACCINATION SITE PAIN (Pain on the injection site) and VACCINATION SITE SWELLING (Swelling on the injection site). On an unknown date, the patient experienced FATIGUE (Really tired). At the time of the report, VACCINATION SITE PAIN (Pain on the injection site), VACCINATION SITE SWELLING (Swelling on the injection site) and FATIGUE (Really tired) 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: 1552688
Sex: F
Age:
State: MD

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

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

Lab Data:

Allergies:

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

Symptoms: Feeling was just odd; Feeling Jittery; Different taste in my mouth; Dryness in my mouth; Light headedness; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Feeling was just odd), FEELING JITTERY (Feeling Jittery), TASTE DISORDER (Different taste in my mouth), DRY MOUTH (Dryness in my mouth) and DIZZINESS (Light headedness) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history was reported). On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced FEELING ABNORMAL (Feeling was just odd), FEELING JITTERY (Feeling Jittery), TASTE DISORDER (Different taste in my mouth) and DRY MOUTH (Dryness in my mouth). On an unknown date, the patient experienced DIZZINESS (Light headedness). At the time of the report, FEELING ABNORMAL (Feeling was just odd), FEELING JITTERY (Feeling Jittery), TASTE DISORDER (Different taste in my mouth), DRY MOUTH (Dryness in my mouth) and DIZZINESS (Light headedness) 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.

Other Meds:

Current Illness:

ID: 1552689
Sex: F
Age: 73
State: AL

Vax Date: 01/18/2021
Onset Date: 01/18/2021
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: had a sore arm; woke up and was about to fall on the floor; had a mini nerve attack; A spontaneous report was received from a consumer concerning a 73-year-old, female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced woke up and was about to fall on the floor, had a mini nerve attack, and sore arm. The patient's medical history, was not provided by the reporter. Concomitant medications were not reported. On 18 Jan 2021, approximately same day prior to the onset of the events, the patient received the first of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On 18 Jan 2021, after receiving mRNA-1273, the patient woke up in the middle of that night experiencing "mini nerve attack". The patient stated "was about to fall on the floor but didn't and sat back down" on bed and was able to go back to sleep. The patient woke up again and was given two Tylenols by the nurse. At 0700am, the patient wasn't feeling normal and had a sore arm. Patient was then given Norco to relieve the pain. Treatment for the events included acetaminophen, Narco was reported. Action taken with mRNA-1273 in response to the events was not reported. The events, woke up and was about to fall on the floor, had a mini nerve attack, and sore arm were considered resolved on an unknown date.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1552690
Sex: F
Age: 44
State: MA

Vax Date: 01/04/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (sore arm at the injection site that resolved), INJECTION SITE PAIN (sore arm at the injection site), CHILLS (chills), NAUSEA (nausea) and HEADACHE (mild headache) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No historical condition was reported). On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 01-Feb-2021, the patient experienced INJECTION SITE PAIN (sore arm at the injection site that resolved), INJECTION SITE PAIN (sore arm at the injection site), CHILLS (chills), NAUSEA (nausea) and HEADACHE (mild headache). On 02-Feb-2021, INJECTION SITE PAIN (sore arm at the injection site that resolved), INJECTION SITE PAIN (sore arm at the injection site), CHILLS (chills) and NAUSEA (nausea) had resolved. At the time of the report, HEADACHE (mild headache) outcome was unknown.

Other Meds:

Current Illness:

ID: 1552691
Sex: M
Age:
State: CA

Vax Date: 01/28/2021
Onset Date:
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: Fever of 102F; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever of 102F) and HEADACHE (Headache) in an 82-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in December 2020. 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 PYREXIA (Fever of 102F) and HEADACHE (Headache). At the time of the report, PYREXIA (Fever of 102F) and HEADACHE (Headache) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 102F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552692
Sex: M
Age: 34
State: NY

Vax Date: 02/03/2021
Onset Date: 02/04/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever), CHILLS (Chills), NAUSEA (nausea) and HEADACHE (headache) in a 34-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013620A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On 03-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced PYREXIA (fever), CHILLS (Chills), NAUSEA (nausea) and HEADACHE (headache). At the time of the report, PYREXIA (fever), CHILLS (Chills), NAUSEA (nausea) and HEADACHE (headache) outcome was unknown.

Other Meds:

Current Illness:

ID: 1552693
Sex: F
Age:
State: WA

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

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Red Spots (Injection Site); Swollen; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (Red Spots (Injection Site)) and VACCINATION SITE SWELLING (Swollen) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On 18-Jan-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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jan-2021, the patient experienced VACCINATION SITE RASH (Red Spots (Injection Site)) and VACCINATION SITE SWELLING (Swollen). At the time of the report, VACCINATION SITE RASH (Red Spots (Injection Site)) and VACCINATION SITE SWELLING (Swollen) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to US-MODERNATX, INC.-MOD-2021-063831 (E2B Linked Report).

Other Meds:

Current Illness:

ID: 1552694
Sex: M
Age: 94
State: OH

Vax Date: 02/04/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Extreme shakiness; was unable to walk well; vomiting; pain injection site/soreness around injection site; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (Extreme shakiness), GAIT INABILITY (was unable to walk well), VOMITING (vomiting) and VACCINATION SITE PAIN (pain injection site/soreness around injection site) in a 94-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported). On 04-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced VACCINATION SITE PAIN (pain injection site/soreness around injection site). On 05-Feb-2021, the patient experienced TREMOR (Extreme shakiness), GAIT INABILITY (was unable to walk well) and VOMITING (vomiting). At the time of the report, TREMOR (Extreme shakiness), GAIT INABILITY (was unable to walk well), VOMITING (vomiting) and VACCINATION SITE PAIN (pain injection site/soreness around injection site) outcome was unknown.

Other Meds:

Current Illness:

ID: 1552695
Sex: F
Age:
State:

Vax Date: 02/11/2021
Onset Date: 02/16/2021
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: it's going down the inside of the arm now; it started to itch in that area; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (it's going down the inside of the arm now) and VACCINATION SITE PRURITUS (it started to itch in that area) 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 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 16-Feb-2021, the patient experienced PRURITUS (it's going down the inside of the arm now) and VACCINATION SITE PRURITUS (it started to itch in that area). At the time of the report, PRURITUS (it's going down the inside of the arm now) and VACCINATION SITE PRURITUS (it started to itch in that area) outcome was unknown. Treatment and concomitant medications were not reported. Action taken in response to mRNA-1273 was not applicable. Most recent FOLLOW-UP information incorporated above includes: On 17-Feb-2021: process with initial

Other Meds:

Current Illness:

ID: 1552696
Sex: F
Age: 25
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Experienced flu like symptoms; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Experienced flu like symptoms) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025J20-A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No historical condition was reported). On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Jan-2021, the patient experienced INFLUENZA LIKE ILLNESS (Experienced flu like symptoms). At the time of the report, INFLUENZA LIKE ILLNESS (Experienced flu like symptoms) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitants or treatment medications were reported.

Other Meds:

Current Illness:

ID: 1552697
Sex: F
Age:
State: NM

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

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Little sore at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Little sore at injection site) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A202A) for COVID-19 vaccination. The patient's past medical history included Chemotherapy. On 07-Jan-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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Jan-2021, the patient experienced VACCINATION SITE PAIN (Little sore at injection site). At the time of the report, VACCINATION SITE PAIN (Little sore at injection site) outcome was unknown. Not Provided mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. Concomitant products included Blood Pressure and Cholesterol medications. No corrective treatment was provided. Most recent FOLLOW-UP information incorporated above includes: On 20-Apr-2021: Added second dosage regimen.

Other Meds:

Current Illness:

ID: 1552698
Sex: M
Age:
State: CA

Vax Date: 01/28/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: SORE ARM; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (SORE ARM) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). 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 PAIN (SORE ARM). At the time of the report, VACCINATION SITE PAIN (SORE ARM) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552699
Sex: M
Age: 78
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: can not get out of bed; muscle pain; Headache; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of BEDRIDDEN (can not get out of bed), MYALGIA (muscle pain), HEADACHE (Headache) and VACCINATION SITE PAIN (sore arm) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for an unknown indication. The patient's past medical history included COVID-19 on 13-Jan-2021. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced BEDRIDDEN (can not get out of bed), MYALGIA (muscle pain), HEADACHE (Headache) and VACCINATION SITE PAIN (sore arm). At the time of the report, BEDRIDDEN (can not get out of bed), MYALGIA (muscle pain), HEADACHE (Headache) and VACCINATION SITE PAIN (sore arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552700
Sex: F
Age: 79
State: TX

Vax Date: 01/27/2021
Onset Date: 02/04/2021
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: Pink around the injection site; It itches; Patient's injection site became raised and swollen, the size of a lemon; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOLOURATION (Pink around the injection site), VACCINATION SITE PRURITUS (It itches) and VACCINATION SITE SWELLING (Patient's injection site became raised and swollen, the size of a lemon) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no medical history was reported). On 27-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 PRURITUS (It itches) and VACCINATION SITE SWELLING (Patient's injection site became raised and swollen, the size of a lemon). On an unknown date, the patient experienced VACCINATION SITE DISCOLOURATION (Pink around the injection site). At the time of the report, VACCINATION SITE DISCOLOURATION (Pink around the injection site), VACCINATION SITE PRURITUS (It itches) and VACCINATION SITE SWELLING (Patient's injection site became raised and swollen, the size of a lemon) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1552701
Sex: F
Age: 71
State: FL

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: sugar levels went very low; itchiness on injection site; Swollen arm; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen arm), BLOOD GLUCOSE DECREASED (sugar levels went very low) and VACCINATION SITE PRURITUS (itchiness on injection site) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. D13L20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 27-Jan-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Jan-2021, the patient experienced PERIPHERAL SWELLING (Swollen arm) and VACCINATION SITE PRURITUS (itchiness on injection site). On an unknown date, the patient experienced BLOOD GLUCOSE DECREASED (sugar levels went very low). At the time of the report, PERIPHERAL SWELLING (Swollen arm), BLOOD GLUCOSE DECREASED (sugar levels went very low) and VACCINATION SITE PRURITUS (itchiness on injection site) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood glucose: low (Low) Low. 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. Most recent FOLLOW-UP information incorporated above includes: On 17-Apr-2021: Added a new event (blood glucose decreased).; 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:

ID: 1552702
Sex: F
Age: 85
State: NC

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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: Skin feels warm; Skin feels hard; Skin itching; Red rash on site of administration; A spontaneous report was received from a consumer concerning herself a 85? years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced red rash on site of administration/vaccination site rash, skin itching/vaccination site pruritus, skin feels warm/vaccination site warmth and skin feels hard/vaccination site induration. The patient's medical history was not provided. No relevant concomitant medications were reported. On 21 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot/batch unknown) intramuscularly for prophylaxis of COVID-19 infection. On 21 Jan 2021, the patient experienced red rash on site of administration and skin itching. She also says that her skin feels warm and hard. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events, red rash on site of administration, skin itching, skin feels warm and skin feels hard were unknown.

Other Meds:

Current Illness:

ID: 1552703
Sex: M
Age: 80
State: IA

Vax Date: 01/22/2021
Onset Date: 01/30/2021
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: Missed second dose; Itching; big rash on his chest/got a horrible rash all over their entire body; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching), RASH (big rash on his chest/got a horrible rash all over their entire body) and PRODUCT DOSE OMISSION ISSUE (Missed second dose) in an 81-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. 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 30-Jan-2021, the patient experienced PRURITUS (Itching) and RASH (big rash on his chest/got a horrible rash all over their entire body). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Missed second dose). The patient was treated with PREDNISONE (oral) for Rash and Itching, at an unspecified dose and frequency. At the time of the report, PRURITUS (Itching) outcome was unknown, RASH (big rash on his chest/got a horrible rash all over their entire body) had not resolved and PRODUCT DOSE OMISSION ISSUE (Missed second dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment included injectable steroids. No concomitant medication was provided. On an unknown date, Biopsy and Throat culture was performed, but result was not available. Most recent FOLLOW-UP information incorporated above includes: On 21-Apr-2021: Updated event - Product dose omission issue.

Other Meds:

Current Illness:

ID: 1552704
Sex: F
Age: 43
State: VA

Vax Date: 01/28/2021
Onset Date: 02/17/2021
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: Anxiety; Panic attack; Confusion; Unusual sensations on the brain; Problems to concentrate; This spontaneous case was reported by an other health care professional and describes the occurrence of ANXIETY (Anxiety), PANIC ATTACK (Panic attack), CONFUSIONAL STATE (Confusion), FEELING ABNORMAL (Unusual sensations on the brain) and DISTURBANCE IN ATTENTION (Problems to concentrate) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Feb-2021, the patient experienced ANXIETY (Anxiety), PANIC ATTACK (Panic attack), CONFUSIONAL STATE (Confusion), FEELING ABNORMAL (Unusual sensations on the brain) and DISTURBANCE IN ATTENTION (Problems to concentrate). At the time of the report, ANXIETY (Anxiety), PANIC ATTACK (Panic attack), CONFUSIONAL STATE (Confusion), FEELING ABNORMAL (Unusual sensations on the brain) and DISTURBANCE IN ATTENTION (Problems to concentrate) outcome was unknown. Not Provided 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.; Sender's Comments: Very limited information regarding this events has been provided at this time. Further information has been requested. Company assessed the events to be unlikely related to company product.

Other Meds:

Current Illness:

ID: 1552705
Sex: F
Age: 77
State: MI

Vax Date: 03/05/2021
Onset Date: 03/08/2021
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: In lot of pain; Shoulder blade pain; Back pain; Left arm extremely sore; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Back pain), PAIN IN EXTREMITY (Left arm extremely sore), PAIN (In lot of pain) and ARTHRALGIA (Shoulder blade pain) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. The patient's past medical history included Lung cancer and Cancer surgery (Lung cancer surgery). Concomitant products included AMLODIPINE, HYDROCHLOROTHIAZIDE and ATORVASTATIN for an unknown indication. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021, the patient experienced BACK PAIN (Back pain), PAIN IN EXTREMITY (Left arm extremely sore) and ARTHRALGIA (Shoulder blade pain). On an unknown date, the patient experienced PAIN (In lot of pain). The patient was treated with PARACETAMOL (TYLENOL) for Pain, at an unspecified dose and frequency and ACETYLSALICYLIC ACID (ASPRIN) for Pain, at an unspecified dose and frequency. At the time of the report, BACK PAIN (Back pain), PAIN IN EXTREMITY (Left arm extremely sore), PAIN (In lot of pain) and ARTHRALGIA (Shoulder blade pain) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. patient is on radiation therapy Radiation therapy. Most recent FOLLOW-UP information incorporated above includes: On 05-May-2021: Added current condition (Radiation). New event (In lot of pain) added. On 21-May-2021: Follow-up information received on 21-MAY-2021 contains non-significant information ("The patient reported that the reaction had nothing to do with the vaccine").

Other Meds: AMLODIPINE; HYDROCHLOROTHIAZIDE; ATORVASTATIN

Current Illness:

ID: 1552706
Sex: F
Age: 26
State: IL

Vax Date: 01/18/2021
Onset Date: 01/31/2021
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: patient was breastfeeding; developed a runny nose; Felt cold; Body aches; had chills; Tired; Headache / headache was pretty bad; This spontaneous case was reported by a nurse and describes the occurrence of RHINORRHOEA (developed a runny nose), NASOPHARYNGITIS (Felt cold), EXPOSURE VIA BREAST MILK (patient was breastfeeding), MYALGIA (Body aches) and CHILLS (had chills) in a 26-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 01320A) for COVID-19 immunisation. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 18-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jan-2021, the patient experienced NASOPHARYNGITIS (Felt cold), MYALGIA (Body aches), CHILLS (had chills), FATIGUE (Tired) and HEADACHE (Headache / headache was pretty bad). On 02-Feb-2021, the patient experienced RHINORRHOEA (developed a runny nose). On an unknown date, the patient experienced EXPOSURE VIA BREAST MILK (patient was breastfeeding). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and IBUPROFEN (MOTRIN [IBUPROFEN]) at an unspecified dose and frequency. On 03-Feb-2021, RHINORRHOEA (developed a runny nose), NASOPHARYNGITIS (Felt cold), MYALGIA (Body aches), CHILLS (had chills) and FATIGUE (Tired) had resolved. On 04-Feb-2021, HEADACHE (Headache / headache was pretty bad) had resolved. At the time of the report, EXPOSURE VIA BREAST MILK (patient was breastfeeding) 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 concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1552707
Sex: M
Age: 69
State: VA

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

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Deterioration to the point that he cannot hold a fork or tie his shoelaces; he also cannot go to the bathroom on his own; This spontaneous case was reported by a physician and describes the occurrence of MUSCULAR WEAKNESS (Deterioration to the point that he cannot hold a fork or tie his shoelaces) and HYPOKINESIA (he also cannot go to the bathroom on his own) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A15) for COVID-19 vaccination. The patient's past medical history included Neuropathy (this decreased her mobility and weakened it (tenderness in the hands) but it had been improving well.) in November 2020. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Jan-2021, the patient experienced MUSCULAR WEAKNESS (Deterioration to the point that he cannot hold a fork or tie his shoelaces) and HYPOKINESIA (he also cannot go to the bathroom on his own). At the time of the report, MUSCULAR WEAKNESS (Deterioration to the point that he cannot hold a fork or tie his shoelaces) and HYPOKINESIA (he also cannot go to the bathroom on his own) 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. concomitantly, in Nov-2020, Patient took only a pill at atb (Livoaquam). No treatment related information has been reported.

Other Meds:

Current Illness:

ID: 1552708
Sex: F
Age: 33
State: TX

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Exposure during pregnancy; This spontaneous prospective pregnancy case was reported by a health care professional and describes the occurrence of EXPOSURE DURING PREGNANCY (Exposure during pregnancy) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 043L20A) for COVID-19 vaccination. The patient's past medical history included Infertility, Spontaneous abortion on 21-Jul-2020 and Alcohol use (1 to 4 drinks a week). On 29-Jan-2021 at 1:00 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on 27-Aug-2020 and the estimated date of delivery was 03-Jun-2021. On 29-Jan-2021, the patient experienced EXPOSURE DURING PREGNANCY (Exposure during pregnancy). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the twenty-second week of the pregnancy. On 29-Jan-2021, EXPOSURE DURING PREGNANCY (Exposure during pregnancy) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Nov-2020, Prenatal screening test: normal (normal) Normal. On 21-Dec-2020, Aspartate aminotransferase: normal (normal) Normal. On 14-Jan-2021, Ultrasound foetal: normal (normal) normal. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitantly, on 01-Jan-2020, patient started taking Nature Made Prenatal orally once a day as prenatal vitamin. No treatment related information has been reported. On 15-Nov-2020, genetic test came with normal results.

Other Meds:

Current Illness:

ID: 1552709
Sex: M
Age:
State: NY

Vax Date: 01/31/2021
Onset Date: 02/05/2021
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: dizziness and could not stand up; dizziness and could not stand up; Chills; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizziness and could not stand up), DYSSTASIA (dizziness and could not stand up), CHILLS (Chills) and NAUSEA (Nausea) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 31-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021 at 6:00 AM, the patient experienced DIZZINESS (dizziness and could not stand up), DYSSTASIA (dizziness and could not stand up), CHILLS (Chills) and NAUSEA (Nausea). At the time of the report, DIZZINESS (dizziness and could not stand up), DYSSTASIA (dizziness and could not stand up), CHILLS (Chills) and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment was taken by the patient.

Other Meds:

Current Illness:

ID: 1552710
Sex: F
Age:
State: TX

Vax Date: 01/27/2021
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: on her right arm, it became red; on her right arm, it became hot; on her right arm, it became itchy; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (on her right arm, it became red), FEELING HOT (on her right arm, it became hot) and PRURITUS (on her right arm, it became itchy) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Shellfish allergy. On 27-Jan-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced ERYTHEMA (on her right arm, it became red), FEELING HOT (on her right arm, it became hot) and PRURITUS (on her right arm, it became itchy). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency; Physical therapy (Patient put some cool thing on her arm.) for Erythema; Physical therapy (Patient put some cool thing on her arm.) for Feeling hot and Physical therapy (Patient put some cool thing on her arm.) for Pruritus. At the time of the report, ERYTHEMA (on her right arm, it became red) had not resolved and FEELING HOT (on her right arm, it became hot) and PRURITUS (on her right arm, it became itchy) was resolving. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Reporter did not allow further contact

Other Meds:

Current Illness: Shellfish allergy

ID: 1552711
Sex: F
Age: 65
State: PA

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: hives on upper left arm , upper left thigh , upper right thigh, upper right arm; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (hives on upper left arm , upper left thigh , upper right thigh, upper right arm) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included INSULIN 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 URTICARIA (hives on upper left arm , upper left thigh , upper right thigh, upper right arm). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) ongoing since an unknown date for Hives, at an unspecified dose and frequency. At the time of the report, URTICARIA (hives on upper left arm , upper left thigh , upper right thigh, upper right arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitantly, patient was taking cholesterol shot, heart medications, and blood thinners.

Other Meds: INSULIN

Current Illness:

ID: 1552712
Sex: M
Age: 41
State: IL

Vax Date: 01/22/2021
Onset Date: 01/24/2021
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: Chest pain constantly (due to high heat in room); Malaise; Weakness; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Chest pain constantly (due to high heat in room)), MALAISE (Malaise), ASTHENIA (Weakness) and FATIGUE (Fatigue) in a 41-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. UNK) for COVID-19 vaccination. 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 24-Jan-2021, the patient experienced CHEST PAIN (Chest pain constantly (due to high heat in room)), MALAISE (Malaise), ASTHENIA (Weakness) and FATIGUE (Fatigue). On 03-Feb-2021, CHEST PAIN (Chest pain constantly (due to high heat in room)) had resolved. At the time of the report, MALAISE (Malaise), ASTHENIA (Weakness) and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment related information has been reported.

Other Meds:

Current Illness:

ID: 1552713
Sex: F
Age: 74
State:

Vax Date: 01/27/2021
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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: A spontaneous report was received from a consumer concerning a 74-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events arm a rash/ rash, warm/ feeling hot, swollen/ peripheral swelling. 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 their first of two planned doses of mRNA-1273 (lot/batch: 012M20A) intramuscularly for prophylaxis of COVID-19 infection. On 5 Feb 2021, the patient experienced the events arm a rash, warm, swollen. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events arm a rash, worm, swollen was unknown. Based on comment, Peripheral swelling (code to LLT/PT vaccination site swelling which is listed across labels) and Feeling hot (code to LLT/PT vaccination site warmth which is listed across labels)

Other Meds:

Current Illness:

ID: 1552714
Sex: F
Age: 55
State: NV

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
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: nonstop fever at 100Degrees; This spontaneous case was reported by a patient and describes the occurrence of PYREXIA (nonstop fever at 100Degrees) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007L20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 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 02-Feb-2021, the patient experienced PYREXIA (nonstop fever at 100Degrees). At the time of the report, PYREXIA (nonstop fever at 100Degrees) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 02-Feb-2021, Body temperature: 100degree High. No concomitant and treatment medication reported.

Other Meds:

Current Illness:

ID: 1552715
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Delayed reaction; Somnolence; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Delayed reaction) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Delayed reaction). At the time of the report, VACCINATION COMPLICATION (Delayed reaction) outcome was unknown. 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. Most recent FOLLOW-UP information incorporated above includes: On 01-Feb-2021: Follow up received on 22-Apr-2021 included no new information. On 22-Apr-2021: Followup was received on 22 April 2021. Reporter's last name from Patch to Hatch was added.Follow up received on 22-Apr-2021 included no new information.

Other Meds:

Current Illness:

ID: 1552716
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: large red mark around vaccination area that lasted 9 days; A spontaneous report was received from a Consumer concerning a 2021--years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events large red mark around vaccination area that lasted 9 days. The patient's medical history was not provided. No relevant concomitant medications were reported. On 15 Jan 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot batch: Unknown) intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the events large red mark around vaccination area that lasted 9 days. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. On an unknown date the outcome of events include, large red mark around vaccination area that lasted 9 days was not reported. Based on comment Injection site erythema coded as Vaccination site erythema

Other Meds:

Current Illness:

ID: 1552717
Sex: F
Age:
State: MA

Vax Date: 02/10/2021
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: feels like there is a rod in her arm; proceeded to dry-heave; feeling abnormal; Vaccination site reaction; felt really achy in her hips; have not regained her normal level of energy; pretty good headache; felt like she was doing shoulder press for a month nonstop; A spontaneous report was received from a consumer concerning a 53-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events pretty bad reaction, pretty serious vomiting, immediate reaction, massive rush up her chest into her neck, like an adrenaline sensation, felt high and buzzed up, felt a little funny, felt creaky and foggy, felt really achy in her hips, lethargic, vomited all over, 3 rounds of vomiting, didn`t feel great, arm was really sore, felt like she was doing shoulder press for a month nonstop, felt a little foggy, proceeded to dry-heave, was in bed for 2 and half days, pretty good headache, appetite been off, sleep been off, feels like there is a rod in her arm, have not regained her normal level of energy. The patient's medical history was not provided. No relevant concomitant medications were reported. On 10 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 026120A) via unknown route in the left arm for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the event(s) pretty bad reaction, pretty serious vomiting, immediate reaction, massive rush up her chest into her neck, like an adrenaline sensation, felt high and buzzed up, felt a little funny, felt creaky and foggy, felt really achy in her hips, lethargic, vomited all over, 3 rounds of vomiting, didn`t feel great, arm was really sore, felt like she was doing shoulder press for a month nonstop, felt a little foggy, proceeded to dry-heave, Was in bed for 2 and half days, pretty good headache, appetite been off, sleep been off, feels like there is a rod in her arm, have not regained her normal level of energy.Consent for safety to follow-up was received. Treatment details included none Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), pretty bad reaction, pretty serious vomiting, immediate reaction, massive rush up her chest into her neck, like an adrenaline sensation, felt high and buzzed up, felt a little funny, felt creaky and foggy, felt really achy in her hips, lethargic, vomited all over, 3 rounds of vomiting, didn`t feel great, arm was really sore, felt like she was doing shoulder press for a month nonstop, felt a little foggy, proceeded to dry-heave was in bed for 2 and half days, pretty good headache, appetite been off, sleep been off, feels like there is a rod in her arm, have not regained her normal level of energy was unknown. Based on MSA comment, Anxiety, Feeling abnormal, Euphoric, and Malaise is deleted.

Other Meds:

Current Illness:

ID: 1552718
Sex: F
Age: 60
State: CA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
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: Still in bed; had strong reactions; Sore arm; Chills; Foggy brain; Diarrhea; Headache; No appetite; Felt clammy; Weakness; Raspy throat; A spontaneous report was received from a consumer concerning his wife, who is a 60-years-old female patient received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events had strong reactions, sore arm, chills, foggy brain, diarrhea, headache, no appetite, felt clammy, weakness, raspy throat, still in bed. The patient's medical history was lupus, Sjogren's syndrome, allergic to sulfa drugs and passion fruit. Concomitant medications reported were prednisone, lubiprostone, aripiprazole, acetylsalicylic acid, carisoprodol, diltiazem hydrochloride, escitalopram oxalate, folic acid, hydroxychloroquine sulfate, lamotrigine, levothyroxine sodium, lorazepam, metoprolol succinate, sumatriptan succinate, tramadol hydrochloride, prazosin, gabapentin for drug use for unknown indication. On 2 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 027L20A) via unknown route in the left arm for prophylaxis of COVID-19 infection. On 3 Feb 2021, the patient experienced the events strong reactions. About 1 day later she had a sore arm, chills, a foggy brain, diarrhea, headache, no appetite, felt clammy, had weakness, had a raspy throat and is still in bed. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. Based on comment Pain in extremity coded as Vaccination site pain and Adverse reaction coded as Vaccination adverse reaction/PT Vaccination complication The outcome of events had strong reactions, sore arm, chills, foggy brain, diarrhea, headache, no appetite, felt clammy, weakness, raspy throat, still in bed was unknown.

Other Meds: PREDNISONE; AMITIZA; ARIPIPRAZOLE; BABY ASPIRIN; CARISOPRODOL; CARTIA XT; LEXAPRO; FOLIC ACID; PLAQUENIL S; LAMICTAL; SYNTHROID; LORAZEPAM; TOPROL XL; IMITREX DF; ULTRAM ER; PRAZOSIN; NEURONTIN

Current Illness: Drug allergy (Sulfa drugs); Fruit allergy

ID: 1552719
Sex: F
Age:
State: FL

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

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Arm is hurting/Arm is really sore; Limb discount; A Spontaneous report was received from a consumer, concerning herself, a female patient of unknown age, who received Moderna's COVID-19 vaccine (m-RNA-1273) and experienced the events, arm is hurting, arm really sore, can't even lift it. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273, intramuscularly in the left arm. On 01-FEB-2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly, in the left arm, for the prophylaxis of COVID-19 infection. On 01-FEB-2021, the patient experienced the events, arm is hurting, arm really sore, can't even lift it. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not applicable. The outcome of events, arm is hurting, arm really sore, can't even lift it, was unknown at the time of this report. Based on MSA comment Pain in extremity coded as Vaccination adverse reaction and Limb discomfort coded Vaccination site movement impairment

Other Meds:

Current Illness:

ID: 1552720
Sex: F
Age: 35
State: FL

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: Erythema, Pruritus

Symptoms: pain; pain; bedridden; pain; body aches; Fatigue; fever; This spontaneous case was reported by a consumer and describes the occurrence of EYE PAIN (pain), EAR PAIN (pain), BEDRIDDEN (bedridden), MYALGIA (body aches) and FATIGUE (Fatigue) in a 35-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 05-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 MYALGIA (body aches), FATIGUE (Fatigue) and PYREXIA (fever). On an unknown date, the patient experienced EYE PAIN (pain), EAR PAIN (pain), BEDRIDDEN (bedridden) and HEADACHE (pain). The patient was treated with NAPROXEN (MOTRIN [NAPROXEN]) at an unspecified dose and frequency. At the time of the report, EYE PAIN (pain), EAR PAIN (pain), BEDRIDDEN (bedridden), MYALGIA (body aches), FATIGUE (Fatigue), PYREXIA (fever) and HEADACHE (pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1552721
Sex: M
Age:
State: NV

Vax Date: 02/01/2021
Onset Date: 02/03/2021
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: rash on his neck and lower legs; This spontaneous case was reported by a consumer and describes the occurrence of RASH (rash on his neck and lower legs) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. No Medical History information was reported. On 01-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced RASH (rash on his neck and lower legs). At the time of the report, RASH (rash on his neck and lower legs) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. No treatment was reported. Upon in internal review on 21 May 2021, the age was corrected to unknown age.

Other Meds:

Current Illness:

ID: 1552722
Sex: M
Age:
State: TX

Vax Date: 01/21/2021
Onset Date: 01/27/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: COVID-19; This spontaneous case was reported by a nurse and describes the occurrence of COVID-19 (COVID-19) in a 41-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Hypertension. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Jan-2021, the patient experienced COVID-19 (COVID-19). At the time of the report, COVID-19 (COVID-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Jan-2021, SARS-CoV-2 test: positive (Positive) SARS-CoV-2 test 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. No relevant concomitant medications were reported. Treatment information was not provided. This case was linked to MOD-2021-025817 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 24-Jun-2021: Follow-up information received on 24-JUN-2021 contains no new information. On 24-Jun-2021: Follow-up information received on 24-JUN-2021 contains no new information.

Other Meds:

Current Illness: Hypertension

ID: 1552723
Sex: M
Age: 65
State: NC

Vax Date: 01/23/2021
Onset Date: 01/26/2021
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: Super weak; Really nauseous; A really disgusting wet cough; Fever; Generally exhausted; A spontaneous report was received from a Consumer concerning a 66-years-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events super weak, really nauseous, a really disgusting wet cough, fever, generally exhausted. The patient's medical history was not provided. No relevant concomitant medications were reported. On 23 Jan 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot/batch: 012L20A) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On 26 Jan 2021, the patient experienced the event super weak,Really nauseous, A really disgusting wet cough, Fever, Generally exhausted and the outcome of event is Unknown. Treatment details included Tylenol, Mucinex Action taken with mRNA-1273 in response to the events was not reported.

Other Meds:

Current Illness:

ID: 1552724
Sex: F
Age: 69
State: MO

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

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

Lab Data:

Allergies:

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

Symptoms: Soreness and some pain at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Soreness and some pain at the injection site) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) 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 04-Feb-2021, the patient experienced VACCINATION SITE PAIN (Soreness and some pain at the injection site). At the time of the report, VACCINATION SITE PAIN (Soreness and some pain at the injection site) outcome was unknown. 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: 1552725
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: Aching; Chills; High fever, fever was of 100?F; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Aching), CHILLS (Chills) and PYREXIA (High fever, fever was of 100?F) 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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN (Aching), CHILLS (Chills) and PYREXIA (High fever, fever was of 100?F). At the time of the report, PAIN (Aching), CHILLS (Chills) and PYREXIA (High fever, fever was of 100?F) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100 ?F (High) 100. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment related information has been reported.

Other Meds:

Current Illness:

ID: 1552726
Sex: F
Age:
State: MA

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Digestive stuffs; Shortness of breath 6 to 7 days; Chills; Fever; Nausea; Fatigue; Headache; This spontaneous case was reported by a physician and describes the occurrence of GASTROINTESTINAL DISORDER (Digestive stuffs), DYSPNOEA (Shortness of breath 6 to 7 days), CHILLS (Chills), PYREXIA (Fever) and NAUSEA (Nausea) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. 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 an unknown date, the patient experienced GASTROINTESTINAL DISORDER (Digestive stuffs), DYSPNOEA (Shortness of breath 6 to 7 days), CHILLS (Chills), PYREXIA (Fever), NAUSEA (Nausea), FATIGUE (Fatigue) and HEADACHE (Headache). At the time of the report, GASTROINTESTINAL DISORDER (Digestive stuffs) had not resolved and DYSPNOEA (Shortness of breath 6 to 7 days), CHILLS (Chills), PYREXIA (Fever), NAUSEA (Nausea), FATIGUE (Fatigue) and HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment related information has been reported.

Other Meds:

Current Illness:

ID: 1552727
Sex: F
Age: 72
State: CA

Vax Date: 01/23/2021
Onset Date: 02/23/2021
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: Back ache; Nauseous; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (Nauseous) and BACK PAIN (Back ache) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Bladder infection. Concurrent medical conditions included Blood pressure fluctuation (Taking blood pressure pill.). On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Feb-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced NAUSEA (Nauseous). On an unknown date, the patient experienced BACK PAIN (Back ache). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency; IBUPROFEN (ADVIL [IBUPROFEN]) at an unspecified dose and frequency and DIMENHYDRINATE (DRAMAMINE) at an unspecified dose and frequency. At the time of the report, NAUSEA (Nauseous) had not resolved and BACK PAIN (Back ache) outcome was unknown. Concomitantly, patient was taking unspecified blood pressure pills. Action taken with mRNA-1273 in response to the events was not applicable

Other Meds:

Current Illness: Blood pressure fluctuation (Taking blood pressure pill.)

ID: 1552728
Sex: F
Age: 25
State: IL

Vax Date: 01/27/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Warmness at the injection site), VACCINATION SITE INDURATION (Hardness at the injection site), VACCINATION SITE SWELLING (Swelling at the injection site) and VACCINATION SITE ERYTHEMA (Redness at the injection site) in a 25-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 27-Jan-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE WARMTH (Warmness at the injection site), VACCINATION SITE INDURATION (Hardness at the injection site), VACCINATION SITE SWELLING (Swelling at the injection site) and VACCINATION SITE ERYTHEMA (Redness at the injection site). At the time of the report, VACCINATION SITE WARMTH (Warmness at the injection site), VACCINATION SITE INDURATION (Hardness at the injection site), VACCINATION SITE SWELLING (Swelling at the injection site) and VACCINATION SITE ERYTHEMA (Redness at the injection site) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment related information has been reported.

Other Meds:

Current Illness:

ID: 1552729
Sex: F
Age: 31
State: CA

Vax Date: 01/09/2021
Onset Date: 02/03/2021
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: Bump on her lymph node. It is 5 inches long and 4 inches wide.; Vaccination site hot to touch; Redness; Bump on her clavicle; Vaccination site swelling; This spontaneous case was reported by a health care professional and describes the occurrence of LYMPHOEDEMA (Bump on her lymph node. It is 5 inches long and 4 inches wide.), VACCINATION SITE WARMTH (Vaccination site hot to touch), ERYTHEMA (Redness), SWELLING (Bump on her clavicle) and VACCINATION SITE SWELLING (Vaccination site swelling) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011Y20A and 007M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Feb-2021, the patient experienced LYMPHOEDEMA (Bump on her lymph node. It is 5 inches long and 4 inches wide.), VACCINATION SITE WARMTH (Vaccination site hot to touch), ERYTHEMA (Redness), SWELLING (Bump on her clavicle) and VACCINATION SITE SWELLING (Vaccination site swelling). The patient was treated with IBUPROFEN (IBUPROFEN EG) at a dose of unknown and PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, LYMPHOEDEMA (Bump on her lymph node. It is 5 inches long and 4 inches wide.), VACCINATION SITE WARMTH (Vaccination site hot to touch), ERYTHEMA (Redness), SWELLING (Bump on her clavicle) and VACCINATION SITE SWELLING (Vaccination site swelling) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment for the event included ibuprofen and acetaminophen. Action taken with mRNA-1273 in response to the events was not applicable.

Other Meds:

Current Illness:

ID: 1552730
Sex: F
Age: 82
State: CA

Vax Date: 01/29/2021
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: rapid heart beat; Headache; This spontaneous case was reported by a consumer and describes the occurrence of TACHYCARDIA (rapid heart beat) and HEADACHE (Headache) in an 84-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included CLONIDINE HYDROCHLORIDE (CATAPRES [CLONIDINE HYDROCHLORIDE]). On 29-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 TACHYCARDIA (rapid heart beat) and HEADACHE (Headache). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, TACHYCARDIA (rapid heart beat) and HEADACHE (Headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, Blood pressure measurement: increased (High) Increased. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: CATAPRES [CLONIDINE HYDROCHLORIDE]

Current Illness:

ID: 1552731
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: felt weak; fever; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (felt weak) and PYREXIA (fever) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced ASTHENIA (felt weak) and PYREXIA (fever). At the time of the report, ASTHENIA (felt weak) and PYREXIA (fever) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment related information has been reported.

Other Meds:

Current Illness:

ID: 1552732
Sex: F
Age:
State:

Vax Date: 01/31/2021
Onset Date: 01/31/2021
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: diarrhea; vomiting; nausea; horrible headache; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (diarrhea), VOMITING (vomiting), NAUSEA (nausea) and HEADACHE (horrible headache) 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 31-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jan-2021, the patient experienced DIARRHOEA (diarrhea), VOMITING (vomiting), NAUSEA (nausea) and HEADACHE (horrible headache). On 31-Jan-2021, DIARRHOEA (diarrhea), VOMITING (vomiting), NAUSEA (nausea) and HEADACHE (horrible headache) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment related information has been reported.

Other Meds:

Current Illness:

ID: 1552733
Sex: M
Age:
State: TX

Vax Date:
Onset Date: 02/05/2021
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: Positive COVID-19; This spontaneous case was reported by a health care professional and describes the occurrence of COVID-19 (Positive COVID-19) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) 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 05-Feb-2021, the patient experienced COVID-19 (Positive COVID-19). At the time of the report, COVID-19 (Positive COVID-19) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment related information has been reported.

Other Meds:

Current Illness:

ID: 1552734
Sex: F
Age: 61
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: swollen right eye; warm; red spot; egg-sized lymph node on the right side of her neck where the clavicle bone is located; hard; headache; Patient says they are feeling achiness; chills; This spontaneous case was reported by a consumer and describes the occurrence of EYE SWELLING (swollen right eye), VACCINATION SITE WARMTH (warm), VACCINATION SITE ERYTHEMA (red spot), LYMPHADENOPATHY (egg-sized lymph node on the right side of her neck where the clavicle bone is located) and VACCINATION SITE INDURATION (hard) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 02-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Feb-2021, the patient experienced HEADACHE (headache), MYALGIA (Patient says they are feeling achiness) and CHILLS (chills). On 03-Feb-2021, the patient experienced EYE SWELLING (swollen right eye), VACCINATION SITE WARMTH (warm), VACCINATION SITE ERYTHEMA (red spot), LYMPHADENOPATHY (egg-sized lymph node on the right side of her neck where the clavicle bone is located) and VACCINATION SITE INDURATION (hard). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and CETIRIZINE HYDROCHLORIDE (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) at an unspecified dose and frequency. At the time of the report, EYE SWELLING (swollen right eye), VACCINATION SITE WARMTH (warm), VACCINATION SITE ERYTHEMA (red spot), LYMPHADENOPATHY (egg-sized lymph node on the right side of her neck where the clavicle bone is located), VACCINATION SITE INDURATION (hard), HEADACHE (headache), MYALGIA (Patient says they are feeling achiness) and CHILLS (chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1552735
Sex: F
Age: 75
State: NY

Vax Date: 01/22/2021
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: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Left arm is itchy; Arm has red rash; Had a sore arm on site of administration; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Left arm is itchy), VACCINATION SITE RASH (Arm has red rash) and VACCINATION SITE PAIN (Had a sore arm on site of administration) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. 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 04-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (Left arm is itchy), VACCINATION SITE RASH (Arm has red rash) and VACCINATION SITE PAIN (Had a sore arm on site of administration). At the time of the report, VACCINATION SITE PRURITUS (Left arm is itchy), VACCINATION SITE RASH (Arm has red rash) and VACCINATION SITE PAIN (Had a sore arm on site of administration) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported by reporter. Treatment medication not reported.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm