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

Incidents per State

State Total
63,479
AK1,562
AL4,914
AR3,110
AS44
AZ12,730
CA54,886
CO10,464
CT7,347
DC1,568
DE1,561
FL33,514
FM3
GA12,508
GU74
HI2,078
IA4,130
ID2,361
IL18,091
IN22,023
KS4,061
KY6,276
LA4,395
MA13,121
MD11,272
ME2,858
MH8
MI16,697
MN10,689
MO8,360
MP30
MS2,487
MT2,035
NC14,437
ND1,184
NE2,562
NH2,717
NJ16,033
NM3,532
NV3,784
NY30,921
OH17,029
OK5,673
OR7,479
PA21,111
PR1,959
QM2
RI1,833
SC5,601
SD1,087
TN8,048
TX31,896
UT3,791
VA13,180
VI48
VT1,592
WA13,026
WI9,856
WV2,120
WY754
XB5
XL1
XV2

ID: 1603434
Sex: F
Age: 62
State: AZ

Vax Date: 02/13/2021
Onset Date:
Rec V Date: 08/21/2021
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Symptoms: pain behind ear; burning of her chest (like a sunburn); colder skin; tearful; anxiety; more depressed than usual; Pain in lower abdomen periodically; This spontaneous case was reported by a consumer and describes the occurrence of EAR PAIN (pain behind ear), CHEST PAIN (burning of her chest (like a sunburn)), PERIPHERAL COLDNESS (colder skin), TEARFULNESS (tearful) and ANXIETY (anxiety) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse event. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Mar-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 EAR PAIN (pain behind ear), CHEST PAIN (burning of her chest (like a sunburn)), PERIPHERAL COLDNESS (colder skin), TEARFULNESS (tearful), ANXIETY (anxiety), DEPRESSION (more depressed than usual) and ABDOMINAL PAIN LOWER (Pain in lower abdomen periodically). At the time of the report, EAR PAIN (pain behind ear), CHEST PAIN (burning of her chest (like a sunburn)), PERIPHERAL COLDNESS (colder skin), TEARFULNESS (tearful), ANXIETY (anxiety), DEPRESSION (more depressed than usual) and ABDOMINAL PAIN LOWER (Pain in lower abdomen periodically) outcome was unknown. No concomitant medication were provided. No treatment medication were provided. Action taken in response to mRNA-1273 was considered to be not applicable. This case was linked to MOD-2021-058166 (Patient Link).

Other Meds:

Current Illness:

ID: 1603435
Sex: M
Age: 60
State: FL

Vax Date: 01/11/2021
Onset Date:
Rec V Date: 08/21/2021
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Symptoms: Slight soreness; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Slight soreness) in a 60-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0211L20A) for COVID-19 vaccination. Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN 81) for an unknown indication. On 11-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN (Slight soreness). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) at an unspecified dose and frequency. At the time of the report, PAIN (Slight soreness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Other relevant concomitant medication included statin. This case was linked to -MODERNATX, INC.-MOD-2021-066954 (E2B Linked Report).; Sender's Comments: -MODERNATX, INC.-MOD-2021-066954:2nd dose

Other Meds: ASPIRIN 81

Current Illness:

ID: 1603436
Sex: M
Age: 58
State: CA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 08/21/2021
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Symptoms: Vaccine administered after temperature excursion; This spontaneous case was reported by a health care professional and describes the occurrence of WRONG TECHNIQUE IN PRODUCT USAGE PROCESS (Vaccine administered after temperature excursion) in a 58-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003B21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Apr-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Apr-2021, the patient experienced WRONG TECHNIQUE IN PRODUCT USAGE PROCESS (Vaccine administered after temperature excursion). On 02-Apr-2021, WRONG TECHNIQUE IN PRODUCT USAGE PROCESS (Vaccine administered after temperature excursion) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1603437
Sex: F
Age: 74
State: FL

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 08/21/2021
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Symptoms: Ringing in the ears; This spontaneous case was reported by a consumer and describes the occurrence of TINNITUS (Ringing in the ears) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included FLUTICASONE PROPIONATE (FLONASE ALLERGY RELIEF) and PREDNISONE for an unknown indication. On 30-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Dec-2020, the patient experienced TINNITUS (Ringing in the ears). The patient was treated with PREDNISONE at an unspecified dose and frequency and MOMETASONE FUROATE (FLONASE [MOMETASONE FUROATE]) at an unspecified dose and frequency. At the time of the report, TINNITUS (Ringing in the ears) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: unknown (Negative) negative. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Most recent FOLLOW-UP information incorporated above includes: On 25-Jun-2021: Additional document received on 25-JUN-2021: Contain non-significant information. No new information.

Other Meds: FLONASE ALLERGY RELIEF; PREDNISONE

Current Illness:

ID: 1603438
Sex: F
Age: 56
State: MO

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 08/21/2021
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Symptoms: Could not get out of bed; Hot and cold feeling; Sweating; Fever; Swollen Lymph nodes Armpit; Joint pain; Stomach pain; This spontaneous case was reported by an other health care professional and describes the occurrence of FEELING OF BODY TEMPERATURE CHANGE (Hot and cold feeling), HYPERHIDROSIS (Sweating), PYREXIA (Fever), LYMPHADENOPATHY (Swollen Lymph nodes Armpit) and ARTHRALGIA (Joint pain) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 022M20A and 004M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Hashimoto's disease. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-Feb-2021, the patient experienced FEELING OF BODY TEMPERATURE CHANGE (Hot and cold feeling), HYPERHIDROSIS (Sweating), PYREXIA (Fever), LYMPHADENOPATHY (Swollen Lymph nodes Armpit), ARTHRALGIA (Joint pain) and ABDOMINAL PAIN UPPER (Stomach pain). On 04-Feb-2021, the patient experienced ILLNESS (Could not get out of bed). On 07-Feb-2021, FEELING OF BODY TEMPERATURE CHANGE (Hot and cold feeling), HYPERHIDROSIS (Sweating), PYREXIA (Fever), LYMPHADENOPATHY (Swollen Lymph nodes Armpit), ARTHRALGIA (Joint pain), ABDOMINAL PAIN UPPER (Stomach pain) and ILLNESS (Could not get out of bed) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Treatment information was reported.

Other Meds:

Current Illness:

ID: 1603439
Sex: M
Age: 60
State: FL

Vax Date: 01/11/2021
Onset Date:
Rec V Date: 08/21/2021
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Symptoms: Pain scale is 3/10 / spike up to 6-7/10 at times when he is asleep and rolls over; Left arm muscle pain/ seems to be getting worse; pain on injection site radiates down to his elbow; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Pain scale is 3/10 / spike up to 6-7/10 at times when he is asleep and rolls over), MYALGIA (Left arm muscle pain/ seems to be getting worse) and INJECTION SITE PAIN (pain on injection site radiates down to his elbow) in a 60-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012M20A and 0211L20A) for COVID-19 vaccination. Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN 81) for an unknown indication. On 11-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-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 PAIN (Pain scale is 3/10 / spike up to 6-7/10 at times when he is asleep and rolls over), MYALGIA (Left arm muscle pain/ seems to be getting worse) and INJECTION SITE PAIN (pain on injection site radiates down to his elbow). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) at an unspecified dose and frequency. At the time of the report, PAIN (Pain scale is 3/10 / spike up to 6-7/10 at times when he is asleep and rolls over), MYALGIA (Left arm muscle pain/ seems to be getting worse) and INJECTION SITE PAIN (pain on injection site radiates down to his elbow) outcome was unknown. Other relevant concomitant medication included statin. This case was linked to US-MODERNATX, INC.-MOD-2021-066932 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-066932:1st dose

Other Meds: ASPIRIN 81

Current Illness:

ID: 1603440
Sex: F
Age: 74
State: FL

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 08/21/2021
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Symptoms: Middle Ear Congestion; ringing in right ear; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of EAR CONGESTION (Middle Ear Congestion) and TINNITUS (ringing in right ear) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029K20A) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy. Concomitant products included FLUTICASONE PROPIONATE (FLONASE ALLERGY RELIEF) and PREDNISONE for an unknown indication. On 30-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 31-Dec-2020, the patient experienced TINNITUS (ringing in right ear). On an unknown date, the patient experienced EAR CONGESTION (Middle Ear Congestion). At the time of the report, EAR CONGESTION (Middle Ear Congestion) outcome was unknown and TINNITUS (ringing in right ear) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) Negative. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient had negative for past history of COVID-19 . Patient diagnosed with middle ear congestion. Most recent FOLLOW-UP information incorporated above includes: On 19-May-2021: Patient demographics is updated.Medical History is updated. Event list is updated.

Other Meds: FLONASE ALLERGY RELIEF; PREDNISONE

Current Illness:

ID: 1603441
Sex: F
Age: 61
State: NY

Vax Date: 02/25/2021
Onset Date:
Rec V Date: 08/21/2021
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Symptoms: Pain in spine; Stiffness in neck and shoulder; Have a red circle in my arm; Ran very high fever next day and for two days; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 29-Mar-2021 and was forwarded to Moderna on 30-Mar-2021. This spontaneous case was reported by a consumer and describes the occurrence of SPINAL PAIN (Pain in spine), MUSCULOSKELETAL STIFFNESS (Stiffness in neck and shoulder), ERYTHEMA (Have a red circle in my arm) and PYREXIA (Ran very high fever next day and for two days) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 014M20A and 038A21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Mar-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 SPINAL PAIN (Pain in spine), MUSCULOSKELETAL STIFFNESS (Stiffness in neck and shoulder), ERYTHEMA (Have a red circle in my arm) and PYREXIA (Ran very high fever next day and for two days). At the time of the report, SPINAL PAIN (Pain in spine), MUSCULOSKELETAL STIFFNESS (Stiffness in neck and shoulder), ERYTHEMA (Have a red circle in my arm) and PYREXIA (Ran very high fever next day and for two days) outcome 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 information was provided. This case was linked to MOD-2021-061143 (Patient Link).

Other Meds:

Current Illness:

ID: 1603442
Sex: M
Age:
State: CT

Vax Date: 02/25/2021
Onset Date:
Rec V Date: 08/21/2021
Hospital:

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Symptoms: Arm started itching; breaking out in pustules; little red marks; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Arm started itching), RASH PUSTULAR (breaking out in pustules) and ERYTHEMA (little red marks) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002A21A) for COVID-19 vaccination. The patient's past medical history included Blood pressure high and Cholesterol. On 25-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 PRURITUS (Arm started itching), RASH PUSTULAR (breaking out in pustules) and ERYTHEMA (little red marks). At the time of the report, PRURITUS (Arm started itching), RASH PUSTULAR (breaking out in pustules) and ERYTHEMA (little red marks) outcome was unknown. Concomitant medication includes high blood pressure and cholesterol medication. No treatment medication details was reported. This case was linked to US-MODERNATX, INC.-MOD-2021-064268 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-064268:First dose

Other Meds:

Current Illness:

ID: 1603443
Sex: F
Age: 32
State: OK

Vax Date: 03/02/2021
Onset Date: 03/30/2021
Rec V Date: 08/21/2021
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Symptoms: Body hurts; Nose bleed upon blowing; Coughing up blood; Body pain that hurts worse; Migraine; Dizziness; Fever of 101.8 degrees fahrenheit; Bad headache; Arm started to hurt pretty bad, 10 minutes after shot; Pain traveled to neck and head; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm started to hurt pretty bad, 10 minutes after shot), NECK PAIN (Pain traveled to neck and head), PAIN (Body hurts), EPISTAXIS (Nose bleed upon blowing) and HAEMOPTYSIS (Coughing up blood) in a 32-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 014M20A and 020B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Sulfonamide allergy. Concurrent medical conditions included Bee sting hypersensitivity. On 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 30-Mar-2021, the patient experienced PAIN IN EXTREMITY (Arm started to hurt pretty bad, 10 minutes after shot), NECK PAIN (Pain traveled to neck and head), PAIN (Body pain that hurts worse), MIGRAINE (Migraine), DIZZINESS (Dizziness), PYREXIA (Fever of 101.8 degrees fahrenheit) and HEADACHE (Bad headache). On 31-Mar-2021, the patient experienced PAIN (Body hurts), EPISTAXIS (Nose bleed upon blowing) and HAEMOPTYSIS (Coughing up blood). At the time of the report, PAIN IN EXTREMITY (Arm started to hurt pretty bad, 10 minutes after shot), NECK PAIN (Pain traveled to neck and head), PAIN (Body hurts), EPISTAXIS (Nose bleed upon blowing), HAEMOPTYSIS (Coughing up blood), PAIN (Body pain that hurts worse), MIGRAINE (Migraine), DIZZINESS (Dizziness), PYREXIA (Fever of 101.8 degrees fahrenheit) and HEADACHE (Bad headache) 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. Treatment products-Ibuprofen and Excedrin

Other Meds:

Current Illness:

ID: 1603444
Sex: F
Age: 62
State: OH

Vax Date: 03/31/2021
Onset Date:
Rec V Date: 08/21/2021
Hospital:

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Symptoms: This spontaneous case reported by a consumer (subsequently medically confirmed), describes the occurrence of arthropathy (knee problem) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. On Feb 24, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. On Mar 31, 2021, patient received the second dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On an unknown date, patient experienced arthropathy (knee problem). The patient treated with ibuprofen for unspecified disorder of knee joint, at a dose of 1 dosage form. At the time of the report, arthropathy (knee problem) outcome: unknown/not provided. For mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; dosing remained unchanged. No concomitant medication reported. Action taken with mRNA-1273 in response to the drug: N/A.

Other Meds:

Current Illness:

ID: 1603445
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Lab Data:

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Symptoms: Got Ill; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS in a patient of an unknown age and gender 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ILLNESS. At the time of the report, ILLNESS outcome was unknown. No concomitant medications were reported. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1603446
Sex: F
Age: 80
State: GA

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptoms: arm was sore for several; tired for the rest of the day; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm was sore for several) and FATIGUE (tired for the rest of the day) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031L20A and 030A21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 14-Feb-2021, the patient experienced PAIN IN EXTREMITY (arm was sore for several) and FATIGUE (tired for the rest of the day). At the time of the report, PAIN IN EXTREMITY (arm was sore for several) and FATIGUE (tired for the rest of the day) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. Action taken with mRNA-1273 in response to the drug was no change. No concomitant medication information was provided. No treatment medication information was provided. This case was linked to MOD-2021-064419 (Patient Link).

Other Meds:

Current Illness:

ID: 1603447
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
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Symptoms: Sick for a day and a half; Fever; Rigors in her legs; This spontaneous case was reported by a non-health professional and describes the occurrence of ILLNESS (Sick for a day and a half), PYREXIA (Fever) and CHILLS (Rigors in her legs) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced ILLNESS (Sick for a day and a half), PYREXIA (Fever) and CHILLS (Rigors in her legs). At the time of the report, ILLNESS (Sick for a day and a half), PYREXIA (Fever) and CHILLS (Rigors in her legs) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient's relevant concomitant medications weren't reported Treatment information was not provided

Other Meds:

Current Illness:

ID: 1603448
Sex: U
Age:
State: IL

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
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Symptoms: negative serological antibody test results after having the vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by an other health care professional and describes the occurrence of SARS-COV-2 ANTIBODY TEST NEGATIVE (negative serological antibody test results after having the vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced SARS-COV-2 ANTIBODY TEST NEGATIVE (negative serological antibody test results after having the vaccine). At the time of the report, SARS-COV-2 ANTIBODY TEST NEGATIVE (negative serological antibody test results after having the vaccine) outcome was unknown. Not Provided 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. No treatment information was reported. This case was linked to MOD-2021-066059, MOD-2021-066059 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 11-May-2021: Follow up information was received and contain no new information

Other Meds:

Current Illness:

ID: 1603449
Sex: U
Age:
State: LA

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

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Allergies:

Symptom List:

Symptoms: 16 year old twins received Moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old twins received Moderna vaccine) in a 16-year-old patient of an unknown gender 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 PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old twins received Moderna vaccine). At the time of the report, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old twins received Moderna vaccine) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment information was provided. This case was linked to US-MODERNATX, INC.-MOD-2021-064213 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-064213:case for 1st of of twin

Other Meds:

Current Illness:

ID: 1603450
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

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Symptom List:

Symptoms: rash after taking it; This spontaneous case was reported by an other health care professional and describes the occurrence of RASH (rash after taking it) 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 Drug allergy (Dilantin). 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 RASH (rash after taking it). At the time of the report, RASH (rash after taking it) 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 information for the event was provided.

Other Meds:

Current Illness:

ID: 1603451
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

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Symptom List:

Symptoms: First dose Moderna and Second dose Pfizer; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist (subsequently medically confirmed) and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (First dose Moderna and Second dose Pfizer) in a patient of an unknown age and gender 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 INTERCHANGE OF VACCINE PRODUCTS (First dose Moderna and Second dose Pfizer). At the time of the report, INTERCHANGE OF VACCINE PRODUCTS (First dose Moderna and Second dose Pfizer) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patient's relevant concomitant medications weren't reported Treatment information was not provided

Other Meds:

Current Illness:

ID: 1603452
Sex: M
Age:
State: WI

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

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Symptom List:

Symptoms: fever; chills; This spontaneous case was reported by a non-health professional and describes the occurrence of PYREXIA (fever) and CHILLS (chills) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19 in December 2020. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PYREXIA (fever) and CHILLS (chills). At the time of the report, PYREXIA (fever) and CHILLS (chills) outcome was unknown. The patient's concomitant medications weren't reported Treatment information was not provided

Other Meds:

Current Illness:

ID: 1603453
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

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Symptom List:

Symptoms: arm rash, another bad rash; This spontaneous case was reported by a consumer and describes the occurrence of RASH (arm rash, another bad rash) in a patient of an unknown age and gender 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 RASH (arm rash, another bad rash). At the time of the report, RASH (arm rash, another bad rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. No treatment information provided. This case was linked to MOD-2021-067091 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1603454
Sex: F
Age:
State: IL

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

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Symptom List:

Symptoms: Stiffness; Swelling; Crippled; skin disorder; Fatigue; This spontaneous case was reported by a physician and describes the occurrence of MUSCULOSKELETAL STIFFNESS (Stiffness), SWELLING (Swelling), MOBILITY DECREASED (Crippled), SKIN DISORDER (skin disorder) and FATIGUE (Fatigue) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product ADALIMUMAB (HUMIRA) solution for injection for Psoriatic arthritis. Concurrent medical conditions included Psoriatic arthritis. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form On an unknown date, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. and ADALIMUMAB (HUMIRA) (Subcutaneous) at an unspecified dose. On an unknown date, the patient experienced MUSCULOSKELETAL STIFFNESS (Stiffness), SWELLING (Swelling), MOBILITY DECREASED (Crippled), SKIN DISORDER (skin disorder) and FATIGUE (Fatigue). At the time of the report, MUSCULOSKELETAL STIFFNESS (Stiffness), SWELLING (Swelling) and MOBILITY DECREASED (Crippled) was resolving and SKIN DISORDER (skin disorder) and FATIGUE (Fatigue) 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. It was reported that in 2021, the patient experienced crippled. No relevant concomitant medications were reported. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 13-May-2021: No specific follow-up information recorded.

Other Meds:

Current Illness: Psoriatic arthritis

ID: 1603455
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

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Symptom List:

Symptoms: Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. UNK) 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 PAIN IN EXTREMITY (Sore arm). At the time of the report, PAIN IN EXTREMITY (Sore arm) outcome was unknown. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1603456
Sex: F
Age:
State:

Vax Date: 12/23/2020
Onset Date:
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
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Symptoms: Aches; Cough; Rash; shakes/ "almost rigors"; Fever (102F); This spontaneous case was reported by an other health care professional and describes the occurrence of PAIN (Aches), COUGH (Cough), RASH (Rash), CHILLS (shakes/ "almost rigors") and PYREXIA (Fever (102F)) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19. On 23-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN (Aches), COUGH (Cough), RASH (Rash), CHILLS (shakes/ "almost rigors") and PYREXIA (Fever (102F)). At the time of the report, PAIN (Aches), COUGH (Cough), RASH (Rash), CHILLS (shakes/ "almost rigors") and PYREXIA (Fever (102F)) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 102 ?F (High) 102. 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. Concomitant product information was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1603457
Sex: F
Age:
State: IL

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptoms: vaccination site erythema; This spontaneous case was reported by a physician and describes the occurrence of VACCINATION SITE ERYTHEMA (vaccination site erythema) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product ADALIMUMAB (HUMIRA) for an unknown indication. Concurrent medical conditions included Crohn's disease (moderate to severe). On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form and ADALIMUMAB (HUMIRA) (Subcutaneous) injection. On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (vaccination site erythema). At the time of the report, VACCINATION SITE ERYTHEMA (vaccination site erythema) 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 relevant concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness: Crohn's disease (moderate to severe.)

ID: 1603458
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptoms: 45hrs later Moderna Arm is developing; acute pain at the injection site; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of RASH (45hrs later Moderna Arm is developing) and INJECTION SITE PAIN (acute pain at the injection site) in a patient of an unknown age and gender 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 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 RASH (45hrs later Moderna Arm is developing) and INJECTION SITE PAIN (acute pain at the injection site). At the time of the report, RASH (45hrs later Moderna Arm is developing) and INJECTION SITE PAIN (acute pain at the injection site) outcome was unknown. The patient reported after the 2nd dose of vaccine he experienced acute pain at the injection site, unlike any other vaccine. The patient reported that he has taken a lot of vaccines in the past. The patient reported that it was his 2nd arm now as recommended. This case was linked to MOD-2021-067078, MOD-2021-067078 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1603459
Sex: F
Age: 83
State: CA

Vax Date: 02/02/2021
Onset Date: 03/09/2021
Rec V Date: 08/21/2021
Hospital:

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Symptoms: itchiness; rash couple of inches below injection site; redness; This spontaneous case was reported by a patient and describes the occurrence of PRURITUS (itchiness), RASH (rash couple of inches below injection site) and ERYTHEMA (redness) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced PRURITUS (itchiness), RASH (rash couple of inches below injection site) and ERYTHEMA (redness). The patient was treated with HYDROCORTISONE (CORTISONE [HYDROCORTISONE]) for Adverse event, at a dose of cream. At the time of the report, PRURITUS (itchiness), RASH (rash couple of inches below injection site) and ERYTHEMA (redness) had resolved. No concomitant medications were provided. This case was linked to MOD-2021-038241 (Patient Link). Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 07-Apr-2021: AE resolved

Other Meds:

Current Illness:

ID: 1603460
Sex: F
Age:
State:

Vax Date: 03/29/2021
Onset Date: 03/01/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptoms: Hives; Migraine; Body aches; Fever; This spontaneous case was reported by a non-health professional and describes the occurrence of URTICARIA (Hives), MIGRAINE (Migraine), MYALGIA (Body aches) and PYREXIA (Fever) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 29-Mar-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 March 2021, the patient experienced URTICARIA (Hives), MIGRAINE (Migraine), MYALGIA (Body aches) and PYREXIA (Fever). On 31-Mar-2021, URTICARIA (Hives), MIGRAINE (Migraine), MYALGIA (Body aches) and PYREXIA (Fever) had resolved. No relevant concomitant medications were reported. No treatment information was provided. Action taken with mRNA-1273 in response to events was not applicable.

Other Meds:

Current Illness:

ID: 1603461
Sex: F
Age: 39
State: IL

Vax Date: 07/22/2020
Onset Date: 03/01/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Sore arm; Morning stiffness; Lower back pain; This spontaneous case was reported by a physician and describes the occurrence of PAIN IN EXTREMITY (Sore arm), MUSCULOSKELETAL STIFFNESS (Morning stiffness) and BACK PAIN (Lower back pain) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product ADALIMUMAB (HUMIRA) solution for injection for Ankylosing spondylitis. The patient's past medical history included Early morning stiffness in 2020, Low back pain in 2020, Injection site bruising in 2020 and Bruising in 2020. Concurrent medical conditions included Ankylosing spondylitis. On 22-Jul-2020, the patient started ADALIMUMAB (HUMIRA) (Subcutaneous) 40 mg. On 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In March 2021, the patient experienced PAIN IN EXTREMITY (Sore arm), MUSCULOSKELETAL STIFFNESS (Morning stiffness) and BACK PAIN (Lower back pain). At the time of the report, PAIN IN EXTREMITY (Sore arm), MUSCULOSKELETAL STIFFNESS (Morning stiffness) and BACK PAIN (Lower back pain) 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 reported included immunosuppressant and non steroidal anti-inflammatory drugs.

Other Meds: HUMIRA

Current Illness: Ankylosing spondylitis

ID: 1603462
Sex: F
Age: 72
State: NJ

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 018B21A) for COVID-19 vaccination. No Medical History information was reported. On 05-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Apr-2021, the patient experienced HEADACHE (Headache). At the time of the report, HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications reported. No treatment information was provided

Other Meds:

Current Illness:

ID: 1603463
Sex: F
Age:
State: SC

Vax Date: 03/05/2021
Onset Date: 03/12/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Caller received the 1st dose on 05Mar2021 and tested positive for Covid-19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Caller received the 1st dose on 05Mar2021 and tested positive for Covid-19) 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 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, the patient experienced COVID-19 (Caller received the 1st dose on 05Mar2021 and tested positive for Covid-19). At the time of the report, COVID-19 (Caller received the 1st dose on 05Mar2021 and tested positive for Covid-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Mar-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications provided. No treatment medications provided.

Other Meds:

Current Illness:

ID: 1603464
Sex: F
Age: 58
State: PA

Vax Date: 03/06/2021
Onset Date: 04/05/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Dizziness; When she is lying in bed it feels everything is spinning/when she is sitting upright she feels fine; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness) and VERTIGO (When she is lying in bed it feels everything is spinning/when she is sitting upright she feels fine) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 029A21A and 028A21A) for COVID-19 vaccination. No Medical History information was reported. On 06-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 05-Apr-2021, the patient experienced DIZZINESS (Dizziness) and VERTIGO (When she is lying in bed it feels everything is spinning/when she is sitting upright she feels fine). At the time of the report, DIZZINESS (Dizziness) and VERTIGO (When she is lying in bed it feels everything is spinning/when she is sitting upright she feels fine) had not resolved. No concomitant medications provided. No treatment information reported.

Other Meds:

Current Illness:

ID: 1603465
Sex: F
Age:
State: FL

Vax Date: 02/17/2021
Onset Date: 02/24/2020
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: 2nd dose pass 35 days; Red bumps; red bumps and was covered in hives; Left buttock extremely sore; Left hip extremely sore; itching; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of MUSCULOSKELETAL PAIN (Left buttock extremely sore), PRURITUS (itching), ERYTHEMA (Red bumps), URTICARIA (red bumps and was covered in hives) and PRODUCT DOSE OMISSION ISSUE (2nd dose pass 35 days) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Feb-2020, the patient experienced PRURITUS (itching). On 19-Feb-2021, the patient experienced MUSCULOSKELETAL PAIN (Left buttock extremely sore) and ARTHRALGIA (Left hip extremely sore). On 24-Feb-2021, the patient experienced ERYTHEMA (Red bumps) and URTICARIA (red bumps and was covered in hives). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (2nd dose pass 35 days). The patient was treated with PREDNISONE at an unspecified dose and frequency. At the time of the report, MUSCULOSKELETAL PAIN (Left buttock extremely sore), PRURITUS (itching), ERYTHEMA (Red bumps), URTICARIA (red bumps and was covered in hives) and ARTHRALGIA (Left hip extremely sore) outcome was unknown and PRODUCT DOSE OMISSION ISSUE (2nd dose pass 35 days) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Most recent FOLLOW-UP information incorporated above includes: On 06-Apr-2021: Additional information received on 06-APR-2021and does not contain any information.

Other Meds:

Current Illness:

ID: 1603466
Sex: F
Age: 53
State: MS

Vax Date: 04/01/2021
Onset Date:
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: lump on collar bone; This spontaneous case was reported by a consumer and describes the occurrence of lump on collar bone in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Apr-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 an unknown date, the patient experienced lump on collar bone. At the time of the report, lump on collar bone outcome was unknown. No relevant concomitant medications reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1603467
Sex: F
Age: 17
State: NJ

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

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Symptom List:

Symptoms: 17 year old patient received the vaccine; This spontaneous case was reported by a physician and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17 year old patient received the vaccine) in a 17-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Asthma. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Feb-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17 year old patient received the vaccine). On 26-Feb-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17 year old patient received the vaccine) 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. Relevant concomitant medication included inhaler for asthma. No treatment medications were provided Most recent FOLLOW-UP information incorporated above includes: On 05-Apr-2021: Additional information received and contains medical history and concomitant medication.

Other Meds:

Current Illness: Asthma

ID: 1603468
Sex: U
Age:
State: MI

Vax Date:
Onset Date:
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Under 18 years of age was given first dose; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Under 18 years of age was given first dose) in a 17-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 018B21A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history 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 PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Under 18 years of age was given first dose). At the time of the report, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Under 18 years of age was given first dose) 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.; Sender's Comments: This report refers to a case of Product Administered to Patient of Inappropriate Age for mRNA-1273 (Lot number: 018B21A) with no associated AEs.

Other Meds:

Current Illness:

ID: 1603469
Sex: F
Age: 89
State: AL

Vax Date: 03/24/2021
Onset Date:
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Sore arm; Red at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Sore arm) and INJECTION SITE ERYTHEMA (Red at the injection site) in an 89-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046A21A) for COVID-19 vaccination. Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN LOW) for an unknown indication. On 24-Mar-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 VACCINATION SITE PAIN (Sore arm) and INJECTION SITE ERYTHEMA (Red at the injection site). At the time of the report, VACCINATION SITE PAIN (Sore arm) and INJECTION SITE ERYTHEMA (Red at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Relevant concomitant medications also included high blood pressure medication and cholesterol medication. The patient did not take any treatment medication.

Other Meds: ASPIRIN LOW

Current Illness:

ID: 1603470
Sex: F
Age: 59
State: NY

Vax Date: 03/26/2021
Onset Date:
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: pain in arm; fatigue; nauseas; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (pain in arm), FATIGUE (fatigue) and NAUSEA (nauseas) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 26-Mar-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 PAIN (pain in arm), FATIGUE (fatigue) and NAUSEA (nauseas). At the time of the report, VACCINATION SITE PAIN (pain in arm), FATIGUE (fatigue) and NAUSEA (nauseas) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1603471
Sex: F
Age: 41
State: TN

Vax Date: 03/03/2021
Onset Date: 04/02/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: diarrhea; little tiredness; mild fatigue; chills; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (diarrhea), FATIGUE (little tiredness), FATIGUE (mild fatigue) and CHILLS (chills) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040P21A and 031L20A) for COVID-19 vaccination. No Medical History information was reported. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 02-Apr-2021, the patient experienced DIARRHOEA (diarrhea), FATIGUE (little tiredness) and FATIGUE (mild fatigue). 02-Apr-2021, the patient experienced CHILLS (chills). On 04-Apr-2021, DIARRHOEA (diarrhea), FATIGUE (mild fatigue) and CHILLS (chills) had resolved. At the time of the report, FATIGUE (little tiredness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications reported. No treatment information was provided. This case was linked to MOD-2021-067364 (E2B Linked Report).; Sender's Comments: MOD-2021-067364:family member case

Other Meds:

Current Illness:

ID: 1603472
Sex: F
Age: 69
State: CA

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

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Symptom List:

Symptoms: Pain on lower back; Joint pain on her left hip; Joint pain on left knee; Joint pain on both shoulders; Headache; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Pain on lower back), ARTHRALGIA (Joint pain on her left hip), ARTHRALGIA (Joint pain on left knee), ARTHRALGIA (Joint pain on both shoulders) and HEADACHE (Headache) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. Concomitant products included OMEPRAZOLE for Antacid therapy. On 16-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Mar-2021, the patient experienced BACK PAIN (Pain on lower back), ARTHRALGIA (Joint pain on her left hip), ARTHRALGIA (Joint pain on left knee), ARTHRALGIA (Joint pain on both shoulders) and HEADACHE (Headache). At the time of the report, BACK PAIN (Pain on lower back), ARTHRALGIA (Joint pain on her left hip), ARTHRALGIA (Joint pain on left knee), ARTHRALGIA (Joint pain on both shoulders) and HEADACHE (Headache) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided.

Other Meds: OMEPRAZOLE.

Current Illness:

ID: 1603473
Sex: F
Age:
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: lingering headache that comes and goes; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (lingering headache that comes and goes) 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-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 31-Mar-2021, the patient experienced HEADACHE (lingering headache that comes and goes). At the time of the report, HEADACHE (lingering headache that comes and goes) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1603474
Sex: M
Age: 24
State: TX

Vax Date: 03/26/2021
Onset Date: 04/05/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: tested positive; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (tested positive) in a 24-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008B21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Apr-2021, the patient experienced COVID-19 (tested positive). At the time of the report, COVID-19 (tested positive) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-Apr-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. No treatment medications were provided.

Other Meds:

Current Illness:

ID: 1603475
Sex: F
Age:
State: IN

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Loss of taste; Loss of smell; This spontaneous case was reported by a consumer and describes the occurrence of AGEUSIA (Loss of taste) and ANOSMIA (Loss of smell) 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 24-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Apr-2021, the patient experienced AGEUSIA (Loss of taste) and ANOSMIA (Loss of smell). At the time of the report, AGEUSIA (Loss of taste) and ANOSMIA (Loss of smell) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) COVID-19 test was negative. No concomitant medications were provided. No treatment details pertained to the events were provided.

Other Meds:

Current Illness:

ID: 1603476
Sex: M
Age: 24
State: TX

Vax Date: 03/26/2021
Onset Date: 04/05/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Tested positive; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Tested positive) in a 24-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008B21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Apr-2021, the patient experienced COVID-19 (Tested positive). At the time of the report, COVID-19 (Tested positive) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-Apr-2021, SARS-CoV-2 test: positive (Positive) Tested positive for COVID-19. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. No treatment details pertained to the events were provided.

Other Meds:

Current Illness:

ID: 1603477
Sex: M
Age: 51
State: VA

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Tiredness; Fever; Chills; Body aches; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Tiredness), PYREXIA (Fever), CHILLS (Chills) and MYALGIA (Body aches) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047A21A) for COVID-19 vaccination. Concurrent medical conditions included Nasal congestion (Nasal congestion and chest congestion). Concomitant products included DEXTROMETHORPHAN for Nasal congestion and Congestion pulmonary, FLUTICASONE, ATORVASTATIN CALCIUM (LIPITOR) and FEXOFENADINE HYDROCHLORIDE (ALLEGRA) for an unknown indication. On 21-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Mar-2021, the patient experienced FATIGUE (Tiredness), PYREXIA (Fever), CHILLS (Chills) and MYALGIA (Body aches). On 23-Mar-2021, FATIGUE (Tiredness), PYREXIA (Fever), CHILLS (Chills) and MYALGIA (Body aches) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Second dose of mRNA-1273 vaccine scheduled for 18-Apr-2021.

Other Meds: FLUTICASONE; LIPITOR; DEXTROMETHORPHAN; ALLEGRA

Current Illness: Nasal congestion (Nasal congestion and chest congestion)

ID: 1603478
Sex: F
Age: 57
State: TX

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Severe chills; Fatigue; Lethargic; Nausea; soreness; Tenderness; This spontaneous case was reported by a consumer and describes the occurrence of LETHARGY (Lethargic), TENDERNESS (Tenderness), PAIN (Soreness), FATIGUE (Fatigue) and CHILLS (Severe chills) in a 57-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 02-Apr-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-Apr-2021, the patient experienced LETHARGY (Lethargic), TENDERNESS (Tenderness), PAIN (Soreness), FATIGUE (Fatigue), CHILLS (Severe chills) and NAUSEA (Nausea). On 04-Apr-2021, TENDERNESS (Tenderness), PAIN (Soreness), FATIGUE (Fatigue), CHILLS (Severe chills) and NAUSEA (Nausea) had resolved. At the time of the report, LETHARGY (Lethargic) outcome was unknown. No concomitant medications were provided No treatment medications were provided. Action taken with mRNA-1273 in response to the event was not applicable.

Other Meds:

Current Illness:

ID: 1603479
Sex: F
Age: 58
State: NJ

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: lifts her arm it is very achy; warm to the touch; injection arm sore/hurt; swollen; achy; sore arm for a day or two; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm for a day or two), VACCINATION SITE MOVEMENT IMPAIRMENT (lifts her arm it is very achy), VACCINATION SITE WARMTH (warm to the touch), VACCINATION SITE PAIN (injection arm sore/hurt) and VACCINATION SITE SWELLING (swollen) in a 58-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. The patient's past medical history included No adverse event. On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Mar-2021, the patient experienced PAIN IN EXTREMITY (sore arm for a day or two). On 02-Apr-2021, the patient experienced VACCINATION SITE MOVEMENT IMPAIRMENT (lifts her arm it is very achy), VACCINATION SITE WARMTH (warm to the touch), VACCINATION SITE PAIN (injection arm sore/hurt), VACCINATION SITE SWELLING (swollen) and MYALGIA (achy). At the time of the report, PAIN IN EXTREMITY (sore arm for a day or two), VACCINATION SITE MOVEMENT IMPAIRMENT (lifts her arm it is very achy), VACCINATION SITE WARMTH (warm to the touch), VACCINATION SITE PAIN (injection arm sore/hurt), VACCINATION SITE SWELLING (swollen) and MYALGIA (achy) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1603480
Sex: F
Age: 44
State: TX

Vax Date: 04/02/2021
Onset Date:
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Elevated sugar level since getting the second dose; Sore arm; Body aches; headache; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of BLOOD GLUCOSE INCREASED (Elevated sugar level since getting the second dose), VACCINATION SITE PAIN (Sore arm), MYALGIA (Body aches), HEADACHE (headache) and FATIGUE (Fatigue) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 02-Apr-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 an unknown date, the patient experienced BLOOD GLUCOSE INCREASED (Elevated sugar level since getting the second dose), VACCINATION SITE PAIN (Sore arm), MYALGIA (Body aches), HEADACHE (headache) and FATIGUE (Fatigue). At the time of the report, BLOOD GLUCOSE INCREASED (Elevated sugar level since getting the second dose), VACCINATION SITE PAIN (Sore arm), MYALGIA (Body aches), HEADACHE (headache) and FATIGUE (Fatigue) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood glucose: elevated (High) Elevated blood glucose level. No concomitant medications were provided No treatment medications were provided. Action taken with mRNA-1273 in response to the event was not applicable.

Other Meds:

Current Illness:

ID: 1603481
Sex: M
Age:
State: MI

Vax Date: 03/26/2021
Onset Date:
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Dizziness; Sore Arm; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness) and VACCINATION SITE PAIN (Sore Arm) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008821-2A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in 2020. On 26-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DIZZINESS (Dizziness) and VACCINATION SITE PAIN (Sore Arm). At the time of the report, DIZZINESS (Dizziness) and VACCINATION SITE PAIN (Sore Arm) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications provided. No treatment information provided. This case was linked to US-MODERNATX, INC.-MOD-2021-067157 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-067157:crosslinked with wife case

Other Meds:

Current Illness:

ID: 1603482
Sex: F
Age: 45
State: MA

Vax Date: 03/24/2021
Onset Date: 04/05/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: sore arm; Arm has a huge lump; Arm is red; Arm is warm to the touch; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE WARMTH (Arm is warm to the touch), VACCINATION SITE PAIN (sore arm), INJECTION SITE SWELLING (Arm has a huge lump) and INJECTION SITE ERYTHEMA (Arm is red) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 018B21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Apr-2021, the patient experienced INJECTION SITE WARMTH (Arm is warm to the touch), INJECTION SITE SWELLING (Arm has a huge lump) and INJECTION SITE ERYTHEMA (Arm is red). On an unknown date, the patient experienced VACCINATION SITE PAIN (sore arm). At the time of the report, INJECTION SITE WARMTH (Arm is warm to the touch), INJECTION SITE SWELLING (Arm has a huge lump) and INJECTION SITE ERYTHEMA (Arm is red) had not resolved and VACCINATION SITE PAIN (sore arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications provided. No treatment information provided.

Other Meds:

Current Illness:

ID: 1603483
Sex: F
Age:
State:

Vax Date: 03/20/2021
Onset Date: 03/27/2021
Rec V Date: 08/21/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: worst hives on feet only; itching at the vaccination site; swelled up a bit but no big deal; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (worst hives on feet only), VACCINATION SITE PRURITUS (itching at the vaccination site) and VACCINATION SITE SWELLING (swelled up a bit but no big deal) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. No Medical History information was reported. On 20-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Mar-2021, the patient experienced URTICARIA (worst hives on feet only), VACCINATION SITE PRURITUS (itching at the vaccination site) and VACCINATION SITE SWELLING (swelled up a bit but no big deal). At the time of the report, URTICARIA (worst hives on feet only) had not resolved and VACCINATION SITE PRURITUS (itching at the vaccination site) and VACCINATION SITE SWELLING (swelled up a bit but no big deal) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment information provided.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 559,999

Page last modified: 03 October 2021 5:28pm