VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1564542
Sex: F
Age: 58
State: MI

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: fatigue; Nauseous; extreme headache; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (Nauseous), HEADACHE (extreme headache) and FATIGUE (fatigue) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010A21A) for COVID-19 vaccination. Concurrent medical conditions included Brain tumor (Experience regular headache). On 08-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021, the patient experienced NAUSEA (Nauseous) and HEADACHE (extreme headache). On 09-Mar-2021, the patient experienced FATIGUE (fatigue). At the time of the report, NAUSEA (Nauseous) outcome was unknown and HEADACHE (extreme headache) and FATIGUE (fatigue) was resolving. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient states that her headache was extreme to an extent it dwarfed her tumor headache and it was different. On 10-Mar-2021, her headache and fatigue seemed to be improving. Concomitant medications were not reported. Treatment information in response to events was not provided.

Other Meds:

Current Illness: Brain tumor (Experience regular headache)

ID: 1564543
Sex: F
Age: 73
State: NC

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Fatigue) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. No Medical History information was reported. On 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 FATIGUE (Fatigue). At the time of the report, FATIGUE (Fatigue) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1564544
Sex: F
Age: 89
State: NY

Vax Date: 01/22/2021
Onset Date: 02/19/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Unable to get 2nd dose due to a snowstrom. More than 36 days have passed since first shot; A spontaneous report was received from a consumer concerning a 89-years-old female patient who received Moderna's COVID-19 vaccine(mRNA-1273) and experienced unable to get 2nd dose due to a snowstorm. More than 36 days have passed since first shot/missed dose. The patient's medical history provided was not reported. No relevant concomitant medication was reported. On 22 Jan 2020, prior to onset of the event, the patient received their first of two planned doses of mRNA-1273 (lot/batch: 029L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. The patient was unable to get second dose scheduled on 19 Feb 2021, due to a snowstorm. The patient informed that more than 36 days passed since first dose. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event unable to get 2nd dose due to a snowstorm. More than 36 days have passed since first shot was considered recovered.; Reporter's Comments: This report refers to a case of Product dose omission issue for mRNA-1273, lot #unknown with no associated AEs.

Other Meds:

Current Illness:

ID: 1564545
Sex: M
Age:
State:

Vax Date:
Onset Date:
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: Pain in the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Pain in the injection site) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE PAIN (Pain in the injection site). At the time of the report, VACCINATION SITE PAIN (Pain in the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1564546
Sex: F
Age: 120
State: NJ

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
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: Left arm hot and red at injection site; Red blotches on chest and cheeks like sunburn; Flu like feeling; Left arm hot and red at injection site; Fever; chills; Very tired; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Left arm hot and red at injection site), RASH MACULAR (Red blotches on chest and cheeks like sunburn), INFLUENZA LIKE ILLNESS (Flu like feeling), VACCINATION SITE ERYTHEMA (Left arm hot and red at injection site) and PYREXIA (Fever) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M20A) 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 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 05-Mar-2021, the patient experienced VACCINATION SITE WARMTH (Left arm hot and red at injection site), RASH MACULAR (Red blotches on chest and cheeks like sunburn), INFLUENZA LIKE ILLNESS (Flu like feeling), VACCINATION SITE ERYTHEMA (Left arm hot and red at injection site), PYREXIA (Fever), CHILLS (chills) and FATIGUE (Very tired). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and LORATADINE, PSEUDOEPHEDRINE HYDROCHLORIDE (BENADRYL 24 D) at an unspecified dose and frequency. At the time of the report, VACCINATION SITE WARMTH (Left arm hot and red at injection site), RASH MACULAR (Red blotches on chest and cheeks like sunburn), INFLUENZA LIKE ILLNESS (Flu like feeling), VACCINATION SITE ERYTHEMA (Left arm hot and red at injection site), PYREXIA (Fever), CHILLS (chills) and FATIGUE (Very tired) outcome was unknown. Concomitant medications were not reported. Patient took Tylenol and Benadryl to relieve her symptoms. Action taken with mRNA-123 (Moderna COVID-19 Vaccine) (Intramuscular) was not applicable.

Other Meds:

Current Illness:

ID: 1564547
Sex: F
Age: 81
State: NY

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: Soreness of arm; Collapsed completely; feeling so dizzy that she went to sleep; Noose down; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 09-Mar-2021 and was forwarded to Moderna on 10-Mar-2021. This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 09-Mar-2021 and was forwarded to Moderna on 10-Mar-2021. This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Soreness of arm), FEELING ABNORMAL (Collapsed completely), DIZZINESS (feeling so dizzy that she went to sleep) and DEPRESSED MOOD (Noose down) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 07-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Mar-2021, the patient experienced PAIN IN EXTREMITY (Soreness of arm), FEELING ABNORMAL (Collapsed completely), DIZZINESS (feeling so dizzy that she went to sleep) and DEPRESSED MOOD (Noose down). At the time of the report, PAIN IN EXTREMITY (Soreness of arm), FEELING ABNORMAL (Collapsed completely), DIZZINESS (feeling so dizzy that she went to sleep) and DEPRESSED MOOD (Noose down) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Treatment information was unknown. Most recent FOLLOW-UP information incorporated above includes: On 21-Jun-2021: Follow-up information received on 21-JUN-2021, contains no new information.

Other Meds:

Current Illness:

ID: 1564548
Sex: F
Age: 80
State: MA

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: worst reaction; temp went up to 101.8; weak; eyes were bothering me; light would bother them too; just like the COVID over again; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE REACTION (worst reaction), BODY TEMPERATURE INCREASED (temp went up to 101.8), ASTHENIA (weak), ABNORMAL SENSATION IN EYE (eyes were bothering me) and PHOTOPHOBIA (light would bother them too) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19. On 08-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced ADVERSE REACTION (worst reaction), BODY TEMPERATURE INCREASED (temp went up to 101.8), ASTHENIA (weak), ABNORMAL SENSATION IN EYE (eyes were bothering me), PHOTOPHOBIA (light would bother them too) and COVID-19 (just like the COVID over again). At the time of the report, ADVERSE REACTION (worst reaction), BODY TEMPERATURE INCREASED (temp went up to 101.8), ASTHENIA (weak), ABNORMAL SENSATION IN EYE (eyes were bothering me), PHOTOPHOBIA (light would bother them too) and COVID-19 (just like the COVID over again) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 29-Jan-2021, SARS-CoV-2 test: positive (Positive) Positive. On 09-Mar-2021, Body temperature: 101.8 High. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1564549
Sex: M
Age: 78
State: AZ

Vax Date: 03/06/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: nickel sized purple bruised at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (nickel sized purple bruised at the injection site) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. 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 10-Mar-2021, the patient experienced VACCINATION SITE ERYTHEMA (nickel sized purple bruised at the injection site). At the time of the report, VACCINATION SITE ERYTHEMA (nickel sized purple bruised at the injection site) 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 medications were not reported. Treatment information in response to events was not provided.

Other Meds:

Current Illness:

ID: 1564550
Sex: F
Age: 71
State: TX

Vax Date: 02/24/2021
Onset Date: 02/25/2021
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: back pain on her left side; breath; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (back pain on her left side) and HYPERVENTILATION (breath) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013A21A) 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 25-Feb-2021, the patient experienced BACK PAIN (back pain on her left side) and HYPERVENTILATION (breath). At the time of the report, BACK PAIN (back pain on her left side) and HYPERVENTILATION (breath) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not reported. Treatment information in response to events was not provided.

Other Meds:

Current Illness:

ID: 1564551
Sex: M
Age:
State: OK

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: Flu like symptoms; Sore arm at the vaccination site; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu like symptoms) and VACCINATION SITE PAIN (Sore arm at the vaccination site) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INFLUENZA LIKE ILLNESS (Flu like symptoms) and VACCINATION SITE PAIN (Sore arm at the vaccination site). At the time of the report, INFLUENZA LIKE ILLNESS (Flu like symptoms) and VACCINATION SITE PAIN (Sore arm at the vaccination site) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1564552
Sex: M
Age:
State: NJ

Vax Date: 03/08/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: numbness around injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE HYPOAESTHESIA (numbness around injection site) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. No medical history information was reported. Concomitant products included AMLODIPINE and ATORVASTATIN CALCIUM for an unknown indication. On 08-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Mar-2021, the patient experienced VACCINATION SITE HYPOAESTHESIA (numbness around injection site). At the time of the report, VACCINATION SITE HYPOAESTHESIA (numbness around injection site) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Treatment medication were reported. Most recent FOLLOW-UP information incorporated above includes: On 23-Jun-2021: Event outcome updated.

Other Meds: AMLODIPINE; ATORVASTATIN CALCIUM

Current Illness:

ID: 1564553
Sex: F
Age: 78
State: IN

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: bad headache; arm got so sore she cannot hardly move it ? from shoulder to elbow; This spontaneous case was reported by a patient (subsequently medically confirmed) and describes the occurrence of MYALGIA (arm got so sore she cannot hardly move it ? from shoulder to elbow) and HEADACHE (bad headache) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. Concurrent medical conditions included Peripheral arterial disease. On 11-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, the patient experienced MYALGIA (arm got so sore she cannot hardly move it ? from shoulder to elbow). On an unknown date, the patient experienced HEADACHE (bad headache). At the time of the report, MYALGIA (arm got so sore she cannot hardly move it ? from shoulder to elbow) had not resolved and HEADACHE (bad headache) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication include two types of blood thinners used for unknown indication. Patient was told to apply heat and rub pain relievers, but they did not help.

Other Meds:

Current Illness: Peripheral arterial disease

ID: 1564554
Sex: F
Age: 50
State: NM

Vax Date: 03/04/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: discomfort from swollen lymph nodes; This spontaneous case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (discomfort from swollen lymph nodes) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021, the patient experienced LYMPHADENOPATHY (discomfort from swollen lymph nodes). At the time of the report, LYMPHADENOPATHY (discomfort from swollen lymph nodes) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1564555
Sex: F
Age: 81
State: CA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
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: The injection site was red for a while; Her arm hurt a little (L arm); Arm is swollen (L arm); Her armpits and the right arm began to hurt; Headache; Cold (chills); General tiredness; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Her arm hurt a little (L arm)), PERIPHERAL SWELLING (Arm is swollen (L arm)), AXILLARY PAIN (Her armpits and the right arm began to hurt), HEADACHE (Headache) and CHILLS (Cold (chills)) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included VITAMINS NOS for an unknown indication. On 28-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Feb-2021, the patient experienced FATIGUE (General tiredness). On 02-Mar-2021, the patient experienced PAIN IN EXTREMITY (Her arm hurt a little (L arm)), PERIPHERAL SWELLING (Arm is swollen (L arm)), AXILLARY PAIN (Her armpits and the right arm began to hurt), HEADACHE (Headache) and CHILLS (Cold (chills)). On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (The injection site was red for a while). At the time of the report, PAIN IN EXTREMITY (Her arm hurt a little (L arm)), PERIPHERAL SWELLING (Arm is swollen (L arm)), AXILLARY PAIN (Her armpits and the right arm began to hurt), HEADACHE (Headache), CHILLS (Cold (chills)), FATIGUE (General tiredness) and VACCINATION SITE ERYTHEMA (The injection site was red for a while) 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: VITAMINS NOS

Current Illness:

ID: 1564556
Sex: F
Age: 84
State: GA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: blood glucose fluctuating; stomach upset; slight headache and went away; This spontaneous case was reported by a consumer and describes the occurrence of BLOOD GLUCOSE FLUCTUATION (blood glucose fluctuating), ABDOMINAL DISCOMFORT (stomach upset) and HEADACHE (slight headache and went away) in an 84-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unkown) for COVID-19 vaccination. Concurrent medical conditions included Diabetes. Concomitant products included INSULIN ASPART (NOVOLOG), INSULIN GLARGINE (LANTUS), CLOPIDOGREL BISULFATE (PLAVIX), NIFEDIPINE, FUROSEMIDE, MECLIZINE HCL, ACETYLSALICYLIC ACID (ASPIRIN (E.C.)), POTASSIUM, 12 VITAMINS FOR INJECTION, FOLIC ACID, ALLOPURINOL, COLCHICINE and VITAMIN B COMPLEX for an unknown indication. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced ABDOMINAL DISCOMFORT (stomach upset) and HEADACHE (slight headache and went away). On 10-Mar-2021, the patient experienced BLOOD GLUCOSE FLUCTUATION (blood glucose fluctuating). On 09-Mar-2021, HEADACHE (slight headache and went away) had resolved. At the time of the report, BLOOD GLUCOSE FLUCTUATION (blood glucose fluctuating) had not resolved and ABDOMINAL DISCOMFORT (stomach upset) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. Reporter did not allow further contact

Other Meds: NOVOLOG; LANTUS; PLAVIX; NIFEDIPINE; FUROSEMIDE; MECLIZINE HCL; ASPIRIN (E.C.); POTASSIUM; 12 VITAMINS FOR INJECTION; FOLIC ACID; ALLOPURINOL; COLCHICINE; VITAMIN B COMPLEX

Current Illness: Diabetes

ID: 1564557
Sex: M
Age: 69
State: DC

Vax Date: 01/16/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Over 42 days for the second dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Over 42 days for the second dose) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. No Medical History information was reported. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Over 42 days for the second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Over 42 days for the second dose) had resolved. 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: 1564558
Sex: M
Age: 89
State:

Vax Date: 02/26/2021
Onset Date: 02/26/2021
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: This spontaneous case was reported by a physician and describes the occurrence of WRONG TECHNIQUE IN DEVICE USAGE PROCESS (During administration of the vaccine the lady stuck the needle inside and after few minutes that was removed), PAIN IN EXTREMITY (Severe arm pain, right before his elbow up to his neck through his shoulder), RASH MACULAR (Hot spots), PAIN IN EXTREMITY (Intense pain in his arm and about 4 inch into the arm) and FATIGUE (Tiredness) in an 89-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Blood pressure and Diabetes. Concomitant products included WARFARIN SODIUM (COUMADIN) for an unknown indication. On 26-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Feb-2021, the patient experienced WRONG TECHNIQUE IN DEVICE USAGE PROCESS (During administration of the vaccine the lady stuck the needle inside and after few minutes that was removed). On 28-Feb-2021, the patient experienced PAIN IN EXTREMITY (Intense pain in his arm and about 4 inch into the arm), FATIGUE (Tiredness) and CHILLS (Chills). On 06-Mar-2021, the patient experienced PAIN IN EXTREMITY (Severe arm pain, right before his elbow up to his neck through his shoulder) and RASH MACULAR (Hot spots). The patient was treated with PARACETAMOL (TYLENOL 8 HR ARTHRITIS PAIN) at an unspecified dose and frequency and TRAMADOL at a dose of 50 mg. At the time of the report, WRONG TECHNIQUE IN DEVICE USAGE PROCESS (During administration of the vaccine the lady stuck the needle inside and after few minutes that was removed), PAIN IN EXTREMITY (Severe arm pain, right before his elbow up to his neck through his shoulder), RASH MACULAR (Hot spots), FATIGUE (Tiredness) and CHILLS (Chills) outcome was unknown and PAIN IN EXTREMITY (Intense pain in his arm and about 4 inch into the arm) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product used included blood pressure medications, diabetic medications and pain pill for treatment of pain. The patient experienced intense pain which he never had in his life. He was taken to the emergency room and pain was so intense which lasted for 3hrs, then it stopped. Doctors have examined him and found nothing, told him nothing wrong and gave him pain pills. He took 2 of them and pain went away. Most recent FOLLOW-UP information incorporated above includes: On 05-May-2021: Follow-up SD added on 09-MAR-2021 updated event information and treatment information.

Other Meds: COUMADIN

Current Illness: Blood pressure; Diabetes

ID: 1564559
Sex: F
Age: 42
State: AZ

Vax Date: 01/25/2021
Onset Date: 03/04/2021
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: Menstruation cycle stated two weeks early; Menstruation is painful; This spontaneous case was reported by a consumer and describes the occurrence of MENSTRUAL DISORDER (Menstruation cycle stated two weeks early) and DYSMENORRHOEA (Menstruation is painful) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 010A21A and 04L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history was provided.). On 25-Jan-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 04-Mar-2021, the patient experienced MENSTRUAL DISORDER (Menstruation cycle stated two weeks early) and DYSMENORRHOEA (Menstruation is painful). At the time of the report, MENSTRUAL DISORDER (Menstruation cycle stated two weeks early) and DYSMENORRHOEA (Menstruation is painful) had resolved. Concomitant products were not provided. Treatment products were not provided. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 04-May-2021: contact info provided: email address

Other Meds:

Current Illness:

ID: 1564560
Sex: F
Age:
State: NJ

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: swelling near injection site; redness near injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE SWELLING (swelling near injection site) and VACCINATION SITE ERYTHEMA (redness near injection site) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 27-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 VACCINATION SITE SWELLING (swelling near injection site) and VACCINATION SITE ERYTHEMA (redness near injection site). At the time of the report, VACCINATION SITE SWELLING (swelling near injection site) and VACCINATION SITE ERYTHEMA (redness near injection site) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. No relevant concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1564561
Sex: F
Age: 79
State: CA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: Headache; Left Hip Pain; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ARTHRALGIA (Left Hip Pain) and HEADACHE (Headache) in a 79-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 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, the patient experienced ARTHRALGIA (Left Hip Pain). On 08-Mar-2021, the patient experienced HEADACHE (Headache). The patient was treated with IBUPROFEN at an unspecified dose and frequency and PREGABALIN at an unspecified dose and frequency. At the time of the report, ARTHRALGIA (Left Hip Pain) and HEADACHE (Headache) 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. Concomitant medications were not reported. Patient was given Ibuprofen and Pregabalin by HCP to treat events. Patient had his second dose scheduled on 10-Mar-2021.

Other Meds:

Current Illness:

ID: 1564562
Sex: F
Age: 68
State: TN

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: big red spot, (2 inches by 2 1/2 inches); little bit a sore arm; little red spot in the injection site.; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (little bit a sore arm), VACCINATION SITE ERYTHEMA (little red spot in the injection site.) and VACCINATION SITE RASH (big red spot, (2 inches by 2 1/2 inches)) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. Concurrent medical conditions included Diabetes, Blood pressure high, High cholesterol, Hypothyroidism and Anxiety. Concomitant products included DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for an unknown indication. On 24-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Feb-2021, the patient experienced PAIN IN EXTREMITY (little bit a sore arm) and VACCINATION SITE ERYTHEMA (little red spot in the injection site.). On 10-Mar-2021, the patient experienced VACCINATION SITE RASH (big red spot, (2 inches by 2 1/2 inches)). At the time of the report, PAIN IN EXTREMITY (little bit a sore arm), VACCINATION SITE ERYTHEMA (little red spot in the injection site.) and VACCINATION SITE RASH (big red spot, (2 inches by 2 1/2 inches)) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.

Other Meds: BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]

Current Illness: Anxiety; Blood pressure high; Diabetes; High cholesterol; Hypothyroidism

ID: 1564563
Sex: F
Age:
State: IL

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

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: pain in the arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in the arm) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Mar-2021, the patient experienced PAIN IN EXTREMITY (pain in the arm). At the time of the report, PAIN IN EXTREMITY (pain in the arm) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication information not reported. Treatment information not provided by reporter.

Other Meds:

Current Illness:

ID: 1564564
Sex: F
Age: 52
State: WI

Vax Date: 02/02/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: some aches; swelling; lymph node in her neck; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (some aches), SWELLING (swelling) and LYMPHADENOPATHY (lymph node in her neck) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013A21A and 007M20A) for COVID-19 vaccination. No medical history reported. Concomitant products included SUMATRIPTAN for Migraine. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-Mar-2021, the patient experienced PAIN (some aches), SWELLING (swelling) and LYMPHADENOPATHY (lymph node in her neck). At the time of the report, PAIN (some aches), SWELLING (swelling) and LYMPHADENOPATHY (lymph node in her neck) had not resolved. Not Provided Treatment medications included Medicine for migraine after shot. On 4 March lymph node was bigger.

Other Meds: SUMATRIPTAN

Current Illness:

ID: 1564565
Sex: F
Age:
State: CA

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: full blown stomach flu symptoms overnight; stomach ache; couldn't eat; puke evrytime; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL DISTENSION (full blown stomach flu symptoms overnight), ABDOMINAL PAIN UPPER (stomach ache), DECREASED APPETITE (couldn't eat) and VOMITING (puke evrytime) in a 94-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Cancer (NOS) (Patient was diagnosed with terminal cancer after receiving the first vaccine. She was not aware of this before receiving the vaccine.). On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced ABDOMINAL DISTENSION (full blown stomach flu symptoms overnight), ABDOMINAL PAIN UPPER (stomach ache), DECREASED APPETITE (couldn't eat) and VOMITING (puke evrytime). The patient was treated with DIMENHYDRINATE (DRAMAMINE) at an unspecified dose and frequency. At the time of the report, ABDOMINAL DISTENSION (full blown stomach flu symptoms overnight), ABDOMINAL PAIN UPPER (stomach ache), DECREASED APPETITE (couldn't eat) and VOMITING (puke evrytime) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication were provided by the reporter. Patient's son gave her some unspecified homeopathic nausea medications which did not helped her much with the symptoms. Then he gave her Dramamine. Reporter did not allow further contact

Other Meds:

Current Illness: Cancer (NOS) (Patient was diagnosed with terminal cancer after receiving the first vaccine. She was not aware of this before receiving the vaccine.)

ID: 1564566
Sex: F
Age:
State: NC

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: all across her lip and cheek, she has a dark red, round bruise; looks like a bruise that has been healing; This spontaneous case was reported by a consumer and describes the occurrence of CONTUSION (all across her lip and cheek, she has a dark red, round bruise) and IMPAIRED HEALING (looks like a bruise that has been healing) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M20A) for COVID-19 vaccination. The patient's past medical history included Lip augmentation (fillers in lips and cheeks.). On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Mar-2021, the patient experienced CONTUSION (all across her lip and cheek, she has a dark red, round bruise) and IMPAIRED HEALING (looks like a bruise that has been healing). At the time of the report, CONTUSION (all across her lip and cheek, she has a dark red, round bruise) was resolving and IMPAIRED HEALING (looks like a bruise that has been healing) had not resolved. 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. Concomitant product used were not provided by the reporter. Treatment medication were not reported by the reporter.

Other Meds:

Current Illness:

ID: 1564567
Sex: F
Age: 62
State: NM

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: bump on the injection spot; itchy on the injection spot; injection site sore; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE REACTION (bump on the injection spot), INJECTION SITE PRURITUS (itchy on the injection spot) and INJECTION SITE PAIN (injection site sore) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Nasal disorder. On 24-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Feb-2021, the patient experienced INJECTION SITE REACTION (bump on the injection spot), INJECTION SITE PRURITUS (itchy on the injection spot) and INJECTION SITE PAIN (injection site sore). At the time of the report, INJECTION SITE REACTION (bump on the injection spot), INJECTION SITE PRURITUS (itchy on the injection spot) and INJECTION SITE PAIN (injection site sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. After three days of initial occurrence, the events they got better, then after 10 days the symptoms came back again. Patient had a nostril problem for which she was taking unspecified anti fungal medication. Patient used ice and anti itch cream to treat the symptoms.

Other Meds:

Current Illness:

ID: 1564568
Sex: M
Age: 82
State: TX

Vax Date: 02/03/2021
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: Around his neck lot of itching; His arm was puffy, warm and swollen; His arm was puffy, warm and swollen; Around his neck he had a very bad red rash; Arm hurt like crazy; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm hurt like crazy), PRURITUS (Around his neck lot of itching), PERIPHERAL SWELLING (His arm was puffy, warm and swollen), FEELING HOT (His arm was puffy, warm and swollen) and RASH (Around his neck he had a very bad red rash) in an 82-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 032M20A and 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-Mar-2021, the patient experienced PAIN IN EXTREMITY (Arm hurt like crazy). On 07-Mar-2021, the patient experienced PRURITUS (Around his neck lot of itching), PERIPHERAL SWELLING (His arm was puffy, warm and swollen), FEELING HOT (His arm was puffy, warm and swollen) and RASH (Around his neck he had a very bad red rash). On 05-Mar-2021, PAIN IN EXTREMITY (Arm hurt like crazy) had resolved. At the time of the report, PRURITUS (Around his neck lot of itching), PERIPHERAL SWELLING (His arm was puffy, warm and swollen), FEELING HOT (His arm was puffy, warm and swollen) and RASH (Around his neck he had a very bad red rash) outcome was unknown. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medication was reported. No Treatment medication was reported. Most recent FOLLOW-UP information incorporated above includes: On 22-Jun-2021: Follow-up was received on 22-Jun-2021 contains Non- Significant Follow-up ( Reporter Email address was updated)

Other Meds:

Current Illness:

ID: 1564569
Sex: F
Age: 63
State: CT

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: little rash on both feet; hives on legs, chest, face, back, ears; headache; nausea; Very tired and fatigue; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (hives on legs, chest, face, back, ears), RASH (little rash on both feet), HEADACHE (headache), NAUSEA (nausea) and FATIGUE (Very tired and fatigue) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. The patient's past medical history included Lymphoma (The patient has a past medical history of underlying condition of cancer (lymphoma). Patient reports she has a rare "B cell "lymphoma"). Concurrent medical conditions included Drug allergy (Allergic to some medications but not anaphylaxis.). Concomitant products included FAMOTIDINE for Acid phosphatase normal, SIMVASTATIN for Blood pressure, LISINOPRIL for Blood pressure high, DOCUSATE SODIUM (COLACE) for Increased stool volume, OXYMETAZOLINE HYDROCHLORIDE (CLARITIN ALLERGIC) for Multiple allergies, CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000), VITAMIN B6 and CYAMOPSIS TETRAGONOLOBA GUM (FIBER MATE KIDDY) for an unknown indication. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced HEADACHE (headache), NAUSEA (nausea) and FATIGUE (Very tired and fatigue). On 10-Mar-2021, the patient experienced URTICARIA (hives on legs, chest, face, back, ears). On an unknown date, the patient experienced RASH (little rash on both feet). The patient was treated with PREDNISONE at a dose of 20 mg once a day and LORATADINE, PSEUDOEPHEDRINE HYDROCHLORIDE (BENADRYL 24 D) at a dose of 25 mg. On 11-Mar-2021, URTICARIA (hives on legs, chest, face, back, ears) had resolved. At the time of the report, RASH (little rash on both feet), HEADACHE (headache), NAUSEA (nausea) and FATIGUE (Very tired and fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to MOD-2021-231311 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 22-Jun-2021: Follow-up information received on 22-Jun-2021 Updated patient demographics, medical history, Added concomitant medications, treatment medications, Added new event Fatigue, updated the end date of the event Hives.

Other Meds: LISINOPRIL; SIMVASTATIN; VITAMIN D 2000; VITAMIN B6; COLACE; FIBER MATE KIDDY; FAMOTIDINE; CLARITIN ALLERGIC

Current Illness: Drug allergy (Allergic to some medications but not anaphylaxis.)

ID: 1564570
Sex: F
Age: 21
State: AL

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

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

Lab Data:

Allergies:

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

Symptoms: The arm was still red and hard; The arm was still red and hard.The redness started going away and it's back and it's worst; Developed a rash on her arms and her legs; This spontaneous case was reported by a consumer and describes the occurrence of INDURATION (The arm was still red and hard), ERYTHEMA (The arm was still red and hard.The redness started going away and it's back and it's worst) and RASH (Developed a rash on her arms and her legs) in a 21-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported. ). On 28-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced INDURATION (The arm was still red and hard), ERYTHEMA (The arm was still red and hard.The redness started going away and it's back and it's worst) and RASH (Developed a rash on her arms and her legs). At the time of the report, INDURATION (The arm was still red and hard), ERYTHEMA (The arm was still red and hard.The redness started going away and it's back and it's worst) and RASH (Developed a rash on her arms and her legs) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication were provided by the reporter. Patient used an itch cream on the arms and legs where it was breaking out to treat the symptoms.

Other Meds:

Current Illness:

ID: 1564571
Sex: F
Age: 54
State: CA

Vax Date: 01/13/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Arm got swollen; Pain in the left arm; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of PAIN IN EXTREMITY (Pain in the left arm) and PERIPHERAL SWELLING (Arm got swollen) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 027L20A and 016M20A) for COVID-19 vaccination. No Medical History information was reported. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. In February 2021, the patient experienced PAIN IN EXTREMITY (Pain in the left arm). On an unknown date, the patient experienced PERIPHERAL SWELLING (Arm got swollen). At the time of the report, PAIN IN EXTREMITY (Pain in the left arm) outcome was unknown and PERIPHERAL SWELLING (Arm got swollen) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant Medication was provided. Treatment provided was muscular relaxants and neuromuscular pain relievers. Patient reported the pain in the arm got worse after 2 days and the arm got swollen, which is why her physician prescribed muscular relaxants and neuromuscular pain relievers. The medication helped and now she is feeling well. Her physician explained that it was probably because the needle touched a nerve in the arm, and she did not blame the components of the vaccine. Most recent FOLLOW-UP information incorporated above includes: On 04-May-2021: Follow up included new events and event outcome were updated.

Other Meds:

Current Illness:

ID: 1564572
Sex: M
Age: 84
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Itching on arms and legs; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching on arms and legs) in an 85-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030M20A) for COVID-19 vaccination. No Medical History information was reported. On 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 PRURITUS (Itching on arms and legs). The patient was treated with HYDROCORTISONE for Itching, at a dose of 1 percent; CAMPHOR, MENTHOL (SARNA [CAMPHOR;MENTHOL]) for Itching, at an unspecified dose and frequency and CETIRIZINE HYDROCHLORIDE (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) for Itching, at an unspecified dose and frequency. At the time of the report, PRURITUS (Itching on arms and legs) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported by investigator

Other Meds:

Current Illness:

ID: 1564573
Sex: F
Age: 69
State: AZ

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported.). On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Mar-2021, 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 medication were provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1564574
Sex: F
Age:
State: WI

Vax Date: 02/09/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: She has had her tongue coming out; Partial dyskinesia; This spontaneous case was reported by a consumer and describes the occurrence of TONGUE DISORDER (She has had her tongue coming out) and DYSKINESIA (Partial dyskinesia) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Intellectual disability. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced TONGUE DISORDER (She has had her tongue coming out) and DYSKINESIA (Partial dyskinesia). At the time of the report, TONGUE DISORDER (She has had her tongue coming out) and DYSKINESIA (Partial dyskinesia) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product information was not provided. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 21-Jun-2021: Follow-up information received on 21-JUN-2021 .Reporter contact details were updated and Patient initials was updated On 22-Jun-2021: Non-significant Follow-up appended

Other Meds:

Current Illness:

ID: 1564575
Sex: F
Age: 32
State: UT

Vax Date: 03/02/2021
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: Tremor

Symptoms: Diarrhea; Arm was dead weight; Achnyess; Low grade fever; Chills; Headache; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea), MUSCULAR WEAKNESS (Arm was dead weight), PAIN (Achnyess), PYREXIA (Low grade fever) and CHILLS (Chills) in a 32-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Lupus erythematosus and COVID-19. Concomitant products included HYDROXYCHLOROQUINE for an unknown indication. On 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DIARRHOEA (Diarrhea), MUSCULAR WEAKNESS (Arm was dead weight), PAIN (Achnyess), PYREXIA (Low grade fever), CHILLS (Chills) and HEADACHE (Headache). At the time of the report, DIARRHOEA (Diarrhea), MUSCULAR WEAKNESS (Arm was dead weight), PAIN (Achnyess), PYREXIA (Low grade fever), CHILLS (Chills) and HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided.

Other Meds: HYDROXYCHLOROQUINE

Current Illness:

ID: 1564576
Sex: M
Age: 64
State: CA

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Fever; Myalgia; Pain in hip; This spontaneous case was reported by a patient and describes the occurrence of PYREXIA (Fever), MYALGIA (Myalgia) and ARTHRALGIA (Pain in hip) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. 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 10-Mar-2021, the patient experienced PYREXIA (Fever), MYALGIA (Myalgia) and ARTHRALGIA (Pain in hip). The patient was treated with IBUPROFEN (ADVIL 12 HOUR) at an unspecified dose and frequency. At the time of the report, PYREXIA (Fever), MYALGIA (Myalgia) and ARTHRALGIA (Pain in hip) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication use was not provided by reporter.

Other Meds:

Current Illness:

ID: 1564577
Sex: F
Age: 77
State: NC

Vax Date: 02/11/2021
Onset Date: 02/25/2021
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: X-ray showed something in reference to arthritis; Rash; Dizziness; Severe muscle pain; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ARTHRITIS (X-ray showed something in reference to arthritis), RASH (Rash), DIZZINESS (Dizziness) and MYALGIA (Severe muscle pain) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. The patient's past medical history included Muscle pain since an unknown date. Concomitant products included CHLORTHALIDONE and EZETIMIBE for an unknown indication. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, the patient experienced RASH (Rash), DIZZINESS (Dizziness) and MYALGIA (Severe muscle pain). On an unknown date, the patient experienced ARTHRITIS (X-ray showed something in reference to arthritis). On 26-Feb-2021, RASH (Rash) had resolved. At the time of the report, ARTHRITIS (X-ray showed something in reference to arthritis), DIZZINESS (Dizziness) and MYALGIA (Severe muscle pain) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, Blood pressure measurement: normal normal. In 2021, X-ray: (Inconclusive) showed something in reference to arthritis.. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient used Aloe Vera to rub down on the rash to treat and it went away the next day. She is been taken off from her cholesterol medication by her doctor to check if there will be change in her muscle pain.

Other Meds: CHLORTHALIDONE; EZETIMIBE

Current Illness: Muscle pain

ID: 1564578
Sex: F
Age: 90
State: KS

Vax Date: 02/12/2021
Onset Date: 02/22/2021
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: Itching; Injection site hot to touch; Swelling in right arm; Redness from shoulder to elbow in right arm; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching), INJECTION SITE WARMTH (Injection site hot to touch), SWELLING (Swelling in right arm) and ERYTHEMA (Redness from shoulder to elbow in right arm) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030M20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Feb-2021, the patient experienced PRURITUS (Itching), INJECTION SITE WARMTH (Injection site hot to touch), SWELLING (Swelling in right arm) and ERYTHEMA (Redness from shoulder to elbow in right arm). On 27-Feb-2021, PRURITUS (Itching), INJECTION SITE WARMTH (Injection site hot to touch), SWELLING (Swelling in right arm) and ERYTHEMA (Redness from shoulder to elbow in right arm) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication information was not provided. Patient took Benadryl and the adverse events resolved in 5 days afterwards. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1564579
Sex: F
Age: 93
State: AR

Vax Date: 02/06/2021
Onset Date: 03/07/2021
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: "really,really weak"; is not her normal self; Fatigue; could not get up from bed; This spontaneous case was reported by a consumer and describes the occurrence of MOVEMENT DISORDER (could not get up from bed), ASTHENIA ("really,really weak"), FEELING ABNORMAL (is not her normal self) and FATIGUE (Fatigue) in a 93-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025A21A and 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 07-Mar-2021, the patient experienced MOVEMENT DISORDER (could not get up from bed). On 08-Mar-2021, the patient experienced ASTHENIA ("really,really weak"), FEELING ABNORMAL (is not her normal self) and FATIGUE (Fatigue). On 08-Mar-2021, MOVEMENT DISORDER (could not get up from bed) had resolved. At the time of the report, ASTHENIA ("really,really weak"), FEELING ABNORMAL (is not her normal self) and FATIGUE (Fatigue) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were provided by the reporter.

Other Meds:

Current Illness:

ID: 1564580
Sex: M
Age:
State: MI

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Stomach is still hard and swollen; Stomach hurt so bad he could barely walk; Sweating profusely; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (Stomach hurt so bad he could barely walk), HYPERHIDROSIS (Sweating profusely) and ABDOMINAL DISTENSION (Stomach is still hard and swollen) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 015M20A) for COVID-19 vaccination. Concurrent medical conditions included Type 1 diabetes mellitus. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Mar-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach hurt so bad he could barely walk) and HYPERHIDROSIS (Sweating profusely). On an unknown date, the patient experienced ABDOMINAL DISTENSION (Stomach is still hard and swollen). At the time of the report, ABDOMINAL PAIN UPPER (Stomach hurt so bad he could barely walk) and ABDOMINAL DISTENSION (Stomach is still hard and swollen) outcome was unknown and HYPERHIDROSIS (Sweating profusely) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Treatment included Milk of Magnesia and 2 Dulcolax gummies.

Other Meds:

Current Illness: Type 1 diabetes mellitus

ID: 1564581
Sex: F
Age: 57
State: FL

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: VACCINATION ERROR; SORE FEELING IN HER ARM; stressed; depressed; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION ERROR (VACCINATION ERROR), PAIN IN EXTREMITY (SORE FEELING IN HER ARM), STRESS (stressed) and DEPRESSED MOOD (depressed) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 02M20A) for COVID-19 vaccination. No Medical History information was reported. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, the patient experienced VACCINATION ERROR (VACCINATION ERROR), PAIN IN EXTREMITY (SORE FEELING IN HER ARM), STRESS (stressed) and DEPRESSED MOOD (depressed). At the time of the report, VACCINATION ERROR (VACCINATION ERROR), PAIN IN EXTREMITY (SORE FEELING IN HER ARM), STRESS (stressed) and DEPRESSED MOOD (depressed) 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 provided by the reporter.

Other Meds:

Current Illness:

ID: 1564582
Sex: F
Age: 19
State: CA

Vax Date: 03/10/2021
Onset Date: 03/09/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Knotted muscle; Tense muscle; Throat causing a sore throat; Fever; Viral infection which is similar to strep; Pain at injection site; This spontaneous case was reported by a patient and describes the occurrence of VACCINATION SITE NODULE (Knotted muscle), MUSCULOSKELETAL STIFFNESS (Tense muscle), VIRAL INFECTION (Viral infection which is similar to strep), OROPHARYNGEAL PAIN (Throat causing a sore throat) and VACCINATION SITE PAIN (Pain at injection site) in a 19-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003A21A) 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 prior medical history was reported). On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced VACCINATION SITE PAIN (Pain at injection site). On 19-Mar-2021, the patient experienced VIRAL INFECTION (Viral infection which is similar to strep). On an unknown date, the patient experienced VACCINATION SITE NODULE (Knotted muscle), MUSCULOSKELETAL STIFFNESS (Tense muscle), OROPHARYNGEAL PAIN (Throat causing a sore throat) and PYREXIA (Fever). At the time of the report, VACCINATION SITE NODULE (Knotted muscle), MUSCULOSKELETAL STIFFNESS (Tense muscle), VIRAL INFECTION (Viral infection which is similar to strep), OROPHARYNGEAL PAIN (Throat causing a sore throat), VACCINATION SITE PAIN (Pain at injection site) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Treatment details included the use of prednisone and penicillin. Most recent FOLLOW-UP information incorporated above includes: On 05-Apr-2021: As per the follow-up document received on 05 Apr 2021, the route of administration, anatomical location additional events and treatment details has been added.

Other Meds:

Current Illness:

ID: 1564583
Sex: F
Age: 37
State: GA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: little bit of skin sensitivity; burning; itching; really bad stinging on face; This spontaneous case was reported by a consumer and describes the occurrence of BURNING SENSATION (burning), PRURITUS (itching), PAIN (really bad stinging on face) and SENSITIVE SKIN (little bit of skin sensitivity) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. 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-Mar-2021, the patient experienced BURNING SENSATION (burning), PRURITUS (itching) and PAIN (really bad stinging on face). On 10-Mar-2021, the patient experienced SENSITIVE SKIN (little bit of skin sensitivity). On 10-Mar-2021, BURNING SENSATION (burning), PRURITUS (itching) and PAIN (really bad stinging on face) had resolved. At the time of the report, SENSITIVE SKIN (little bit of skin sensitivity) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication information not provided. Patient used cold pack as treatment for the symptoms. Events started 17 minutes after receiving vaccine and they lasted nearly two hours.

Other Meds:

Current Illness:

ID: 1564584
Sex: F
Age: 88
State: AZ

Vax Date: 02/07/2021
Onset Date: 03/08/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Warm; Itchy; Chills; Around the injection site, it is swollen; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Warm), VACCINATION SITE PRURITUS (Itchy), CHILLS (Chills) and VACCINATION SITE SWELLING (Around the injection site, it is swollen) in an 88-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M204) for COVID-19 vaccination. No Medical History information was reported. On 07-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Mar-2021, the patient experienced VACCINATION SITE WARMTH (Warm), VACCINATION SITE PRURITUS (Itchy), CHILLS (Chills) and VACCINATION SITE SWELLING (Around the injection site, it is swollen). At the time of the report, VACCINATION SITE WARMTH (Warm), VACCINATION SITE PRURITUS (Itchy), CHILLS (Chills) and VACCINATION SITE SWELLING (Around the injection site, it is swollen) outcome was unknown. Action taken with mRNA-1273 in response to the event was not applicable. Treatment details included Cocoa butter and shea butter.

Other Meds:

Current Illness:

ID: 1564585
Sex: F
Age:
State:

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: Nausea; Chills; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (Nausea) and CHILLS (Chills) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced NAUSEA (Nausea) and CHILLS (Chills). At the time of the report, NAUSEA (Nausea) and CHILLS (Chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1564586
Sex: M
Age: 73
State:

Vax Date: 01/21/2021
Onset Date: 02/25/2021
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: Weird feeling in his head; Headache; This spontaneous case was reported by a consumer and describes the occurrence of HEAD DISCOMFORT (Weird feeling in his head) and HEADACHE (Headache) in a 73-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 001A21A and 0391K20A) for COVID-19 vaccination. Concurrent medical conditions included Asthma. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 25-Feb-2021, the patient experienced HEAD DISCOMFORT (Weird feeling in his head) and HEADACHE (Headache). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, HEAD DISCOMFORT (Weird feeling in his head) outcome was unknown and HEADACHE (Headache) had resolved. Concomitant medications included medication for asthma NOS.

Other Meds:

Current Illness: Asthma

ID: 1564587
Sex: M
Age: 81
State: MI

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: Feeling horrible and is on bed; Feeling very tired; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (Feeling horrible and is on bed) and FATIGUE (Feeling very tired) in an 81-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) 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 MALAISE (Feeling horrible and is on bed) and FATIGUE (Feeling very tired). At the time of the report, MALAISE (Feeling horrible and is on bed) and FATIGUE (Feeling very tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication were provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1564588
Sex: F
Age:
State: PA

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

Symptoms: Dull headache; Felt tired; Didn't feel hungry; Arm swollen; Strange pain; Arm red; Fever; This spontaneous case was reported by a consumer and describes the occurrence of DECREASED APPETITE (Didn't feel hungry), PERIPHERAL SWELLING (Arm swollen), PAIN (Strange pain), ERYTHEMA (Arm red) and PYREXIA (Fever) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Blood pressure abnormal (Not specified). Concomitant products included MULTIVITAMINS + IRON and CALCIUM for an unknown indication. On 03-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Mar-2021, the patient experienced DECREASED APPETITE (Didn't feel hungry), PERIPHERAL SWELLING (Arm swollen), PAIN (Strange pain), ERYTHEMA (Arm red) and PYREXIA (Fever). On 04-Mar-2021, the patient experienced HEADACHE (Dull headache) and FATIGUE (Felt tired). At the time of the report, DECREASED APPETITE (Didn't feel hungry), PERIPHERAL SWELLING (Arm swollen), PAIN (Strange pain), ERYTHEMA (Arm red) and PYREXIA (Fever) outcome was unknown and HEADACHE (Dull headache) and FATIGUE (Felt tired) was resolving. On 04-Mar-2021, the patient felt better overall. Additional concomitant medications reported included blood pressure medicine unspecified. Treatment for the events included Ibuprofen.

Other Meds: MULTIVITAMINS + IRON; CALCIUM

Current Illness: Blood pressure abnormal

ID: 1564589
Sex: F
Age: 66
State: DC

Vax Date: 02/12/2021
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: Thyroid got real big in her neck; Chills off and on; This spontaneous case was reported by a consumer and describes the occurrence of GOITRE (Thyroid got real big in her neck) and CHILLS (Chills off and on) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced GOITRE (Thyroid got real big in her neck) and CHILLS (Chills off and on). At the time of the report, GOITRE (Thyroid got real big in her neck) and CHILLS (Chills off and on) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant and treatment medications were reported. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1564590
Sex: M
Age: 71
State:

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

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

Lab Data:

Allergies:

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

Symptoms: soreness and Body pain; joint pain; headache; muscle pain; experiencing more pain ever since he received the vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (soreness and Body pain), ARTHRALGIA (joint pain), HEADACHE (headache), MYALGIA (muscle pain) and VACCINATION SITE PAIN (experiencing more pain ever since he received the vaccine) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001A21A) for COVID-19 vaccination. Concurrent medical conditions included Peripheral neuropathy. On 20-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN (soreness and Body pain), ARTHRALGIA (joint pain), HEADACHE (headache), MYALGIA (muscle pain) and VACCINATION SITE PAIN (experiencing more pain ever since he received the vaccine). At the time of the report, PAIN (soreness and Body pain), ARTHRALGIA (joint pain), HEADACHE (headache), MYALGIA (muscle pain) and VACCINATION SITE PAIN (experiencing more pain ever since he received the vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1564591
Sex: F
Age: 36
State: KY

Vax Date: 02/02/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: flue like symptoms; Vaccine exposure during pregnancy; headache; nausea; chills; little fever ( do not know the temperature); extreme body aches like someone had beat her; pain at the arm of the injection after the 2nd dose; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (flue like symptoms), EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy), HEADACHE (headache), NAUSEA (nausea) and CHILLS (chills) in a 36-year-old female patient (gravida 2) who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012A21A and 013M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Induced abortion (blood problem, the baby did not come out, had to have surgery) in 2018 and Spontaneous abortion in 2012. Concurrent medical conditions included Hemochromatosis and Blood disorder NOS. On 02-Feb-2021 at 5:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021 at 5:30 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. The patient's last menstrual period was on 28-Jan-2021 and the estimated date of delivery was 03-Oct-2021. On 09-Mar-2021, the patient experienced INFLUENZA LIKE ILLNESS (flue like symptoms), EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy), HEADACHE (headache), NAUSEA (nausea), CHILLS (chills), PYREXIA (little fever ( do not know the temperature)), MYALGIA (extreme body aches like someone had beat her) and INJECTION SITE PAIN (pain at the arm of the injection after the 2nd dose). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the fifth week of the pregnancy. At the time of the report, INFLUENZA LIKE ILLNESS (flue like symptoms), EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy), HEADACHE (headache), NAUSEA (nausea), CHILLS (chills), PYREXIA (little fever ( do not know the temperature)), MYALGIA (extreme body aches like someone had beat her) and INJECTION SITE PAIN (pain at the arm of the injection after the 2nd dose) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 29-Jan-2021, Pregnancy test: positive (Positive) positive. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications included an unspecified allergy medicine. No treatment medication was reported. This case was linked to MOD-2021-210217 (Patient Link).

Other Meds: PRENATAL VITAMINS [ASCORBIC ACID;BETACAROTENE;CALCIUM SULFATE;COLECALCIFEROL;CYANOCOBALAMIN;FERROUS ; ASPIRIN LOW

Current Illness: Blood disorder NOS; Hemochromatosis

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm