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: 1557489
Sex: M
Age: 47
State: TX

Vax Date: 01/19/2021
Onset Date: 01/19/2021
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: Heart rate elevated; This spontaneous case was reported by a consumer and describes the occurrence of TACHYCARDIA (Heart rate elevated) in a 48-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jan-2021, the patient experienced TACHYCARDIA (Heart rate elevated). At the time of the report, TACHYCARDIA (Heart rate elevated) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 19-Jan-2021, Heart rate: 124 (High) Normal resting rate is 70. On 08-Feb-2021, Heart rate: 90 (High) 90-110 beats per minute. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1557490
Sex: F
Age:
State: CA

Vax Date:
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: Site was warm to touch; Patient experienced a rash; Fatigue; Mild pain; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Site was warm to touch), RASH (Patient experienced a rash), FATIGUE (Fatigue) and VACCINATION SITE PAIN (Mild pain) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE WARMTH (Site was warm to touch), RASH (Patient experienced a rash), FATIGUE (Fatigue) and VACCINATION SITE PAIN (Mild pain). At the time of the report, VACCINATION SITE WARMTH (Site was warm to touch), RASH (Patient experienced a rash), FATIGUE (Fatigue) and VACCINATION SITE PAIN (Mild pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1557491
Sex: F
Age: 67
State: MI

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: Hazy; Felt Weird; Sweating Profusely; Red; Sore; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE ERYTHEMA (Red), INJECTION SITE PAIN (Sore), DIZZINESS (Hazy), FEELING ABNORMAL (Felt Weird) and HYPERHIDROSIS (Sweating Profusely) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Jan-2021, the patient experienced INJECTION SITE ERYTHEMA (Red) and INJECTION SITE PAIN (Sore). On 24-Jan-2021, the patient experienced DIZZINESS (Hazy), FEELING ABNORMAL (Felt Weird) and HYPERHIDROSIS (Sweating Profusely). On 25-Jan-2021, INJECTION SITE PAIN (Sore), DIZZINESS (Hazy), FEELING ABNORMAL (Felt Weird) and HYPERHIDROSIS (Sweating Profusely) had resolved. At the time of the report, INJECTION SITE ERYTHEMA (Red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1557492
Sex: U
Age:
State: CA

Vax Date:
Onset Date:
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: potential side effect; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of ADVERSE EVENT (potential side effect) 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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On an unknown date, the patient experienced ADVERSE EVENT (potential side effect). At the time of the report, ADVERSE EVENT (potential side effect) 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. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1557493
Sex: F
Age:
State: CT

Vax Date: 12/23/2020
Onset Date: 12/23/2020
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: Achy; Muscles hurt; Joints hurt; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Achy), MYALGIA (Muscles hurt) and ARTHRALGIA (Joints hurt) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 23-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Dec-2020, the patient experienced PAIN (Achy), MYALGIA (Muscles hurt) and ARTHRALGIA (Joints hurt). At the time of the report, PAIN (Achy), MYALGIA (Muscles hurt) and ARTHRALGIA (Joints hurt) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. This case was linked to MOD-2021-043100.

Other Meds:

Current Illness:

ID: 1557494
Sex: M
Age: 68
State: MI

Vax Date: 02/02/2021
Onset Date: 02/08/2021
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: fatigue; drowsy; dizzy; weak; doesn't feel well; lost appetite; didn't sleep last night; muscle pain; don't feel comfortable; little pain (site of shot); This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (fatigue), SOMNOLENCE (drowsy), DIZZINESS (dizzy), ASTHENIA (weak) and MALAISE (doesn't feel well) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Feb-2021, the patient experienced FATIGUE (fatigue), SOMNOLENCE (drowsy), DIZZINESS (dizzy), ASTHENIA (weak), MALAISE (doesn't feel well), DECREASED APPETITE (lost appetite), INSOMNIA (didn't sleep last night), MYALGIA (muscle pain), FEELING ABNORMAL (don't feel comfortable) and VACCINATION SITE PAIN (little pain (site of shot)). At the time of the report, FATIGUE (fatigue), SOMNOLENCE (drowsy), DIZZINESS (dizzy), ASTHENIA (weak), MALAISE (doesn't feel well), DECREASED APPETITE (lost appetite), INSOMNIA (didn't sleep last night), MYALGIA (muscle pain), FEELING ABNORMAL (don't feel comfortable) and VACCINATION SITE PAIN (little pain (site of shot)) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1557495
Sex: F
Age: 77
State:

Vax Date: 02/05/2021
Onset Date:
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: shortness of breath; Fever; puffed face; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (shortness of breath), PYREXIA (Fever) and SWELLING FACE (puffed face) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 05-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 DYSPNOEA (shortness of breath), PYREXIA (Fever) and SWELLING FACE (puffed face). At the time of the report, DYSPNOEA (shortness of breath), PYREXIA (Fever) and SWELLING FACE (puffed face) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1557496
Sex: M
Age: 76
State: WA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
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: Pharyngeal swelling

Symptoms: and then a couple of little ones after; Sharp pain in upper chest; Took breath away; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Sharp pain in upper chest), DYSPNOEA (Took breath away) and VACCINATION COMPLICATION (and then a couple of little ones after) in an 86-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included QUINAPRIL, ACETYLSALICYLIC ACID (ASPIRIN (E.C.)), METOPROLOL, OMEPRAZOLE and ATORVASTATIN 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 04-Feb-2021, the patient experienced CHEST PAIN (Sharp pain in upper chest) and DYSPNOEA (Took breath away). On an unknown date, the patient experienced VACCINATION COMPLICATION (and then a couple of little ones after). On 04-Feb-2021, CHEST PAIN (Sharp pain in upper chest) and DYSPNOEA (Took breath away) had resolved. At the time of the report, VACCINATION COMPLICATION (and then a couple of little ones after) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: QUINAPRIL; ASPIRIN (E.C.); METOPROLOL; OMEPRAZOLE; ATORVASTATIN

Current Illness:

ID: 1557497
Sex: F
Age: 79
State: CA

Vax Date: 01/29/2021
Onset Date: 02/04/2021
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: swelling and redness on the area; swelling and redness on the area; itching on the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (itching on the injection site), VACCINATION SITE ERYTHEMA (swelling and redness on the area) and VACCINATION SITE SWELLING (swelling and redness on the area) in a 79-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 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (itching on the injection site). On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (swelling and redness on the area) and VACCINATION SITE SWELLING (swelling and redness on the area). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency and PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, VACCINATION SITE PRURITUS (itching on the injection site), VACCINATION SITE ERYTHEMA (swelling and redness on the area) and VACCINATION SITE SWELLING (swelling and redness on the area) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No relevant concomitant medications reported. This case was linked to MOD-2021-084525 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 21-Apr-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1557498
Sex: F
Age: 74
State: TX

Vax Date: 01/20/2021
Onset Date: 01/30/2021
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: pale on the injection site; darker spot bruise on the injection site; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of INJECTION SITE BRUISING (darker spot bruise on the injection site) and PALLOR (pale on the injection site) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 vaccination. Concomitant products included DICYCLOMINE HCL, GABAPENTIN, FLECAINIDE, RIVAROXABAN (XARELTO) and LISINOPRIL 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 30-Jan-2021, the patient experienced INJECTION SITE BRUISING (darker spot bruise on the injection site). On 31-Jan-2021, the patient experienced PALLOR (pale on the injection site). At the time of the report, INJECTION SITE BRUISING (darker spot bruise on the injection site) and PALLOR (pale on the injection site) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. . Most recent FOLLOW-UP information incorporated above includes: On 01-Feb-2021: Follow Up done. symptoms of the event updated.concomitant medications were reported.the outcome of the event was mentioned to be resolving

Other Meds: DICYCLOMINE HCL; GABAPENTIN; FLECAINIDE; XARELTO; LISINOPRIL

Current Illness:

ID: 1557499
Sex: F
Age: 71
State: FL

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: weak; hurt in the back of her neck; cold sweats; feels like she was going to die; nauseated; threw up; body aches; sick all night; fever; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (sick all night), COLD SWEAT (cold sweats), FEELING ABNORMAL (feels like she was going to die), ASTHENIA (weak) and NECK PAIN (hurt in the back of her neck) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012L20A and 010M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included VITAMIN A [RETINOL] and PROBIOTICS NOS for an unknown indication. On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 05-Feb-2021, the patient experienced PYREXIA (fever). On 06-Feb-2021, the patient experienced ILLNESS (sick all night) and MYALGIA (body aches). On 08-Feb-2021, the patient experienced COLD SWEAT (cold sweats), FEELING ABNORMAL (feels like she was going to die), NAUSEA (nauseated) and VOMITING (threw up). On 09-Feb-2021, the patient experienced ASTHENIA (weak) and NECK PAIN (hurt in the back of her neck). At the time of the report, ILLNESS (sick all night), COLD SWEAT (cold sweats), FEELING ABNORMAL (feels like she was going to die), ASTHENIA (weak), NECK PAIN (hurt in the back of her neck), MYALGIA (body aches), PYREXIA (fever), NAUSEA (nauseated) and VOMITING (threw up) outcome was unknown.

Other Meds: VITAMIN A [RETINOL]; PROBIOTICS NOS

Current Illness:

ID: 1557500
Sex: F
Age: 73
State: OK

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Fever - As High as 101.0F; Fatigue; Swollen - Near Injection Site; Red - Near Injection Site; Hot to the Touch Sensation - Near Injection Site; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of PYREXIA (Fever - As High as 101.0F), FATIGUE (Fatigue), INJECTION SITE SWELLING (Swollen - Near Injection Site), INJECTION SITE ERYTHEMA (Red - Near Injection Site) and INJECTION SITE WARMTH (Hot to the Touch Sensation - Near Injection Site) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Jan-2021, the patient experienced PYREXIA (Fever - As High as 101.0F), FATIGUE (Fatigue), INJECTION SITE SWELLING (Swollen - Near Injection Site), INJECTION SITE ERYTHEMA (Red - Near Injection Site) and INJECTION SITE WARMTH (Hot to the Touch Sensation - Near Injection Site). On 01-Feb-2021, PYREXIA (Fever - As High as 101.0F), FATIGUE (Fatigue), INJECTION SITE SWELLING (Swollen - Near Injection Site), INJECTION SITE ERYTHEMA (Red - Near Injection Site) and INJECTION SITE WARMTH (Hot to the Touch Sensation - Near Injection Site) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1557501
Sex: F
Age: 70
State: FL

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:
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: whelps have gone away; rash is all over her body and is not going away; rash all over her body, arms, face, legs, and bottom of her feet; broke out in whelps on her legs; itching is worse at night.; both her legs experienced intense burning and itching such that she could not sit still; went from her ankles to the top of her legs; This spontaneous case was reported by a consumer and describes the occurrence of BURNING SENSATION (both her legs experienced intense burning and itching such that she could not sit still), BURNING SENSATION (went from her ankles to the top of her legs), URTICARIA (whelps have gone away), URTICARIA (broke out in whelps on her legs) and PRURITUS (itching is worse at night.) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Co-suspect products included non-company products DIETHYLTOLUAMIDE (MOSQUITO GUARD) for an unknown indication, DIPHENHYDRAMINE HYDROCHLORIDE, PARACETAMOL, PSEUDOEPHEDRINE HYDROCHLORIDE (BENADRYL ALLERGY/COLD) for an unknown indication and DIPHENHYDRAMINE HYDROCHLORIDE (ITCH RELIEF) for an unknown indication. 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 an unknown date, the patient started DIETHYLTOLUAMIDE (MOSQUITO GUARD) (unknown route) at an unspecified dose, DIPHENHYDRAMINE HYDROCHLORIDE, PARACETAMOL, PSEUDOEPHEDRINE HYDROCHLORIDE (BENADRYL ALLERGY/COLD) (unknown route) at an unspecified dose and DIPHENHYDRAMINE HYDROCHLORIDE (ITCH RELIEF) (unknown route) at an unspecified dose. On 06-Feb-2021, the patient experienced BURNING SENSATION (both her legs experienced intense burning and itching such that she could not sit still), BURNING SENSATION (went from her ankles to the top of her legs) and PRURITUS (itching is worse at night.). On 07-Feb-2021, the patient experienced URTICARIA (broke out in whelps on her legs) and RASH (rash all over her body, arms, face, legs, and bottom of her feet). On 09-Feb-2021, the patient experienced URTICARIA (whelps have gone away) and RASH (rash is all over her body and is not going away). At the time of the report, BURNING SENSATION (both her legs experienced intense burning and itching such that she could not sit still), BURNING SENSATION (went from her ankles to the top of her legs), URTICARIA (broke out in whelps on her legs), PRURITUS (itching is worse at night.) and RASH (rash is all over her body and is not going away) outcome was unknown, URTICARIA (whelps have gone away) had resolved and RASH (rash all over her body, arms, face, legs, and bottom of her feet) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: MOSQUITO GUARD; BENADRYL ALLERGY/COLD; ITCH RELIEF

Current Illness:

ID: 1557502
Sex: F
Age:
State: GA

Vax Date: 01/01/2021
Onset Date: 01/01/2021
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: Swollen lymph nodes in the breast; This spontaneous case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (Swollen lymph nodes in the breast) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In January 2021, the patient experienced LYMPHADENOPATHY (Swollen lymph nodes in the breast). At the time of the report, LYMPHADENOPATHY (Swollen lymph nodes in the breast) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication reported. No treatment was provided.

Other Meds:

Current Illness:

ID: 1557503
Sex: M
Age:
State:

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: headaches; Muscle fatigue in his leg and Back; feels like a load on the muscles; sharp pain or something weird; This spontaneous case was reported by a health care professional and describes the occurrence of PAIN (sharp pain or something weird), MUSCLE FATIGUE (Muscle fatigue in his leg and Back), MYALGIA (feels like a load on the muscles) and HEADACHE (headaches) in a 54-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 25-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Jan-2021, the patient experienced MUSCLE FATIGUE (Muscle fatigue in his leg and Back). On an unknown date, the patient experienced PAIN (sharp pain or something weird), MYALGIA (feels like a load on the muscles) and HEADACHE (headaches). At the time of the report, PAIN (sharp pain or something weird), MUSCLE FATIGUE (Muscle fatigue in his leg and Back), MYALGIA (feels like a load on the muscles) and HEADACHE (headaches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medicines were reported and no treatment medicines were given. Patient stated he received the 2nd vaccine and reported his symptoms were worse. Patient also stated he had some lingering symptoms Most recent FOLLOW-UP information incorporated above includes: On 22-Jul-2021: Additional information received, added events

Other Meds:

Current Illness:

ID: 1557504
Sex: F
Age: 50
State:

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: Sore arm; Back pain; very sharp pain and it felt like I cannot sit; Pain radiating up to spine; This spontaneous case was reported by a health care professional and describes the occurrence of BACK PAIN (Back pain), PAIN (very sharp pain and it felt like I cannot sit), SPINAL PAIN (Pain radiating up to spine) and PAIN IN EXTREMITY (Sore arm) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029K20A) for COVID-19 vaccination. No Medical History information was reported. On 08-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 BACK PAIN (Back pain), PAIN (very sharp pain and it felt like I cannot sit) and SPINAL PAIN (Pain radiating up to spine). On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm). At the time of the report, BACK PAIN (Back pain), PAIN (very sharp pain and it felt like I cannot sit), SPINAL PAIN (Pain radiating up to spine) and PAIN IN EXTREMITY (Sore arm) 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.

Other Meds:

Current Illness:

ID: 1557505
Sex: M
Age: 82
State: WA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
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: severe diarrhea; bedridden 3-4 days; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (severe diarrhea) and BEDRIDDEN (bedridden 3-4 days) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy (Amoxicillin). 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 DIARRHOEA (severe diarrhea) and BEDRIDDEN (bedridden 3-4 days). At the time of the report, DIARRHOEA (severe diarrhea) and BEDRIDDEN (bedridden 3-4 days) outcome was unknown. Not Related The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness: Drug allergy (Amoxicillin)

ID: 1557506
Sex: F
Age:
State: IN

Vax Date:
Onset Date:
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: skin rash post-vaccination; This spontaneous case was reported by a nurse and describes the occurrence of RASH (skin rash post-vaccination) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced RASH (skin rash post-vaccination). At the time of the report, RASH (skin rash post-vaccination) 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. Reporter stated that rash began within 20 hours up to 9 days after vaccine administration. Treatment provided: Topical steroid cream. This case was linked to US-MODERNATX, INC.-MOD-2021-027398 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-027398:Group reporting

Other Meds:

Current Illness:

ID: 1557507
Sex: F
Age:
State: MA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: cold chills; This spontaneous case was reported by a patient and describes the occurrence of CHILLS (cold 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 08-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 CHILLS (cold chills). At the time of the report, CHILLS (cold chills) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication and treatment drug were not reported.

Other Meds:

Current Illness:

ID: 1557508
Sex: F
Age: 63
State: DE

Vax Date: 01/17/2021
Onset Date: 01/18/2021
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: Felt tired; Her body ached; She slept a lot; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Felt tired), MYALGIA (Her body ached) and HYPERSOMNIA (She slept a lot) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. No Medical History information was reported. On 17-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Jan-2021, the patient experienced FATIGUE (Felt tired), MYALGIA (Her body ached) and HYPERSOMNIA (She slept a lot). On 20-Jan-2021, FATIGUE (Felt tired), MYALGIA (Her body ached) and HYPERSOMNIA (She slept a lot) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1557509
Sex: F
Age:
State:

Vax Date:
Onset Date:
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: Very tender lymphadenopathy; This spontaneous case was reported by a health care professional and describes the occurrence of LYMPHADENOPATHY (Very tender lymphadenopathy) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 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 LYMPHADENOPATHY (Very tender lymphadenopathy). At the time of the report, LYMPHADENOPATHY (Very tender lymphadenopathy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant products were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1557510
Sex: F
Age: 86
State: PA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
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: weakness; Soreness; Vomiting; This spontaneous case was reported by a consumer and describes the occurrence of VOMITING (Vomiting), ASTHENIA (weakness) and PAIN (Soreness) in an 86-year-old female patient 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) (Intramuscular) 1 dosage form. On 06-Feb-2021, the patient experienced VOMITING (Vomiting). On 09-Feb-2021, the patient experienced ASTHENIA (weakness) and PAIN (Soreness). On 08-Feb-2021, VOMITING (Vomiting) had resolved. At the time of the report, ASTHENIA (weakness) and PAIN (Soreness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1557511
Sex: F
Age: 68
State: AZ

Vax Date: 01/30/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: dizziness; kind of a headache; has not been able to drive; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizziness), HEADACHE (kind of a headache) and IMPAIRED DRIVING ABILITY (has not been able to drive) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. Concurrent medical conditions included Sleep disorder. Concomitant products included Norityptiline for Sleep disorder. On 30-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 DIZZINESS (dizziness), HEADACHE (kind of a headache) and IMPAIRED DRIVING ABILITY (has not been able to drive). At the time of the report, DIZZINESS (dizziness), HEADACHE (kind of a headache) and IMPAIRED DRIVING ABILITY (has not been able to drive) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: Norityptiline

Current Illness: Sleep disorder

ID: 1557512
Sex: F
Age: 91
State: CA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: red; still itching; Arm pain at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Arm pain at injection site), PRURITUS (still itching) and ERYTHEMA (red) in a 91-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041671A) for COVID-19 vaccination. The patient's past medical history included Childhood asthma. Concurrent medical conditions included Fruit allergy (Oranges) and Food allergy (Tamatoes). On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Jan-2021, the patient experienced VACCINATION SITE PAIN (Arm pain at injection site). On 31-Jan-2021, the patient experienced PRURITUS (still itching). On 04-Feb-2021, the patient experienced ERYTHEMA (red). At the time of the report, VACCINATION SITE PAIN (Arm pain at injection site), PRURITUS (still itching) and ERYTHEMA (red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment medication was reported. This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 04-Feb-2021 and was forwarded to Moderna on 05-Feb-2021. This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Arm pain at injection site), PRURITUS (still itching) and ERYTHEMA (red) in a 91-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041671A) for COVID-19 vaccination. The patient's past medical history included Childhood asthma. Concurrent medical conditions included Fruit allergy (Oranges) and Food allergy (Tamatoes). On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Jan-2021, the patient experienced VACCINATION SITE PAIN (Arm pain at injection site). On 31-Jan-2021, the patient experienced PRURITUS (still itching). On 04-Feb-2021, the patient experienced ERYTHEMA (red). At the time of the report, VACCINATION SITE PAIN (Arm pain at injection site), PRURITUS (still itching) and ERYTHEMA (red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment medication was reported.

Other Meds:

Current Illness: Food allergy (Tamatoes); Fruit allergy (Oranges.)

ID: 1557513
Sex: F
Age:
State: FL

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: 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 VACCINATION SITE ERYTHEMA (the site of injection was red), VACCINATION SITE SWELLING (swollen injection site), VACCINATION SITE PAIN (ainfull injection site), VACCINATION SITE PRURITUS (intensely itchy) and PAIN (mild body aches). The patient was treated with HYDROCORTISONE at an unspecified dose and frequency. At the time of the report, VACCINATION SITE ERYTHEMA (the site of injection was red), VACCINATION SITE SWELLING (swollen injection site), VACCINATION SITE PAIN (ainfull injection site), VACCINATION SITE PRURITUS (intensely itchy) and PAIN (mild body aches) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1557514
Sex: F
Age: 74
State: FL

Vax Date: 01/31/2021
Onset Date: 02/01/2021
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: diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (diarrhea) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038K20A) for COVID-19 vaccination. Concomitant products included VITAMIN D NOS, ASCORBIC ACID (VITAMIN C ACID), CALCIUM and LISINOPRIL for an unknown indication. On 31-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, the patient experienced DIARRHOEA (diarrhea). At the time of the report, DIARRHOEA (diarrhea) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient did not take any treatment medication. This case was linked to MOD-2021-022461 (Patient Link).

Other Meds: VITAMIN D NOS; VITAMIN C ACID; CALCIUM; LISINOPRIL

Current Illness:

ID: 1557515
Sex: U
Age:
State:

Vax Date:
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Stomach Pain; Diarrhea; 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 ABDOMINAL PAIN UPPER (Stomach Pain) and DIARRHOEA (Diarrhea) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included MACROGOL 3350 (MIRALAX) for an unknown indication. 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 ABDOMINAL PAIN UPPER (Stomach Pain) and DIARRHOEA (Diarrhea). At the time of the report, ABDOMINAL PAIN UPPER (Stomach Pain) and DIARRHOEA (Diarrhea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment medications was not provided Reporter did not allow further contact

Other Meds: MIRALAX

Current Illness:

ID: 1557516
Sex: F
Age: 82
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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: hot to touch; arm Itchy; arm red; swollen down to her elbow; arm hurt for 2 days; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (hot to touch), VACCINATION SITE PRURITUS (arm Itchy), VACCINATION SITE PAIN (arm hurt for 2 days), VACCINATION SITE ERYTHEMA (arm red) and VACCINATION SITE SWELLING (swollen down to her elbow) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004M20A) 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) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, 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 hurt for 2 days). On 02-Feb-2021, the patient experienced VACCINATION SITE WARMTH (hot to touch), VACCINATION SITE PRURITUS (arm Itchy), VACCINATION SITE ERYTHEMA (arm red) and VACCINATION SITE SWELLING (swollen down to her elbow). The patient was treated with HYDROCORTISONE (CORTISONE [HYDROCORTISONE]) for Itching, at a dose of 1 dosage form. On 30-Jan-2021, VACCINATION SITE PAIN (arm hurt for 2 days) had resolved. At the time of the report, VACCINATION SITE WARMTH (hot to touch), VACCINATION SITE ERYTHEMA (arm red) and VACCINATION SITE SWELLING (swollen down to her elbow) outcome was unknown and VACCINATION SITE PRURITUS (arm Itchy) was resolving. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. As reported by the consumer from the TCR follow up on 6-Jul-21, she used anti-itch cream and cold/warm compresses to treat events from her 1st vaccine and they resolved within 3-4 days. She also reported that she received the second vaccine, date and vaccine info not reported, and had no adverse events. No concomitant medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 06-Jul-2021: Significant TCR follow-up -outcome of the events

Other Meds:

Current Illness:

ID: 1557517
Sex: F
Age: 75
State: DE

Vax Date: 02/05/2021
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: 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: Slight headache; Itches; Rash under where she got the injection; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itches), VACCINATION SITE RASH (Rash under where she got the injection) and HEADACHE (Slight headache) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. Concurrent medical conditions included Diabetes. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (Itches) and VACCINATION SITE RASH (Rash under where she got the injection). On 10-Feb-2021, the patient experienced HEADACHE (Slight headache). At the time of the report, VACCINATION SITE PRURITUS (Itches), VACCINATION SITE RASH (Rash under where she got the injection) and HEADACHE (Slight 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 included: unspecified medication for diabetes, unspecified medication for cholesterol. No treatment medication was provided.

Other Meds:

Current Illness: Diabetes

ID: 1557518
Sex: M
Age: 83
State: CA

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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Stuffy nose; Arm hurt; Tired; This spontaneous case was reported by a consumer and describes the occurrence of NASAL CONGESTION (Stuffy nose), PAIN IN EXTREMITY (Arm hurt) and FATIGUE (Tired) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Knee pain and Back pain. Concomitant products included NAPROXEN SODIUM (ALEVE) for Knee pain and Back pain. 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 NASAL CONGESTION (Stuffy nose), PAIN IN EXTREMITY (Arm hurt) and FATIGUE (Tired). At the time of the report, NASAL CONGESTION (Stuffy nose), PAIN IN EXTREMITY (Arm hurt) and FATIGUE (Tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medication was not reported. Reporter did not allow further contact

Other Meds: ALEVE

Current Illness: Back pain; Knee pain

ID: 1557519
Sex: F
Age: 75
State: OH

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: warm to the touch around the injection site - right arm; itchy near injection site - right arm; little hard near injection site - right arm; red patch near injection site - bout 3 by 4 inches - right arm; rash around the injection site - right arm; headache; sore arm - right arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (warm to the touch around the injection site - right arm), PAIN IN EXTREMITY (sore arm - right arm), VACCINATION SITE PRURITUS (itchy near injection site - right arm), VACCINATION SITE INDURATION (little hard near injection site - right arm) and HEADACHE (headache) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included OMEPRAZOLE (PRILOSEC [OMEPRAZOLE]) for an unknown indication. 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 PAIN IN EXTREMITY (sore arm - right arm) and HEADACHE (headache). On 06-Feb-2021, the patient experienced VACCINATION SITE WARMTH (warm to the touch around the injection site - right arm), VACCINATION SITE PRURITUS (itchy near injection site - right arm), VACCINATION SITE INDURATION (little hard near injection site - right arm), VACCINATION SITE ERYTHEMA (red patch near injection site - bout 3 by 4 inches - right arm) and VACCINATION SITE RASH (rash around the injection site - right arm). At the time of the report, VACCINATION SITE WARMTH (warm to the touch around the injection site - right arm), VACCINATION SITE PRURITUS (itchy near injection site - right arm), VACCINATION SITE INDURATION (little hard near injection site - right arm), VACCINATION SITE ERYTHEMA (red patch near injection site - bout 3 by 4 inches - right arm) and VACCINATION SITE RASH (rash around the injection site - right arm) had not resolved and PAIN IN EXTREMITY (sore arm - right arm) and HEADACHE (headache) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment included cool packs.

Other Meds: PRILOSEC [OMEPRAZOLE]

Current Illness:

ID: 1557520
Sex: F
Age:
State: TX

Vax Date: 02/03/2021
Onset Date: 02/01/2021
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: body aches; felt weird all of the next day; knot at the injection site; severe itching at the injection site; fever; chills; Redness at the injection site; This spontaneous case was reported by a dietician and describes the occurrence of PYREXIA (fever), PAIN (body aches), CHILLS (chills), FEELING ABNORMAL (felt weird all of the next day) and VACCINATION SITE INDURATION (knot at the injection site) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19 on 21-Dec-2020, Fever on 21-Dec-2020 and Headache on 21-Dec-2020. Concomitant products included LEVOTHYROXINE, ATORVASTATIN, GLUCOSAMINE, MULTIVITAMIN [VITAMINS NOS] and OSPEMIFENE (OSPHENA) for an unknown indication. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In February 2021, the patient experienced PYREXIA (fever), PAIN (body aches), CHILLS (chills), FEELING ABNORMAL (felt weird all of the next day), VACCINATION SITE INDURATION (knot at the injection site), VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE PRURITUS (severe itching at the injection site). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. In February 2021, PYREXIA (fever), PAIN (body aches), CHILLS (chills), FEELING ABNORMAL (felt weird all of the next day) and VACCINATION SITE INDURATION (knot at the injection site) had resolved. At the time of the report, VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE PRURITUS (severe itching at the injection site) was resolving. 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.

Other Meds: LEVOTHYROXINE; ATORVASTATIN; GLUCOSAMINE; MULTIVITAMIN [VITAMINS NOS]; OSPHENA

Current Illness:

ID: 1557521
Sex: F
Age: 71
State: GA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Nerves in my face were jumping; Teeth occasionally chatter; This spontaneous case was reported by a consumer and describes the occurrence of MUSCLE TWITCHING (Nerves in my face were jumping) and CHILLS (Teeth occasionally chatter) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) and ROSUVASTATIN for an unknown indication. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Jan-2021, the patient experienced MUSCLE TWITCHING (Nerves in my face were jumping) and CHILLS (Teeth occasionally chatter). On 28-Jan-2021, MUSCLE TWITCHING (Nerves in my face were jumping) had resolved. At the time of the report, CHILLS (Teeth occasionally chatter) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was reported.

Other Meds: ASPIRIN (E.C.); ROSUVASTATIN

Current Illness:

ID: 1557522
Sex: F
Age: 76
State:

Vax Date: 01/12/2021
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: Tremor

Symptoms: Painful to touch; Shoulder inflamed; Nerve pain; Vertigo; Dizziness; Joint pain; Fatigue; Arm redness; Muscle pain; Fare up in her immune systems; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Painful to touch), INFLAMMATION (Shoulder inflamed), NEURALGIA (Nerve pain), VERTIGO (Vertigo) and DIZZINESS (Dizziness) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 12-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 PAIN (Painful to touch), INFLAMMATION (Shoulder inflamed), NEURALGIA (Nerve pain), VERTIGO (Vertigo), DIZZINESS (Dizziness), ARTHRALGIA (Joint pain), FATIGUE (Fatigue), ERYTHEMA (Arm redness), MYALGIA (Muscle pain) and IMMUNE SYSTEM DISORDER (Fare up in her immune systems). At the time of the report, PAIN (Painful to touch), INFLAMMATION (Shoulder inflamed), NEURALGIA (Nerve pain), ARTHRALGIA (Joint pain), ERYTHEMA (Arm redness), MYALGIA (Muscle pain) and IMMUNE SYSTEM DISORDER (Fare up in her immune systems) had resolved and VERTIGO (Vertigo), DIZZINESS (Dizziness) and FATIGUE (Fatigue) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Concomitant and treatment information were not provided.

Other Meds:

Current Illness:

ID: 1557523
Sex: F
Age: 85
State: GA

Vax Date: 01/30/2021
Onset Date:
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: Itching arm; Swollen down to elbow; Arm sensitive to touch; Red down to the elbow; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching arm), PERIPHERAL SWELLING (Swollen down to elbow), SKIN SENSITISATION (Arm sensitive to touch) and ERYTHEMA (Red down to the elbow) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 30-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 PRURITUS (Itching arm), PERIPHERAL SWELLING (Swollen down to elbow), SKIN SENSITISATION (Arm sensitive to touch) and ERYTHEMA (Red down to the elbow). At the time of the report, PRURITUS (Itching arm), PERIPHERAL SWELLING (Swollen down to elbow), SKIN SENSITISATION (Arm sensitive to touch) and ERYTHEMA (Red down to the elbow) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication was not reported. Treatment medication was not reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1557524
Sex: F
Age: 42
State: AZ

Vax Date: 01/29/2021
Onset Date: 01/31/2021
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: I still don't feel good; Headache; Fatigue; Felt like crap again; Started feeling like a shit for 4 days; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (I still don't feel good), FEELING ABNORMAL (Started feeling bad for 4 days), FEELING ABNORMAL (Felt bad again), HEADACHE (Headache) and FATIGUE (Fatigue) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025L20A) for COVID-19 vaccination. Concurrent medical conditions included Autoimmune disorder. On 29-Jan-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jan-2021, the patient experienced FEELING ABNORMAL (Started feeling like a shit for 4 days). On 08-Feb-2021, the patient experienced FEELING ABNORMAL (Felt bad again). On an unknown date, the patient experienced FEELING ABNORMAL (I still don't feel good), HEADACHE (Headache) and FATIGUE (Fatigue). On 03-Feb-2021, FEELING ABNORMAL (Started feeling bad for 4 days) had resolved. At the time of the report, FEELING ABNORMAL (I still don't feel good), FEELING ABNORMAL (Felt bad again), HEADACHE (Headache) and FATIGUE (Fatigue) had not 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 MOD-2021-086720 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 28-Apr-2021: NNI regarding Outcome: Not recovered

Other Meds:

Current Illness: Autoimmune disorder

ID: 1557525
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: 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: Allergic reaction; This spontaneous case was reported by a consumer and describes the occurrence of HYPERSENSITIVITY (Allergic reaction) in a 66-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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced HYPERSENSITIVITY (Allergic reaction). At the time of the report, HYPERSENSITIVITY (Allergic reaction) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication reported. No treatment was provided.

Other Meds:

Current Illness:

ID: 1557526
Sex: F
Age: 69
State: NY

Vax Date: 02/05/2021
Onset Date: 02/01/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Fell asleep during day; very sore arm; Fatigue; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (Fell asleep during day), PAIN IN EXTREMITY (very sore arm), FATIGUE (Fatigue) and NAUSEA (Nausea) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 05-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In February 2021, the patient experienced SOMNOLENCE (Fell asleep during day), PAIN IN EXTREMITY (very sore arm), FATIGUE (Fatigue) and NAUSEA (Nausea). At the time of the report, SOMNOLENCE (Fell asleep during day), PAIN IN EXTREMITY (very sore arm), FATIGUE (Fatigue) and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication was not reported. Treatment medication was not reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1557527
Sex: M
Age:
State: FL

Vax Date:
Onset Date:
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: reaction to moderna vaccine due to allergy to shelfish; This spontaneous case was reported by a consumer and describes the occurrence of HYPERSENSITIVITY (reaction to moderna vaccine due to allergy to shelfish) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Kidney disorder. 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 HYPERSENSITIVITY (reaction to moderna vaccine due to allergy to shelfish). At the time of the report, HYPERSENSITIVITY (reaction to moderna vaccine due to allergy to shelfish) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant as well as treatment information was provided. Patient was also received Pfizer covid vaccine on an unknown date.

Other Meds:

Current Illness: Kidney disorder

ID: 1557528
Sex: F
Age:
State: CA

Vax Date: 01/09/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: clogged ear; vertigo; tinnitus; Muscle fatigue; Unable to unplug hair dryer/ debiliatting enough to disable from walking, sitting upright, or even eating; vomitting; dizziness; injection site swelling; weakness; giant bump on injection site; Fever; chills/ shivering; muscle aches; headache on top of the head; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (weakness), VACCINATION SITE MASS (giant bump on injection site), DIZZINESS (dizziness), EAR DISCOMFORT (clogged ear) and VERTIGO (vertigo) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 042L20A and 027L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History Information was given by the reporter. Concomitant products included VITAMIN D3 and CYANOCOBALAMIN (VITAMIN B12 [CYANOCOBALAMIN]) for an unknown indication. On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 06-Feb-2021, the patient experienced ASTHENIA (weakness), VACCINATION SITE MASS (giant bump on injection site), PYREXIA (Fever), CHILLS (chills/ shivering), MYALGIA (muscle aches), HEADACHE (headache on top of the head) and VACCINATION SITE SWELLING (injection site swelling). On 27-Mar-2021, the patient experienced DIZZINESS (dizziness). On an unknown date, the patient experienced EAR DISCOMFORT (clogged ear), VERTIGO (vertigo), TINNITUS (tinnitus), MUSCLE FATIGUE (Muscle fatigue), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (Unable to unplug hair dryer/ debiliatting enough to disable from walking, sitting upright, or even eating) and VOMITING (vomitting). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and DEXTROMETHORPHAN HYDROBROMIDE, GUAIFENESIN, PARACETAMOL, PHENYLEPHRINE HYDROCHLORIDE (TYLENOL COLD + FLU SEVERE) at an unspecified dose and frequency. On 08-Feb-2021, ASTHENIA (weakness), VACCINATION SITE MASS (giant bump on injection site), PYREXIA (Fever), CHILLS (chills/ shivering) and MYALGIA (muscle aches) had resolved. At the time of the report, DIZZINESS (dizziness), EAR DISCOMFORT (clogged ear), VERTIGO (vertigo), TINNITUS (tinnitus), MUSCLE FATIGUE (Muscle fatigue), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (Unable to unplug hair dryer/ debiliatting enough to disable from walking, sitting upright, or even eating), HEADACHE (headache on top of the head), VOMITING (vomitting) and VACCINATION SITE SWELLING (injection site swelling) had not resolved. This case was linked to mod-2021-090644 (Patient Link). Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 22-Apr-2021: The Significant Follow up Information was received on 22-APR-2021.Events are updated. Patient demographics are added. First dose information was added.

Other Meds: VITAMIN D3; VITAMIN B12 [CYANOCOBALAMIN]

Current Illness:

ID: 1557529
Sex: U
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: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: ran fever around 24 hrs; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (ran fever around 24 hrs) 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 1. On an unknown date, the patient experienced PYREXIA (ran fever around 24 hrs). At the time of the report, PYREXIA (ran fever around 24 hrs) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not reported. Treatment medication was not reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1557530
Sex: F
Age: 79
State: FL

Vax Date: 01/11/2021
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: nauseous; 100?F fever; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (nauseous) and PYREXIA (100?F fever) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 010M20A and 026L20A) for COVID-19 vaccination. No Medical History information was reported. On 11-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Feb-2021, the patient experienced NAUSEA (nauseous) and PYREXIA (100?F fever). At the time of the report, NAUSEA (nauseous) and PYREXIA (100?F fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In February 2021, Body temperature: 100 ?F High. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not reported. Treatment medication was not reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1557531
Sex: U
Age:
State:

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

Lab Data:

Allergies:

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

Symptoms: Mild dizziness; Nausea; Mild flu like symptoms; Heightened temperature; Headache; This spontaneous case was reported by an other and describes the occurrence of INFLUENZA LIKE ILLNESS (Mild flu like symptoms), DIZZINESS (Mild dizziness), PYREXIA (Heightened temperature), HEADACHE (Headache) and NAUSEA (Nausea) 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 01-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Feb-2021, the patient experienced INFLUENZA LIKE ILLNESS (Mild flu like symptoms), PYREXIA (Heightened temperature) and HEADACHE (Headache). On 02-Feb-2021, the patient experienced DIZZINESS (Mild dizziness) and NAUSEA (Nausea). On 03-Feb-2021, INFLUENZA LIKE ILLNESS (Mild flu like symptoms), DIZZINESS (Mild dizziness), PYREXIA (Heightened temperature), HEADACHE (Headache) and NAUSEA (Nausea) had resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Feb-2021, Body temperature: high (High) heightened temperature. Action taken with mRNA-1273 in response to the events was not Applicable. Concomitant product use was not provided by the reporter. Patient was treated with standard OTC medication.

Other Meds:

Current Illness:

ID: 1557532
Sex: M
Age: 82
State: KS

Vax Date: 01/19/2021
Onset Date: 01/29/2021
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: nauseous; fatigue; stomach pain; can not breathe; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (stomach pain), DYSPNOEA (can not breathe), NAUSEA (nauseous) and FATIGUE (fatigue) in an 82-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 02G(?)L20A) for COVID-19 vaccination. No Medical History information was reported. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Jan-2021, the patient experienced ABDOMINAL PAIN UPPER (stomach pain) and DYSPNOEA (can not breathe). On 02-Feb-2021, the patient experienced FATIGUE (fatigue). On an unknown date, the patient experienced NAUSEA (nauseous). At the time of the report, ABDOMINAL PAIN UPPER (stomach pain), DYSPNOEA (can not breathe) and FATIGUE (fatigue) had not resolved and NAUSEA (nauseous) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Oxygen saturation: normal (normal) normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication details were provided. No treatment medication details were provided.

Other Meds:

Current Illness:

ID: 1557533
Sex: F
Age: 68
State: OR

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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: Arm is hurting; Arm ache for a few days; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm ache for a few days) and PAIN IN EXTREMITY (Arm is hurting) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. NDC number 99) for COVID-19 vaccination. No medical history was provided by the reporter. . On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Jan-2021, the patient experienced PAIN IN EXTREMITY (Arm ache for a few days). On 04-Feb-2021, the patient experienced PAIN IN EXTREMITY (Arm is hurting). The patient was treated with IBUPROFEN (ADVIL 12 HOUR) at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (Arm ache for a few days) had resolved and PAIN IN EXTREMITY (Arm is hurting) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1557534
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: arm is hard; arm is red; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE INDURATION (arm is hard) and VACCINATION SITE ERYTHEMA (arm is 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 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 VACCINATION SITE INDURATION (arm is hard) and VACCINATION SITE ERYTHEMA (arm is red). At the time of the report, VACCINATION SITE INDURATION (arm is hard) and VACCINATION SITE ERYTHEMA (arm is red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not reported. Treatment medication was not reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1557535
Sex: M
Age:
State: GA

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

Lab Data:

Allergies:

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

Symptoms: Palpitations; This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (Palpitations) in a 74-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) 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 16-Jan-2021, the patient experienced PALPITATIONS (Palpitations). On 16-Jan-2021, PALPITATIONS (Palpitations) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment medication was reported.; 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:

Current Illness:

ID: 1557536
Sex: F
Age: 70
State: CO

Vax Date: 01/29/2021
Onset Date: 02/07/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: A red, swollen and tender area around the injection site; A red, swollen and tender area around the injection site; A red, swollen and tender area around the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (A red, swollen and tender area around the injection site), VACCINATION SITE ERYTHEMA (A red, swollen and tender area around the injection site) and VACCINATION SITE SWELLING (A red, swollen and tender area around the injection site) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included ATORVASTATIN and IBANDRONATE SODIUM (BONIVA) for an unknown indication. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Feb-2021, the patient experienced VACCINATION SITE PAIN (A red, swollen and tender area around the injection site), VACCINATION SITE ERYTHEMA (A red, swollen and tender area around the injection site) and VACCINATION SITE SWELLING (A red, swollen and tender area around the injection site). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. At the time of the report, VACCINATION SITE PAIN (A red, swollen and tender area around the injection site), VACCINATION SITE ERYTHEMA (A red, swollen and tender area around the injection site) and VACCINATION SITE SWELLING (A red, swollen and tender area around the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Additional event treatment included ice.

Other Meds: ATORVASTATIN; BONIVA

Current Illness:

ID: 1557537
Sex: U
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: Delayed allergic reaction; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of HYPERSENSITIVITY (Delayed allergic reaction) 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 HYPERSENSITIVITY (Delayed allergic reaction). At the time of the report, HYPERSENSITIVITY (Delayed allergic reaction) 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 was not reported. Treatment medication was not reported.

Other Meds:

Current Illness:

ID: 1557538
Sex: M
Age: 87
State: CA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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: Stomach pain; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (Stomach pain) in an 87-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach pain). At the time of the report, ABDOMINAL PAIN UPPER (Stomach pain) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication was not reported. Treatment medication was not reported.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm