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: 1559541
Sex: F
Age: 64
State: MO

Vax Date: 02/10/2021
Onset Date: 02/16/2021
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: delayed (started on Day 6) pain under armpit; This spontaneous case was reported by a consumer and describes the occurrence of AXILLARY PAIN (delayed (started on Day 6) pain under armpit) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced AXILLARY PAIN (delayed (started on Day 6) pain under armpit). At the time of the report, AXILLARY PAIN (delayed (started on Day 6) pain under armpit) 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: 1559542
Sex: F
Age:
State: CA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
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: Swollen lymph nodes on the injection arm; This spontaneous case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (Swollen lymph nodes on the injection arm) 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 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 LYMPHADENOPATHY (Swollen lymph nodes on the injection arm). At the time of the report, LYMPHADENOPATHY (Swollen lymph nodes on the injection arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. Treatment medications were unknown. Most recent FOLLOW-UP information incorporated above includes: On 16-Feb-2021: Follow-up received on 16-FEB-2021 and does not contain any new information (NNI). On 28-Apr-2021: Case for 2nd dose created. Contact information updated. The outcome of the event (swollen lymph nodes) changed (from Unknown to Resolved).

Other Meds:

Current Illness:

ID: 1559543
Sex: F
Age:
State: CA

Vax Date: 01/30/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Got a little itchy, pink again; Little raised at injection site; Some pinkness at injection spot, little pink; Arm sore; Can not lift the arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm sore), LIMB DISCOMFORT (Can not lift the arm), VACCINATION SITE DISCOLOURATION (Some pinkness at injection spot, little pink), VACCINATION SITE PRURITUS (Got a little itchy, pink again) and VACCINATION SITE SWELLING (Little raised at injection site) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M120A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 30-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 PAIN IN EXTREMITY (Arm sore) and LIMB DISCOMFORT (Can not lift the arm). On 02-Feb-2021, the patient experienced VACCINATION SITE DISCOLOURATION (Some pinkness at injection spot, little pink) and VACCINATION SITE SWELLING (Little raised at injection site). On 07-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (Got a little itchy, pink again). At the time of the report, PAIN IN EXTREMITY (Arm sore), LIMB DISCOMFORT (Can not lift the arm), VACCINATION SITE DISCOLOURATION (Some pinkness at injection spot, little pink), VACCINATION SITE PRURITUS (Got a little itchy, pink again) and VACCINATION SITE SWELLING (Little raised at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication provided by the reporter. No treatment information provided by the reporter. The patient stated that she was feeling fine. Most recent FOLLOW-UP information incorporated above includes: On 26-Apr-2021: NNI- AE contact information updated

Other Meds:

Current Illness:

ID: 1559544
Sex: F
Age: 80
State: IL

Vax Date: 02/09/2021
Onset Date: 02/16/2021
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: injection site itched really bad; a little bit of a rash appeared; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PRURITUS (injection site itched really bad) and RASH (a little bit of a rash appeared) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. Concomitant products included APIXABAN, LISINOPRIL, HYDROCHLOROTHIAZIDE, OMEPRAZOLE and CITRULLINE for an unknown indication. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced INJECTION SITE PRURITUS (injection site itched really bad) and RASH (a little bit of a rash appeared). At the time of the report, INJECTION SITE PRURITUS (injection site itched really bad) and RASH (a little bit of a rash appeared) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided.

Other Meds: APIXABAN; LISINOPRIL; HYDROCHLOROTHIAZIDE; OMEPRAZOLE; CITRULLINE

Current Illness:

ID: 1559545
Sex: F
Age: 35
State: MN

Vax Date: 02/14/2021
Onset Date: 02/14/2021
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: still feeling a little tingling of the face; not feeling normal; Mouth was tingly; Heart rate was fast; Mouth was numb/Numbness spread to the face and tongue; Numbness spread to the face and tongue; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA ORAL (Mouth was tingly), HEART RATE ABNORMAL (Heart rate was fast), PARAESTHESIA (still feeling a little tingling of the face), HYPOAESTHESIA ORAL (Mouth was numb/Numbness spread to the face and tongue) and HYPOAESTHESIA (Numbness spread to the face and tongue) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 022M20A and 044A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Penicillin allergy (Patient was allergic to penicillin (rash).). On 14-Feb-2021 at 8:40 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Mar-2021 at 6:30 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Feb-2021, the patient experienced HEART RATE ABNORMAL (Heart rate was fast), HYPOAESTHESIA ORAL (Mouth was numb/Numbness spread to the face and tongue) and HYPOAESTHESIA (Numbness spread to the face and tongue). On 14-Feb-2021 at 9:05 PM, the patient experienced PARAESTHESIA ORAL (Mouth was tingly). On 16-Feb-2021, the patient experienced PARAESTHESIA (still feeling a little tingling of the face) and FEELING ABNORMAL (not feeling normal). On 14-Feb-2021, HEART RATE ABNORMAL (Heart rate was fast) had resolved. On 16-Feb-2021, PARAESTHESIA ORAL (Mouth was tingly) had resolved. At the time of the report, PARAESTHESIA (still feeling a little tingling of the face), HYPOAESTHESIA ORAL (Mouth was numb/Numbness spread to the face and tongue), HYPOAESTHESIA (Numbness spread to the face and tongue) and FEELING ABNORMAL (not feeling normal) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Most recent FOLLOW-UP information incorporated above includes: On 26-Apr-2021: Patient demographics updated- initial and follow up will be submitted to regulatory authority together

Other Meds:

Current Illness:

ID: 1559546
Sex: F
Age: 67
State: FL

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: left arm had swelled up to the size of a credit card; arm is still bruised; injection site redness; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of VACCINATION SITE SWELLING (left arm had swelled up to the size of a credit card), CONTUSION (arm is still bruised) and VACCINATION SITE ERYTHEMA (injection site redness) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. No Medical History information was reported. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Jan-2021, the patient experienced VACCINATION SITE SWELLING (left arm had swelled up to the size of a credit card), CONTUSION (arm is still bruised) and VACCINATION SITE ERYTHEMA (injection site redness). At the time of the report, VACCINATION SITE SWELLING (left arm had swelled up to the size of a credit card), CONTUSION (arm is still bruised) and VACCINATION SITE ERYTHEMA (injection site redness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Treatment details included steroid injection, Cephalexin, ice.

Other Meds:

Current Illness:

ID: 1559547
Sex: F
Age:
State: WA

Vax Date: 01/31/2021
Onset Date:
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: Red at injection site; Itchy at injection site; Swollen at injection site/ Raised its head up again at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (Red at injection site), VACCINATION SITE PRURITUS (Itchy at injection site) and VACCINATION SITE SWELLING (Swollen at injection site/ Raised its head up again at the injection site) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 31-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (Red at injection site), VACCINATION SITE PRURITUS (Itchy at injection site) and VACCINATION SITE SWELLING (Swollen at injection site/ Raised its head up again at the injection site). At the time of the report, VACCINATION SITE ERYTHEMA (Red at injection site) and VACCINATION SITE PRURITUS (Itchy at injection site) had resolved and VACCINATION SITE SWELLING (Swollen at injection site/ Raised its head up again at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment was not provided/ unknown.

Other Meds:

Current Illness:

ID: 1559548
Sex: F
Age: 51
State: GA

Vax Date: 02/12/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: starting having a funny taste in her mouth; injection site really bruised; really sore like you would get the flu; cough; rash real red; arm itching; felt like sleeping all day; sore all over/ muscle aches; fatigue; fever at 102.0; This spontaneous case was reported by a consumer and describes the occurrence of DYSGEUSIA (starting having a funny taste in her mouth), INJECTION SITE BRUISING (injection site really bruised), INFLUENZA LIKE ILLNESS (really sore like you would get the flu), COUGH (cough) and RASH ERYTHEMATOUS (rash real red) 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. No Medical History information was reported. On 12-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced DYSGEUSIA (starting having a funny taste in her mouth), INJECTION SITE BRUISING (injection site really bruised), INFLUENZA LIKE ILLNESS (really sore like you would get the flu), COUGH (cough), RASH ERYTHEMATOUS (rash real red), PRURITUS (arm itching), SOMNOLENCE (felt like sleeping all day), MYALGIA (sore all over/ muscle aches), FATIGUE (fatigue) and PYREXIA (fever at 102.0). At the time of the report, DYSGEUSIA (starting having a funny taste in her mouth), INJECTION SITE BRUISING (injection site really bruised), INFLUENZA LIKE ILLNESS (really sore like you would get the flu), COUGH (cough), RASH ERYTHEMATOUS (rash real red), PRURITUS (arm itching), SOMNOLENCE (felt like sleeping all day), MYALGIA (sore all over/ muscle aches), FATIGUE (fatigue) and PYREXIA (fever at 102.0) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Feb-2021, Body temperature: 102 (High) units not reported. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant and treatment medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 06-Jul-2021: Follow-up information received provided event onset date.

Other Meds:

Current Illness:

ID: 1559549
Sex: F
Age: 71
State: FL

Vax Date: 01/29/2021
Onset Date: 02/01/2021
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: Dizziness; Abdominal Pain; No Appetite; Fatigue; Extreme Headache; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), ABDOMINAL PAIN (Abdominal Pain), DECREASED APPETITE (No Appetite), FATIGUE (Fatigue) and HEADACHE (Extreme Headache) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 38K20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included ATORVASTATIN CALCIUM, EZETIMIBE (STATIN EZ) and METHOTREXATE 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 01-Feb-2021, the patient experienced DIZZINESS (Dizziness), ABDOMINAL PAIN (Abdominal Pain), DECREASED APPETITE (No Appetite), FATIGUE (Fatigue), HEADACHE (Extreme Headache) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, DIZZINESS (Dizziness), ABDOMINAL PAIN (Abdominal Pain), DECREASED APPETITE (No Appetite), FATIGUE (Fatigue), HEADACHE (Extreme Headache) and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: STATIN EZ; METHOTREXATE

Current Illness:

ID: 1559550
Sex: F
Age:
State: AL

Vax Date: 02/01/2021
Onset Date:
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: Allergic reaction to the Covid 19 vaccine; Itchy; Big red spot on her arm; This spontaneous case was reported by a consumer and describes the occurrence of HYPERSENSITIVITY (Allergic reaction to the Covid 19 vaccine), VACCINATION SITE PRURITUS (Itchy) and VACCINATION SITE ERYTHEMA (Big red spot on her arm) 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 01-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 HYPERSENSITIVITY (Allergic reaction to the Covid 19 vaccine), VACCINATION SITE PRURITUS (Itchy) and VACCINATION SITE ERYTHEMA (Big red spot on her arm). At the time of the report, HYPERSENSITIVITY (Allergic reaction to the Covid 19 vaccine) and VACCINATION SITE PRURITUS (Itchy) outcome was unknown and VACCINATION SITE ERYTHEMA (Big red spot on her arm) had not 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. Concomitant product use was not provided by the reporter. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 23-Apr-2021: Reporter contact information and patient demographics were updated.

Other Meds:

Current Illness:

ID: 1559551
Sex: M
Age:
State: GA

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

Lab Data:

Allergies:

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

Symptoms: sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm) in a 68-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 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 PAIN IN EXTREMITY (sore arm). On 18-Jan-2021, PAIN IN EXTREMITY (sore arm) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1559552
Sex: F
Age: 50
State: OH

Vax Date: 01/06/2021
Onset Date: 02/03/2021
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: diarrhea; stomach ache; sore throat; nausea; body aches; chills; head ache; This spontaneous case was reported by an other health care professional and describes the occurrence of DIARRHOEA (diarrhea), ABDOMINAL PAIN UPPER (stomach ache), OROPHARYNGEAL PAIN (sore throat), NAUSEA (nausea) and MYALGIA (body aches) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 028L20A and 039K202A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19 on 19-Nov-2020. Concomitant products included THYROID (ARMOUR THYROID) and LIOTHYRONINE SODIUM (CYTOMEL) for an unknown indication. On 06-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-Feb-2021, the patient experienced DIARRHOEA (diarrhea), ABDOMINAL PAIN UPPER (stomach ache), OROPHARYNGEAL PAIN (sore throat), NAUSEA (nausea), MYALGIA (body aches), CHILLS (chills) and HEADACHE (head ache). The patient was treated with ONDANSETRON (ZOFRAN [ONDANSETRON]) for Adverse event, at an unspecified dose and frequency; PARACETAMOL (TYLENOL EXTRA STRENGTH) for Adverse event, at an unspecified dose and frequency; LORATADINE, PSEUDOEPHEDRINE SULFATE (CLARITIN D 12 HOUR) for Adverse event, at an unspecified dose and frequency and ZINGIBER OFFICINALE (GINGER [ZINGIBER OFFICINALE]) for Adverse event, at an unspecified dose and frequency. At the time of the report, DIARRHOEA (diarrhea), ABDOMINAL PAIN UPPER (stomach ache), OROPHARYNGEAL PAIN (sore throat), NAUSEA (nausea), MYALGIA (body aches), CHILLS (chills) and HEADACHE (head ache) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. This case was linked to MOD-2021-043709 (Patient Link).

Other Meds: ARMOUR THYROID; CYTOMEL

Current Illness:

ID: 1559553
Sex: M
Age: 84
State: OH

Vax Date: 01/27/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: wrists started to hurt again; KEPT SLEEPING; could not even walk; whole body ached; CHILLS; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of SOMNOLENCE (KEPT SLEEPING), GAIT DISTURBANCE (could not even walk), ARTHRALGIA (wrists started to hurt again), CHILLS (CHILLS) and MYALGIA (whole body ached) in an 84-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0001335991) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included ASCORBIC ACID, BETACAROTENE, CUPRIC OXIDE, TOCOPHERYL ACETATE, ZINC OXIDE (PRESERVISION) for Dry eyes, DICLOFENAC, HYDROCHLOROTHIAZIDE, FISH OIL, LEVOTHYROXINE, ADALIMUMAB (HUMIRA), ASCORBIC ACID, ACETYLSALICYLIC ACID (BABY ASPIRIN), ATENOLOL, TRAMADOL, OMEPRAZOLE and SIMVASTATIN for an unknown indication. On 27-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 CHILLS (CHILLS). On 29-Jan-2021, the patient experienced SOMNOLENCE (KEPT SLEEPING), GAIT DISTURBANCE (could not even walk) and MYALGIA (whole body ached). On 14-Feb-2021, the patient experienced ARTHRALGIA (wrists started to hurt again). On 15-Feb-2021, SOMNOLENCE (KEPT SLEEPING), GAIT DISTURBANCE (could not even walk), CHILLS (CHILLS) and MYALGIA (whole body ached) had resolved. At the time of the report, ARTHRALGIA (wrists started to hurt again) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient did not receive any treatment medications.

Other Meds: PRESERVISION; DICLOFENAC; HYDROCHLOROTHIAZIDE; FISH OIL; LEVOTHYROXINE; HUMIRA; ASCORBIC ACID; BABY ASPIRIN; ATENOLOL; TRAMADOL; OMEPRAZOLE; SIMVASTATIN

Current Illness:

ID: 1559554
Sex: M
Age:
State: TX

Vax Date:
Onset Date:
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: Had Covid after first shot; This spontaneous case was reported by a health care professional and describes the occurrence of COVID-19 (Had Covid after first shot) in a 27-year-old male 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 COVID-19 (Had Covid after first shot). At the time of the report, COVID-19 (Had Covid after first shot) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Coronavirus test: positive (Inconclusive) positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided. No treatment was reported.

Other Meds:

Current Illness:

ID: 1559555
Sex: F
Age: 56
State: WA

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: 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: Good bumps just on the left thigh; Arm was little sore; Being tired; Tingling sensation of left side of the body,left thigh(felt like you were pulling spider web) , left calf,left shoulder; Numb - left thigh/left calf/left shoulder; Discomfort; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (Tingling sensation of left side of the body,left thigh(felt like you were pulling spider web) , left calf,left shoulder), HYPOAESTHESIA (Numb - left thigh/left calf/left shoulder), NODULE (Good bumps just on the left thigh), DISCOMFORT (Discomfort) and PAIN IN EXTREMITY (Arm was little sore) in a 56-year-old female 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 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced DISCOMFORT (Discomfort). On 04-Feb-2021, the patient experienced PARAESTHESIA (Tingling sensation of left side of the body,left thigh(felt like you were pulling spider web) , left calf,left shoulder) and HYPOAESTHESIA (Numb - left thigh/left calf/left shoulder). On an unknown date, the patient experienced NODULE (Good bumps just on the left thigh), PAIN IN EXTREMITY (Arm was little sore) and FATIGUE (Being tired). On 10-Feb-2021, PARAESTHESIA (Tingling sensation of left side of the body,left thigh(felt like you were pulling spider web) , left calf,left shoulder) and HYPOAESTHESIA (Numb - left thigh/left calf/left shoulder) had resolved. At the time of the report, NODULE (Good bumps just on the left thigh), DISCOMFORT (Discomfort), PAIN IN EXTREMITY (Arm was little sore) and FATIGUE (Being tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided. The patient did not take any medications for her symptoms.

Other Meds:

Current Illness:

ID: 1559556
Sex: M
Age: 74
State: NY

Vax Date: 01/08/2021
Onset Date: 02/07/2021
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: On 8 Jan 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch:unknown) Intramuscularly for prophylaxis of COVID-19 infection. On 5 Feb 2021, prior to the onset of the events the patient received their second of two planned doses of mRNA-1273 (lot/batch: unknown) Intramuscularly for prophylaxis of COVID-19 infection. On 7 Feb 2021, the patient experienced itchy on the neck/pruritus, rash on the neck./rash. on an unknown date the patient experienced fatigue. Treatment details included None. Action taken with mRNA-1273 in response to the events was not reported. On 8 Feb 2021 the outcome of itchy on the neck/pruritus was resolved. The outcome of rash on the neck./rash, fatigue was unknown.

Other Meds:

Current Illness:

ID: 1559557
Sex: F
Age:
State:

Vax Date:
Onset Date:
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: redness at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE ERYTHEMA (redness at the injection site) 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 INJECTION SITE ERYTHEMA (redness at the injection site). At the time of the report, INJECTION SITE ERYTHEMA (redness at the injection site) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1559558
Sex: M
Age: 78
State: IL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: Chills; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Chills) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030m20a) for COVID-19 vaccination. No Medical History information was reported. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, the patient experienced CHILLS (Chills). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, CHILLS (Chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1559559
Sex: M
Age:
State: MA

Vax Date: 02/05/2021
Onset Date: 02/12/2021
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: itchy red circle; red splodges; This spontaneous case was reported by a non-health professional and describes the occurrence of ERYTHEMA (red splodges) and PRURITUS (itchy red circle) in a 90-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included ALFUZOSIN and SIMVASTATIN for an unknown indication. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Feb-2021, the patient experienced ERYTHEMA (red splodges). On 13-Feb-2021, the patient experienced PRURITUS (itchy red circle). On 16-Feb-2021, ERYTHEMA (red splodges) and PRURITUS (itchy red circle) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 26-Apr-2021: Follow up information received on 26-Apr-2021 Contains No New Information. On 01-Jul-2021: Follow-up information received on 01-Jun-2021 Contains No New Information.

Other Meds: ALFUZOSIN; SIMVASTATIN

Current Illness:

ID: 1559560
Sex: M
Age: 66
State: PA

Vax Date: 02/03/2021
Onset Date: 02/08/2021
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: Cough; nasal congestion; nasal congestion progressed to throat; chest congestion; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (Cough), NASAL CONGESTION (nasal congestion), PHARYNGITIS (nasal congestion progressed to throat) and CHEST DISCOMFORT (chest congestion) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012M20A and 012A21A) for COVID-19 vaccination. The patient's past medical history included Sleep apnea and Coronary artery disease. Concurrent medical conditions included Blood pressure high and Cholesterol. Concomitant products included HYDROCHLOROTHIAZIDE, LISINOPRIL (LISINOPRIL HCTZ), ATORVASTATIN CALCIUM (LIPITOR), ACETYLSALICYLIC ACID (ASPIRIN 81), TAMSULOSIN and VITAMIN B12 NOS for an unknown indication. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 08-Feb-2021, the patient experienced COUGH (Cough), NASAL CONGESTION (nasal congestion), PHARYNGITIS (nasal congestion progressed to throat) and CHEST DISCOMFORT (chest congestion). On 13-Feb-2021, COUGH (Cough), NASAL CONGESTION (nasal congestion), PHARYNGITIS (nasal congestion progressed to throat) and CHEST DISCOMFORT (chest congestion) had resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood cholesterol: abnormal (abnormal) abnormal. On an unknown date, Blood pressure measurement: abnormal (abnormal) abnormal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. Concomitant medication included cholesterol and blood pressure pills. Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: Significant FU: Event updated, outcome updated, conmeds added, suspect details added.

Other Meds: LISINOPRIL HCTZ; LIPITOR; ASPIRIN 81; TAMSULOSIN; VITAMIN B12 NOS

Current Illness: Blood pressure high; Cholesterol

ID: 1559561
Sex: F
Age: 83
State: IL

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: 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: Arm sensitivity; Tiredness; false positive (benign) swollen right lymph node/Swollen lymph node opposite side of vaccine/Lymph nodes that could be a concern; This spontaneous case was reported by a patient (subsequently medically confirmed) and describes the occurrence of LIMB DISCOMFORT (Arm sensitivity), LYMPHADENOPATHY (false positive (benign) swollen right lymph node/Swollen lymph node opposite side of vaccine/Lymph nodes that could be a concern) and FATIGUE (Tiredness) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031M20A and 032M20A) for COVID-19 vaccination. Concomitant products included ATENOLOL and ATORVASTATIN for an unknown indication. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to at an unspecified dose. On 09-Feb-2021, the patient experienced LYMPHADENOPATHY (false positive (benign) swollen right lymph node/Swollen lymph node opposite side of vaccine/Lymph nodes that could be a concern). On an unknown date, the patient experienced LIMB DISCOMFORT (Arm sensitivity) and FATIGUE (Tiredness). At the time of the report, LIMB DISCOMFORT (Arm sensitivity), LYMPHADENOPATHY (false positive (benign) swollen right lymph node/Swollen lymph node opposite side of vaccine/Lymph nodes that could be a concern) and FATIGUE (Tiredness) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 09-Feb-2021, Mammogram: (Positive) false positive (benign) swollen right lymph node. In 2021, Diagnostic procedure: Inconclusive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Concomitant medication was not provided. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 09-Mar-2021: Suspect product batch/lot number were updated. Lab data and event were added. On 09-Jul-2021: Patient demographics were updated.

Other Meds: ATENOLOL; ATORVASTATIN

Current Illness:

ID: 1559562
Sex: F
Age: 91
State: NM

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: everything came back; major discomfort; felt bad Saturday/felt bad Sunday; really sick/felt sick all over/ like she "had some kind of disease"/extremely sick after receiving the vaccine; very weak /was not flu-like; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (really sick/felt sick all over/ like she "had some kind of disease"/extremely sick after receiving the vaccine), ASTHENIA (very weak /was not flu-like), DISCOMFORT (major discomfort), SYMPTOM RECURRENCE (everything came back) and FEELING ABNORMAL (felt bad Saturday/felt bad Sunday) in a 91-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Hypertension. Concurrent medical conditions included Illness on 23-Jan-2021, Asthenia on 23-Jan-2021, Discomfort on 23-Jan-2021, Symptom recurrence on 28-Jan-2021 and Allergy (fosamax). Concomitant products included LISINOPRIL and METOPROLOL for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Jan-2021, the patient experienced ILLNESS (really sick/felt sick all over/ like she "had some kind of disease"/extremely sick after receiving the vaccine), ASTHENIA (very weak /was not flu-like) and FEELING ABNORMAL (felt bad Saturday/felt bad Sunday). On 25-Jan-2021, the patient experienced DISCOMFORT (major discomfort). On 28-Jan-2021, the patient experienced SYMPTOM RECURRENCE (everything came back). At the time of the report, ILLNESS (really sick/felt sick all over/ like she "had some kind of disease"/extremely sick after receiving the vaccine), ASTHENIA (very weak /was not flu-like), DISCOMFORT (major discomfort), SYMPTOM RECURRENCE (everything came back) and FEELING ABNORMAL (felt bad Saturday/felt bad Sunday) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment information was provided.

Other Meds: LISINOPRIL; METOPROLOL

Current Illness:

ID: 1559563
Sex: M
Age: 58
State: MO

Vax Date: 02/10/2021
Onset Date:
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: stayed in bed; driving headache; felt like throat had something in it; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (stayed in bed), HEADACHE (driving headache), OROPHARYNGEAL DISCOMFORT (felt like throat had something in it) and PAIN IN EXTREMITY (sore arm) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included FISH OIL and RIVAROXABAN (XARELTO) for an unknown indication. On 10-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 ASTHENIA (stayed in bed), HEADACHE (driving headache), OROPHARYNGEAL DISCOMFORT (felt like throat had something in it) and PAIN IN EXTREMITY (sore arm). At the time of the report, ASTHENIA (stayed in bed), HEADACHE (driving headache), OROPHARYNGEAL DISCOMFORT (felt like throat had something in it) and PAIN IN EXTREMITY (sore arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: FISH OIL; XARELTO

Current Illness:

ID: 1559564
Sex: F
Age: 90
State:

Vax Date: 02/02/2021
Onset Date: 02/03/2021
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: experiencing side effects; arm hurts; muscle ache; feeling tired; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE DRUG REACTION (experiencing side effects), PAIN IN EXTREMITY (arm hurts), MYALGIA (muscle ache) and FATIGUE (feeling tired) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced ADVERSE DRUG REACTION (experiencing side effects), PAIN IN EXTREMITY (arm hurts), MYALGIA (muscle ache) and FATIGUE (feeling tired). At the time of the report, ADVERSE DRUG REACTION (experiencing side effects), PAIN IN EXTREMITY (arm hurts), MYALGIA (muscle ache) and FATIGUE (feeling tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1559565
Sex: F
Age: 67
State: FL

Vax Date: 02/05/2021
Onset Date: 02/15/2021
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: Very large area of erythema that persists; Slight induration; Skin is tense; COVID arm; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Very large area of erythema that persists), INDURATION (Slight induration), SKIN TIGHTNESS (Skin is tense) and VACCINATION SITE REACTION (COVID arm) in a 67-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 05-Feb-2021 at 4:00 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Feb-2021, the patient experienced ERYTHEMA (Very large area of erythema that persists), INDURATION (Slight induration) and SKIN TIGHTNESS (Skin is tense). 15-Feb-2021, the patient experienced VACCINATION SITE REACTION (COVID arm). At the time of the report, ERYTHEMA (Very large area of erythema that persists), INDURATION (Slight induration), SKIN TIGHTNESS (Skin is tense) and VACCINATION SITE REACTION (COVID arm) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No relevant concomitant medications were reported. No treatment information was provided. This case was linked to MOD-2021-252560 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 08-Jul-2021: Follow-up information received: Contains reporter address, demographics, 2nd dose details, new adverse event and event outcome updated.

Other Meds:

Current Illness:

ID: 1559566
Sex: M
Age: 75
State: WV

Vax Date: 02/04/2021
Onset Date: 02/05/2021
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: arm sore; fever; chills; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (arm sore), PYREXIA (fever) and CHILLS (chills) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Feb-2021, the patient experienced PAIN (arm sore), PYREXIA (fever) and CHILLS (chills). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. At the time of the report, PAIN (arm sore), PYREXIA (fever) and CHILLS (chills) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient took medicine for his cholesterol and his heart rate. No relevant concomitant medications reported. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 21-Apr-2021: Follow-up received on 21-Apr-2021,patient received second dose and no adverse event reported.

Other Meds:

Current Illness:

ID: 1559567
Sex: M
Age: 62
State: NY

Vax Date: 02/07/2021
Onset Date: 02/08/2021
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: Pain in their arm; felt tired, stayed in bed all day.; headache; nausea; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain in their arm), FATIGUE (felt tired, stayed in bed all day.), HEADACHE (headache) and NAUSEA (nausea) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 07-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 PAIN IN EXTREMITY (Pain in their arm), FATIGUE (felt tired, stayed in bed all day.), HEADACHE (headache) and NAUSEA (nausea). At the time of the report, PAIN IN EXTREMITY (Pain in their arm), FATIGUE (felt tired, stayed in bed all day.), HEADACHE (headache) and NAUSEA (nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. This case was linked to US-MODERNATX, INC.-MOD-2021-027768 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-027768:Crosslinked case

Other Meds:

Current Illness:

ID: 1559568
Sex: F
Age: 47
State: AZ

Vax Date: 01/29/2021
Onset Date:
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: Coughing; Headache; Soreness; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (Coughing), HEADACHE (Headache), PAIN (Soreness) and FATIGUE (Fatigue) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) 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 an unknown date, the patient experienced COUGH (Coughing), HEADACHE (Headache), PAIN (Soreness) and FATIGUE (Fatigue). At the time of the report, COUGH (Coughing), HEADACHE (Headache), PAIN (Soreness) and FATIGUE (Fatigue) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1559569
Sex: F
Age: 72
State: VA

Vax Date: 02/02/2021
Onset Date: 02/14/2021
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: mild headache; occasionally feels like someone is sticking a pin in the rash; rash came back to a hot pink color; Loss of appetite; wasn't feeling well; t pink rash on both sides of her neck that was worse on the side of the injection; nausea; This spontaneous case was reported by a consumer and describes the occurrence of DECREASED APPETITE (Loss of appetite), MALAISE (wasn't feeling well), RASH (t pink rash on both sides of her neck that was worse on the side of the injection), NAUSEA (nausea) and HEADACHE (mild headache) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011M20A and 026A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Stevens-Johnson syndrome (10 Years Ago) in 2011. Concurrent medical conditions included Drug allergy (Lidocaine Allergy Arm Tingling, Swelling, Difficulty Breathing) since 2015, Egg allergy (Egg Whites allergy Severe Difficulty Breathing, Swelling) since 2010, Iodine contrast media allergy (IVP dyes allergy Severe difficulty breathing, swelling) since 1980, Penicillin allergy (hives, swelling) since 1970, Myasthenia gravis since 2019, Sjogren's syndrome since 2010, Radiation therapy since 1975 and Hypothyroidism since 2012. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID) for Hypothyroidism, CLOPIDOGREL for Ladd procedure, ASPIRIN [ACETYLSALICYLIC ACID] for Stent related infection, METOPROLOL, FAMOTIDINE (PEPCID [FAMOTIDINE]), GLIMEPIRIDE (AMARYL), VITAMIN D3 and VITAMIN B12 NOS for an unknown indication. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Feb-2021, the patient experienced DECREASED APPETITE (Loss of appetite), MALAISE (wasn't feeling well), RASH (t pink rash on both sides of her neck that was worse on the side of the injection) and NAUSEA (nausea). On 15-Feb-2021, the patient experienced VACCINATION SITE RASH (rash came back to a hot pink color). On an unknown date, the patient experienced HEADACHE (mild headache) and VACCINATION SITE PAIN (occasionally feels like someone is sticking a pin in the rash). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (ANTIHISTAMINE ALLERGY RELIEF) ongoing from February 2021 at an unspecified dose and frequency. On 15-Feb-2021, RASH (t pink rash on both sides of her neck that was worse on the side of the injection) had resolved. At the time of the report, DECREASED APPETITE (Loss of appetite), MALAISE (wasn't feeling well), NAUSEA (nausea), HEADACHE (mild headache), VACCINATION SITE PAIN (occasionally feels like someone is sticking a pin in the rash) and VACCINATION SITE RASH (rash came back to a hot pink color) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and 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. Symptoms: Patient reported that after two and half weeks post vaccination she had rash on left side of her neck extending to top of left arm, she had followed up with Dermatologist Virtually via video Call. Treatment details were not provided. This case was linked to MOD-2021-090390 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 31-May-2021: Follow up Received: Added Patient demographics, Medical history, Concomitant Medication, treatment medication, Event Outcome

Other Meds: SYNTHROID; METOPROLOL; CLOPIDOGREL; ASPIRIN [ACETYLSALICYLIC ACID]; PEPCID [FAMOTIDINE]; AMARYL; VITAMIN D3; VITAMIN B12 NOS

Current Illness: Drug allergy (Lidocaine Allergy Arm Tingling, Swelling, Difficulty Breathing); Egg allergy (Egg Whites allergy Severe Difficulty Breathing, Swelling); Hypothyroidism; Iodine contrast media allergy (IVP dyes allergy Severe difficulty breathing, swelling); Myasthenia gravis; Penicillin allergy (hives, swelling); Radiation therapy; Sjogren's syndrome

ID: 1559570
Sex: U
Age:
State: NH

Vax Date:
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: weakness; nausea; a couple of people at my clinic have gotten really ill from the vaccine; This spontaneous case was reported by a health care professional (subsequently medically confirmed) and describes the occurrence of ASTHENIA (weakness), NAUSEA (nausea) and ILLNESS (a couple of people at my clinic have gotten really ill from the vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ASTHENIA (weakness), NAUSEA (nausea) and ILLNESS (a couple of people at my clinic have gotten really ill from the vaccine). At the time of the report, ASTHENIA (weakness), NAUSEA (nausea) and ILLNESS (a couple of people at my clinic have gotten really ill from the vaccine) 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 were reported. Treatment details included Not provided.

Other Meds:

Current Illness:

ID: 1559571
Sex: M
Age: 51
State: PA

Vax Date: 02/05/2021
Onset Date: 02/07/2021
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: Lost sense of taste and smell; Lost sense of taste and smell; This spontaneous case was reported by a consumer and describes the occurrence of AGEUSIA (Lost sense of taste and smell) and ANOSMIA (Lost sense of taste and smell) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Feb-2021, the patient experienced AGEUSIA (Lost sense of taste and smell) and ANOSMIA (Lost sense of taste and smell). At the time of the report, AGEUSIA (Lost sense of taste and smell) and ANOSMIA (Lost sense of taste and smell) 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: 1559572
Sex: F
Age: 79
State: WA

Vax Date: 02/06/2021
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: little bit of pain at the injection site; heart racing; Blood pressure of 163/n/a/could feel the high blood pressure in head and throughout the body; itchy chest; red dots under skin on chest as if rash is about to form; rash on face; face being warm; dizziness; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (little bit of pain at the injection site), PALPITATIONS (heart racing), BLOOD PRESSURE ABNORMAL (Blood pressure of 163/n/a/could feel the high blood pressure in head and throughout the body), PRURITUS (itchy chest) and ERYTHEMA (red dots under skin on chest as if rash is about to form) in a 79-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 Breast cancer (previous breast cancer patient,(occurred 20 years ago).). Concurrent medical conditions included Asthma (Patient has severe asthma). Concomitant products included SALBUTAMOL (ALBUTEROL HFA) 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 09-Feb-2021, the patient experienced VACCINATION SITE PAIN (little bit of pain at the injection site), PALPITATIONS (heart racing), BLOOD PRESSURE ABNORMAL (Blood pressure of 163/n/a/could feel the high blood pressure in head and throughout the body), PRURITUS (itchy chest), ERYTHEMA (red dots under skin on chest as if rash is about to form), RASH (rash on face), FEELING HOT (face being warm) and DIZZINESS (dizziness). At the time of the report, VACCINATION SITE PAIN (little bit of pain at the injection site), PALPITATIONS (heart racing), BLOOD PRESSURE ABNORMAL (Blood pressure of 163/n/a/could feel the high blood pressure in head and throughout the body), PRURITUS (itchy chest), ERYTHEMA (red dots under skin on chest as if rash is about to form), RASH (rash on face), FEELING HOT (face being warm) and DIZZINESS (dizziness) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: 163/n/a.. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided.

Other Meds: ALBUTEROL HFA

Current Illness: Asthma (Patient has severe asthma)

ID: 1559573
Sex: U
Age:
State: NJ

Vax Date:
Onset Date:
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: Felt fatigue; chills; 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 FATIGUE (Felt fatigue) and CHILLS (chills) 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 FATIGUE (Felt fatigue) and CHILLS (chills). At the time of the report, FATIGUE (Felt fatigue) and CHILLS (chills) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1559574
Sex: F
Age: 83
State: OH

Vax Date: 01/23/2021
Onset Date: 01/30/2021
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: fatigue; headache; muscle pain; cough; chills; diarrhea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of FATIGUE (fatigue), HEADACHE (headache), MYALGIA (muscle pain), COUGH (cough) and CHILLS (chills) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) 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 relevant medical history). On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Jan-2021, the patient experienced FATIGUE (fatigue), HEADACHE (headache), MYALGIA (muscle pain), COUGH (cough), CHILLS (chills) and DIARRHOEA (diarrhea). On 30-Jan-2021, DIARRHOEA (diarrhea) had resolved. On 03-Feb-2021, HEADACHE (headache) had resolved. On 06-Feb-2021, FATIGUE (fatigue), MYALGIA (muscle pain), COUGH (cough) and CHILLS (chills) 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. Treatment for events included Emergen-C, Pedialyte and Waltussin-DMX.

Other Meds:

Current Illness:

ID: 1559575
Sex: F
Age: 43
State: NY

Vax Date: 02/08/2021
Onset Date: 02/09/2021
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: lymphadenopathy; Fused rash; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of LYMPHADENOPATHY (lymphadenopathy) and RASH (Fused rash) in a 43-year-old female patient 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 09-Feb-2021, the patient experienced LYMPHADENOPATHY (lymphadenopathy) and RASH (Fused rash). At the time of the report, LYMPHADENOPATHY (lymphadenopathy) and RASH (Fused rash) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. Treatment details included Tylenol, Antiallergy medication

Other Meds:

Current Illness:

ID: 1559576
Sex: F
Age:
State: NJ

Vax Date:
Onset Date:
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: Experience side effects; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Experience side effects) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Experience side effects). At the time of the report, VACCINATION COMPLICATION (Experience side effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. No relevant concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1559577
Sex: F
Age:
State: FL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: feels her arm sore; body aches; feels her arm sore, had a low grade headache and body aches; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (feels her arm sore), MYALGIA (body aches) and HEADACHE (feels her arm sore, had a low grade headache and body aches) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 10-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 2 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Feb-2021, the patient experienced PAIN IN EXTREMITY (feels her arm sore), MYALGIA (body aches) and HEADACHE (feels her arm sore, had a low grade headache and body aches). At the time of the report, PAIN IN EXTREMITY (feels her arm sore), MYALGIA (body aches) and HEADACHE (feels her arm sore, had a low grade headache and body aches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1559578
Sex: F
Age: 70
State: DE

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Swollen lip; This spontaneous case was reported by a consumer and describes the occurrence of LIP SWELLING (Swollen lip) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L2OA) 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 LIP SWELLING (Swollen lip). The patient was treated with CETOMACROGOL, PARAFFIN, LIQUID, PROPYLENE GLYCOL, WHITE SOFT PARAFFIN (VASELINE CETOMACROGOL CREAM) at an unspecified dose and frequency. At the time of the report, LIP SWELLING (Swollen lip) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1559579
Sex: F
Age: 77
State: NY

Vax Date: 01/15/2021
Onset Date: 01/16/2021
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: COVID-19 virus test positive; This spontaneous case was reported by a consumer and describes the occurrence of SARS-COV-2 TEST POSITIVE (COVID-19 virus test positive) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). Concomitant products included VALSARTAN and ATENOLOL for an unknown indication. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Jan-2021, the patient experienced SARS-COV-2 TEST POSITIVE (COVID-19 virus test positive). At the time of the report, SARS-COV-2 TEST POSITIVE (COVID-19 virus test positive) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: VALSARTAN; ATENOLOL

Current Illness:

ID: 1559580
Sex: M
Age: 49
State: FL

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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: yellowing and pale skin on both arms; fever of 101 degrees; chills; fatigue; This spontaneous case was reported by a consumer and describes the occurrence of PALLOR (yellowing and pale skin on both arms), PYREXIA (fever of 101 degrees), CHILLS (chills) and FATIGUE (fatigue) in a 49-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included LISINOPRIL for an unknown indication. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Feb-2021, the patient experienced PALLOR (yellowing and pale skin on both arms), PYREXIA (fever of 101 degrees), CHILLS (chills) and FATIGUE (fatigue). At the time of the report, PALLOR (yellowing and pale skin on both arms), PYREXIA (fever of 101 degrees), CHILLS (chills) and FATIGUE (fatigue) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 101 101. 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 details included None.

Other Meds: LISINOPRIL

Current Illness:

ID: 1559581
Sex: M
Age: 85
State: AZ

Vax Date: 02/04/2021
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: Pain in extremity

Symptoms: Rash on the left shoulder at the injection site, went down to the elbow, was on the back of his hands and slightly down the back of his left leg.; Blisters; Itching; Spent two sleepless nights; Rash was red; This spontaneous case was reported by a consumer and describes the occurrence of RASH (Rash on the left shoulder at the injection site, went down to the elbow, was on the back of his hands and slightly down the back of his left leg.), BLISTER (Blisters), PRURITUS (Itching), INSOMNIA (Spent two sleepless nights) and RASH ERYTHEMATOUS (Rash was red) in an 85-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 015M20A) for COVID-19 vaccination. No Medical History information was reported. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, the patient experienced RASH (Rash on the left shoulder at the injection site, went down to the elbow, was on the back of his hands and slightly down the back of his left leg.), BLISTER (Blisters), PRURITUS (Itching), INSOMNIA (Spent two sleepless nights) and RASH ERYTHEMATOUS (Rash was red). On 11-Feb-2021, BLISTER (Blisters) outcome was unknown. At the time of the report, RASH (Rash on the left shoulder at the injection site, went down to the elbow, was on the back of his hands and slightly down the back of his left leg.), PRURITUS (Itching), INSOMNIA (Spent two sleepless nights) and RASH ERYTHEMATOUS (Rash was red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1559582
Sex: F
Age: 77
State: MD

Vax Date: 01/27/2021
Onset Date: 02/03/2021
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: wants to sleep all the time even if I had nap; lung area feels a bit sore inside; achy; chills; itchy; red below her injection site; Hypersensitivity reaction; rash on back across lung area and below injection site; Two lumps below her injection site; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (itchy), VACCINATION SITE INDURATION (Two lumps below her injection site), VACCINATION SITE ERYTHEMA (red below her injection site), SOMNOLENCE (wants to sleep all the time even if I had nap) and PULMONARY PAIN (lung area feels a bit sore inside) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Hay fever, Hives (endorsed allergy history on ADR), Hypersensitivity reaction (NOS) (endorsed allergy history on ADR) and Catheter management (self catharize twice daily) since an unknown date. Concurrent medical conditions included Sulfonamide allergy (had swelling of fingers and lips as adverse reaction) since 1960, Allergy to antibiotic (had rash, stomach upset as adverse reaction) since 2019, Allergy to antibiotic (Had rash as adverse reaction) since 2019, Arrhythmia since 2011 and Incomplete bladder emptying. Concomitant products included APIXABAN (ELIQUIS) from 2018 to an unknown date and METOPROLOL from 2011 to an unknown date for Arrhythmia, CENTRUM VITAMINTS for Routine health maintenance. On 27-Jan-2021 at 12:10 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced PRURITUS (itchy), VACCINATION SITE INDURATION (Two lumps below her injection site), VACCINATION SITE ERYTHEMA (red below her injection site), HYPERSENSITIVITY (Hypersensitivity reaction) and RASH (rash on back across lung area and below injection site). On 16-Feb-2021, the patient experienced SOMNOLENCE (wants to sleep all the time even if I had nap), PULMONARY PAIN (lung area feels a bit sore inside), MYALGIA (achy) and CHILLS (chills). On 06-Feb-2021, PRURITUS (itchy), HYPERSENSITIVITY (Hypersensitivity reaction) and RASH (rash on back across lung area and below injection site) had resolved, VACCINATION SITE INDURATION (Two lumps below her injection site) and VACCINATION SITE ERYTHEMA (red below her injection site) outcome was unknown. At the time of the report, SOMNOLENCE (wants to sleep all the time even if I had nap) outcome was unknown and PULMONARY PAIN (lung area feels a bit sore inside), MYALGIA (achy) and CHILLS (chills) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No treatment was reported for the events. This case was linked to MOD-2021-239054 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 28-Jun-2021: includes medical history of allergic reactions and long-standing conditions, updates to concomitant medications, resolution with date.

Other Meds: ELIQUIS; METOPROLOL; CENTRUM VITAMINTS

Current Illness: Allergy to antibiotic (had rash, stomach upset as adverse reaction); Allergy to antibiotic (Had rash as adverse reaction); Arrhythmia; Catheter management (self catharize twice daily); Incomplete bladder emptying; Sulfonamide allergy (had swelling of fingers and lips as adverse reaction)

ID: 1559583
Sex: F
Age: 66
State: NC

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

Lab Data:

Allergies:

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

Symptoms: Tired; Didn't feel well; red rash below the injection site; Nausea; Headache; Fever; Tachycardia; This spontaneous case was reported by a consumer and describes the occurrence of TACHYCARDIA (Tachycardia), MALAISE (Didn't feel well), VACCINATION SITE ERYTHEMA (red rash below the injection site), FATIGUE (Tired) and NAUSEA (Nausea) in a 66-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. Concurrent medical conditions included Tachycardia, Drug allergy (Codeine Allergy), Drug allergy (Sulfa drugs), Penicillin allergy, Drug allergy (Doxycycline allergy), Drug allergy (Z-Pack) and Epinephrine. Concomitant products included DEXLANSOPRAZOLE (DEXILANT), CYANOCOBALAMIN (VITAMIN B12 [CYANOCOBALAMIN]) and COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) 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 29-Jan-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced TACHYCARDIA (Tachycardia). On 30-Jan-2021, the patient experienced VACCINATION SITE ERYTHEMA (red rash below the injection site), NAUSEA (Nausea), HEADACHE (Headache) and PYREXIA (Fever). On an unknown date, the patient experienced MALAISE (Didn't feel well) and FATIGUE (Tired). On 29-Jan-2021, TACHYCARDIA (Tachycardia) had resolved. On 31-Jan-2021, NAUSEA (Nausea), HEADACHE (Headache) and PYREXIA (Fever) had resolved. On 06-Feb-2021, VACCINATION SITE ERYTHEMA (red rash below the injection site) had resolved. At the time of the report, MALAISE (Didn't feel well) had resolved and FATIGUE (Tired) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Antibody test: unknown (Inconclusive) SARCOV2 serology (covid-19) abigg and the results were positive.. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medications were not reported.

Other Meds: DEXILANT; VITAMIN B12 [CYANOCOBALAMIN]; VITAMIN D [COLECALCIFEROL]

Current Illness: Drug allergy (Z-Pack); Drug allergy (Sulfa drugs); Drug allergy (Doxycycline allergy); Drug allergy (Codeine Allergy); Epinephrine; Penicillin allergy; Tachycardia

ID: 1559584
Sex: F
Age:
State:

Vax Date: 02/11/2021
Onset Date: 02/13/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: warm injection site; sore-to-the-touch injection site; big red blotch a few inches above the elbow; rash above the arm; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE WARMTH (warm injection site), INJECTION SITE PAIN (sore-to-the-touch injection site), INJECTION SITE ERYTHEMA (big red blotch a few inches above the elbow) and VACCINATION SITE RASH (rash above the arm) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 11-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (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 13-Feb-2021, the patient experienced INJECTION SITE WARMTH (warm injection site), INJECTION SITE PAIN (sore-to-the-touch injection site), INJECTION SITE ERYTHEMA (big red blotch a few inches above the elbow) and VACCINATION SITE RASH (rash above the arm). At the time of the report, INJECTION SITE WARMTH (warm injection site), INJECTION SITE PAIN (sore-to-the-touch injection site), INJECTION SITE ERYTHEMA (big red blotch a few inches above the elbow) and VACCINATION SITE RASH (rash above the arm) outcome was unknown. No concomitant medication was provided No treatment medication was provided This case was linked to MOD-2021-028898 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 26-Apr-2021: Follow up received on 26-APR-2021 contains non-significant information.

Other Meds:

Current Illness:

ID: 1559585
Sex: F
Age: 70
State: NY

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: arm was hot; her arm started to itch; again a large welt (3,25 inch diameter), pink in her arm; arm was Swollen; arm was swollen; she had a large welt,pink in her arm; arm was a little sore; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (arm was a little sore), VACCINATION SITE URTICARIA (she had a large welt,pink in her arm), VACCINATION SITE SWELLING (arm was swollen), VACCINATION SITE PRURITUS (her arm started to itch) and VACCINATION SITE WARMTH (arm was hot) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013K20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included WARFARIN for Clotting disorder, ACETYLSALICYLIC ACID (BABY ASPIRIN) and MONTELUKAST for an unknown indication. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021, the patient experienced VACCINATION SITE PAIN (arm was a little sore). On 06-Feb-2021, the patient experienced VACCINATION SITE URTICARIA (she had a large welt,pink in her arm) and VACCINATION SITE SWELLING (arm was swollen). On 12-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (her arm started to itch), VACCINATION SITE WARMTH (arm was hot), VACCINATION SITE URTICARIA (again a large welt (3,25 inch diameter), pink in her arm) and VACCINATION SITE SWELLING (arm was Swollen). On 06-Feb-2021, VACCINATION SITE PAIN (arm was a little sore), VACCINATION SITE URTICARIA (she had a large welt,pink in her arm) and VACCINATION SITE SWELLING (arm was swollen) had resolved. At the time of the report, VACCINATION SITE PRURITUS (her arm started to itch), VACCINATION SITE WARMTH (arm was hot), VACCINATION SITE URTICARIA (again a large welt (3,25 inch diameter), pink in her arm) and VACCINATION SITE SWELLING (arm was Swollen) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The concomitant medications included high blood pressure medication and diuretic. Treatment included ice and allergy pill.

Other Meds: WARFARIN; BABY ASPIRIN; MONTELUKAST

Current Illness:

ID: 1559586
Sex: M
Age: 44
State: KS

Vax Date: 01/13/2021
Onset Date: 01/14/2021
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: right arm discomfort; eyelids became heavy; small slits of eyes; brow was brought down; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOMFORT (right arm discomfort), ASTHENOPIA (eyelids became heavy), OCULAR DISCOMFORT (small slits of eyes) and FACIAL DISCOMFORT (brow was brought down) in a 45-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025J20-2A) for COVID-19 vaccination. The patient's past medical history included Scar. Previously administered products included for an unreported indication: JUVEDERM. Concurrent medical conditions included Drug allergy, Drug allergy, Drug allergy, Seasonal allergy and Complex regional pain syndrome Type II (affects left arm). Concomitant products included POTASSIUM, PROPRANOLOL, LISDEXAMFETAMINE MESILATE (VYVANSE), VITAMIN D NOS and FLUTICASONE PROPIONATE (FLONASE ALLERGY RELIEF) for an unknown indication. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 14-Jan-2021, the patient experienced VACCINATION SITE DISCOMFORT (right arm discomfort), ASTHENOPIA (eyelids became heavy), OCULAR DISCOMFORT (small slits of eyes) and FACIAL DISCOMFORT (brow was brought down). On 14-Jan-2021, VACCINATION SITE DISCOMFORT (right arm discomfort), ASTHENOPIA (eyelids became heavy), OCULAR DISCOMFORT (small slits of eyes) and FACIAL DISCOMFORT (brow was brought down) had resolved. Treatment information was not provided. This case was linked to MODERNATX, INC.-MOD-2021-029855 (E2B Linked Report).; Sender's Comments: MODERNATX, INC.-MOD-2021-029855:

Other Meds: POTASSIUM; PROPRANOLOL; VYVANSE; VITAMIN D NOS; FLONASE ALLERGY RELIEF

Current Illness: Complex regional pain syndrome Type II (affects left arm); Drug allergy; Seasonal allergy

ID: 1559587
Sex: M
Age: 68
State: FL

Vax Date: 01/15/2021
Onset Date: 02/05/2021
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: Loss of appetite; Headache; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of DECREASED APPETITE (Loss of appetite), HEADACHE (Headache) and FATIGUE (Fatigue) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. No Medical History information was reported. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Feb-2021, the patient experienced DECREASED APPETITE (Loss of appetite), HEADACHE (Headache) and FATIGUE (Fatigue). At the time of the report, DECREASED APPETITE (Loss of appetite), HEADACHE (Headache) and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Patient's second shot was due on 12 Feb 2021. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1559588
Sex: F
Age: 61
State: IL

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: diarrhea; feeling nauseous; soreness at the site of the injection; she felt like she was having a frozen shoulder again; This spontaneous case was reported by a consumer and describes the occurrence of PERIARTHRITIS (soreness progressed, felt like she was having a frozen shoulder again), DIARRHOEA (diarrhea), NAUSEA (feeling nauseous) and VACCINATION SITE PAIN (soreness at the site of the injection) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Frozen shoulder. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, the patient experienced PERIARTHRITIS (soreness progressed, felt like she was having a frozen shoulder again) and VACCINATION SITE PAIN (soreness at the site of the injection). On 11-Feb-2021, the patient experienced DIARRHOEA (diarrhea) and NAUSEA (feeling nauseous). On 11-Feb-2021, PERIARTHRITIS (soreness progressed, felt like she was having a frozen shoulder again) and VACCINATION SITE PAIN (soreness at the site of the injection) had resolved. On 13-Feb-2021, DIARRHOEA (diarrhea) had resolved. On 15-Feb-2021, NAUSEA (feeling nauseous) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant and treatment medications were not reported.

Other Meds:

Current Illness:

ID: 1559589
Sex: M
Age: 78
State: MA

Vax Date: 02/08/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: malaise; itching on the side of his neck (From under the ear to shoulder); Rash on the side of his neck (From under the ear to shoulder); This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (malaise), PRURITUS (itching on the side of his neck (From under the ear to shoulder)) and RASH (Rash on the side of his neck (From under the ear to shoulder)) in a 78-year-old male patient 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) (Intramuscular) 1 dosage form. On 09-Feb-2021, the patient experienced MALAISE (malaise), PRURITUS (itching on the side of his neck (From under the ear to shoulder)) and RASH (Rash on the side of his neck (From under the ear to shoulder)). At the time of the report, MALAISE (malaise), PRURITUS (itching on the side of his neck (From under the ear to shoulder)) and RASH (Rash on the side of his neck (From under the ear to shoulder)) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication was not reported. The patient had a rash and itching on the side of his neck (from under the ear to shoulder) which looked like shingles. The patient used a Steroid cream that he had at home and it looked better.

Other Meds:

Current Illness:

ID: 1559590
Sex: F
Age: 83
State: PA

Vax Date: 01/11/2021
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: Arm started to aches; felt agitated; Crown of head really hurt; Couldnt Sleep; Eyes were droopy; body hurt; got hot; Bad headache; Woke up fatigue; Chills; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm started to aches), AGITATION (felt agitated), HEAD DISCOMFORT (Crown of head really hurt), INSOMNIA (Couldnt Sleep) and EYELID PTOSIS (Eyes were droopy) in an 84-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No reported medical history. On 11-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Arm started to aches), AGITATION (felt agitated), HEAD DISCOMFORT (Crown of head really hurt), INSOMNIA (Couldnt Sleep), EYELID PTOSIS (Eyes were droopy), PAIN (body hurt), FEELING HOT (got hot), HEADACHE (Bad headache), FATIGUE (Woke up fatigue) and CHILLS (Chills). At the time of the report, PAIN IN EXTREMITY (Arm started to aches), AGITATION (felt agitated), HEAD DISCOMFORT (Crown of head really hurt), INSOMNIA (Couldnt Sleep), EYELID PTOSIS (Eyes were droopy), PAIN (body hurt), FEELING HOT (got hot), HEADACHE (Bad headache), FATIGUE (Woke up fatigue) and CHILLS (Chills) outcome was unknown. No Concomitant information provided. No Treatment information provided

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm