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: 1556188
Sex: F
Age: 84
State: TX

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/14/2021
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: Arm itches; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Arm itches) in an 84-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Jan-2021, the patient experienced VACCINATION SITE PRURITUS (Arm itches). At the time of the report, VACCINATION SITE PRURITUS (Arm itches) 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. Concomitant medications was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1556189
Sex: F
Age:
State:

Vax Date: 01/27/2021
Onset Date:
Rec V Date: 08/14/2021
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: hot; itches like crazy; one week after receiving the vaccine at the site of injection she has a huge arm rash; bright red; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (hot), VACCINATION SITE PRURITUS (itches like crazy), INJECTION SITE RASH (one week after receiving the vaccine at the site of injection she has a huge arm rash) and VACCINATION SITE ERYTHEMA (bright red) 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 27-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 VACCINATION SITE WARMTH (hot), VACCINATION SITE PRURITUS (itches like crazy), INJECTION SITE RASH (one week after receiving the vaccine at the site of injection she has a huge arm rash) and VACCINATION SITE ERYTHEMA (bright red). At the time of the report, VACCINATION SITE WARMTH (hot), VACCINATION SITE PRURITUS (itches like crazy), INJECTION SITE RASH (one week after receiving the vaccine at the site of injection she has a huge arm rash) and VACCINATION SITE ERYTHEMA (bright red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1556190
Sex: F
Age: 30
State: TX

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 08/14/2021
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: Patient is 25 weeks pregnant and received both doses of the Moderna vaccine; This spontaneous prospective pregnancy case was reported by a physician (subsequently medically confirmed) and describes the occurrence of MATERNAL EXPOSURE DURING PREGNANCY (Patient is 25 weeks pregnant and received both doses of the Moderna vaccine) in a 30-year-old female patient (gravida 1) who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 042L02A and 022M20A) for COVID-19 vaccination. No Medical History information was reported. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. The patient's last menstrual period was on an unknown date and the estimated date of delivery was 07-Jun-2021. On 16-Jan-2021, the patient experienced MATERNAL EXPOSURE DURING PREGNANCY (Patient is 25 weeks pregnant and received both doses of the Moderna vaccine). The delivery occurred on an unknown date, which was reported as Unknown. For neonate 1, The outcome was reported as Unknown. On 13-Feb-2021, MATERNAL EXPOSURE DURING PREGNANCY (Patient is 25 weeks pregnant and received both doses of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant and treatment medications were not reported.

Other Meds:

Current Illness:

ID: 1556191
Sex: F
Age: 75
State: NV

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/14/2021
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: Mild Nausea; arm was red from the injection site down to just above my elbow; soreness; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (soreness), NAUSEA (Mild Nausea) and VACCINATION SITE ERYTHEMA (arm was red from the injection site down to just above my elbow) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007N20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 01-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, the patient experienced PAIN (soreness). On 02-Feb-2021, the patient experienced NAUSEA (Mild Nausea) and VACCINATION SITE ERYTHEMA (arm was red from the injection site down to just above my elbow). At the time of the report, PAIN (soreness), NAUSEA (Mild Nausea) and VACCINATION SITE ERYTHEMA (arm was red from the injection site down to just above my elbow) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant medication information was provided. No treatment information was provided by the reporter. On 01 Feb 2021, patient got her 1st dose of the Moderna vaccine. Patient reported soreness on the1st day. The next day on 02Feb2021, her arm was red from the injection site down to just above her elbow. Patient felt tired, and had mild nausea.

Other Meds:

Current Illness:

ID: 1556192
Sex: F
Age: 62
State: TX

Vax Date: 01/08/2021
Onset Date: 02/05/2021
Rec V Date: 08/14/2021
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: Muscle pain on the right side, in the upper chest, right underneath the breast; This spontaneous case was reported by an other health care professional and describes the occurrence of MYALGIA (Muscle pain on the right side, in the upper chest, right underneath the breast) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 027L20A and 032L20A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high. Concomitant products included AMLODIPINE for Blood pressure high. On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 05-Feb-2021, the patient experienced MYALGIA (Muscle pain on the right side, in the upper chest, right underneath the breast). On 07-Feb-2021, MYALGIA (Muscle pain on the right side, in the upper chest, right underneath the breast) had resolved. 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.

Other Meds: AMLODIPINE

Current Illness: Blood pressure high

ID: 1556193
Sex: F
Age:
State: KY

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 08/14/2021
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: contracted Bronchitis; This spontaneous case was reported by a consumer and describes the occurrence of BRONCHITIS (contracted Bronchitis) 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-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Feb-2021, the patient experienced BRONCHITIS (contracted Bronchitis). At the time of the report, BRONCHITIS (contracted Bronchitis) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication details were not reported by the reporter. Treatment details was not reported by the reporter.

Other Meds:

Current Illness:

ID: 1556194
Sex: F
Age: 65
State: OH

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 08/14/2021
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: Soreness under her left Arm; swollen lymph node; Chills; chest tightness; Dizziness; A spontaneous report was received from a healthcare professional concerning a 65-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events chest tightness/chest discomfort, dizziness, chills, soreness under her left arm/pain in extremity, swollen lymph node/lymphadenopathy. The patient's medical history included asthma. No relevant concomitant medications were reported. On 19 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 031L20A) via unknown route in the left arm for prophylaxis of COVID-19 infection. On 19 Feb 2021, the patient experienced the event(s) chest tightness, dizziness, chills. On 24 Feb 2021, the patient experienced the event(s) soreness under her left arm, swollen lymph node. Treatment details included rescue inhaler. Action taken with mRNA-1273 in response to the events was not reported. On 20 Feb 2021 the outcome of event(s), chest tightness, dizziness, chills was resolved. The outcome of event(s), soreness under her left arm, swollen lymph node was unknown.

Other Meds:

Current Illness: Asthma

ID: 1556195
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/14/2021
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: 100.2?F fever; Throw up; A spontaneous report was received from Consumer concerning a patient 50 year old, female and who received Moderna's COVID-19 vaccine(mRNA-1273) and experienced 100.2?F fever and throw up. The patient's medical history was not provided. Concomitant products were not provided. On unknown date, the patient received their unknown dose of two planned doses of mRNA-1273 (Batch Number unknown) viz unknown route for prophylaxis of COVID-19 infection. The patient experienced a 100.2?F fever and the reporter said that throw up. The age of the patient is around 50. Treatment provided was unknown. Action taken with mRNA-1273 in response to the event was unknown. The outcome of the event 100.2?F fever and throw up is unknown.

Other Meds:

Current Illness:

ID: 1556196
Sex: F
Age: 22
State: MN

Vax Date: 02/04/2021
Onset Date: 02/25/2021
Rec V Date: 08/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: tested COVID19 positive; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of SARS-COV-2 TEST POSITIVE (tested COVID19 positive) in a 23-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Feb-2021, the patient experienced SARS-COV-2 TEST POSITIVE (tested COVID19 positive). At the time of the report, SARS-COV-2 TEST POSITIVE (tested COVID19 positive) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 25-Feb-2021, SARS-CoV-2 test positive: positive positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1556197
Sex: F
Age:
State:

Vax Date: 02/08/2021
Onset Date: 02/19/2021
Rec V Date: 08/14/2021
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: Rash in the arm 11 days after the vaccination; This spontaneous case was reported by a consumer and describes the occurrence of RASH (Rash in the arm 11 days after the vaccination) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for an unknown indication. No Medical History information was reported. On 08-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, the patient experienced RASH (Rash in the arm 11 days after the vaccination). At the time of the report, RASH (Rash in the arm 11 days after the vaccination) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication were not reported by the reporter. Treatment details was not reported by the reporter.

Other Meds:

Current Illness:

ID: 1556198
Sex: F
Age:
State:

Vax Date: 02/06/2021
Onset Date:
Rec V Date: 08/14/2021
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: diarrhea; Fever; Chills; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (diarrhea), PYREXIA (Fever) and CHILLS (Chills) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced DIARRHOEA (diarrhea), PYREXIA (Fever) and CHILLS (Chills). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, DIARRHOEA (diarrhea), PYREXIA (Fever) and CHILLS (Chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication details were not reported by the reporter.

Other Meds:

Current Illness:

ID: 1556199
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/14/2021
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: Adverse event; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE EVENT (Adverse event) 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 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 ADVERSE EVENT (Adverse event). At the time of the report, ADVERSE EVENT (Adverse event) outcome was unknown. Not Provided Concomitant medication details were not reported by the reporter. Treatment details was not reported by the reporter.

Other Meds:

Current Illness:

ID: 1556200
Sex: M
Age: 75
State: TN

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/14/2021
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: Pain in his low leg,knee pain,hip pain; Pain on his right leg, that comes and goes up to his ankles; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain on his right leg, that comes and goes up to his ankles) and ARTHRALGIA (Pain in his low leg,knee pain,hip pain) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. Concomitant products included CETIRIZINE HYDROCHLORIDE (ZYRTEC ALLERGY) for COPD, DEXTROMETHORPHAN HYDROBROMIDE, DOXYLAMINE SUCCINATE, EPHEDRINE SULFATE, ETHANOL, PARACETAMOL (NYQUIL) for an unknown indication. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, the patient experienced PAIN IN EXTREMITY (Pain on his right leg, that comes and goes up to his ankles). On an unknown date, the patient experienced ARTHRALGIA (Pain in his low leg,knee pain,hip pain). At the time of the report, PAIN IN EXTREMITY (Pain on his right leg, that comes and goes up to his ankles) and ARTHRALGIA (Pain in his low leg,knee pain,hip pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Products known to have been used by the patient, within two weeks prior to the event, included prostate medication and pain medication for the leg and hips. Treatment for the event included ibuprofen. Reporter did not allow further contact

Other Meds: ZYRTEC ALLERGY; NYQUIL

Current Illness:

ID: 1556201
Sex: M
Age:
State:

Vax Date:
Onset Date: 02/05/2021
Rec V Date: 08/14/2021
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: Severe chills; fever of 101F; Nausea; Headache; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Severe chills), PYREXIA (fever of 101F), NAUSEA (Nausea) and HEADACHE (Headache) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 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 05-Feb-2021, the patient experienced CHILLS (Severe chills), PYREXIA (fever of 101F), NAUSEA (Nausea) and HEADACHE (Headache). At the time of the report, CHILLS (Severe chills), PYREXIA (fever of 101F), NAUSEA (Nausea) and HEADACHE (Headache) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-Feb-2021, Body temperature: 101 High. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication details were not reported by the reporter. Treatment details was not reported by the reported.

Other Meds:

Current Illness:

ID: 1556202
Sex: F
Age: 68
State: MN

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 08/14/2021
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: soreness/tenderness at the injection site; muscle aches; headache; chills; A spontaneous report was received from a consumer concerning a 68 years old patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events soreness tenderness at the injection site /injection site pain, muscle aches /myalgia, headache, chills. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Feb 2021,approximately 1 day prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 007M20A) via unknown route in the left arm for prophylaxis of COVID-19 infection. On 22 Feb 2021, the patient experienced the event(s) soreness tenderness at the injection site, muscle aches, headache, chills. Treatment details included Ibuprofen. Action taken with mRNA-1273 in response to the events was not reported. On 25 Feb 2021 the outcome of event(s), muscle aches, headache, chills was resolved. The outcome of event(s), soreness tenderness at the injection site was unknown.

Other Meds:

Current Illness:

ID: 1556203
Sex: F
Age: 67
State: GA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 08/14/2021
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: Rash on Bilateral arms; This spontaneous case was reported by a health care professional (subsequently medically confirmed) and describes the occurrence of RASH (Rash on Bilateral arms) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. The patient's past medical history included Mitral valve prolapse. Concurrent medical conditions included Hypertension and Iodine allergy. On 08-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, the patient experienced RASH (Rash on Bilateral arms). The patient was treated with LOSARTAN at an unspecified dose and frequency and SPIRONOLACTONE (SPIROLACTON) at an unspecified dose and frequency. At the time of the report, RASH (Rash on Bilateral arms) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Feb-2021, Electrocardiogram: normal (normal) Normal. 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 reported. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 09-Feb-2021: Follow up received on 9-Feb-2021 Regulatory Authority On 22-Apr-2021: Follow-up received on 22-Feb-2021

Other Meds:

Current Illness:

ID: 1556204
Sex: F
Age: 74
State: NY

Vax Date: 02/08/2021
Onset Date:
Rec V Date: 08/14/2021
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: VAccination site itchiness; Rash; Vaccination site swelling; VAccination site redness; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (VAccination site itchiness), RASH (Rash), VACCINATION SITE SWELLING (Vaccination site swelling) and VACCINATION SITE ERYTHEMA (VAccination site redness) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. No Medical History information was reported. On 08-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE PRURITUS (VAccination site itchiness), RASH (Rash), VACCINATION SITE SWELLING (Vaccination site swelling) and VACCINATION SITE ERYTHEMA (VAccination site redness). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL A) ongoing since an unknown date at an unspecified dose and frequency and HYDROCORTISONE ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, VACCINATION SITE PRURITUS (VAccination site itchiness), RASH (Rash), VACCINATION SITE SWELLING (Vaccination site swelling) and VACCINATION SITE ERYTHEMA (VAccination site redness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication were not reported by the reporter. Treatment included ice pack. Most recent FOLLOW-UP information incorporated above includes: On 08-Feb-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1556205
Sex: F
Age: 63
State: OH

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 08/14/2021
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: Ongoing nausea; Headache; Sore arm; Loss of appetite; Felt sluggish; Numb feeling all the way down arm to hand; Tingly feeling all te way down arm to hand; Nausea; A spontaneous report was received from Consumer concerning a patient 64 year old, female and who received Moderna's COVID-19 vaccine(mRNA-1273) and experienced Headache, Sore arm, Loss of appetite, Nausea, Felt sluggish, Numb feeling all the way down arm to hand and Tingly feeling all the way down arm to hand The patient's medical history was COPD. Concomitant products were not provided. On 24 Feb 2021, the patient received their first of two planned doses of mRNA-1273 (Batch Number unknown) viz intramuscular route for prophylaxis of COVID-19 infection. Patient stated she had mild side effects of headache, sore arm, loss of appetite and nausea. Patient stated she felt sluggish. Patient stated she had numb and tingly feeling all the way down her arm to her hand. Patient stated she has COPD. Treatment provided was unknown. Action taken with mRNA-1273 in response to the event was unknown. The outcome of the event Headache, Sore arm, Loss of appetite, Nausea, Felt sluggish, Numb feeling all the way down arm to hand, Tingly feeling all the way down arm to hand is unknown. Follow up : A spontaneous report was received from Consumer concerning a patient 64 years old, female and who received Moderna's COVID-19 vaccine(mRNA-1273) and experienced mild intermittent nausea, sore arm, mild headache, ongoing nausea and nausea returned. The patient's medical history was reported as borderline obesity, high cholesterol, mild COPD, Hepatitis C (15 years ago), foot surgery (3 years ago). The consumer stated she quit drinking alcohol 15 years ago. Concomitant products was Lipitor unknown indication. On 24 Feb 2021, the patient received their first of two planned doses of mRNA-1273 (Batch Number 022M20A), dose quantity 0.5 ml millilitre(s) viz intramuscular route for prophylaxis of COVID-19 infection. Patient stated five hours after the vaccination she experienced mild intermittent nausea. On 25Feb2021, she reported a sore arm, mild headache, and ongoing nausea. On 26Feb2021, she reported the events resolved. No treatment medications reported. She did not report these events to her HCP. On or around 01Mar2021, she reported the nausea returned and is ongoing. Treatment was not provided . Action taken with mRNA-1273 in response to the event was unknown. The outcome of the event mild intermittent nausea, sore arm, mild headache, ongoing nausea was Recovered / Resolved and nausea returned was Not Recovered / Not Resolved.

Other Meds: LIPITOR

Current Illness:

ID: 1556206
Sex: F
Age: 91
State: CT

Vax Date: 02/22/2021
Onset Date: 02/25/2021
Rec V Date: 08/14/2021
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: Pain in Hips; Injection Site Pain; Body Aches; This spontaneous case was reported by a consumer and describes the occurrence of ARTHRALGIA (Pain in Hips), INJECTION SITE PAIN (Injection Site Pain) and MYALGIA (Body Aches) in a 91-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) for COVID-19 vaccination. No Medical History information was reported. On 22-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, the patient experienced ARTHRALGIA (Pain in Hips), INJECTION SITE PAIN (Injection Site Pain) and MYALGIA (Body Aches). At the time of the report, ARTHRALGIA (Pain in Hips), INJECTION SITE PAIN (Injection Site Pain) and MYALGIA (Body Aches) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1556207
Sex: M
Age: 68
State: PA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 08/14/2021
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: Fast pulse; No energy; achiness; Severe headache; Chills; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE INCREASED (Fast pulse), ASTHENIA (No energy), PAIN (achiness), HEADACHE (Severe headache) and CHILLS (Chills) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030LZ0A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-Feb-2021, the patient experienced HEART RATE INCREASED (Fast pulse), ASTHENIA (No energy), PAIN (achiness), HEADACHE (Severe headache), CHILLS (Chills) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, HEART RATE INCREASED (Fast pulse), ASTHENIA (No energy), PAIN (achiness), CHILLS (Chills) and NAUSEA (Nausea) had resolved and HEADACHE (Severe 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. Concomitant medication details was not reported by the reporter.

Other Meds:

Current Illness:

ID: 1556208
Sex: F
Age:
State: OH

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 08/14/2021
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: fatigued; slept all day; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (fatigued) and HYPERSOMNIA (slept all day) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for an unknown indication. No Medical History information was reported. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 29-Jan-2021, the patient experienced HYPERSOMNIA (slept all day). On 20-Feb-2021, the patient experienced FATIGUE (fatigued). At the time of the report, FATIGUE (fatigued) and HYPERSOMNIA (slept all day) outcome was unknown. Treatment details not provided. This case was linked to MOD21-038182, MOD-2021-025031 (Patient Link).

Other Meds:

Current Illness:

ID: 1556209
Sex: F
Age:
State: FL

Vax Date: 02/04/2021
Onset Date: 02/08/2021
Rec V Date: 08/14/2021
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: Redness in hands; Itchiness at hands; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Redness in hands) and PRURITUS (Itchiness at hands) 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 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Feb-2021, the patient experienced ERYTHEMA (Redness in hands) and PRURITUS (Itchiness at hands). At the time of the report, ERYTHEMA (Redness in hands) and PRURITUS (Itchiness at hands) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 21-Apr-2021: Follow up received on 21-Apr-2021 contains no new information as reporter declined further follow up.

Other Meds:

Current Illness:

ID: 1556210
Sex: M
Age: 72
State: TN

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 08/14/2021
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: sore arm; A spontaneous report was received from a consumer concerning a 72-years-old male patient who received Moderna's COVID-19 1556210(mRNA-1273) and experienced events sore arm/pain in extremity. The patient's medical history was not provided. No relevant concomitant medications were reported. On 18 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: unavailable) via unknown route in the right arm for prophylaxis of COVID-19 infection. On 19 Feb 2021, the patient experienced the event(s) sore arm. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event sore arm was unknown at the time of reporting.

Other Meds:

Current Illness:

ID: 1556211
Sex: F
Age: 85
State: PA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/14/2021
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: inflammation in the injection site; pinkish discoloration around the circle; arm tenderness; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE INFLAMMATION (inflammation in the injection site), VACCINATION SITE DISCOLOURATION (pinkish discoloration around the circle) and VACCINATION SITE PAIN (arm tenderness) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension. Concomitant products included ACETYLSALICYLIC ACID (ECOTRIN) for Anticoagulant therapy, LISINOPRIL for Hypertension, COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) for Skin disorder, FOLIC ACID for Vitamin B complex supplementation. On 28-Jan-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Jan-2021, the patient experienced VACCINATION SITE PAIN (arm tenderness). On 06-Feb-2021, the patient experienced VACCINATION SITE INFLAMMATION (inflammation in the injection site) and VACCINATION SITE DISCOLOURATION (pinkish discoloration around the circle). At the time of the report, VACCINATION SITE INFLAMMATION (inflammation in the injection site), VACCINATION SITE DISCOLOURATION (pinkish discoloration around the circle) and VACCINATION SITE PAIN (arm tenderness) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: VITAMIN D [COLECALCIFEROL]; LISINOPRIL; ECOTRIN; FOLIC ACID

Current Illness: Hypertension

ID: 1556212
Sex: M
Age:
State: FL

Vax Date: 02/24/2021
Onset Date:
Rec V Date: 08/14/2021
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: aches; nausea; Low grade Fever; fatigue; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (aches), NAUSEA (nausea), PYREXIA (Low grade Fever) and FATIGUE (fatigue) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 24-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MYALGIA (aches), NAUSEA (nausea), PYREXIA (Low grade Fever) and FATIGUE (fatigue). At the time of the report, MYALGIA (aches), NAUSEA (nausea), PYREXIA (Low grade Fever) and FATIGUE (fatigue) outcome was unknown.

Other Meds:

Current Illness:

ID: 1556213
Sex: F
Age: 76
State: FL

Vax Date: 01/27/2021
Onset Date: 02/06/2021
Rec V Date: 08/14/2021
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: Small rash at the site; the site of injection is incredibly itchy; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (the site of injection is incredibly itchy) and VACCINATION SITE RASH (Small rash at the site) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038K20A) for COVID-19 vaccination. No Medical History information was reported. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (the site of injection is incredibly itchy). On 07-Feb-2021, the patient experienced VACCINATION SITE RASH (Small rash at the site). At the time of the report, VACCINATION SITE PRURITUS (the site of injection is incredibly itchy) and VACCINATION SITE RASH (Small rash at the site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1556214
Sex: F
Age: 77
State: PA

Vax Date: 01/29/2021
Onset Date: 02/06/2021
Rec V Date: 08/14/2021
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: Injection site itchiness in the arm at injection site; blush colored redness at injection site after scratching; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Injection site itchiness in the arm at injection site) and VACCINATION SITE ERYTHEMA (blush colored redness at injection site after scratching) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (Injection site itchiness in the arm at injection site) and VACCINATION SITE ERYTHEMA (blush colored redness at injection site after scratching). At the time of the report, VACCINATION SITE PRURITUS (Injection site itchiness in the arm at injection site) and VACCINATION SITE ERYTHEMA (blush colored redness at injection site after scratching) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1556215
Sex: F
Age: 52
State: MN

Vax Date: 02/04/2021
Onset Date:
Rec V Date: 08/14/2021
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: Temperature was 101.8; Felt a little warm; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Temperature was 101.8) and FEELING HOT (Felt a little warm) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. The patient's past medical history included COPD since an unknown date. Concomitant products included BUPROPION HYDROCHLORIDE (WELLBUTRIN), METHADONE, DILTIAZEM, ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) and VITAMINS NOS for an unknown indication. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PYREXIA (Temperature was 101.8) and FEELING HOT (Felt a little warm). At the time of the report, PYREXIA (Temperature was 101.8) and FEELING HOT (Felt a little warm) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 101.8 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Treatment information for the event was provided. This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 05-Feb-2021 and was forwarded to Moderna on 07-Feb-2021. This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Temperature was 101.8) and FEELING HOT (Felt a little warm) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. The patient's past medical history included COPD since an unknown date. Concomitant products included BUPROPION HYDROCHLORIDE (WELLBUTRIN), METHADONE, DILTIAZEM, ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) and VITAMINS NOS for an unknown indication. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PYREXIA (Temperature was 101.8) and FEELING HOT (Felt a little warm). At the time of the report, PYREXIA (Temperature was 101.8) and FEELING HOT (Felt a little warm) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 101.8 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Treatment information for the event was provided.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds: WELLBUTRIN; METHADONE; DILTIAZEM; ASPIRIN (E.C.); VITAMINS NOS

Current Illness: COPD

ID: 1556216
Sex: M
Age:
State:

Vax Date: 02/20/2021
Onset Date:
Rec V Date: 08/14/2021
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: Back pain; Covid-19; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Back pain) and COVID-19 (Covid-19) 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 No adverse event. On 20-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 2 dosage form. On an unknown date, the patient experienced BACK PAIN (Back pain) and COVID-19 (Covid-19). At the time of the report, BACK PAIN (Back pain) had not resolved and COVID-19 (Covid-19) outcome was unknown. No concomitant medication was provided. No treatment details were provided. Most recent FOLLOW-UP information incorporated above includes: On 28-Apr-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1556217
Sex: F
Age:
State: SC

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 08/14/2021
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: had soreness where the vaccine was given; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (had soreness where the vaccine was given) 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 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Feb-2021, the patient experienced INJECTION SITE PAIN (had soreness where the vaccine was given). On 10-Feb-2021, INJECTION SITE PAIN (had soreness where the vaccine was given) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment and concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1556218
Sex: F
Age: 79
State: CA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 08/14/2021
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: a shortness of breath; difficulty swallowing food; Lots of tiredness; feeling weak; warm; nausea; fatigue; body Aches; couldn't move her arm although now she can; 4th day post vaccination, she had red spots; itchiness at the vaccination site; The red spots that are hard to touch and similar to chicken pox; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Lots of tiredness), ASTHENIA (feeling weak), VACCINATION SITE WARMTH (warm), NAUSEA (nausea) and FATIGUE (fatigue) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced FATIGUE (Lots of tiredness), ASTHENIA (feeling weak), VACCINATION SITE WARMTH (warm), NAUSEA (nausea), FATIGUE (fatigue), MYALGIA (body Aches), HYPOKINESIA (couldn't move her arm although now she can), VACCINATION SITE ERYTHEMA (4th day post vaccination, she had red spots), VACCINATION SITE PRURITUS (itchiness at the vaccination site), VACCINATION SITE ERYTHEMA (The red spots that are hard to touch and similar to chicken pox) and DYSPHAGIA (difficulty swallowing food). On an unknown date, the patient experienced DYSPNOEA (a shortness of breath). At the time of the report, FATIGUE (Lots of tiredness), ASTHENIA (feeling weak), VACCINATION SITE WARMTH (warm), NAUSEA (nausea), FATIGUE (fatigue), MYALGIA (body Aches), HYPOKINESIA (couldn't move her arm although now she can), VACCINATION SITE ERYTHEMA (4th day post vaccination, she had red spots), VACCINATION SITE PRURITUS (itchiness at the vaccination site), VACCINATION SITE ERYTHEMA (The red spots that are hard to touch and similar to chicken pox), DYSPNOEA (a shortness of breath) and DYSPHAGIA (difficulty swallowing food) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Treatment details included includes warm patches and pain pills. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1556219
Sex: M
Age: 69
State: IN

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/14/2021
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: Tendonitis is flaring up/ ankles have had a tendonitis flare up; Excruciating pain in the right wrist; Pain was so excruciating that the patient couldn't even walk; Knees are flaring up and are swollen; Low grade fever; Sweating; This spontaneous case was reported by a consumer and describes the occurrence of TENDONITIS (Tendonitis is flaring up/ ankles have had a tendonitis flare up), ARTHRALGIA (Excruciating pain in the right wrist), GAIT DISTURBANCE (Pain was so excruciating that the patient couldn't even walk), JOINT SWELLING (Knees are flaring up and are swollen) and PYREXIA (Low grade fever) in a 69-year-old male 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 Tendonitis. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Jan-2021, the patient experienced TENDONITIS (Tendonitis is flaring up/ ankles have had a tendonitis flare up), ARTHRALGIA (Excruciating pain in the right wrist), GAIT DISTURBANCE (Pain was so excruciating that the patient couldn't even walk), JOINT SWELLING (Knees are flaring up and are swollen), PYREXIA (Low grade fever) and HYPERHIDROSIS (Sweating). At the time of the report, TENDONITIS (Tendonitis is flaring up/ ankles have had a tendonitis flare up), ARTHRALGIA (Excruciating pain in the right wrist), GAIT DISTURBANCE (Pain was so excruciating that the patient couldn't even walk), JOINT SWELLING (Knees are flaring up and are swollen), PYREXIA (Low grade fever) and HYPERHIDROSIS (Sweating) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment medications were not provided by reporter.

Other Meds:

Current Illness:

ID: 1556220
Sex: F
Age: 74
State: CO

Vax Date: 02/09/2021
Onset Date: 02/24/2021
Rec V Date: 08/14/2021
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: itchy at the injection site; red at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (itchy at the injection site) and VACCINATION SITE ERYTHEMA (red at the injection site) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 Vaccination. Concurrent medical conditions included Hypertension, Cholesterol, Diabetes and Breast cancer. Concomitant products included NICOTINAMIDE (VITAMIN B COMPLEX [NICOTINAMIDE]) for an unknown indication. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (itchy at the injection site) and VACCINATION SITE ERYTHEMA (red at the injection site). On 25-Feb-2021, VACCINATION SITE PRURITUS (itchy at the injection site) had resolved. At the time of the report, VACCINATION SITE ERYTHEMA (red at the injection site) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Other concomitant medications included unspecified blood pressure medication, cholesterol medication, diabetes medication and unspecified medication for breast cancer. No treatment information was provided.

Other Meds: VITAMIN B COMPLEX [NICOTINAMIDE]

Current Illness: Breast cancer; Cholesterol; Diabetes; Hypertension

ID: 1556221
Sex: F
Age:
State: CT

Vax Date:
Onset Date:
Rec V Date: 08/14/2021
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: Experienced a weird reaction; A spontaneous report was received from a consumer concerning an unknown-years-old Female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events experienced a weird reaction/vaccination site reaction. The patient's medical history was not provided. No relevant concomitant medications were reported. On unknown date, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: unknown) via intramuscular route for prophylaxis of COVID-19 infection. On unknown date, the patient experienced the event(s) experienced a weird reaction. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event experienced a weird reaction was unknown.

Other Meds:

Current Illness:

ID: 1556222
Sex: F
Age: 31
State: CA

Vax Date: 02/08/2021
Onset Date: 02/16/2021
Rec V Date: 08/14/2021
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: Distortion of smell and taste; Distortion of smell and taste; Problems with remembering things , like "fogs" in the memory; This spontaneous case was reported by a consumer and describes the occurrence of TASTE DISORDER (Distortion of smell and taste), PAROSMIA (Distortion of smell and taste) and FEELING ABNORMAL (Problems with remembering things , like "fogs" in the memory) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 on 09-Oct-2020. On 08-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Feb-2021, the patient experienced TASTE DISORDER (Distortion of smell and taste), PAROSMIA (Distortion of smell and taste) and FEELING ABNORMAL (Problems with remembering things , like "fogs" in the memory). At the time of the report, TASTE DISORDER (Distortion of smell and taste), PAROSMIA (Distortion of smell and taste) and FEELING ABNORMAL (Problems with remembering things , like "fogs" in the memory) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 09-Oct-2020, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1556223
Sex: F
Age: 83
State: FL

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 08/14/2021
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: Fever; This spontaneous case was reported by a physician and describes the occurrence of PYREXIA (Fever) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030M20A) for COVID-19 vaccination. No Medical History information was reported. On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Feb-2021, the patient experienced PYREXIA (Fever). At the time of the report, PYREXIA (Fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Feb-2021, Body temperature: 101.8 (High) 101.8 degree F. 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. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1556224
Sex: M
Age:
State: GA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 08/14/2021
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: Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm; Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm; Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm; This spontaneous case was reported by a consumer and describes the occurrence of NECK PAIN (Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm), MUSCULOSKELETAL STIFFNESS (Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm) and ARTHRALGIA (Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 22-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 ml. On 22-Feb-2021, the patient experienced NECK PAIN (Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm), MUSCULOSKELETAL STIFFNESS (Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm) and ARTHRALGIA (Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm). The patient was treated with PARACETAMOL (TYLENOL) for Pain, at a dose of 4 dosage form and ASPIRIN [ACETYLSALICYLIC ACID] for Pain, at a dose of 4 dosage form. At the time of the report, NECK PAIN (Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm) and ARTHRALGIA (Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm) had not resolved and MUSCULOSKELETAL STIFFNESS (Patient is experiencing pain across all shoulder, back of neck is sore and stiffness on left arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Treatment for the event also included pain relieving cream.

Other Meds:

Current Illness:

ID: 1556225
Sex: M
Age: 71
State: NC

Vax Date: 02/24/2021
Onset Date:
Rec V Date: 08/14/2021
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: Sore arm; mild fatigue; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) and FATIGUE (mild fatigue) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002H20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 24-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm) and FATIGUE (mild fatigue). At the time of the report, PAIN IN EXTREMITY (Sore arm) and FATIGUE (mild fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1556226
Sex: F
Age:
State:

Vax Date:
Onset Date: 02/24/2021
Rec V Date: 08/14/2021
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: severe reaction; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (severe reaction) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Feb-2021, the patient experienced VACCINATION SITE REACTION (severe reaction). At the time of the report, VACCINATION SITE REACTION (severe reaction) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment and concomitant medicines were not provided Action taken with mRNA-1273 in response to the event was unknown

Other Meds:

Current Illness:

ID: 1556227
Sex: F
Age: 55
State: OH

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 08/14/2021
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: A sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (A sore arm) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. No Medical History Information was Reported. Concomitant products included MEDROXYPROGESTERONE ACETATE (DEPO PROVERA) for Birth control. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Jan-2021, the patient experienced PAIN IN EXTREMITY (A sore arm). At the time of the report, PAIN IN EXTREMITY (A sore arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Treatment information for the event was provided. This case was linked to MOD-2021-025587 (Patient Link). This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 08-Feb-2021 and was forwarded to Moderna on 09-Feb-2021. This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (A sore arm) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. No Medical History Information was Reported. Concomitant products included MEDROXYPROGESTERONE ACETATE (DEPO PROVERA) for Birth control. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Jan-2021, the patient experienced PAIN IN EXTREMITY (A sore arm). At the time of the report, PAIN IN EXTREMITY (A sore arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Treatment information for the event was provided. This case was linked to MOD-2021-025587 (Patient Link).; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of this event, a causal relationship cannot be excluded.

Other Meds: DEPO PROVERA

Current Illness:

ID: 1556228
Sex: M
Age: 85
State: CA

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 08/14/2021
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: lost sense of taste; lost sense of taste smell; cough; no appetite; weak; This spontaneous case was reported by a consumer and describes the occurrence of AGEUSIA (lost sense of taste), ANOSMIA (lost sense of taste smell), COUGH (cough), DECREASED APPETITE (no appetite) and ASTHENIA (weak) in an 85-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 043L20A) for COVID-19 vaccination. No Medical History information was reported. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Jan-2021, the patient experienced AGEUSIA (lost sense of taste), ANOSMIA (lost sense of taste smell), COUGH (cough), DECREASED APPETITE (no appetite) and ASTHENIA (weak). At the time of the report, AGEUSIA (lost sense of taste), ANOSMIA (lost sense of taste smell), COUGH (cough), DECREASED APPETITE (no appetite) and ASTHENIA (weak) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1556229
Sex: M
Age: 57
State: NM

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 08/14/2021
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: a ringing in the ears, tinnitus,It's like a hissing and it's been consisting; This spontaneous case was reported by a consumer and describes the occurrence of TINNITUS (a ringing in the ears, tinnitus,It's like a hissing and it's been consisting) in a 57-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, the patient experienced TINNITUS (a ringing in the ears, tinnitus,It's like a hissing and it's been consisting). At the time of the report, TINNITUS (a ringing in the ears, tinnitus,It's like a hissing and it's been consisting) 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. This case was linked to MOD-2021-075096 (Patient Link).

Other Meds:

Current Illness:

ID: 1556230
Sex: F
Age: 63
State: IN

Vax Date: 01/22/2021
Onset Date: 02/05/2021
Rec V Date: 08/14/2021
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: tchy Arm; Red at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (tchy Arm) and VACCINATION SITE ERYTHEMA (Red at injection site) in a 64-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 05-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (tchy Arm) and VACCINATION SITE ERYTHEMA (Red at injection site). At the time of the report, VACCINATION SITE PRURITUS (tchy Arm) and VACCINATION SITE ERYTHEMA (Red at injection site) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1556231
Sex: F
Age: 67
State:

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 08/14/2021
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: swelling in her Bicep and deltoid; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (swelling in her Bicep and deltoid) in a 67-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 05-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) UNK dosage form. On 06-Feb-2021, the patient experienced PERIPHERAL SWELLING (swelling in her Bicep and deltoid). At the time of the report, PERIPHERAL SWELLING (swelling in her Bicep and deltoid) outcome was unknown. Patient has been using ice to treat the ailments.

Other Meds:

Current Illness:

ID: 1556232
Sex: M
Age: 69
State: IL

Vax Date: 02/02/2021
Onset Date: 02/05/2021
Rec V Date: 08/14/2021
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: experiencing headache, chills/shakes, and fever of 100.2 F (normal is 97.5 F).; experiencing headache, chills/shakes, and fever of 100.2 F (normal is 97.5 F).; slept for 14 hours (normal is 7-8 hours); Fever; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HYPERSOMNIA (slept for 14 hours (normal is 7-8 hours)), PYREXIA (Fever), HEADACHE (experiencing headache, chills/shakes, and fever of 100.2 F (normal is 97.5 F).) and CHILLS (experiencing headache, chills/shakes, and fever of 100.2 F (normal is 97.5 F).) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021, the patient experienced HYPERSOMNIA (slept for 14 hours (normal is 7-8 hours)) and PYREXIA (Fever). On an unknown date, the patient experienced HEADACHE (experiencing headache, chills/shakes, and fever of 100.2 F (normal is 97.5 F).) and CHILLS (experiencing headache, chills/shakes, and fever of 100.2 F (normal is 97.5 F).). At the time of the report, HYPERSOMNIA (slept for 14 hours (normal is 7-8 hours)), PYREXIA (Fever), HEADACHE (experiencing headache, chills/shakes, and fever of 100.2 F (normal is 97.5 F).) and CHILLS (experiencing headache, chills/shakes, and fever of 100.2 F (normal is 97.5 F).) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-Feb-2021, Body temperature: 100.2 f (High) high. On 07-Feb-2021, Body temperature: 97.1 (abnormal) His temperature has bounced up and down between 97.1- 98.6 F.. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitants were added. Treatment information was not provided by the reporter. This case was linked to MOD-2021-121138. Most recent FOLLOW-UP information incorporated above includes: On 21-Apr-2021: No specific follow-up information recorded. On 21-Apr-2021: NNI On 23-Jun-2021: Follow up was received on 23-Jun-2021. Its regarding second dose outcome. No new information regarding first dose events.

Other Meds:

Current Illness:

ID: 1556233
Sex: F
Age:
State: FL

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 08/14/2021
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: loss of appetite; body aches; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (body aches) and DECREASED APPETITE (loss of appetite) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included Lily infusion for an unknown indication. On 20-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Jan-2021, the patient experienced PAIN (body aches). On an unknown date, the patient experienced DECREASED APPETITE (loss of appetite). At the time of the report, PAIN (body aches) and DECREASED APPETITE (loss of appetite) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Reporter did not allow further contact

Other Meds: Lily infusion

Current Illness:

ID: 1556234
Sex: F
Age: 65
State:

Vax Date: 01/28/2021
Onset Date: 02/25/2021
Rec V Date: 08/14/2021
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: UTI Urinary Track infection; This spontaneous case was reported by a consumer and describes the occurrence of URINARY TRACT INFECTION (UTI Urinary Track infection) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. The patient's past medical history included Low back pain (low back pain from herniated disc). Concurrent medical conditions included Emphysema (lung disease emphysema). On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, the patient experienced URINARY TRACT INFECTION (UTI Urinary Track infection). The patient was treated with HYDROCODONE BITARTRATE, PARACETAMOL (VICODIN) for Low back pain, at an unspecified dose and frequency. At the time of the report, URINARY TRACT INFECTION (UTI Urinary Track infection) 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. Patients second dose was scheduled on 25-Feb-2021.

Other Meds:

Current Illness: Emphysema (lung disease emphysema)

ID: 1556235
Sex: F
Age: 59
State: CO

Vax Date: 01/27/2021
Onset Date:
Rec V Date: 08/14/2021
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: sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. No Medical History information was reported. On 27-Jan-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 2 UNK. 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 PAIN IN EXTREMITY (sore arm). At the time of the report, PAIN IN EXTREMITY (sore arm) outcome was unknown. Not Provided Action taken with mRNA-1273 in response to the events was not applicable. This case was linked to MOD-2021-025114 (Patient Link).

Other Meds:

Current Illness:

ID: 1556236
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/14/2021
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: headache; intense itching at the injection site; redness approximately 2cm; bruising developed; This spontaneous case was reported by an other health care professional and describes the occurrence of HEADACHE (headache), INJECTION SITE PRURITUS (intense itching at the injection site), INJECTION SITE ERYTHEMA (redness approximately 2cm) and VACCINATION SITE ERYTHEMA (bruising developed) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 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 HEADACHE (headache), INJECTION SITE PRURITUS (intense itching at the injection site), INJECTION SITE ERYTHEMA (redness approximately 2cm) and VACCINATION SITE ERYTHEMA (bruising developed). At the time of the report, HEADACHE (headache), INJECTION SITE PRURITUS (intense itching at the injection site), INJECTION SITE ERYTHEMA (redness approximately 2cm) and VACCINATION SITE ERYTHEMA (bruising developed) outcome was unknown. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment and concomitant medications included by reporter.

Other Meds:

Current Illness:

ID: 1556237
Sex: M
Age: 78
State: MA

Vax Date: 02/17/2021
Onset Date: 02/01/2021
Rec V Date: 08/14/2021
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: lightheaded; Diarrhoea; can't sleep; threw up once; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (lightheaded), DIARRHOEA (Diarrhoea), INSOMNIA (can't sleep) and VOMITING (threw up once) in a 77-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included SIMVASTATIN, METFORMIN, PIOGLITAZONE, LISINOPRIL, TAMSULOSIN, INSULIN and PREDNISONE for an unknown indication. On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In February 2021, the patient experienced DIARRHOEA (Diarrhoea), INSOMNIA (can't sleep) and VOMITING (threw up once). On 17-Feb-2021, the patient experienced DIZZINESS (lightheaded). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, DIZZINESS (lightheaded) had not resolved and DIARRHOEA (Diarrhoea), INSOMNIA (can't sleep) and VOMITING (threw up once) 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: SIMVASTATIN; METFORMIN; PIOGLITAZONE; LISINOPRIL; TAMSULOSIN; INSULIN; PREDNISONE

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm