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: 1559291
Sex: F
Age: 64
State: NJ

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 08/15/2021
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: gland swollen under injection arm; Gland under her right arm was swollen and hard. It hurt to the touch.; gland hurt to the touch; A spontaneous report was received from a consumer concerning a 63-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events gland swollen under injection arm, gland hard under injection arm, gland hurt to the touch. The patient's medical history was not provided. No relevant concomitant medications were reported. On 26 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 022M20A) via unknown route in the right arm for prophylaxis of COVID-19 infection. On 27 Feb 2021, the patient experienced the event(s) gland swollen under injection arm, gland hard under injection arm, gland hurt to the touch. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), gland swollen under injection arm, gland hard under injection arm, gland hurt to the touch was unknown.

Other Meds:

Current Illness:

ID: 1559292
Sex: F
Age:
State:

Vax Date:
Onset Date: 02/28/2021
Rec V Date: 08/15/2021
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: Side effects to the COVID vaccine; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Side effects to the COVID vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Feb-2021, the patient experienced VACCINATION COMPLICATION (Side effects to the COVID vaccine). At the time of the report, VACCINATION COMPLICATION (Side effects to the COVID vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1559293
Sex: F
Age: 70
State: MA

Vax Date: 02/18/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Itching all over the body; Blisters all over her body; Swollen Injection Site (3.5" Inches); This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching all over the body), BLISTER (Blisters all over her body) and INJECTION SITE SWELLING (Swollen Injection Site (3.5" Inches)) 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 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Feb-2021, the patient experienced PRURITUS (Itching all over the body), BLISTER (Blisters all over her body) and INJECTION SITE SWELLING (Swollen Injection Site (3.5" Inches)). At the time of the report, PRURITUS (Itching all over the body), BLISTER (Blisters all over her body) and INJECTION SITE SWELLING (Swollen Injection Site (3.5" Inches)) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 30-Apr-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1559294
Sex: F
Age:
State:

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/15/2021
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: arm pain; fever and chills; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm pain) and PYREXIA (fever and 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 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, the patient experienced PAIN IN EXTREMITY (arm pain) and PYREXIA (fever and chills). At the time of the report, PAIN IN EXTREMITY (arm pain) and PYREXIA (fever and chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1559295
Sex: F
Age: 75
State: IN

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 08/15/2021
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: soreness in their arm; hurt to raise arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (soreness in their arm) and LIMB DISCOMFORT (hurt to raise arm) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. Concomitant products included LORAZEPAM, ESCITALOPRAM OXALATE (ESCITALOPRAM [ESCITALOPRAM OXALATE]), CARVEDILOL, LISINOPRIL and FAMOTIDINE for an unknown indication. 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 PAIN IN EXTREMITY (soreness in their arm) and LIMB DISCOMFORT (hurt to raise arm). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date at a dose of 1 dosage form. At the time of the report, PAIN IN EXTREMITY (soreness in their arm) and LIMB DISCOMFORT (hurt to raise arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: LORAZEPAM; ESCITALOPRAM [ESCITALOPRAM OXALATE]; CARVEDILOL; LISINOPRIL; FAMOTIDINE

Current Illness:

ID: 1559296
Sex: M
Age: 46
State: MN

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
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: swollen hand that is extremely painful; feels like fluid is running back and forth in my arm; Sore arm; A spontaneous report was received from a consumer concerning a 46-years-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events sore arm, swollen hand that is extremely painful, feels like fluid is running back and forth in my arm. The patient's medical history was not provided. No relevant concomitant medications were reported. On 26 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: UNK) intramuscularly for prophylaxis of COVID-19 infection. On 26 Feb 2021, the patient experienced the event(s) sore arm. On 27 Feb 2021, the patient experienced the event(s) swollen hand that is extremely painful, feels like fluid is running back and forth in my arm. Treatment details included Tylenol: 2 tablets, Ibuprofen: 4 tablets for 2 or 3 times a day. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), sore arm, swollen hand that is extremely painful, feels like fluid is running back and forth in my arm was unknown.

Other Meds:

Current Illness:

ID: 1559297
Sex: F
Age:
State: MI

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/15/2021
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: Within 45 minutes to hour of taking vaccine my right knee locked up; I could barely walk or barely put pressure on it/I cannot get out of the bed or go to the bathroom; wet my pants; This spontaneous case was reported by a consumer and describes the occurrence of JOINT LOCK (Within 45 minutes to hour of taking vaccine my right knee locked up), GAIT DISTURBANCE (I could barely walk or barely put pressure on it/I cannot get out of the bed or go to the bathroom) and ENURESIS (wet my pants) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. Concomitant products included VITAMINS NOS and VITAMIN D3 for an unknown indication. On 27-Feb-2021 at 3:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, the patient experienced JOINT LOCK (Within 45 minutes to hour of taking vaccine my right knee locked up), GAIT DISTURBANCE (I could barely walk or barely put pressure on it/I cannot get out of the bed or go to the bathroom) and ENURESIS (wet my pants). The patient was treated with ACETAMINOPHEN at a dose of 500 mg. At the time of the report, JOINT LOCK (Within 45 minutes to hour of taking vaccine my right knee locked up), GAIT DISTURBANCE (I could barely walk or barely put pressure on it/I cannot get out of the bed or go to the bathroom) and ENURESIS (wet my pants) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to US-MODERNATX, INC.-MOD-2021-062826 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-062826:Patient case

Other Meds: VITAMINS NOS; VITAMIN D3

Current Illness:

ID: 1559298
Sex: F
Age: 72
State: VA

Vax Date: 02/10/2021
Onset Date: 02/20/2021
Rec V Date: 08/15/2021
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: "Covid arm"; warm; red 6 inches wide; A spontaneous report was received from a consumer concerning a 72-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events covid arm/vaccination site reaction, warm/vaccination site warmth, red 6 inches wide/vaccination site erythema. The patient's medical history included emphysema, high cholesterol, hypothyroidism, high pulse rate and high anxiety. Concomitant medications reported were propranolol, escitalopram, bupropion, raloxifene, levothyroxine, atorvastatin for drug use for unknown indication. On 10 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 007M20A) in the left arm for prophylaxis of COVID-19 infection. On 20 Feb 2021, ten days after receiving the vaccine the patient experienced the events covid arms which was warm and red 6 inches wide. Treatment details included cream. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events covid arm warm, red 6 inches wide was unknown.

Other Meds: PROPRANOLOL; ESCITALOPRAM; BUPROPION; RALOXIFENE; LEVOTHYROXINE; ATORVASTATIN

Current Illness: Anxiety; Drug allergy (Montelukast); Emphysema; High cholesterol; High pulse rate; Hypothyroidism

ID: 1559299
Sex: F
Age: 76
State: WA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 08/15/2021
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: sore arm; A spontaneous report was received from a consumer concerning a 76-years-old female patient who received Moderna's COVID-19 vaccine (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 24 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 042L20A) for prophylaxis of COVID-19 infection. On 24 Feb 2021, the patient experienced the event sore arm. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events, sore arm was not resolved.

Other Meds:

Current Illness:

ID: 1559300
Sex: M
Age: 82
State: FL

Vax Date: 02/18/2021
Onset Date: 02/24/2021
Rec V Date: 08/15/2021
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: severe flu-like symptoms; Low BP; 102 F; Rash - left arm and chest; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (severe flu-like symptoms), HYPOTENSION (Low BP), BODY TEMPERATURE INCREASED (102 F) and RASH (Rash - left arm and chest) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included TADALAFIL (CIALIS), EPILOBIUM PARVIFLORUM, SERENOA REPENS, URTICA DIOICA (PALMETTO PLUS [EPILOBIUM PARVIFLORUM;SERENOA REPENS;URTICA DIOICA]) and TAMSULOSIN HYDROCHLORIDE (FLOMAX [TAMSULOSIN HYDROCHLORIDE]) for BPH, CHONDROITIN for Cartilage repair, LEVOTHYROXINE SODIUM (SYNTHROID) for Hypothyroidism, GLUCOSAMINE for Osteoarthritis. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Feb-2021, the patient experienced INFLUENZA LIKE ILLNESS (severe flu-like symptoms), HYPOTENSION (Low BP), BODY TEMPERATURE INCREASED (102 F) and RASH (Rash - left arm and chest). The patient was treated with IBUPROFEN ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, INFLUENZA LIKE ILLNESS (severe flu-like symptoms), HYPOTENSION (Low BP), BODY TEMPERATURE INCREASED (102 F) and RASH (Rash - left arm and chest) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In February 2021, Body temperature:. In February 2021, Coronavirus test: (Negative) COVID test result negative. On 24-Feb-2021, Body temperature: 102 F body temperature. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: SYNTHROID; GLUCOSAMINE; CHONDROITIN; CIALIS; PALMETTO PLUS [EPILOBIUM PARVIFLORUM;SERENOA REPENS;URTICA DIOICA]; FLOMAX [TAMSULOSIN HYDROCHLORIDE]

Current Illness:

ID: 1559301
Sex: F
Age: 59
State: NJ

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 08/15/2021
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: Flu-like symptoms; Upset stomach; Bowel movement; Headache; Fatigue; A spontaneous report was received from nurse concerning a 59-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events flu-like symptoms/influenza like illness, headache, fatigue, upset stomach/abdominal discomfort, bowel movement occurred/bowel movement irregularity. The patient's medical history included COVID-19 infection. No relevant concomitant medications were reported. On 16 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: unknown) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 16 Feb 2021, the patient experienced the events flu-like symptoms, headache, fatigue, upset stomach, bowel movement. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events flu-like symptoms, headache, fatigue, upset stomach, bowel movement was unknown.

Other Meds:

Current Illness:

ID: 1559302
Sex: F
Age: 74
State: AL

Vax Date: 02/09/2021
Onset Date: 02/25/2021
Rec V Date: 08/15/2021
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: High blood pressure after receiving the vaccine; Vertigo 16 days after receiving the vaccine; A spontaneous report was received from a consumer concerning a 73-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events high blood pressure after receiving the vaccine/hypertension, vertigo 16 days after receiving the vaccine/vertigo. The patient's medical history was not provided. No relevant concomitant medications were reported. On 9 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 013M20A) for prophylaxis of COVID-19 infection. On 25 Feb 2021, sixteen days after receiving vaccine the patient experienced the events high blood pressure and vertigo. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events high blood pressure and vertigo was unknown.

Other Meds:

Current Illness:

ID: 1559303
Sex: F
Age: 69
State:

Vax Date: 01/20/2021
Onset Date: 02/20/2021
Rec V Date: 08/15/2021
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: Severe sore arm; Immobility of injection arm; Diarrhea; Excruciating pain at injection arm; Chills; Vomiting; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Severe sore arm), VACCINATION SITE MOVEMENT IMPAIRMENT (Immobility of injection arm), DIARRHOEA (Diarrhea), VACCINATION SITE PAIN (Excruciating pain at injection arm) and CHILLS (Chills) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 20-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 20-Feb-2021, the patient experienced PAIN IN EXTREMITY (Severe sore arm), VACCINATION SITE MOVEMENT IMPAIRMENT (Immobility of injection arm), DIARRHOEA (Diarrhea), VACCINATION SITE PAIN (Excruciating pain at injection arm), CHILLS (Chills) and VOMITING (Vomiting). At the time of the report, PAIN IN EXTREMITY (Severe sore arm), VACCINATION SITE MOVEMENT IMPAIRMENT (Immobility of injection arm), DIARRHOEA (Diarrhea), VACCINATION SITE PAIN (Excruciating pain at injection arm), CHILLS (Chills) and VOMITING (Vomiting) outcome was unknown.

Other Meds:

Current Illness:

ID: 1559304
Sex: F
Age: 82
State: OH

Vax Date: 01/22/2021
Onset Date: 02/24/2021
Rec V Date: 08/15/2021
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: Arm swelling around arm; Itching at the injection site; Really really red around arm; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Arm swelling around arm), VACCINATION SITE PRURITUS (Itching at the injection site) and VACCINATION SITE ERYTHEMA (Really really red around arm) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 006M20A and 032L20A) for COVID-19 vaccination. The patient's past medical history included Heart disease, unspecified. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 24-Feb-2021, the patient experienced PERIPHERAL SWELLING (Arm swelling around arm), VACCINATION SITE PRURITUS (Itching at the injection site) and VACCINATION SITE ERYTHEMA (Really really red around arm). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date at a dose of 1 dosage form and IBUPROFEN (MOTRIN [IBUPROFEN]) ongoing since an unknown date at a dose of 1 dosage form. At the time of the report, PERIPHERAL SWELLING (Arm swelling around arm), VACCINATION SITE PRURITUS (Itching at the injection site) and VACCINATION SITE ERYTHEMA (Really really red around arm) outcome was unknown. Treatment details included warm compress, ice. No concomitants were reported. Most recent FOLLOW-UP information incorporated above includes: On 09-Jul-2021: NNI

Other Meds:

Current Illness:

ID: 1559305
Sex: M
Age:
State: GA

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
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: Peeing more often than normal; Like flu symptoms; Reaction to the vaccine; To the point he almost peed in his pants twice today; This spontaneous case was reported by a consumer and describes the occurrence of POLLAKIURIA (Peeing more often than normal), INFLUENZA LIKE ILLNESS (Like flu symptoms), VACCINATION COMPLICATION (Reaction to the vaccine) and BLADDER DISCOMFORT (To the point he almost peed in his pants twice today) in a 43-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 25-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Feb-2021, the patient experienced POLLAKIURIA (Peeing more often than normal), INFLUENZA LIKE ILLNESS (Like flu symptoms), VACCINATION COMPLICATION (Reaction to the vaccine) and BLADDER DISCOMFORT (To the point he almost peed in his pants twice today). At the time of the report, POLLAKIURIA (Peeing more often than normal), INFLUENZA LIKE ILLNESS (Like flu symptoms), VACCINATION COMPLICATION (Reaction to the vaccine) and BLADDER DISCOMFORT (To the point he almost peed in his pants twice today) outcome was unknown. No Concomitant and treatment medications were provided. Action taken with mRNA-1273 in response to the event was not applicable. Most recent FOLLOW-UP information incorporated above includes: On 20-Jul-2021: Non-significant FU - Email address provided.; Reporter's Comments: Based on the current available information which shows a temporal association between the use of the product and the start date of the reported event and excluding any other etiology, a causal relationship with the event cannot be excluded.

Other Meds:

Current Illness:

ID: 1559306
Sex: F
Age: 67
State: WA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 08/15/2021
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: strong metal taste in mouth and throat; dizzy; miserable for 3 weeks; nauseas; extreme tiredness; vaccine was very cold and she could feel it going in; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE COLDNESS (vaccine was very cold and she could feel it going in), DYSGEUSIA (strong metal taste in mouth and throat), DIZZINESS (dizzy), FEELING ABNORMAL (miserable for 3 weeks) and NAUSEA (nauseas) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Jan-2021, the patient experienced VACCINATION SITE COLDNESS (vaccine was very cold and she could feel it going in). On an unknown date, the patient experienced DYSGEUSIA (strong metal taste in mouth and throat), DIZZINESS (dizzy), FEELING ABNORMAL (miserable for 3 weeks), NAUSEA (nauseas) and FATIGUE (extreme tiredness). At the time of the report, VACCINATION SITE COLDNESS (vaccine was very cold and she could feel it going in), DYSGEUSIA (strong metal taste in mouth and throat), DIZZINESS (dizzy), FEELING ABNORMAL (miserable for 3 weeks), NAUSEA (nauseas) and FATIGUE (extreme tiredness) outcome was unknown. 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: 1559307
Sex: F
Age: 82
State: FL

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 08/15/2021
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: Nausea; Vomiting; Chills; Headache; Fatigue; "I just don't feel right, it comes in waves"; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (Nausea), VOMITING (Vomiting), CHILLS (Chills), HEADACHE (Headache) and FATIGUE (Fatigue) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M2-20A) 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced NAUSEA (Nausea), VOMITING (Vomiting), CHILLS (Chills), HEADACHE (Headache), FATIGUE (Fatigue) and MALAISE ("I just don't feel right, it comes in waves"). At the time of the report, NAUSEA (Nausea), VOMITING (Vomiting), CHILLS (Chills), HEADACHE (Headache), FATIGUE (Fatigue) and MALAISE ("I just don't feel right, it comes in waves") outcome was unknown.

Other Meds:

Current Illness:

ID: 1559308
Sex: F
Age: 73
State: TX

Vax Date: 01/16/2021
Onset Date: 02/03/2021
Rec V Date: 08/15/2021
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: Indentation - Near Injection Site; Redness - Near Injection Site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE STREAKING (Indentation - Near Injection Site) and VACCINATION SITE ERYTHEMA (Redness - Near Injection Site) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 307K20A) for COVID-19 vaccination. No Medical History information was reported. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced VACCINATION SITE STREAKING (Indentation - Near Injection Site) and VACCINATION SITE ERYTHEMA (Redness - Near Injection Site). At the time of the report, VACCINATION SITE STREAKING (Indentation - Near Injection Site) and VACCINATION SITE ERYTHEMA (Redness - Near Injection Site) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1559309
Sex: F
Age: 66
State: FL

Vax Date: 02/09/2021
Onset Date:
Rec V Date: 08/15/2021
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: headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headache) 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 09-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 HEADACHE (headache). At the time of the report, HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1559310
Sex: F
Age:
State: AZ

Vax Date: 02/14/2021
Onset Date: 02/23/2021
Rec V Date: 08/15/2021
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: itchy; rash on her arm; swelling on her arm; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (swelling on her arm), RASH PRURITIC (itchy) and RASH (rash on her arm) in a 97-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041620A) for COVID-19 vaccination. Concomitant products included LISINOPRIL for an unknown indication. On 14-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Feb-2021, the patient experienced PERIPHERAL SWELLING (swelling on her arm). On 26-Feb-2021, the patient experienced RASH PRURITIC (itchy) and RASH (rash on her arm). At the time of the report, PERIPHERAL SWELLING (swelling on her arm), RASH PRURITIC (itchy) and RASH (rash on her arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Treatment information was not provided.

Other Meds: LISINOPRIL

Current Illness:

ID: 1559311
Sex: M
Age: 75
State: CA

Vax Date: 01/22/2021
Onset Date: 02/04/2021
Rec V Date: 08/15/2021
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: Throat Closing; Trouble Swallowing; Dry nose; Slight Headache; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of THROAT TIGHTNESS (Throat Closing), DYSPHAGIA (Trouble Swallowing), NASAL DRYNESS (Dry nose) and HEADACHE (Slight Headache) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 vaccination. Concurrent medical conditions included GERD. Concomitant products included LOSARTAN POTASSIUM (COZAAR), AMLODIPINE BESILATE (NORVASC), OMEPRAZOLE MAGNESIUM (PRILOSEC [OMEPRAZOLE MAGNESIUM]), MYCOPHENOLATE MOFETIL (MYCOPHENOLATE) and NICOTINAMIDE for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced THROAT TIGHTNESS (Throat Closing), DYSPHAGIA (Trouble Swallowing), NASAL DRYNESS (Dry nose) and HEADACHE (Slight Headache). At the time of the report, THROAT TIGHTNESS (Throat Closing), DYSPHAGIA (Trouble Swallowing), NASAL DRYNESS (Dry nose) and HEADACHE (Slight Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: COZAAR; NORVASC; PRILOSEC [OMEPRAZOLE MAGNESIUM]; MYCOPHENOLATE; NICOTINAMIDE

Current Illness: GERD

ID: 1559312
Sex: M
Age: 56
State: OK

Vax Date: 02/02/2021
Onset Date:
Rec V Date: 08/15/2021
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: Sinus Infection and it was hurting; Myalgia; Sore Arm; A spontaneous report was received from a consumer concerning a 56-years-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events sinus infection and it was hurting/sinusitis, body ache/pain, sore arm/pain in extremity. The patient's medical history was not provided. No relevant concomitant medications were reported. On 2 Feb 2021 prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch:007M20A) intramuscularly for prophylaxis of COVID-19 infection. On unknown date the patient experienced the events sinus infection and it was hurting, body ache and sore arm. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events sinus infection and it was hurting, body ache and sore arm was unknown.

Other Meds:

Current Illness:

ID: 1559313
Sex: M
Age: 66
State: MI

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 08/15/2021
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: Lethargic; Fatigue; Headache; This spontaneous case was reported by a consumer and describes the occurrence of LETHARGY (Lethargic), FATIGUE (Fatigue) and HEADACHE (Headache) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 09-Feb-2021 at 2:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, the patient experienced LETHARGY (Lethargic), FATIGUE (Fatigue) and HEADACHE (Headache). At the time of the report, LETHARGY (Lethargic) and HEADACHE (Headache) had not resolved and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1559314
Sex: F
Age: 72
State: TX

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
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: High heart rate; Chills; fever; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE INCREASED (High heart rate), CHILLS (Chills) and PYREXIA (fever) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Feb-2021, the patient experienced HEART RATE INCREASED (High heart rate), CHILLS (Chills) and PYREXIA (fever). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency; ACETAMINOPHEN for Adverse event, at an unspecified dose and frequency and ACETYLSALICYLIC ACID (ASPIRIN ANALGESIC) for Adverse event, at an unspecified dose and frequency. At the time of the report, HEART RATE INCREASED (High heart rate), CHILLS (Chills) and PYREXIA (fever) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1559315
Sex: F
Age:
State: IN

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 08/15/2021
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: Headache; fever; chills; joint pain; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache), PYREXIA (fever), CHILLS (chills) and ARTHRALGIA (joint pain) 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 09-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 HEADACHE (Headache), PYREXIA (fever), CHILLS (chills) and ARTHRALGIA (joint pain). At the time of the report, HEADACHE (Headache), PYREXIA (fever), CHILLS (chills) and ARTHRALGIA (joint pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1559316
Sex: F
Age: 70
State: AZ

Vax Date: 02/23/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
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: she noticed a small rash about the size of the bottom of a normal tea glass. It was located an inch below the site of injection; It was swollen; red; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (she noticed a small rash about the size of the bottom of a normal tea glass. It was located an inch below the site of injection), VACCINATION SITE SWELLING (It was swollen) and VACCINATION SITE ERYTHEMA (red) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002A21A) for COVID-19 vaccination. No Medical History information was reported. On 23-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 26-Feb-2021, the patient experienced VACCINATION SITE RASH (she noticed a small rash about the size of the bottom of a normal tea glass. It was located an inch below the site of injection), VACCINATION SITE SWELLING (It was swollen) and VACCINATION SITE ERYTHEMA (red). At the time of the report, VACCINATION SITE RASH (she noticed a small rash about the size of the bottom of a normal tea glass. It was located an inch below the site of injection), VACCINATION SITE SWELLING (It was swollen) and VACCINATION SITE ERYTHEMA (red) outcome was unknown. Concomitant medications were not reported. Treatment information was not reported. Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: Additional information was received on 29-Apr-2021 content no new information.

Other Meds:

Current Illness:

ID: 1559317
Sex: F
Age: 68
State: PA

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 08/15/2021
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: Hot to Touch Sensation - Near Injection Site; Arm Pain; Redness - Near Injection Site; Swelling - Near Injection Site; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE WARMTH (Hot to Touch Sensation - Near Injection Site), PAIN IN EXTREMITY (Arm Pain), VACCINATION SITE ERYTHEMA (Redness - Near Injection Site) and VACCINATION SITE SWELLING (Swelling - Near Injection Site) in a 68-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 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Jan-2021, the patient experienced INJECTION SITE WARMTH (Hot to Touch Sensation - Near Injection Site), PAIN IN EXTREMITY (Arm Pain), VACCINATION SITE ERYTHEMA (Redness - Near Injection Site) and VACCINATION SITE SWELLING (Swelling - Near Injection Site). At the time of the report, INJECTION SITE WARMTH (Hot to Touch Sensation - Near Injection Site), PAIN IN EXTREMITY (Arm Pain), VACCINATION SITE ERYTHEMA (Redness - Near Injection Site) and VACCINATION SITE SWELLING (Swelling - Near Injection Site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1559318
Sex: F
Age: 64
State: OK

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 08/15/2021
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: Red Mark (Injection Site); Itchiness (Injection Site); chills; body aches; fever; headache; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (chills), MYALGIA (body aches), PYREXIA (fever), HEADACHE (headache) and VACCINATION SITE ERYTHEMA (Red Mark (Injection Site)) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 03-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Feb-2021, the patient experienced CHILLS (chills), MYALGIA (body aches), PYREXIA (fever) and HEADACHE (headache). On 06-Feb-2021, the patient experienced VACCINATION SITE ERYTHEMA (Red Mark (Injection Site)) and VACCINATION SITE PRURITUS (Itchiness (Injection Site)). At the time of the report, CHILLS (chills), MYALGIA (body aches), PYREXIA (fever), HEADACHE (headache), VACCINATION SITE ERYTHEMA (Red Mark (Injection Site)) and VACCINATION SITE PRURITUS (Itchiness (Injection Site)) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Feb-2021, Body temperature: 102 (High) 102. No concomitant medication were reported No treatment medication were reported. The patient received both scheduled doses of mRNA-1273 prior to the event, therefore action taken with the drug in the event is not applicable Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1559319
Sex: F
Age:
State: AZ

Vax Date: 02/18/2021
Onset Date: 02/28/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: red circle about 4 inches in diameter at the injection site; A spontaneous report was received from a nurse concerning a 23-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events red circle about 4 inches in diameter at the injection site/vaccination site erythema. 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: 030M20A) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On 28 Feb 2021, ten days after receiving the vaccine the patient experienced the event red circle about 4 inches in diameter at the injection site. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event red circle about 4 inches in diameter at the injection site was unknown.

Other Meds:

Current Illness:

ID: 1559320
Sex: F
Age: 44
State: NY

Vax Date: 02/02/2021
Onset Date: 02/05/2021
Rec V Date: 08/15/2021
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: Chest tightness; Shortness of breath; This spontaneous case was reported by a health care professional and describes the occurrence of CHEST DISCOMFORT (Chest tightness) and DYSPNOEA (Shortness of breath) in a 44-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 02-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 05-Feb-2021, the patient experienced CHEST DISCOMFORT (Chest tightness) and DYSPNOEA (Shortness of breath). At the time of the report, CHEST DISCOMFORT (Chest tightness) and DYSPNOEA (Shortness of breath) outcome was unknown. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.; Sender's Comments: Very limited information regarding this events has been provided at this time. Company assessed the events to be unlikely related to company product.

Other Meds:

Current Illness:

ID: 1559321
Sex: F
Age: 70
State: GA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 08/15/2021
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: On her arm where she got vaccine, she had red spot; it's really hot; sore arm for a day; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (On her arm where she got vaccine, she had red spot), VACCINATION SITE PAIN (sore arm for a day) and VACCINATION SITE WARMTH (it's really hot) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M020A) 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 29-Jan-2021, the patient experienced VACCINATION SITE PAIN (sore arm for a day). On 07-Feb-2021, the patient experienced VACCINATION SITE ERYTHEMA (On her arm where she got vaccine, she had red spot) and VACCINATION SITE WARMTH (it's really hot). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, VACCINATION SITE ERYTHEMA (On her arm where she got vaccine, she had red spot), VACCINATION SITE PAIN (sore arm for a day) and VACCINATION SITE WARMTH (it's really hot) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1559322
Sex: F
Age: 72
State: CA

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 08/15/2021
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: can hardly raise right arm; headache; chills; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (can hardly raise right arm), HEADACHE (headache) and CHILLS (chills) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 015M20A) for COVID-19 vaccination. Previously administered products included for an unreported indication: SHINGRIX. Concurrent medical conditions included Allergy (ibuprofen allergy) and Allergy (tylenol allergy). On 09-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 HEADACHE (headache) and CHILLS (chills). On 10-Feb-2021, the patient experienced PAIN IN EXTREMITY (can hardly raise right arm). At the time of the report, PAIN IN EXTREMITY (can hardly raise right arm), HEADACHE (headache) and CHILLS (chills) 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. Reporter did not allow further contact.

Other Meds:

Current Illness:

ID: 1559323
Sex: F
Age: 85
State: IN

Vax Date: 02/25/2021
Onset Date: 02/27/2021
Rec V Date: 08/15/2021
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: Left Shoulder pain; Neck pain; Arm soreness; This spontaneous case was reported by a consumer and describes the occurrence of ARTHRALGIA (Left Shoulder pain), NECK PAIN (Neck pain) and PAIN IN EXTREMITY (Arm soreness) 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 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, the patient experienced ARTHRALGIA (Left Shoulder pain), NECK PAIN (Neck pain) and PAIN IN EXTREMITY (Arm soreness). At the time of the report, ARTHRALGIA (Left Shoulder pain), NECK PAIN (Neck pain) and PAIN IN EXTREMITY (Arm soreness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1559324
Sex: F
Age: 51
State: MI

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 08/15/2021
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 warm feeling in the chest; Big bumps on left arm and red; Arm soreness; Itch; left arm broke out with rash; Redness on the arm; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (experienced warm feeling in the chest), RASH MACULAR (Big bumps on left arm and red), PAIN IN EXTREMITY (Arm soreness), PRURITUS (Itch) and RASH (left arm broke out with rash) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse event (No reported medical history). On 25-Jan-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Jan-2021, the patient experienced FEELING HOT (experienced warm feeling in the chest), RASH MACULAR (Big bumps on left arm and red), PAIN IN EXTREMITY (Arm soreness), PRURITUS (Itch), RASH (left arm broke out with rash) and ERYTHEMA (Redness on the arm). On 25-Jan-2021, FEELING HOT (experienced warm feeling in the chest), RASH MACULAR (Big bumps on left arm and red), PRURITUS (Itch), RASH (left arm broke out with rash) and ERYTHEMA (Redness on the arm) had resolved. At the time of the report, PAIN IN EXTREMITY (Arm soreness) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant information provided. Treatment included Benadryl

Other Meds:

Current Illness:

ID: 1559325
Sex: F
Age: 71
State: WA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 08/15/2021
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: Fever - Temperature of 99.8F; Body Aches; Headache; Fatigue; Diarrhea; Chills; Arm Pain; A spontaneous report was received from a consumer concerning a 71-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events chills, arm pain, body aches, fever - temperature of 99.8f, headache, diarrhea, fatigue. The patient's medical history included aspergillosis. Concomitant medications reported were antihistamines for aspergillosis. On 22 Jan 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 032L20A) Intramuscularly in her left arm for prophylaxis of COVID-19 infection. On 23 Jan 2021, the patient experienced the events chills and arm pain. On 30 Jan 2021, the patient experienced body aches, fever, headache, diarrhea, fatigue. On the same day the lab test performed included body temperature: 99.9 F(high). On an unknown date covid test was conducted thrice which was negative.Treatment details included Tylenol. Action taken with mRNA-1273 in response to the events was unknown. On 25 Jan 2021 the outcome of events chills, arm pain were resolved.The outcome of events body aches, fever - temperature of 99, 8f, headache, diarrhea and fatigue were unknown.

Other Meds:

Current Illness: Aspergillosis

ID: 1559326
Sex: F
Age: 87
State: PA

Vax Date: 02/01/2021
Onset Date: 02/09/2021
Rec V Date: 08/15/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Heat at Injection Site), VACCINATION SITE PRURITUS (Itchiness) and VACCINATION SITE ERYTHEMA (Redness) in an 87-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 01-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 VACCINATION SITE WARMTH (Heat at Injection Site), VACCINATION SITE PRURITUS (Itchiness) and VACCINATION SITE ERYTHEMA (Redness). At the time of the report, VACCINATION SITE WARMTH (Heat at Injection Site), VACCINATION SITE PRURITUS (Itchiness) and VACCINATION SITE ERYTHEMA (Redness) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1559327
Sex: M
Age:
State: AZ

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 08/15/2021
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: blisters itching quite a bit on legs and arms/marked swelling and rise on skin surface and theres a head; dime sized red swelling on torso; just don't feel right; blisters itching quite a bit on arms; red welts with blisters that had clear fluid; nausea; fatigue; muscle aches; lightheadedness/dizziness; A spontaneous report was received from a consumer concerning a 67-years-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events muscle aches, fatigue, headaches, lightheadedness, dizziness, nausea, red welts with blisters that had clear fluid, blisters itching quite a bit on legs, dime sized red swelling on torso, marked swelling and rise on skin surface and theres a head, just didn't feel right, blisters itching quite a bit on arms. The patient's medical history was not provided. No relevant concomitant medications were reported. On 5 Feb 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot/batch: 057G20A) for prophylaxis of COVID-19 infection. On 6 Feb 2021, the patient experienced the event(s) muscle aches, fatigue, headaches, lightheadedness, dizziness, nausea. On an unknown date, the patient experienced the event(s) red welts with blisters that had clear fluid, blisters itching quite a bit on legs, dime sized red swelling on torso, marked swelling and rise on skin surface and theres a head, just didn't feel right, blisters itching quite a bit on arms. Treatment details included Benadryl. Action taken with mRNA-1273 in response to the events was not reported. On 7 Feb 2021 the outcome of event(s), dizziness, nausea was resolved. The outcome of event(s), muscle aches, fatigue, headaches, lightheadedness, red welts with blisters that had clear fluid, blisters itching quite a bit on legs, dime sized red swelling on torso, marked swelling and rise on skin surface and theres a head, just didn't feel right, blisters itching quite a bit on arms was unknown.

Other Meds:

Current Illness:

ID: 1559328
Sex: F
Age:
State: PA

Vax Date: 02/02/2021
Onset Date: 02/09/2021
Rec V Date: 08/15/2021
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: covid arm; red spot; itchy; warm; hot to touch; has gotten a lot larger; pain to the touch; armed turned red about an egg size; the redness has gotten bigger and it is a deep red; it feels like something is traveling up to the side of her neck; warm to touch; This spontaneous case was reported by a consumer and describes the occurrence of TYPE IV HYPERSENSITIVITY REACTION (covid arm), VACCINATION SITE ERYTHEMA (red spot), VACCINATION SITE PRURITUS (itchy), VACCINATION SITE WARMTH (warm) and VACCINATION SITE WARMTH (hot to touch) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. no medical history is provided and concomitant drugs are provided. Concomitant products included AMOXICILLIN TRIHYDRATE, CLARITHROMYCIN, ESOMEPRAZOLE MAGNESIUM (NEXIUM 1-2-3) and MELOXICAM as needed for an unknown indication. On 02-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 TYPE IV HYPERSENSITIVITY REACTION (covid arm), VACCINATION SITE ERYTHEMA (red spot), VACCINATION SITE PRURITUS (itchy), VACCINATION SITE WARMTH (warm), VACCINATION SITE WARMTH (hot to touch), VACCINATION COMPLICATION (has gotten a lot larger), VACCINATION SITE PAIN (pain to the touch), ERYTHEMA (armed turned red about an egg size), VACCINATION COMPLICATION (the redness has gotten bigger and it is a deep red), VACCINATION COMPLICATION (it feels like something is traveling up to the side of her neck) and FEELING HOT (warm to touch). At the time of the report, TYPE IV HYPERSENSITIVITY REACTION (covid arm), VACCINATION SITE ERYTHEMA (red spot), VACCINATION SITE PRURITUS (itchy), VACCINATION SITE WARMTH (warm), VACCINATION SITE WARMTH (hot to touch), VACCINATION COMPLICATION (has gotten a lot larger), VACCINATION SITE PAIN (pain to the touch), ERYTHEMA (armed turned red about an egg size), VACCINATION COMPLICATION (the redness has gotten bigger and it is a deep red), VACCINATION COMPLICATION (it feels like something is traveling up to the side of her neck) and FEELING HOT (warm to touch) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: NEXIUM 1-2-3; MELOXICAM as needed

Current Illness:

ID: 1559329
Sex: M
Age: 83
State: FL

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/15/2021
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: Both his feet and ankles are swollen as if it is water retention; Both his feet and ankles are swollen as if it is water retention; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Both his feet and ankles are swollen as if it is water retention) and JOINT SWELLING (Both his feet and ankles are swollen as if it is water retention) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022M20A) for COVID-19 vaccination. The patient's past medical history included Peripheral neuropathy (Legs and feet). On 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Feb-2021, the patient experienced PERIPHERAL SWELLING (Both his feet and ankles are swollen as if it is water retention) and JOINT SWELLING (Both his feet and ankles are swollen as if it is water retention). At the time of the report, PERIPHERAL SWELLING (Both his feet and ankles are swollen as if it is water retention) and JOINT SWELLING (Both his feet and ankles are swollen as if it is water retention) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown.

Other Meds:

Current Illness:

ID: 1559330
Sex: F
Age:
State: NY

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/15/2021
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: red round circle around the injection site; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (sore arm) and VACCINATION SITE ERYTHEMA (red round circle around the injection site) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Cholesterol. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Jan-2021, the patient experienced VACCINATION SITE PAIN (sore arm). On 24-Jan-2021, the patient experienced VACCINATION SITE ERYTHEMA (red round circle around the injection site). At the time of the report, VACCINATION SITE PAIN (sore arm) had resolved and VACCINATION SITE ERYTHEMA (red round circle around the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant Products includes Cholesterol Meds.

Other Meds:

Current Illness: Cholesterol

ID: 1559331
Sex: F
Age: 63
State: MS

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/15/2021
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: injection site itchy; injection site rashy; injection site raised; she had a red circle about size of half dollar at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (she had a red circle about size of half dollar at the injection site), VACCINATION SITE PRURITUS (injection site itchy), VACCINATION SITE RASH (injection site rashy) and INJECTION SITE SWELLING (injection site raised) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) 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 ERYTHEMA (she had a red circle about size of half dollar at the injection site). On 07-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (injection site itchy), VACCINATION SITE RASH (injection site rashy) and INJECTION SITE SWELLING (injection site raised). The patient was treated with HYDROCORTISONE ACETATE (CORTIZONE [HYDROCORTISONE ACETATE]) at an unspecified dose and frequency. At the time of the report, VACCINATION SITE ERYTHEMA (she had a red circle about size of half dollar at the injection site), VACCINATION SITE PRURITUS (injection site itchy), VACCINATION SITE RASH (injection site rashy) and INJECTION SITE SWELLING (injection site raised) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1559332
Sex: F
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 08/15/2021
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: This spontaneous case was reported by a non-health professional and describes the occurrence of ANTIBODY TEST NEGATIVE (Got the antibody test and it came back negative) 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ANTIBODY TEST NEGATIVE (Got the antibody test and it came back negative). At the time of the report, ANTIBODY TEST NEGATIVE (Got the antibody test and it came back negative) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, Antibody test: Negative.

Other Meds:

Current Illness:

ID: 1559333
Sex: F
Age: 62
State: WI

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/15/2021
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: Face swelling; Itchiness all over her body; This spontaneous case was reported by a pharmacist (subsequently medically confirmed) and describes the occurrence of SWELLING FACE (Face swelling) and PRURITUS (Itchiness all over her body) in a 62-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 SWELLING FACE (Face swelling) and PRURITUS (Itchiness all over her body). The patient was treated with PREDNISONE at an unspecified dose and frequency. At the time of the report, SWELLING FACE (Face swelling) and PRURITUS (Itchiness all over her body) 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.

Other Meds:

Current Illness:

ID: 1559334
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 08/15/2021
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 under eyes; This spontaneous case was reported by a health care professional and describes the occurrence of EYE SWELLING (swelling under eyes) 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, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EYE SWELLING (swelling under eyes). The patient was treated with IBUPROFEN at an unspecified dose and frequency. At the time of the report, EYE SWELLING (swelling under eyes) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments. patient took ibuprofen as treatment and with in one week the event is resolved.

Other Meds:

Current Illness:

ID: 1559335
Sex: F
Age: 72
State: CA

Vax Date: 02/06/2021
Onset Date: 02/08/2021
Rec V Date: 08/15/2021
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: Chest pain left side; Tightness in the chest 2 nights; Pain on the side; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Chest pain left side), CHEST DISCOMFORT (Tightness in the chest 2 nights) and PAIN (Pain on the side) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. Concurrent medical conditions included Heart disease, unspecified. On 06-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 CHEST PAIN (Chest pain left side), CHEST DISCOMFORT (Tightness in the chest 2 nights) and PAIN (Pain on the side). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, CHEST PAIN (Chest pain left side), CHEST DISCOMFORT (Tightness in the chest 2 nights) and PAIN (Pain on the side) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications provided; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness: Heart disease, unspecified

ID: 1559336
Sex: U
Age:
State:

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 08/15/2021
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: decrease sensation to the left side of my face; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (decrease sensation to the left side of my face) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) 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) (Intramuscular) 1 dosage form. On 17-Jan-2021, the patient experienced HYPOAESTHESIA (decrease sensation to the left side of my face). At the time of the report, HYPOAESTHESIA (decrease sensation to the left side of my face) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1559337
Sex: M
Age: 76
State: WI

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/15/2021
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: It was so bad that he could hardly sleep; warm; night the area started itching; It's a large red circle around the injection site; it was just a little bit sore; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (It's a large red circle around the injection site), PAIN (it was just a little bit sore), PRURITUS (night the area started itching), INSOMNIA (It was so bad that he could hardly sleep) and FEELING HOT (warm) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 immunisation. 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 02-Feb-2021, the patient experienced PAIN (it was just a little bit sore). On 05-Feb-2021, the patient experienced VACCINATION SITE ERYTHEMA (It's a large red circle around the injection site). On 08-Feb-2021, the patient experienced PRURITUS (night the area started itching). On 09-Feb-2021, the patient experienced INSOMNIA (It was so bad that he could hardly sleep) and FEELING HOT (warm). At the time of the report, VACCINATION SITE ERYTHEMA (It's a large red circle around the injection site), PAIN (it was just a little bit sore), PRURITUS (night the area started itching), INSOMNIA (It was so bad that he could hardly sleep) and FEELING HOT (warm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Concomitant medications were not provided. Treatment details Ice,Mosquito bite medication,Topical antihistamine

Other Meds:

Current Illness:

ID: 1559338
Sex: M
Age: 79
State: MD

Vax Date: 01/02/2021
Onset Date: 01/31/2021
Rec V Date: 08/15/2021
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: chills; felt tired; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (chills) and FATIGUE (felt tired) in a 79-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 02-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 31-Jan-2021, the patient experienced CHILLS (chills) and FATIGUE (felt tired). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date at an unspecified dose and frequency. On 31-Jan-2021, CHILLS (chills) and FATIGUE (felt tired) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1559339
Sex: F
Age: 70
State: WA

Vax Date: 01/13/2021
Onset Date: 02/10/2021
Rec V Date: 08/15/2021
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; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headache) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037K20A and 013M20A) for COVID-19 vaccination. Concurrent medical conditions included Migraine. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Feb-2021, the patient experienced HEADACHE (headache). At the time of the report, HEADACHE (headache) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1559340
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/15/2021
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: muscle pain; joint pain; nausea; banging headache; fever; soaring blood sugar; chills; sweating; tired; horrible pain; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (muscle pain), ARTHRALGIA (joint pain), NAUSEA (nausea), HEADACHE (banging headache) and PYREXIA (fever) in a 69-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for an unknown indication. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced MYALGIA (muscle pain), ARTHRALGIA (joint pain), NAUSEA (nausea), HEADACHE (banging headache), PYREXIA (fever), BLOOD GLUCOSE ABNORMAL (soaring blood sugar), CHILLS (chills), HYPERHIDROSIS (sweating), FATIGUE (tired) and PAIN (horrible pain). At the time of the report, MYALGIA (muscle pain), ARTHRALGIA (joint pain), NAUSEA (nausea), HEADACHE (banging headache), PYREXIA (fever), BLOOD GLUCOSE ABNORMAL (soaring blood sugar), CHILLS (chills), HYPERHIDROSIS (sweating), FATIGUE (tired) and PAIN (horrible pain) 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

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm