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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1564092
Sex: F
Age: 83
State: NC

Vax Date: 03/08/2021
Onset Date: 03/09/2021
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: Bone Pain when lying in bed; Joint Pain; Chills; Fever 101 F; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of BONE PAIN (Bone Pain when lying in bed), ARTHRALGIA (Joint Pain), CHILLS (Chills), PYREXIA (Fever 101 F) and NAUSEA (Nausea) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. Concurrent medical conditions included Atrial fibrillation. On 08-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 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 09-Mar-2021, the patient experienced BONE PAIN (Bone Pain when lying in bed), ARTHRALGIA (Joint Pain), CHILLS (Chills), PYREXIA (Fever 101 F) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL) at a dose of UNK dosage form. At the time of the report, BONE PAIN (Bone Pain when lying in bed), ARTHRALGIA (Joint Pain), CHILLS (Chills), PYREXIA (Fever 101 F) and NAUSEA (Nausea) outcome was unknown. Concomitant medication was not provided Most recent FOLLOW-UP information incorporated above includes: On 03-May-2021: declined follow up

Other Meds:

Current Illness: Atrial fibrillation

ID: 1564093
Sex: F
Age: 20
State: AZ

Vax Date: 02/16/2021
Onset Date: 02/23/2021
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: Strep infection; Rash all over the body; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of STREPTOCOCCAL INFECTION (Strep infection) and RASH (Rash all over the body) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. No Medical History information was reported. On 16-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Feb-2021, the patient experienced STREPTOCOCCAL INFECTION (Strep infection) and RASH (Rash all over the body). The patient was treated with TRIAMCINOLONE (topical) at a dose of 1 dosage form and METHYLPREDNISOLONE (MEDROL [METHYLPREDNISOLONE]) at a dose of 1 dosage form. At the time of the report, STREPTOCOCCAL INFECTION (Strep infection) outcome was unknown and RASH (Rash all over the body) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. Treatment medications included Antibiotics.

Other Meds:

Current Illness:

ID: 1564094
Sex: F
Age: 47
State: TX

Vax Date: 03/05/2021
Onset Date:
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: Loss of taste; Wheezing; Cough; Chills; Headache; Fever; This spontaneous case was reported by a consumer and describes the occurrence of AGEUSIA (Loss of taste), WHEEZING (Wheezing), COUGH (Cough), CHILLS (Chills) and HEADACHE (Headache) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Asthma. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced AGEUSIA (Loss of taste), WHEEZING (Wheezing), COUGH (Cough), CHILLS (Chills), HEADACHE (Headache) and PYREXIA (Fever). At the time of the report, AGEUSIA (Loss of taste), WHEEZING (Wheezing), COUGH (Cough), CHILLS (Chills), HEADACHE (Headache) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. Treatment medications were unknown.

Other Meds:

Current Illness: Asthma

ID: 1564095
Sex: F
Age: 52
State: ID

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: Felt a strong heat from the waist down / felt that heat all over her body from her head; Very cold; Pain; Tired; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (Felt a strong heat from the waist down / felt that heat all over her body from her head), NASOPHARYNGITIS (Very cold), PAIN (Pain) and FATIGUE (Tired) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031M20A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Feb-2021, the patient experienced FEELING HOT (Felt a strong heat from the waist down / felt that heat all over her body from her head), NASOPHARYNGITIS (Very cold), PAIN (Pain) and FATIGUE (Tired). At the time of the report, FEELING HOT (Felt a strong heat from the waist down / felt that heat all over her body from her head), NASOPHARYNGITIS (Very cold), PAIN (Pain) and FATIGUE (Tired) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 11-Feb-2021, Heart rate: low (Low) Very low. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. Treatment medications were unknown.

Other Meds:

Current Illness: Blood pressure high

ID: 1564096
Sex: F
Age: 61
State: NY

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching from the rash), RASH (Rash on her neck, rash on her torso, little rash in her leg, little spots), MYALGIA (Severe muscle aches and body aches), CHILLS (Chills) and NAUSEA (Nausea) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) 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 FAMOTIDINE (PEPCID [FAMOTIDINE]) for Reflux gastritis, LEVOTHYROXINE and ATORVASTATIN for an unknown indication. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Mar-2021, the patient experienced MYALGIA (Severe muscle aches and body aches), CHILLS (Chills), NAUSEA (Nausea), PYREXIA (Fever 100.4?F) and FATIGUE (Very tired/ A little tired). On 08-Mar-2021, the patient experienced PRURITUS (Itching from the rash) and RASH (Rash on her neck, rash on her torso, little rash in her leg, little spots). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. At the time of the report, PRURITUS (Itching from the rash), RASH (Rash on her neck, rash on her torso, little rash in her leg, little spots) and FATIGUE (Very tired/ A little tired) outcome was unknown and MYALGIA (Severe muscle aches and body aches), CHILLS (Chills), NAUSEA (Nausea) and PYREXIA (Fever 100.4?F) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: LEVOTHYROXINE; ATORVASTATIN; PEPCID [FAMOTIDINE]

Current Illness:

ID: 1564097
Sex: M
Age: 75
State: VA

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

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: Itching; Felt not his best/terrible and sick described as having no energy and could hardly move; Headache suspected as migraine; Sore arm muscle; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching), PAIN IN EXTREMITY (Sore arm muscle), ILLNESS (Felt not his best/terrible and sick described as having no energy and could hardly move) and HEADACHE (Headache suspected as migraine) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure, Penicillin allergy and Drug allergy (benadryl). Concomitant products included FINASTERIDE and TAMSULOSIN for an unknown indication. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Feb-2021, the patient experienced PAIN IN EXTREMITY (Sore arm muscle). On 27-Feb-2021, the patient experienced ILLNESS (Felt not his best/terrible and sick described as having no energy and could hardly move) and HEADACHE (Headache suspected as migraine). On 28-Feb-2021, the patient experienced PRURITUS (Itching). On 28-Feb-2021, HEADACHE (Headache suspected as migraine) had resolved. On 04-Mar-2021, ILLNESS (Felt not his best/terrible and sick described as having no energy and could hardly move) had resolved. On 05-Mar-2021, PRURITUS (Itching) and PAIN IN EXTREMITY (Sore arm muscle) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medicines included blood pressure medicine. The patient frequently washed the itching areas and applied rubbing alcohol to the itching areas. Because he did not know which medicines to use to treat the reported symptoms, he did not take any medications to treat his symptoms

Other Meds: FINASTERIDE; TAMSULOSIN

Current Illness: Blood pressure; Drug allergy (benadryl); Penicillin allergy

ID: 1564098
Sex: F
Age: 63
State: NY

Vax Date: 02/23/2021
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: felt light headed; arm was just sore initially; Wasn't feeling well; I have the Corona; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (felt light headed), PAIN IN EXTREMITY (arm was just sore initially), MALAISE (Wasn't feeling well) and CORONAVIRUS INFECTION (I have the Corona) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included ZINC and AMLODIPINE for an unknown indication. On 23-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced DIZZINESS (felt light headed), PAIN IN EXTREMITY (arm was just sore initially), MALAISE (Wasn't feeling well) and CORONAVIRUS INFECTION (I have the Corona). At the time of the report, DIZZINESS (felt light headed), PAIN IN EXTREMITY (arm was just sore initially), MALAISE (Wasn't feeling well) and CORONAVIRUS INFECTION (I have the Corona) was resolving. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Mar-2021, SARS-CoV-2 test: negative (Negative) Negative. On 05-Mar-2021, SARS-CoV-2 test: positive (Positive) Positive. Treatment details included Honey with tea. Most recent FOLLOW-UP information incorporated above includes: On 01-Jul-2021: FollowUp Received on 01-JUL-2021: second dose details are added, events outcome was changed from unknown to Recovering/Resolving.

Other Meds: ZINC; AMLODIPINE

Current Illness:

ID: 1564099
Sex: M
Age:
State: MI

Vax Date: 03/08/2021
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: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Achy arm; Joint pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Achy arm) and ARTHRALGIA (Joint pain) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 08-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Achy arm) and ARTHRALGIA (Joint pain). At the time of the report, PAIN IN EXTREMITY (Achy arm) and ARTHRALGIA (Joint pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was not applicable No Concomitant medications were provided. No Treatment information was reported. This case was linked to MOD-2021-039133 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 23-Jul-2021: A follow up was received on 23-JUL-2021, The outcome of the event was updated.

Other Meds:

Current Illness:

ID: 1564100
Sex: F
Age: 71
State: OH

Vax Date: 02/23/2021
Onset Date: 03/08/2021
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: hot to touch; Itchy; red rash; swollen; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (hot to touch), VACCINATION SITE PRURITUS (Itchy), VACCINATION SITE ERYTHEMA (red rash) and VACCINATION SITE SWELLING (swollen) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022M20A) for COVID-19 vaccination. Concurrent medical conditions included Parkinson's disease, Anxiety and Arthritis. Concomitant products included ATENOLOL, ACETYLSALICYLIC ACID (ASPIRIN (E.C.)), HYDROCHLOROTHIAZIDE (DIURETIC [HYDROCHLOROTHIAZIDE]), POTASSIUM and VITAMINS NOS for an unknown indication. On 23-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021, the patient experienced FEELING HOT (hot to touch), VACCINATION SITE PRURITUS (Itchy), VACCINATION SITE ERYTHEMA (red rash) and VACCINATION SITE SWELLING (swollen). At the time of the report, FEELING HOT (hot to touch), VACCINATION SITE PRURITUS (Itchy), VACCINATION SITE ERYTHEMA (red rash) and VACCINATION SITE SWELLING (swollen) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. The reporter denied to follow-up stating that she was doing fine. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Most recent FOLLOW-UP information incorporated above includes: On 09-Mar-2021: Follow-up received on 09-Mar-2021, event updated from unknown to recovering.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds: ATENOLOL; ASPIRIN (E.C.); DIURETIC [HYDROCHLOROTHIAZIDE]; POTASSIUM; VITAMINS NOS

Current Illness: Anxiety; Arthritis; Parkinson's disease

ID: 1564101
Sex: F
Age:
State: WA

Vax Date:
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: Brain fog; Brain fog is so bad it effects her work; Joint pain; Muscle pain; Headache; Fever of 102F; Chills; Nausea; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Brain fog), IMPAIRED WORK ABILITY (Brain fog is so bad it effects her work), ARTHRALGIA (Joint pain), MYALGIA (Muscle pain) and HEADACHE (Headache) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. o4(or9)0a21a) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced FEELING ABNORMAL (Brain fog), IMPAIRED WORK ABILITY (Brain fog is so bad it effects her work), ARTHRALGIA (Joint pain), MYALGIA (Muscle pain), HEADACHE (Headache), PYREXIA (Fever of 102F), CHILLS (Chills), NAUSEA (Nausea) and FATIGUE (Fatigue). At the time of the report, FEELING ABNORMAL (Brain fog) had not resolved, IMPAIRED WORK ABILITY (Brain fog is so bad it effects her work), MYALGIA (Muscle pain), NAUSEA (Nausea) and FATIGUE (Fatigue) outcome was unknown and ARTHRALGIA (Joint pain), HEADACHE (Headache), PYREXIA (Fever of 102F) and CHILLS (Chills) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 102 (High) 102F. Concomitant product use was not provided. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not applicable. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 03-May-2021: Follow up received on 03-May-2021 contains non-significant information

Other Meds:

Current Illness:

ID: 1564102
Sex: F
Age: 66
State: MA

Vax Date: 02/27/2021
Onset Date: 03/06/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Red knot at the site of injection; Itchy knot at the site of injection; Red knot at the site of injection; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE MASS (Red knot at the site of injection), VACCINATION SITE PRURITUS (Itchy knot at the site of injection) and VACCINATION SITE ERYTHEMA (Red knot at the site of injection) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010A21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-Mar-2021, the patient experienced VACCINATION SITE PRURITUS (Itchy knot at the site of injection) and VACCINATION SITE ERYTHEMA (Red knot at the site of injection). On an unknown date, the patient experienced VACCINATION SITE MASS (Red knot at the site of injection). At the time of the report, VACCINATION SITE MASS (Red knot at the site of injection), VACCINATION SITE PRURITUS (Itchy knot at the site of injection) and VACCINATION SITE ERYTHEMA (Red knot at the site of injection) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1564103
Sex: F
Age:
State: WI

Vax Date: 01/05/2021
Onset Date: 01/04/2021
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: Insufficient dose administered; RN was not familar with syringe; This spontaneous case was reported by a nurse (subsequently medically confirmed) and describes the occurrence of INCORRECT DOSE ADMINISTERED (Insufficient dose administered) and WRONG TECHNIQUE IN DEVICE USAGE PROCESS (RN was not familar with syringe) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025L20A) for COVID-19 vaccination. No Medical History information was reported. On 05-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Jan-2021, the patient experienced INCORRECT DOSE ADMINISTERED (Insufficient dose administered) and WRONG TECHNIQUE IN DEVICE USAGE PROCESS (RN was not familar with syringe). On 05-Jan-2021, INCORRECT DOSE ADMINISTERED (Insufficient dose administered) and WRONG TECHNIQUE IN DEVICE USAGE PROCESS (RN was not familar with syringe) 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. On 01-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) (batch no. 41L20A) on her right arm. Concomitant product use was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1564104
Sex: F
Age: 79
State: OH

Vax Date: 01/31/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Fever which went high up to 101.3.; She felt tired and worn out; Bodyaches; She felt crummy; Tired; Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm), FEELING ABNORMAL (She felt crummy), FATIGUE (Tired), MYALGIA (Bodyaches) and PYREXIA (Fever which went high up to 101.3.) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011M20A and 030L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. 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 28-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 01-Feb-2021, the patient experienced PAIN IN EXTREMITY (Sore arm) and FATIGUE (Tired). On 28-Feb-2021, the patient experienced FEELING ABNORMAL (She felt crummy). On 01-Mar-2021, the patient experienced MYALGIA (Bodyaches). On 02-Mar-2021, the patient experienced PYREXIA (Fever which went high up to 101.3.) and FATIGUE (She felt tired and worn out). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 02-Feb-2021, PAIN IN EXTREMITY (Sore arm) and FATIGUE (Tired) had resolved. On 02-Mar-2021, FEELING ABNORMAL (She felt crummy), MYALGIA (Bodyaches), PYREXIA (Fever which went high up to 101.3.) and FATIGUE (She felt tired and worn out) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 02-Mar-2021, Pyrexia: 101.3 (High) recovered on 02mar2021. Concomitant product use was not provided by the reporter. Treatment medication use was not provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 03-May-2021: Action item updated to Patient denied FU

Other Meds:

Current Illness:

ID: 1564105
Sex: M
Age: 66
State: IN

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Didn't feel well; Fever 100?F; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Didn't feel well) and PYREXIA (Fever 100?F) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19 in October 2020. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Feb-2021, the patient experienced FEELING ABNORMAL (Didn't feel well) and PYREXIA (Fever 100?F). On 28-Feb-2021, FEELING ABNORMAL (Didn't feel well) and PYREXIA (Fever 100?F) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100 (High) 100 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant products included medications for blood pressure and cholesterol. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1564106
Sex: F
Age: 83
State: WI

Vax Date: 02/11/2021
Onset Date: 03/07/2021
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: Runny nose; Sore throat; This spontaneous case was reported by a consumer and describes the occurrence of RHINORRHOEA (Runny nose) and OROPHARYNGEAL PAIN (Sore throat) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031M20A) for COVID-19 vaccination. No Medical History information was reported. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Mar-2021, the patient experienced RHINORRHOEA (Runny nose) and OROPHARYNGEAL PAIN (Sore throat). At the time of the report, RHINORRHOEA (Runny nose) and OROPHARYNGEAL PAIN (Sore throat) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1564107
Sex: F
Age: 85
State: AZ

Vax Date: 02/04/2021
Onset Date: 03/05/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: bit of feeling; Circle of redness spread over 2 in diameter; Swelling in the middle; Extreme itching; This spontaneous case was reported by a patient and describes the occurrence of FEELING ABNORMAL (bit of feeling), ERYTHEMA (Circle of redness spread over 2 in diameter), SWELLING (Swelling in the middle) and PRURITUS (Extreme itching) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002A21A) for COVID-19 vaccination. The patient's past medical history included Hypothyroidism. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 05-Mar-2021, the patient experienced ERYTHEMA (Circle of redness spread over 2 in diameter), SWELLING (Swelling in the middle) and PRURITUS (Extreme itching). On an unknown date, the patient experienced FEELING ABNORMAL (bit of feeling). At the time of the report, FEELING ABNORMAL (bit of feeling), ERYTHEMA (Circle of redness spread over 2 in diameter), SWELLING (Swelling in the middle) and PRURITUS (Extreme itching) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1564108
Sex: M
Age: 66
State: TX

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Dizzy for about 15 seconds; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizzy for about 15 seconds) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Feb-2021, the patient experienced DIZZINESS (Dizzy for about 15 seconds). On 12-Feb-2021, DIZZINESS (Dizzy for about 15 seconds) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. Treatment information was not provided. . Most recent FOLLOW-UP information incorporated above includes: On 23-Jul-2021: Follow up received on 23-jul-2021 and contains non-significant information

Other Meds:

Current Illness:

ID: 1564109
Sex: F
Age: 66
State: NV

Vax Date: 03/06/2021
Onset Date: 03/06/2021
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: Loss of appetite; Loss of taste; Loss of smell; Fever; Chills; Nausea; Joint ache; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of DECREASED APPETITE (Loss of appetite), AGEUSIA (Loss of taste), ANOSMIA (Loss of smell), PYREXIA (Fever) and CHILLS (Chills) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 06-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-Mar-2021, the patient experienced DECREASED APPETITE (Loss of appetite), AGEUSIA (Loss of taste), ANOSMIA (Loss of smell), PYREXIA (Fever), CHILLS (Chills), NAUSEA (Nausea), ARTHRALGIA (Joint ache) and FATIGUE (Fatigue). On 09-Mar-2021, DECREASED APPETITE (Loss of appetite), AGEUSIA (Loss of taste), ANOSMIA (Loss of smell), PYREXIA (Fever), CHILLS (Chills), NAUSEA (Nausea), ARTHRALGIA (Joint ache) and FATIGUE (Fatigue) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1564110
Sex: F
Age: 90
State:

Vax Date: 03/03/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 3 small lumps under her chin; This spontaneous case was reported by a physician and describes the occurrence of SKIN MASS (3 small lumps under her chin) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. EYT721824) for COVID-19 vaccination. The patient's past medical history included Cancer (Needs to get a control mammogram before April.) in 2003. Concurrent medical conditions included Diabetes, Heart disorder and Overweight (little overweight.). On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced SKIN MASS (3 small lumps under her chin). At the time of the report, SKIN MASS (3 small lumps under her chin) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided. Treatment information included "hydrating lotion for diabetics dry skin relief" on the affected area.

Other Meds:

Current Illness: Diabetes; Heart disorder; Overweight (little overweight.)

ID: 1564111
Sex: F
Age: 33
State:

Vax Date: 02/19/2021
Onset Date: 02/19/2021
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: lump under arm pit; neck pain; severe pain at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of NECK PAIN (neck pain), NODULE (lump under arm pit) and VACCINATION SITE PAIN (severe pain at the injection site) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. No Medical History information was reported. On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, the patient experienced VACCINATION SITE PAIN (severe pain at the injection site). On 22-Feb-2021, the patient experienced NECK PAIN (neck pain). On 26-Feb-2021, the patient experienced NODULE (lump under arm pit). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 22-Feb-2021, VACCINATION SITE PAIN (severe pain at the injection site) outcome was unknown. At the time of the report, NECK PAIN (neck pain) and NODULE (lump under arm pit) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1564112
Sex: F
Age:
State:

Vax Date:
Onset Date:
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: Tingling of lips; numbness of the face; Tingling of the face/ Tingling on scalp/ Tingling of fingers; Numbness of lips; Numbness on scalp; Numbness on fingers; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of PARAESTHESIA ORAL (Tingling of lips), HYPOAESTHESIA (numbness of the face), PARAESTHESIA (Tingling of the face/ Tingling on scalp/ Tingling of fingers), HYPOAESTHESIA ORAL (Numbness of lips) and HYPOAESTHESIA (Numbness on scalp) in a 54-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 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 PARAESTHESIA ORAL (Tingling of lips), HYPOAESTHESIA (numbness of the face), PARAESTHESIA (Tingling of the face/ Tingling on scalp/ Tingling of fingers), HYPOAESTHESIA ORAL (Numbness of lips), HYPOAESTHESIA (Numbness on scalp) and HYPOAESTHESIA (Numbness on fingers). At the time of the report, PARAESTHESIA ORAL (Tingling of lips), HYPOAESTHESIA (numbness of the face), PARAESTHESIA (Tingling of the face/ Tingling on scalp/ Tingling of fingers), HYPOAESTHESIA ORAL (Numbness of lips), HYPOAESTHESIA (Numbness on scalp) and HYPOAESTHESIA (Numbness on fingers) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1564113
Sex: F
Age: 71
State: MI

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk; chills; deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk; fever; deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk; This spontaneous case was reported by a consumer and describes the occurrence of GAIT DISTURBANCE (deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk), BONE PAIN (deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk), PYREXIA (fever), CHILLS (chills) and MYALGIA (deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19 (august 2020 0r September 2020). On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, the patient experienced GAIT DISTURBANCE (deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk), PYREXIA (fever) and MYALGIA (deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk). On 19-Mar-2021, the patient experienced CHILLS (chills). On an unknown date, the patient experienced BONE PAIN (deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk). The patient was treated with PARACETAMOL (TYLENOL) for Fever and Chills, at a dose of 1 dosage form. At the time of the report, GAIT DISTURBANCE (deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk), BONE PAIN (deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk), PYREXIA (fever), CHILLS (chills) and MYALGIA (deep muscle aches/achy down to the bone/terrible body aches down to bones where she could barely walk) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was provided Most recent FOLLOW-UP information incorporated above includes: On 18-Mar-2021: Follow up received on 18-Mar-2021 and medical history was added.

Other Meds:

Current Illness:

ID: 1564114
Sex: F
Age:
State: MN

Vax Date: 03/04/2021
Onset Date: 02/04/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fever; rash all over the body; pain at injection site; arm was swollen; arm was red; feeling chills; left arm hot; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (left arm hot), RASH (rash all over the body), VACCINATION SITE PAIN (pain at injection site), VACCINATION SITE SWELLING (arm was swollen) and VACCINATION SITE ERYTHEMA (arm was red) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Allergy (Multiple unspecified allergies). On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced VACCINATION SITE WARMTH (left arm hot). On 04-Mar-2021, the patient experienced RASH (rash all over the body), VACCINATION SITE PAIN (pain at injection site), VACCINATION SITE SWELLING (arm was swollen), VACCINATION SITE ERYTHEMA (arm was red) and CHILLS (feeling chills). On 05-Mar-2021, the patient experienced PYREXIA (Fever). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (ALLERGY [DIPHENHYDRAMINE HYDROCHLORIDE]) for Allergy, at an unspecified dose and frequency. At the time of the report, VACCINATION SITE WARMTH (left arm hot), RASH (rash all over the body), VACCINATION SITE PAIN (pain at injection site), VACCINATION SITE SWELLING (arm was swollen), VACCINATION SITE ERYTHEMA (arm was red), CHILLS (feeling chills) and PYREXIA (Fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-Mar-2021, Body temperature: 100 (High) 100 degrees Fahrenheit. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not reported.

Other Meds:

Current Illness: Allergy (Multiple unspecified allergies)

ID: 1564115
Sex: F
Age: 68
State: MI

Vax Date: 02/25/2021
Onset Date: 03/05/2021
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: Rash on her breast around nipple; Rash at the injection/Two rash near injection site; This spontaneous case was reported by a patient (subsequently medically confirmed) and describes the occurrence of RASH (Rash on her breast around nipple) and VACCINATION SITE RASH (Rash at the injection/Two rash near injection site) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, the patient experienced RASH (Rash on her breast around nipple) and VACCINATION SITE RASH (Rash at the injection/Two rash near injection site). On 06-Mar-2021, RASH (Rash on her breast around nipple) had resolved. At the time of the report, VACCINATION SITE RASH (Rash at the injection/Two rash near injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication were not provided. The patient went to urgent care and they told her to put over counter cream on the area.

Other Meds:

Current Illness:

ID: 1564116
Sex: F
Age: 62
State: OH

Vax Date: 03/09/2021
Onset Date: 02/09/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: More than 35 days from first dose; tongue swelling; LIP SWELLING; heart racing; eyes felt funny; nervous; This spontaneous case was reported by a consumer and describes the occurrence of SWOLLEN TONGUE (tongue swelling), LIP SWELLING (LIP SWELLING), PALPITATIONS (heart racing), EYE MOVEMENT DISORDER (eyes felt funny) and NERVOUSNESS (nervous) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, the patient experienced NERVOUSNESS (nervous). On 09-Mar-2021, the patient experienced SWOLLEN TONGUE (tongue swelling), LIP SWELLING (LIP SWELLING), PALPITATIONS (heart racing) and EYE MOVEMENT DISORDER (eyes felt funny). On 22-Jun-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (More than 35 days from first dose). At the time of the report, SWOLLEN TONGUE (tongue swelling), LIP SWELLING (LIP SWELLING), PALPITATIONS (heart racing), EYE MOVEMENT DISORDER (eyes felt funny), NERVOUSNESS (nervous) and PRODUCT DOSE OMISSION ISSUE (More than 35 days from first dose) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Most recent FOLLOW-UP information incorporated above includes: On 22-Jun-2021: Follow-up information received on 22-Jun-2021: Event was added. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1564117
Sex: F
Age: 69
State: WY

Vax Date: 02/25/2021
Onset Date: 03/01/2021
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: nausea getting worse; nausea; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (nausea) and NAUSEA (nausea getting worse) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011a21a) for COVID-19 vaccination. no medical history was provided. Concomitant products included DULOXETINE, AZILSARTAN KAMEDOXOMIL (EDARBI) and FUROSEMIDE (FUROfEMIDE) for an unknown indication. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Mar-2021, the patient experienced NAUSEA (nausea). On 09-Mar-2021, the patient experienced NAUSEA (nausea getting worse). At the time of the report, NAUSEA (nausea) and NAUSEA (nausea getting worse) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: DULOXETINE; EDARBI; FUROfEMIDE

Current Illness:

ID: 1564118
Sex: F
Age: 72
State: OH

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: inflammatory burning sensation, throughout her whole body and into the back of her head; Slept for about an hour that night; Throat and neck were burning; Sore arm; Reaction was painful; Headache; Joint ache; This spontaneous case was reported by a consumer and describes the occurrence of BURNING SENSATION (inflammatory burning sensation, throughout her whole body and into the back of her head), INSOMNIA (Slept for about an hour that night), THROAT IRRITATION (Throat and neck were burning), PAIN IN EXTREMITY (Sore arm) and RASH (Reaction was painful) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Mar-2021, the patient experienced BURNING SENSATION (inflammatory burning sensation, throughout her whole body and into the back of her head), INSOMNIA (Slept for about an hour that night), THROAT IRRITATION (Throat and neck were burning), PAIN IN EXTREMITY (Sore arm), RASH (Reaction was painful), HEADACHE (Headache) and ARTHRALGIA (Joint ache). On 05-Mar-2021, BURNING SENSATION (inflammatory burning sensation, throughout her whole body and into the back of her head), INSOMNIA (Slept for about an hour that night), THROAT IRRITATION (Throat and neck were burning), RASH (Reaction was painful) and ARTHRALGIA (Joint ache) had resolved. On 07-Mar-2021, PAIN IN EXTREMITY (Sore arm) and HEADACHE (Headache) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1564119
Sex: U
Age:
State: NY

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Vaccine was at refrigerated temperature and transferred at frozen temperature at -5C under 15 minutes; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist (subsequently medically confirmed) and describes the occurrence of PRODUCT STORAGE ERROR (Vaccine was at refrigerated temperature and transferred at frozen temperature at -5C under 15 minutes) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001A21A) for COVID-19 immunisation. 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. In March 2021, the patient experienced PRODUCT STORAGE ERROR (Vaccine was at refrigerated temperature and transferred at frozen temperature at -5C under 15 minutes). At the time of the report, PRODUCT STORAGE ERROR (Vaccine was at refrigerated temperature and transferred at frozen temperature at -5C under 15 minutes) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment information was available. No relevant concomitant medications were reported. Reporter did not allow further contact; Sender's Comments: This report refers to a case of Product Storage Error for mRNA-1273 (Lot #: 001A21A) with no associated AEs.

Other Meds:

Current Illness:

ID: 1564120
Sex: F
Age: 64
State: OH

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: Terrible taste; patient tested positive for Covid19; salty taste in her mouth; lost sense of smell; This spontaneous case was reported by a consumer and describes the occurrence of ANOSMIA (lost sense of smell), DYSGEUSIA (salty taste in her mouth), TASTE DISORDER (Terrible taste) and COVID-19 (patient tested positive for Covid19) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Mar-2021, the patient experienced ANOSMIA (lost sense of smell). On 05-Mar-2021, the patient experienced DYSGEUSIA (salty taste in her mouth). On 11-Mar-2021, the patient experienced COVID-19 (patient tested positive for Covid19). On an unknown date, the patient experienced TASTE DISORDER (Terrible taste). At the time of the report, ANOSMIA (lost sense of smell), DYSGEUSIA (salty taste in her mouth), TASTE DISORDER (Terrible taste) and COVID-19 (patient tested positive for Covid19) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 21-Jun-2021: Significant Follow up appended for Event update

Other Meds:

Current Illness:

ID: 1564121
Sex: F
Age: 76
State: FL

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Cough; Diarrhea; sore throat; Nausea/vomiting; Nausea/vomiting; Runny nose; tested positive (+) for COVID-19; Covid19 symptoms; sore arm; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of PAIN IN EXTREMITY (sore arm), COVID-19 (Covid19 symptoms), SARS-COV-2 TEST POSITIVE (tested positive (+) for COVID-19), COUGH (Cough) and DIARRHOEA (Diarrhea) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse event (No relevant medical history reported). 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 PAIN IN EXTREMITY (sore arm). On 19-Feb-2021, the patient experienced COVID-19 (Covid19 symptoms). On 21-Feb-2021, the patient experienced SARS-COV-2 TEST POSITIVE (tested positive (+) for COVID-19). On an unknown date, the patient experienced COUGH (Cough), DIARRHOEA (Diarrhea), OROPHARYNGEAL PAIN (sore throat), RHINORRHOEA (Runny nose), VOMITING (Nausea/vomiting) and NAUSEA (Nausea/vomiting). At the time of the report, PAIN IN EXTREMITY (sore arm), COVID-19 (Covid19 symptoms), SARS-COV-2 TEST POSITIVE (tested positive (+) for COVID-19), COUGH (Cough), DIARRHOEA (Diarrhea), OROPHARYNGEAL PAIN (sore throat), RHINORRHOEA (Runny nose), VOMITING (Nausea/vomiting) and NAUSEA (Nausea/vomiting) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment included intravenous infusion of Bamlanivimav. Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: Follow up received on 27-MAY-2021, Events updated.

Other Meds:

Current Illness:

ID: 1564122
Sex: F
Age: 74
State: NY

Vax Date: 01/22/2021
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: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headache) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Surgery (surgeries), Infection (infection in mouth) in December 2020, TMJ syndrome and Sore tongue (teeth filling sore under tongue,mouth sores and gum aching which resolved with mouth wash.). Concurrent medical conditions included Diabetes (type 2 diabetes), Carcinoid tumor (carcinoid cancer) and Colon cancer (colon cancer 11 years ago). Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN (E.C.)), METFORMIN, LINAGLIPTIN (TRAJENTA), VITAMIN D3 and VITAMIN B12 [VITAMIN B12 NOS] for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced HEADACHE (headache). The patient was treated with DICLOFENAC (VOLTAREN [DICLOFENAC]) at an unspecified dose and frequency and PARACETAMOL (TYLENOL EXTRA STRENGTH) at an unspecified dose and frequency. At the time of the report, HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to MOD-2021-270115, MOD-2021-270115 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 27-Jul-2021: Non-significant follow-up Added.

Other Meds: ASPIRIN (E.C.); METFORMIN; TRAJENTA; VITAMIN D3; VITAMIN B12 [VITAMIN B12 NOS]

Current Illness: Carcinoid tumor (carcinoid cancer); Colon cancer (colon cancer 11 years ago); Diabetes (type 2 diabetes)

ID: 1564123
Sex: F
Age:
State: NC

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Bruise at the site of injection; Heart rate increased from 60 to 113; Felt like a mac truck run over her; Muscle ache; Fatigue; Low graded fever; Chills; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE BRUISING (Bruise at the site of injection), HEART RATE INCREASED (Heart rate increased from 60 to 113), FEELING ABNORMAL (Felt like a mac truck run over her), MYALGIA (Muscle ache) and FATIGUE (Fatigue) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced VACCINATION SITE BRUISING (Bruise at the site of injection), HEART RATE INCREASED (Heart rate increased from 60 to 113), FEELING ABNORMAL (Felt like a mac truck run over her), MYALGIA (Muscle ache), FATIGUE (Fatigue), PYREXIA (Low graded fever) and CHILLS (Chills). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, VACCINATION SITE BRUISING (Bruise at the site of injection) had not resolved and HEART RATE INCREASED (Heart rate increased from 60 to 113), FEELING ABNORMAL (Felt like a mac truck run over her), MYALGIA (Muscle ache), FATIGUE (Fatigue), PYREXIA (Low graded fever) and CHILLS (Chills) was resolving. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. Treatment for the events included acetaminophen. This case was linked to MODERNATX, INC.-MOD-2021-038174 (E2B Linked Report).; Sender's Comments: MODERNATX, INC.-MOD-2021-038174:wife case

Other Meds:

Current Illness:

ID: 1564124
Sex: F
Age: 71
State: MI

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: sharp, shooting pains into neck and head; sharp, shooting pains into neck and head; ugly, painful shingles like lesions; large and small shingles like lesions; elbow pain/ wrist pain/ shoulder pain; bad arm ache at injection site; sore arm; lightheadedness; disorientation; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (lightheadedness), DISORIENTATION (disorientation), PAIN IN EXTREMITY (sore arm), HERPES ZOSTER (ugly, painful shingles like lesions) and HERPES ZOSTER (large and small shingles like lesions) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported. Concomitant products included GABAPENTIN and PARACETAMOL (TYLENOL) for an unknown indication. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Feb-2021, the patient experienced DIZZINESS (lightheadedness) and DISORIENTATION (disorientation). On 14-Feb-2021, the patient experienced PAIN IN EXTREMITY (sore arm). On 24-Feb-2021, the patient experienced ARTHRALGIA (elbow pain/ wrist pain/ shoulder pain) and VACCINATION SITE PAIN (bad arm ache at injection site). On 28-Feb-2021, the patient experienced HERPES ZOSTER (ugly, painful shingles like lesions) and HERPES ZOSTER (large and small shingles like lesions). On 06-Mar-2021, the patient experienced NECK PAIN (sharp, shooting pains into neck and head) and HEADACHE (sharp, shooting pains into neck and head). At the time of the report, DIZZINESS (lightheadedness), DISORIENTATION (disorientation), PAIN IN EXTREMITY (sore arm), HERPES ZOSTER (ugly, painful shingles like lesions), HERPES ZOSTER (large and small shingles like lesions), NECK PAIN (sharp, shooting pains into neck and head), ARTHRALGIA (elbow pain/ wrist pain/ shoulder pain), VACCINATION SITE PAIN (bad arm ache at injection site) and HEADACHE (sharp, shooting pains into neck and head) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment for the event included Gabapentin and Tylenol for nerve pain and general pain. Most recent FOLLOW-UP information incorporated above includes: On 22-Jul-2021: FU information included Email ID and address updated.

Other Meds: GABAPENTIN; TYLENOL

Current Illness:

ID: 1564125
Sex: M
Age: 66
State: MI

Vax Date: 03/04/2021
Onset Date: 03/09/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Both of his ankles are swollen; Short of breath; This spontaneous case was reported by a consumer and describes the occurrence of JOINT SWELLING (Both of his ankles are swollen) and DYSPNOEA (Short of breath) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Stent insertion NOS (Patient has stent implanted in his left heart and one in his right leg.). Concurrent medical conditions included Leukemia. On 04-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Mar-2021, the patient experienced JOINT SWELLING (Both of his ankles are swollen) and DYSPNOEA (Short of breath). At the time of the report, JOINT SWELLING (Both of his ankles are swollen) and DYSPNOEA (Short of breath) outcome was unknown. Action taken with mRNA-1273 in response to the events was not Applicable. No concomitant medications reported by investigator No treatment medications provided by the reporter. Patient stated that he was sleep sitting up in a chair Most recent FOLLOW-UP information incorporated above includes: On 15-Jun-2021: Follow-up received on 15-Jun-2021 and does not contain any new information

Other Meds:

Current Illness: Leukemia

ID: 1564126
Sex: F
Age: 67
State: MA

Vax Date: 02/04/2021
Onset Date: 03/05/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: very painful; spread down to elbow; itching at the injection site; red at the injection site; couldn't get out of bed; very bad reaction; This spontaneous case was reported by a patient and describes the occurrence of MALAISE (couldn't get out of bed), ADVERSE EVENT (very bad reaction), PAIN (very painful), ERYTHEMA (spread down to elbow) and INJECTION SITE PRURITUS (itching at the injection site) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 032L20A and 026A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided. On 04-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to at an unspecified dose. On 05-Mar-2021, the patient experienced MALAISE (couldn't get out of bed) and ADVERSE EVENT (very bad reaction). On an unknown date, the patient experienced PAIN (very painful), ERYTHEMA (spread down to elbow), INJECTION SITE PRURITUS (itching at the injection site) and VACCINATION SITE ERYTHEMA (red at the injection site). The patient was treated with HYDROCORTISONE at an unspecified dose and frequency and PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 07-Mar-2021, MALAISE (couldn't get out of bed) and ADVERSE EVENT (very bad reaction) had resolved. At the time of the report, PAIN (very painful), ERYTHEMA (spread down to elbow), INJECTION SITE PRURITUS (itching at the injection site) and VACCINATION SITE ERYTHEMA (red at the injection site) outcome was unknown. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1564127
Sex: F
Age: 56
State: TX

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: rash itch; reoccuring palpitations; reoccuring tachycardia/ tachycardia; palpitations; fatigue; pressure in head; fever; hot; chills; pain at injection site (left); This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (palpitations), PALPITATIONS (reoccuring palpitations), TACHYCARDIA (reoccuring tachycardia/ tachycardia), RASH (rash itch) and PYREXIA (fever) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Jan-2021, the patient experienced VACCINATION SITE PAIN (pain at injection site (left)). On 04-Feb-2021, the patient experienced PYREXIA (fever), FEELING HOT (hot), CHILLS (chills), FATIGUE (fatigue) and HEADACHE (pressure in head). On 05-Feb-2021, the patient experienced PALPITATIONS (palpitations) and TACHYCARDIA (reoccuring tachycardia/ tachycardia). On 09-Feb-2021, the patient experienced PALPITATIONS (reoccuring palpitations). On 11-Feb-2021, the patient experienced RASH (rash itch). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency; IBUPROFEN (ADVIL 12 HOUR) at an unspecified dose and frequency and LORATADINE, PSEUDOEPHEDRINE HYDROCHLORIDE (BENADRYL 24 D) at an unspecified dose and frequency. On 07-Jan-2021, VACCINATION SITE PAIN (pain at injection site (left)) had resolved. On 08-Feb-2021, PALPITATIONS (palpitations), PYREXIA (fever), CHILLS (chills) and FATIGUE (fatigue) had resolved. On 09-Feb-2021, TACHYCARDIA (reoccuring tachycardia/ tachycardia) had resolved. On 13-Feb-2021, PALPITATIONS (reoccuring palpitations) had resolved. On 25-Feb-2021, RASH (rash itch) had resolved. At the time of the report, FEELING HOT (hot) and HEADACHE (pressure in head) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1564128
Sex: M
Age: 66
State: OH

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: sore body; Headache; Arm soreness; Fever; Chills; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Arm soreness), PYREXIA (Fever), CHILLS (Chills), MYALGIA (sore body) and HEADACHE (Headache) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030AUA) for COVID-19 vaccination. No Medical History information was reported. On 08-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021, the patient experienced VACCINATION SITE PAIN (Arm soreness), PYREXIA (Fever), CHILLS (Chills) and HEADACHE (Headache). On an unknown date, the patient experienced MYALGIA (sore body). At the time of the report, VACCINATION SITE PAIN (Arm soreness), PYREXIA (Fever) and HEADACHE (Headache) was resolving and CHILLS (Chills) and MYALGIA (sore body) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were Blood pressure medication and Thyroid medication. Treatment information was not provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 09-Mar-2021: Significant follow-up : Added new events Headache and Arm soreness and changed outcome for the event fever from unknown to recovering.

Other Meds:

Current Illness:

ID: 1564129
Sex: M
Age: 69
State: CA

Vax Date: 02/06/2021
Onset Date: 02/16/2021
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: bad rash on lower legs that is very itchy; small red spots on bilateral legs spreading to upper legs; bad rash on lower legs that is very itchy; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (bad rash on lower legs that is very itchy), RASH MACULAR (small red spots on bilateral legs spreading to upper legs) and RASH (bad rash on lower legs that is very itchy) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) and VITAMIN C [ASCORBIC ACID] 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 16-Feb-2021, the patient experienced PRURITUS (bad rash on lower legs that is very itchy), RASH MACULAR (small red spots on bilateral legs spreading to upper legs) and RASH (bad rash on lower legs that is very itchy). On 20-Feb-2021, PRURITUS (bad rash on lower legs that is very itchy), RASH MACULAR (small red spots on bilateral legs spreading to upper legs) and RASH (bad rash on lower legs that is very itchy) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment included Patient used topical cream to help relieve symptoms.

Other Meds: VITAMIN D [COLECALCIFEROL]; VITAMIN C [ASCORBIC ACID]

Current Illness:

ID: 1564130
Sex: F
Age: 78
State: MA

Vax Date: 02/13/2021
Onset Date: 02/15/2021
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: next day spend it bed again; felt the knee weak; lt tired and that then felt a little better; felt so weak; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (felt so weak), SOMNOLENCE (next day spend it bed again), ARTHRALGIA (felt the knee weak) and FATIGUE (lt tired and that then felt a little better) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included LOVASTATIN and MULTIVITAMIN [VITAMINS NOS] for an unknown indication. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Feb-2021, the patient experienced ASTHENIA (felt so weak). On an unknown date, the patient experienced SOMNOLENCE (next day spend it bed again), ARTHRALGIA (felt the knee weak) and FATIGUE (lt tired and that then felt a little better). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, ASTHENIA (felt so weak), SOMNOLENCE (next day spend it bed again), ARTHRALGIA (felt the knee weak) and FATIGUE (lt tired and that then felt a little better) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product also include Trinitrin-HCTV.

Other Meds: LOVASTATIN; MULTIVITAMIN [VITAMINS NOS]

Current Illness:

ID: 1564131
Sex: F
Age: 74
State: PA

Vax Date: 02/03/2021
Onset Date: 03/03/2021
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: Extreme lethargy; Less pain than first dose; Every muscle and bone felt achy; Extreme headache; couldnt even get out of bed; This spontaneous case was reported by a consumer and describes the occurrence of LETHARGY (Extreme lethargy), PAIN (Less pain than first dose), MYALGIA (Every muscle and bone felt achy), HEADACHE (Extreme headache) and MALAISE (couldnt even get out of bed) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025A21A and 025A21A) for COVID-19 vaccination. The patient's past medical history included No adverse reaction. Concomitant products included MONTELUKAST SODIUM (SINGULAIR) and VITAMINS NOS for an unknown indication. On 03-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Mar-2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Mar-2021, the patient experienced LETHARGY (Extreme lethargy), PAIN (Less pain than first dose), MYALGIA (Every muscle and bone felt achy), HEADACHE (Extreme headache) and MALAISE (couldnt even get out of bed). On 04-Mar-2021, LETHARGY (Extreme lethargy), PAIN (Less pain than first dose), MYALGIA (Every muscle and bone felt achy), HEADACHE (Extreme headache) and MALAISE (couldnt even get out of bed) had resolved. No treatment information was provided. This case was linked to US-MODERNATX, INC.-MOD-2021-038188 (Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-038188:Crosslinked husbands case

Other Meds: SINGULAIR; VITAMINS NOS

Current Illness:

ID: 1564132
Sex: F
Age: 72
State: LA

Vax Date: 02/05/2021
Onset Date: 02/26/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of TOOTH DISORDER (Problems with tooth) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012M20A and 029A21A) for COVID-19 vaccination. Concomitant products included HYDROCHLOROTHIAZIDE, TRIAMTERENE (TRIAMTERENE/HCTZ), ATORVASTATIN, CETIRIZINE, ACETYLSALICYLIC ACID (ASPRIN), FISH OIL, CALCIUM, BUDESONIDE, FORMOTEROL FUMARATE (SYMBICORT) and FLUTICASONE for an unknown indication, CYANOCOBALAMIN (B12 [CYANOCOBALAMIN]). On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 26-Feb-2021, the patient experienced TOOTH DISORDER (Problems with tooth). At the time of the report, TOOTH DISORDER (Problems with tooth) outcome was unknown. Not Provided. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment medications was not provided.

Other Meds: TRIAMTERENE/HCTZ; ATORVASTATIN; CETIRIZINE; ASPRIN; FISH OIL; CALCIUM; SYMBICORT; FLUTICASONE; B12 [CYANOCOBALAMIN]

Current Illness:

ID: 1564133
Sex: M
Age: 69
State: OH

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: neck pain; Stiff neck; This spontaneous case was reported by a consumer and describes the occurrence of NECK PAIN (neck pain) and MUSCULOSKELETAL STIFFNESS (Stiff neck) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-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 NECK PAIN (neck pain) and MUSCULOSKELETAL STIFFNESS (Stiff neck). The patient was treated with CYCLOBENZAPRINE at an unspecified dose and frequency; TRAMADOL at an unspecified dose and frequency and IBUPROFEN (MOTRIN [IBUPROFEN]) at an unspecified dose and frequency. At the time of the report, NECK PAIN (neck pain) and MUSCULOSKELETAL STIFFNESS (Stiff neck) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Physical therapy regiment. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1564134
Sex: F
Age: 26
State: CO

Vax Date: 02/24/2021
Onset Date:
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: really bad arm pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (really bad arm pain) in a 27-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003a21a) for COVID-19 vaccination. No Medical History information was reported. On 24-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (really bad arm pain). At the time of the report, PAIN IN EXTREMITY (really bad arm pain) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications are provided, treatment to the events are not listed This case was linked to US-MODERNATX, INC.-MOD-2021-061114 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-061114:dose 2

Other Meds:

Current Illness:

ID: 1564135
Sex: U
Age:
State: NC

Vax Date:
Onset Date:
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. 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 PAIN IN EXTREMITY (sore arm). At the time of the report, PAIN IN EXTREMITY (sore arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1564136
Sex: F
Age: 43
State: NY

Vax Date: 02/11/2021
Onset Date: 03/07/2021
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: Fever Blisters on mouth; Fever; This spontaneous case was reported by a consumer and describes the occurrence of ORAL HERPES (Fever Blisters on mouth) and PYREXIA (Fever) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. No Medical History information was reported. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage form. On 07-Mar-2021, the patient experienced PYREXIA (Fever). On 08-Mar-2021, the patient experienced ORAL HERPES (Fever Blisters on mouth). The patient was treated with VALACYCLOVIR [VALACICLOVIR] at an unspecified dose and frequency. At the time of the report, ORAL HERPES (Fever Blisters on mouth) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. no concomitant medications reported.

Other Meds:

Current Illness:

ID: 1564137
Sex: F
Age: 73
State: MA

Vax Date: 03/03/2021
Onset Date: 03/04/2021
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: water was hitting my back and all of the sudden my back was really itchy, scratched it and it hurt; scratched it and it hurt; upper arm was very sensitive, like it burn; Shingles; had a very big rash on my back, looked like the halo rash that you get with lyme disease. 6; in the opposite side of the injection site in her arm it was sore; red mark the size of a dime /Red mark increased in size, size of a silver dollar; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ERYTHEMA (red mark the size of a dime /Red mark increased in size, size of a silver dollar), PRURITUS (water was hitting my back and all of the sudden my back was really itchy, scratched it and it hurt), PAIN (scratched it and it hurt), BURNING SENSATION (upper arm was very sensitive, like it burn) and HERPES ZOSTER (Shingles) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010A21A) for an unknown indication. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Lyme disease (I have had lyme disease). Concomitant products included THYROID, VITAMIN C [ASCORBIC ACID] and VITAMIN D [VITAMIN D NOS] for an unknown indication. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Mar-2021, the patient experienced ERYTHEMA (red mark the size of a dime /Red mark increased in size, size of a silver dollar). On 08-Mar-2021, the patient experienced PRURITUS (water was hitting my back and all of the sudden my back was really itchy, scratched it and it hurt), PAIN (scratched it and it hurt), BURNING SENSATION (upper arm was very sensitive, like it burn), HERPES ZOSTER (Shingles), RASH (had a very big rash on my back, looked like the halo rash that you get with lyme disease. 6) and VACCINATION SITE PAIN (in the opposite side of the injection site in her arm it was sore). The patient was treated with VALACICLOVIR HYDROCHLORIDE (VALACYCLOVIR HCL) at a dose of 1 gram. At the time of the report, ERYTHEMA (red mark the size of a dime /Red mark increased in size, size of a silver dollar), PRURITUS (water was hitting my back and all of the sudden my back was really itchy, scratched it and it hurt), PAIN (scratched it and it hurt), BURNING SENSATION (upper arm was very sensitive, like it burn), HERPES ZOSTER (Shingles), RASH (had a very big rash on my back, looked like the halo rash that you get with lyme disease. 6) and VACCINATION SITE PAIN (in the opposite side of the injection site in her arm it was sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown.

Other Meds: THYROID; VITAMIN C [ASCORBIC ACID]; VITAMIN D [VITAMIN D NOS.]

Current Illness:

ID: 1564138
Sex: F
Age:
State: OH

Vax Date:
Onset Date:
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Lymph nodes swelling; This spontaneous case was reported by a patient and describes the occurrence of LYMPHADENOPATHY (Lymph nodes swelling) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Breast cancer. 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 LYMPHADENOPATHY (Lymph nodes swelling). At the time of the report, LYMPHADENOPATHY (Lymph nodes swelling) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Reporter did not allow further contact

Other Meds:

Current Illness: Breast cancer

ID: 1564139
Sex: F
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Hand Went Numb; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (Hand Went Numb) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) 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-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced HYPOAESTHESIA (Hand Went Numb). At the time of the report, HYPOAESTHESIA (Hand Went Numb) had resolved. No concomitant and treatment product was reported. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the drug in response to the events is not applicable This case was linked to MOD-2021-060206 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1564140
Sex: F
Age: 53
State: MA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
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: stye on her left eye; Sore arm; This spontaneous case was reported by a patient and describes the occurrence of PAIN IN EXTREMITY (Sore arm) and HORDEOLUM (stye on her left eye) in a 53-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 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced PAIN IN EXTREMITY (Sore arm). On 11-Feb-2021, the patient experienced HORDEOLUM (stye on her left eye). The patient was treated with DOXYCYCLINE on 19-Feb-2021 for Stye, at a dose of UNK dosage form and DEXAMETHASONE, TOBRAMYCIN (TOBRADEX) on 01-Mar-2021 for Stye, at a dose of Tobradex SE drops. On 08-Mar-2021, PAIN IN EXTREMITY (Sore arm) had resolved. At the time of the report, HORDEOLUM (stye on her left eye) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant medication was provided. Most recent FOLLOW-UP information incorporated above includes: On 09-Mar-2021: No specific follow-up information recorded. On 21-Jun-2021: Non-Significant follow up appended; Mailing address and email address are updated

Other Meds:

Current Illness:

ID: 1564141
Sex: F
Age: 69
State: GA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: regurgitate food 3 hours later; vomiting; stomach would "churn" about 1 hour after eating; swelling on arm; upset stomach; This spontaneous case was reported by a patient and describes the occurrence of PERIPHERAL SWELLING (swelling on arm), ABDOMINAL DISCOMFORT (upset stomach), REGURGITATION (regurgitate food 3 hours later), VOMITING (vomiting) and NAUSEA (stomach would "churn" about 1 hour after eating) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M2 (orQ)0A) for COVID-19 vaccination. No Medical History information was reported. On 20-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Feb-2021, the patient experienced PERIPHERAL SWELLING (swelling on arm) and ABDOMINAL DISCOMFORT (upset stomach). On 23-Feb-2021, the patient experienced REGURGITATION (regurgitate food 3 hours later), VOMITING (vomiting) and NAUSEA (stomach would "churn" about 1 hour after eating). The patient was treated with ALUMINIUM HYDROXIDE, MAGNESIUM TRISILICATE, SODIUM ALGINATE (PEPCID [ALUMINIUM HYDROXIDE;MAGNESIUM TRISILICATE;SODIUM ALGINATE]) at an unspecified dose and frequency. At the time of the report, PERIPHERAL SWELLING (swelling on arm), ABDOMINAL DISCOMFORT (upset stomach), REGURGITATION (regurgitate food 3 hours later), VOMITING (vomiting) and NAUSEA (stomach would "churn" about 1 hour after eating) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided by reporter

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm