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

Incidents per State

State Total
72,296
AK1,638
AL5,339
AR3,412
AS44
AZ13,316
CA58,147
CO11,002
CT7,824
DC1,626
DE1,670
FL36,235
FM3
GA13,429
GU82
HI2,195
IA4,332
ID2,473
IL19,261
IN22,568
KS4,284
KY6,945
LA4,714
MA13,886
MD11,901
ME2,997
MH8
MI17,865
MN11,345
MO8,919
MP30
MS2,676
MT2,147
NC15,401
ND1,273
NE2,732
NH2,859
NJ17,232
NM3,702
NV4,071
NY32,763
OH18,072
OK5,940
OR7,954
PA22,457
PR2,104
QM2
RI1,911
SC6,055
SD1,133
TN8,691
TX34,122
UT4,023
VA13,944
VI49
VT1,661
WA13,811
WI10,395
WV2,220
WY805
XB5
XL1
XV2

ID: 1611490
Sex: F
Age:
State: CO

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: "side effects were manageable."; headache; slight fever; Covid arm; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE EVENT ("side effects were manageable."), HEADACHE (headache), PYREXIA (slight fever) and VACCINATION SITE REACTION (Covid arm) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Mar-2021, the patient experienced ADVERSE EVENT ("side effects were manageable."), HEADACHE (headache), PYREXIA (slight fever) and VACCINATION SITE REACTION (Covid arm). On 27-Mar-2021, ADVERSE EVENT ("side effects were manageable."), PYREXIA (slight fever) and VACCINATION SITE REACTION (Covid arm) outcome was unknown and HEADACHE (headache) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to MOD-2021-090370 (Patient Link).

Other Meds:

Current Illness:

ID: 1611491
Sex: F
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Some vaccine leaked out during vaccination; Some vaccine leaked out during vaccination; This spontaneous case was reported by a pharmacist and describes the occurrence of DEVICE CONNECTION ISSUE (Some vaccine leaked out during vaccination) and UNDERDOSE (Some vaccine leaked out during vaccination) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DEVICE CONNECTION ISSUE (Some vaccine leaked out during vaccination) and UNDERDOSE (Some vaccine leaked out during vaccination). At the time of the report, DEVICE CONNECTION ISSUE (Some vaccine leaked out during vaccination) and UNDERDOSE (Some vaccine leaked out during vaccination) had resolved. 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. No concomitant medications reported. No treatment medications provided by the reporter.

Other Meds:

Current Illness:

ID: 1611492
Sex: M
Age: 54
State: CA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: impinged nerve in injection site arm; sore left arm; This spontaneous case was reported by a consumer and describes the occurrence of NERVE COMPRESSION (impinged nerve in injection site arm) and PAIN IN EXTREMITY (sore left arm) in a 54-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included PREDNISONE, ALLOPURINOL, ROSUVASTATIN CALCIUM (CRESTOR) and ADALIMUMAB (HUMIRA) 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 NERVE COMPRESSION (impinged nerve in injection site arm) and PAIN IN EXTREMITY (sore left arm). On 13-Mar-2021, PAIN IN EXTREMITY (sore left arm) had resolved. At the time of the report, NERVE COMPRESSION (impinged nerve in injection site arm) outcome was unknown. Not Provided mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. Concomitant therapy included physical therapy. No treatment information was provided. Patient went to the physician on 12 Apr 2021 and the physician did not feel that it was related to the Moderna Covid-19 vaccine. Physician diagnosed it as an impinged nerve in the left arm. After further diagnostics the physician reported that it is not be vaccine related. Although the vaccine did bring the condition to the surface or just weird timing. This case was linked to MOD-2021-091032 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: Follow up received included non significant information.

Other Meds: PREDNISONE; ALLOPURINOL; CRESTOR; HUMIRA

Current Illness:

ID: 1611493
Sex: F
Age: 51
State: OH

Vax Date: 04/22/2021
Onset Date: 04/25/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Lump at Collar Bone; This spontaneous case was reported by a consumer and describes the occurrence of NODULE (Lump at Collar Bone) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 044B21A) for COVID-19 vaccination. No Medical History information was reported. On 22-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Apr-2021, the patient experienced NODULE (Lump at Collar Bone). At the time of the report, NODULE (Lump at Collar Bone) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1611494
Sex: M
Age: 37
State: CT

Vax Date: 03/25/2021
Onset Date: 03/24/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Lot:
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Lab Data:

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Symptom List:

Symptoms: fatigue; Nausea; body aches.; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (fatigue), NAUSEA (Nausea) and MYALGIA (body aches.) in a 37-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Mar-2021, the patient experienced FATIGUE (fatigue), NAUSEA (Nausea) and MYALGIA (body aches.). On 31-Mar-2021, FATIGUE (fatigue), NAUSEA (Nausea) and MYALGIA (body aches.) outcome was unknown. Unknown The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to MOD-2021-090372, MOD-2021-090372 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1611495
Sex: F
Age: 50
State: MN

Vax Date: 03/25/2021
Onset Date: 04/22/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

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Symptom List:

Symptoms: arm hot to touch; a big blotchy rash; Itchy; Dizziness; nausea; Muscle aches; CHILLS; FEVER; was a little tired; headache/stronger headache; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itchy), DIZZINESS (Dizziness), FEELING HOT (arm hot to touch), RASH (a big blotchy rash) and FATIGUE (was a little tired) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 001C21A and 003B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Allergic reaction to antibiotics and Tooth extraction on 16-Apr-2021. Concomitant products included AMOXICILLIN, CLINDAMYCIN, VALACYCLOVIR [VALACICLOVIR], IBUPROFEN and TRAMADOL for an unknown indication. On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 22-Apr-2021, the patient experienced FATIGUE (was a little tired) and HEADACHE (headache/stronger headache). On 23-Apr-2021, the patient experienced DIZZINESS (Dizziness), NAUSEA (nausea), MYALGIA (Muscle aches), CHILLS (CHILLS) and PYREXIA (FEVER). On 25-Apr-2021, the patient experienced PRURITUS (Itchy), FEELING HOT (arm hot to touch) and RASH (a big blotchy rash). At the time of the report, PRURITUS (Itchy), FEELING HOT (arm hot to touch), RASH (a big blotchy rash), FATIGUE (was a little tired), HEADACHE (headache/stronger headache) and MYALGIA (Muscle aches) had not resolved and DIZZINESS (Dizziness), NAUSEA (nausea), CHILLS (CHILLS) and PYREXIA (FEVER) outcome was unknown. The patient treatment data was not provided. This case was linked to MOD-2021-090293 (Patient Link).

Other Meds: AMOXICILLIN; CLINDAMYCIN; VALACYCLOVIR [VALACICLOVIR]; IBUPROFEN; TRAMADOL

Current Illness:

ID: 1611496
Sex: F
Age:
State: MO

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: The injection site is red, but not hurting; Up most of the night last night because of her headache.; bad headache; general body aches all over; This spontaneous case was reported by a consumer and describes the occurrence of INSOMNIA (Up most of the night last night because of her headache.), HEADACHE (bad headache), MYALGIA (general body aches all over) and VACCINATION SITE ERYTHEMA (The injection site is red, but not hurting) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 25-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Apr-2021, the patient experienced INSOMNIA (Up most of the night last night because of her headache.), HEADACHE (bad headache) and MYALGIA (general body aches all over). On 26-Apr-2021, the patient experienced VACCINATION SITE ERYTHEMA (The injection site is red, but not hurting). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, INSOMNIA (Up most of the night last night because of her headache.), HEADACHE (bad headache), MYALGIA (general body aches all over) and VACCINATION SITE ERYTHEMA (The injection site is red, but not hurting) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. Treatment with Tylenol was provided. Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: TCR form is added.

Other Meds:

Current Illness:

ID: 1611497
Sex: F
Age: 80
State: IL

Vax Date: 03/24/2021
Onset Date: 04/23/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Arm/Shoulder pain; Arm/Shoulder pain; Redness at injection site; Burning at injection site; Hardness at injection site; Itchy at injection site; Breathing issues; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Breathing issues), PAIN IN EXTREMITY (Arm/Shoulder pain), VACCINATION SITE INDURATION (Hardness at injection site), VACCINATION SITE PRURITUS (Itchy at injection site) and ARTHRALGIA (Arm/Shoulder pain) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 021B21A and 038A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 24-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Apr-2021, the patient experienced DYSPNOEA (Breathing issues), VACCINATION SITE INDURATION (Hardness at injection site), VACCINATION SITE PRURITUS (Itchy at injection site), VACCINATION SITE ERYTHEMA (Redness at injection site) and VACCINATION SITE PAIN (Burning at injection site). On an unknown date, the patient experienced PAIN IN EXTREMITY (Arm/Shoulder pain) and ARTHRALGIA (Arm/Shoulder pain). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency. At the time of the report, DYSPNOEA (Breathing issues), PAIN IN EXTREMITY (Arm/Shoulder pain), VACCINATION SITE INDURATION (Hardness at injection site), VACCINATION SITE PRURITUS (Itchy at injection site), ARTHRALGIA (Arm/Shoulder pain), VACCINATION SITE ERYTHEMA (Redness at injection site) and VACCINATION SITE PAIN (Burning at injection site) outcome was unknown. Not Provided Patient used Benadryl as concomitant and treatment medication. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: Patient declined further follow up.

Other Meds:

Current Illness:

ID: 1611498
Sex: F
Age:
State: FL

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: occasional stabbing pain at the back of the neck; occasional stabbing pain when bending over; excruciating pain on the lest side of my head; my vision went white; severe headache; fatigue - slept for 15 hours; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (severe headache), NECK PAIN (occasional stabbing pain at the back of the neck), VISUAL IMPAIRMENT (my vision went white), BACK PAIN (occasional stabbing pain when bending over) and HEADACHE (excruciating pain on the lest side of my head) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Lot# 043B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Apr-2021, the patient experienced FATIGUE (fatigue - slept for 15 hours). On 19-Apr-2021, the patient experienced HEADACHE (severe headache). On 22-Apr-2021, the patient experienced VISUAL IMPAIRMENT (my vision went white) and HEADACHE (excruciating pain on the lest side of my head). On 26-Apr-2021, the patient experienced NECK PAIN (occasional stabbing pain at the back of the neck) and BACK PAIN (occasional stabbing pain when bending over). The patient was treated with NAPROXEN SODIUM (ALEVE) at a dose of 1 dosage form; IBUPROFEN at a dose of 1 dosage form; PARACETAMOL (TYLENOL) at a dose of 1 dosage form; DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL ALLERGY [DIPHENHYDRAMINE HYDROCHLORIDE]) at a dose of 1 dosage form and METOCLOPRAMIDE HYDROCHLORIDE (ANTI NAUSEA) at a dose of 1 dosage form. On 16-Apr-2021, FATIGUE (fatigue - slept for 15 hours) had resolved. At the time of the report, HEADACHE (severe headache), NECK PAIN (occasional stabbing pain at the back of the neck), VISUAL IMPAIRMENT (my vision went white), BACK PAIN (occasional stabbing pain when bending over) and HEADACHE (excruciating pain on the lest side of my head) 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 provided by reporter.

Other Meds:

Current Illness:

ID: 1611499
Sex: F
Age:
State: CO

Vax Date: 03/25/2021
Onset Date: 04/22/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: unable to sleep; I could barely see out of eyes"; uncontrollable shaking; "I was so sick, It was so bad."; "I had the chills so bad, I was uncontrollable shaking"; severe fatigue; muscle pain; joint pain; Severe Headache; fever was 102.5 for two days; This spontaneous case was reported by a consumer and describes the occurrence of INSOMNIA (unable to sleep), VISION BLURRED (I could barely see out of eyes"), TREMOR (uncontrollable shaking), ILLNESS ("I was so sick, It was so bad.") and CHILLS ("I had the chills so bad, I was uncontrollable shaking") in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 22-Apr-2021, the patient experienced INSOMNIA (unable to sleep), VISION BLURRED (I could barely see out of eyes"), TREMOR (uncontrollable shaking), ILLNESS ("I was so sick, It was so bad."), CHILLS ("I had the chills so bad, I was uncontrollable shaking"), FATIGUE (severe fatigue), MYALGIA (muscle pain), ARTHRALGIA (joint pain), HEADACHE (Severe Headache) and PYREXIA (fever was 102.5 for two days). On 24-Apr-2021, INSOMNIA (unable to sleep), VISION BLURRED (I could barely see out of eyes"), TREMOR (uncontrollable shaking), ILLNESS ("I was so sick, It was so bad."), CHILLS ("I had the chills so bad, I was uncontrollable shaking"), FATIGUE (severe fatigue), MYALGIA (muscle pain), ARTHRALGIA (joint pain), HEADACHE (Severe Headache) and PYREXIA (fever was 102.5 for two days) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 25-Apr-2021, Body temperature: 102.5 High. No concomitant medication were reported. Treatment medication included Tylenol and Advil to help relieve side effects. This case was linked to MOD-2021-090359 (Patient Link).

Other Meds:

Current Illness:

ID: 1611500
Sex: M
Age:
State: MD

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: tiredness; headache; fever; inappropriate schedule of vaccine administered; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate schedule of vaccine administered), PYREXIA (fever), FATIGUE (tiredness) and HEADACHE (headache) in a 19-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 02-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 02-Apr-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate schedule of vaccine administered). On 23-Apr-2021, the patient experienced PYREXIA (fever). On 26-Apr-2021, the patient experienced FATIGUE (tiredness) and HEADACHE (headache). On 02-Apr-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate schedule of vaccine administered) had resolved. On 25-Apr-2021, PYREXIA (fever) had resolved. At the time of the report, FATIGUE (tiredness) and HEADACHE (headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Apr-2021, Body temperature: 104 High. No concomitant medications were reported. The patient had acetaminophen 600 mg for fever. This case was linked to MODERNATX, INC.-MOD-2021-090443, MODERNATX, INC.-MOD-2021-090451 (E2B Linked Report).; Sender's Comments: MODERNATX, INC.-MOD-2021-090451:Mother's case dose 2 MODERNATX, INC.-MOD-2021-090443:Mother's case dose 1

Other Meds:

Current Illness:

ID: 1611501
Sex: M
Age: 37
State: CT

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Nausea; Fatigue; Muscle pain; body aches; Fatigue; nausea; Myalgia; This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (Nausea), the second episode of FATIGUE (Fatigue), MYALGIA (Muscle pain), PAIN (body aches) and the first episode of FATIGUE (Fatigue) in a 37-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017B21A and 018B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 24-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Mar-2021, the patient experienced the first episode of FATIGUE (Fatigue), NAUSEA (nausea) and MYALGIA (Myalgia). On 21-Apr-2021, the patient experienced NAUSEA (Nausea), the second episode of FATIGUE (Fatigue), MYALGIA (Muscle pain) and PAIN (body aches). On 31-Mar-2021, NAUSEA (nausea) and MYALGIA (Myalgia) had resolved. At the time of the report, NAUSEA (Nausea), the last episode of FATIGUE (Fatigue), MYALGIA (Muscle pain) and PAIN (body aches) outcome was unknown. Unknown The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment medication was provided by the reporter. No concomitant medication was provided by the reporter. No lab data was provided by the reporter. This case was linked to MOD-2021-090364, MOD-2021-090364 (Patient Link).

Other Meds:

Current Illness:

ID: 1611502
Sex: F
Age: 66
State: GA

Vax Date: 03/29/2021
Onset Date:
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Excessive hair fall; This spontaneous case was reported by a consumer and describes the occurrence of ALOPECIA (Excessive hair fall) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038A21A) for COVID-19 vaccination. No Medical History information was reported. On 29-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 ALOPECIA (Excessive hair fall). At the time of the report, ALOPECIA (Excessive hair fall) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medicines were reported. No treatment information were reported.

Other Meds:

Current Illness:

ID: 1611503
Sex: F
Age:
State: TX

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Lethargic; Weak; Tiredness; This spontaneous case was reported by a consumer and describes the occurrence of LETHARGY (Lethargic), ASTHENIA (Weak) and FATIGUE (Tiredness) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 045A21A) for COVID-19 vaccination. The patient's past medical history included Flu vaccination (she has reacting to flu vaccine). Concurrent medical conditions included Chronic kidney disease (she was born with only one functioning kidney). Concomitant products included ATORVASTATIN for an unknown indication. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Mar-2021, the patient experienced LETHARGY (Lethargic), ASTHENIA (Weak) and FATIGUE (Tiredness). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 26-Mar-2021, LETHARGY (Lethargic), ASTHENIA (Weak) and FATIGUE (Tiredness) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. treat This case was linked to MOD-2021-090383 (Patient Link).

Other Meds: ATORVASTATIN

Current Illness: Chronic kidney disease (she was born with only one functioning kidney)

ID: 1611504
Sex: F
Age:
State:

Vax Date: 02/26/2021
Onset Date: 04/26/2021
Rec V Date: 08/22/2021
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Symptoms: Missed the second dose (more than 8 weeks since first dose); This spontaneous case was reported by a physician and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Missed the second dose (more than 8 weeks since first dose)) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Apr-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Missed the second dose (more than 8 weeks since first dose)). On 26-Apr-2021, PRODUCT DOSE OMISSION ISSUE (Missed the second dose (more than 8 weeks since first dose)) had resolved. 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. Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: form, Reporter responding to FU attempt 1

Other Meds:

Current Illness:

ID: 1611505
Sex: F
Age: 51
State: TX

Vax Date: 04/09/2021
Onset Date: 04/22/2021
Rec V Date: 08/22/2021
Hospital:

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Symptoms: inappropriate schedule of vaccine administered; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 26-Apr-2021 and was forwarded to Moderna on 26-Apr-2021. This spontaneous case was reported by a nurse and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate schedule of vaccine administered) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046A21A and 027B21A) for COVID-19 immunisation. No medical history was provided by the reporter. Concomitant products included OMEPRAZOLE, FLUTICASONE PROPIONATE (FLONASE ALLERGY RELIEF), AMLODIPINE, OLANZAPINE, METHIMAZOLE, HYDROXYZINE and ESCITALOPRAM for an unknown indication. On 09-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 22-Apr-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate schedule of vaccine administered). On 22-Apr-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate schedule of vaccine administered) had resolved. Not Provided mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds: OMEPRAZOLE; FLONASE ALLERGY RELIEF; AMLODIPINE; OLANZAPINE; METHIMAZOLE; HYDROXYZINE; ESCITALOPRAM

Current Illness:

ID: 1611506
Sex: F
Age: 71
State: TX

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 08/22/2021
Hospital:

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Symptom List:

Symptoms: eyes became swollen/ mildly swollen eyelids; eyes became painful/ red irritated eyes; tearing in eyes; felt like a grittiness in the eyes; runny nose; sensitivity to light in both eyes; felt like they had a foreign object in eyes; Sore left arm; Swelling at injection site; Hypersensitivity reaction; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 26-Apr-2021 and was forwarded to Moderna on 26-Apr-2021. This spontaneous case was reported by a consumer and describes the occurrence of EYE SWELLING (eyes became swollen/ mildly swollen eyelids), EYE PAIN (eyes became painful/ red irritated eyes), LACRIMATION INCREASED (tearing in eyes), FOREIGN BODY SENSATION IN EYES (felt like a grittiness in the eyes) and RHINORRHOEA (runny nose) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039A21A and 026C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Hypersensitivity reaction since an unknown date, Hives since an unknown date, Hay fever since an unknown date and Stroke (October 2020). Previously administered products included for an unreported indication: flu vaccine (Received on 1970s, and had reactions like Rash & swelling at injection site /severe flu-like symptoms x 2wks (cough,fever,tearing andsore throat)). Concurrent medical conditions included Asthma, Drug allergy (NSAID , and had reactions like GI Bleeding, Diverticulitis, GERD's), Drug allergy (Morphine and Codeine and had reactions like Itching, Rash, Hypersensitivity-altered mental status, easily agitated With both medications), Drug allergy (RTimolol Drops/ Atenolol PO and had reactions like rash, Itching, Cough with both medications), Neptazane and Harvoni (Neptazane and Harvoni and had reactions like Rash,Itching with both medications), Non-Hodgkin's lymphoma since 16-Aug-2013, Hypertension (1995), Diabetes (1970s), Diabetic peripheral neuropathy (1970s), Glaucoma, Cataracts (1995) and Connective tissue disorder (2018). Concomitant products included GABAPENTIN for Diabetic peripheral neuropathy, METOPROLOL TARTRATE for Heart rate irregular, AMLODIPINE and HYDROCHLOROTHIAZIDE, LOSARTAN POTASSIUM (LOSARTAN/HYDROCHLOROTHIAZIDE) for Hypertension, LATANOPROST, DORZOLAMIDE HCL, BRIMONIDINE TARTRATE (BRIMONIDINE TARTRATE TEVA), HYDROCHLOROTHIAZIDE, LOSARTAN POTASSIUM (LOSARTAN/HCTZ), BISACODYL, ATORVASTATIN, ASPIRIN [ACETYLSALICYLIC ACID], CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000) and CYANOCOBALAMIN, PYRIDOXINE HYDROCHLORIDE, THIAMINE HYDROCHLORIDE (Vitamin B12) for an unknown indication. On 21-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 21-Apr-2021, the patient experienced HYPERSENSITIVITY (Hypersensitivity reaction). On an unknown date, the patient experienced EYE SWELLING (eyes became swollen/ mildly swollen eyelids), EYE PAIN (eyes became painful/ red irritated eyes), LACRIMATION INCREASED (tearing in eyes), FOREIGN BODY SENSATION IN EYES (felt like a grittiness in the eyes), RHINORRHOEA (runny nose), PHOTOPHOBIA (sensitivity to light in both eyes), OCULAR DISCOMFORT (felt like they had a foreign object in eyes), PAIN IN EXTREMITY (Sore left arm) and VACCINATION SITE SWELLING (Swelling at injection site). The patient was treated with EPINEPHRINE at a dose of 1 dosage form and PREDNISOLONE ACETATE (ophthalmic) on 22-Apr-2021 at a dose of 1 drop four times per day. On 25-Apr-2021, HYPERSENSITIVITY (Hypersensitivity reaction) had resolved. At the time of the report, EYE SWELLING (eyes became swollen/ mildly swollen eyelids), EYE PAIN (eyes became painful/ red irritated eyes), LACRIMATION INCREASED (tearing in eyes), FOREIGN BODY SENSATION IN EYES (felt like a grittiness in the eyes), RHINORRHOEA (runny nose), PHOTOPHOBIA (sensitivity to light in both eyes), OCULAR DISCOMFORT (felt like they had a foreign object in eyes), PAIN IN EXTREMITY (Sore left arm) and VACCINATION SITE SWELLING (Swelling at injection site) outcome was unknown. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication included Pantoprazole DR 40 MG qd for GERD Treatment medication included Lotemax Ophthalmic Gel 0.5% BID-QID started on 19-May-2021 and ended on 20-May-2021 This case was linked to MOD-2021-194807, MOD-2021-194807 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 01-Jun-2021: Follow up information received on 01-Jun-2021: Updated the Patient demographics, medical history, Allergies, concomitant medications, treatment medication, event details and outcome.

Other Meds: LATANOPROST; DORZOLAMIDE HCL; BRIMONIDINE TARTRATE TEVA; GABAPENTIN; LOSARTAN/HCTZ; METOPROLOL TARTRATE; BISACODYL; ATORVASTATIN; ASPIRIN [ACETYLSALICYLIC ACID]; AMLODIPINE; VITAMIN D 2000; Vitamin B12; LOSARTAN/HYDROCHLOROTHIAZIDE

Current Illness: Asthma; Cataracts (1995); Connective tissue disorder (2018); Diabetes (1970s); Diabetic peripheral neuropathy (1970s); Drug allergy (RTimolol Drops/ Atenolol PO and had reactions like rash, Itching, Cough with both medications); Drug allergy (NSAID , and had reactions like GI Bleeding, Diverticulitis, GERD's); Drug allergy (Morphine and Codeine and had reactions like Itching, Rash, Hypersensitivity-altered mental status, easily agitated With both medications); Glaucoma; Hay fever; Hives; Hypersensitivity reaction; Hypertension (1995); Non-Hodgkin's lymphoma

ID: 1611507
Sex: F
Age: 69
State: HI

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 08/22/2021
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Symptom List:

Symptoms: Remove the wax in her ears; mild hearing loss at 8 khz; ringing in her ears, high pitched & constant, it's in both ears/ongoing; Canceled second dose appointment; Had a pretty hard lump; It had a pretty hard lump, which was warm to touch; hard lump; It had a pretty hard lump, which was tender; It had a pretty hard lump, which was itchy; some swelling in injection site arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE MASS (Had a pretty hard lump), VACCINATION SITE WARMTH (It had a pretty hard lump, which was warm to touch), TINNITUS (ringing in her ears, high pitched & constant, it's in both ears/ongoing), CERUMEN REMOVAL (Remove the wax in her ears) and PRODUCT DOSE OMISSION ISSUE (Canceled second dose appointment) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 27-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Mar-2021, the patient experienced VACCINATION SITE MASS (Had a pretty hard lump), VACCINATION SITE WARMTH (It had a pretty hard lump, which was warm to touch), VACCINATION SITE INDURATION (hard lump), VACCINATION SITE PAIN (It had a pretty hard lump, which was tender), VACCINATION SITE PRURITUS (It had a pretty hard lump, which was itchy) and VACCINATION SITE SWELLING (some swelling in injection site arm). On 24-Apr-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Canceled second dose appointment). On 26-Apr-2021, the patient experienced TINNITUS (ringing in her ears, high pitched & constant, it's in both ears/ongoing). On an unknown date, the patient experienced CERUMEN REMOVAL (Remove the wax in her ears) and HYPOACUSIS (mild hearing loss at 8 khz). At the time of the report, VACCINATION SITE MASS (Had a pretty hard lump), VACCINATION SITE WARMTH (It had a pretty hard lump, which was warm to touch), TINNITUS (ringing in her ears, high pitched & constant, it's in both ears/ongoing), CERUMEN REMOVAL (Remove the wax in her ears), PRODUCT DOSE OMISSION ISSUE (Canceled second dose appointment), HYPOACUSIS (mild hearing loss at 8 khz), VACCINATION SITE INDURATION (hard lump), VACCINATION SITE PAIN (It had a pretty hard lump, which was tender), VACCINATION SITE PRURITUS (It had a pretty hard lump, which was itchy) and VACCINATION SITE SWELLING (some swelling in injection site arm) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Apr-2021, Acoustic stimulation tests: normal (normal) Normal. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Relevant concomitant medications was reported. Treatment information was not provided Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: VAER form appended

Other Meds:

Current Illness:

ID: 1611508
Sex: F
Age: 61
State: CA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: No taste of food; Weak; Body ache; Headache as of Migraine; Nausea; Joint pains; Arm swollen with itching and hurting; Arm swollen with itching and hurting; This spontaneous case was reported by a consumer and describes the occurrence of AGEUSIA (No taste of food), ASTHENIA (Weak), PAIN (Body ache), HEADACHE (Headache as of Migraine) and NAUSEA (Nausea) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 20-Apr-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 20-Apr-2021, the patient experienced VACCINATION SITE PRURITUS (Arm swollen with itching and hurting). On an unknown date, the patient experienced AGEUSIA (No taste of food), ASTHENIA (Weak), PAIN (Body ache), HEADACHE (Headache as of Migraine), NAUSEA (Nausea), ARTHRALGIA (Joint pains) and VACCINATION SITE SWELLING (Arm swollen with itching and hurting). The patient was treated with TRAMADOL for Adverse event, at an unspecified dose and frequency and PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, AGEUSIA (No taste of food), ASTHENIA (Weak), PAIN (Body ache), HEADACHE (Headache as of Migraine), NAUSEA (Nausea), ARTHRALGIA (Joint pains), VACCINATION SITE SWELLING (Arm swollen with itching and hurting) and VACCINATION SITE PRURITUS (Arm swollen with itching and hurting) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided.

Other Meds:

Current Illness:

ID: 1611509
Sex: F
Age:
State: MA

Vax Date: 04/22/2021
Onset Date:
Rec V Date: 08/22/2021
Hospital:

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Symptoms: couldn't move her arm; dizziness; headache; nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of LIMB DISCOMFORT (couldn't move her arm), DIZZINESS (dizziness), HEADACHE (headache) and NAUSEA (nausea) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 22-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced LIMB DISCOMFORT (couldn't move her arm), DIZZINESS (dizziness), HEADACHE (headache) and NAUSEA (nausea). At the time of the report, LIMB DISCOMFORT (couldn't move her arm), DIZZINESS (dizziness), HEADACHE (headache) and NAUSEA (nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided. No treatment information was provided by reporter. This case was linked to MOD-2021-090121 (E2B Linked Report).; Sender's Comments: MOD-2021-090121:

Other Meds:

Current Illness:

ID: 1611510
Sex: F
Age: 39
State: FL

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: lump in the under arm/armpit region that is tender and on the same side she received the injection.; lump in the under arm/armpit region that is tender and on the same side she received the injection.; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE LYMPHADENOPATHY (lump in the under arm/armpit region that is tender and on the same side she received the injection.) and AXILLARY PAIN (lump in the under arm/armpit region that is tender and on the same side she received the injection.) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 018B21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included VITAMINS NOS for an unknown indication. On 19-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Apr-2021, the patient experienced VACCINATION SITE LYMPHADENOPATHY (lump in the under arm/armpit region that is tender and on the same side she received the injection.) and AXILLARY PAIN (lump in the under arm/armpit region that is tender and on the same side she received the injection.). At the time of the report, VACCINATION SITE LYMPHADENOPATHY (lump in the under arm/armpit region that is tender and on the same side she received the injection.) and AXILLARY PAIN (lump in the under arm/armpit region that is tender and on the same side she received the injection.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information was not provided.

Other Meds: VITAMINS NOS

Current Illness:

ID: 1611511
Sex: F
Age:
State: TX

Vax Date: 03/19/2021
Onset Date: 04/20/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Sore arm; sweating; Feeling tired; Low grade fever; She slept a lot; her face was hot; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm), SOMNOLENCE (She slept a lot), FEELING HOT (her face was hot), HYPERHIDROSIS (sweating) and FATIGUE (Feeling tired) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 045A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Previously administered products included for an unreported indication: FLU. Concurrent medical conditions included Chronic kidney disease. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 20-Apr-2021, the patient experienced SOMNOLENCE (She slept a lot), FEELING HOT (her face was hot), FATIGUE (Feeling tired) and PYREXIA (Low grade fever). On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm) and HYPERHIDROSIS (sweating). At the time of the report, PAIN IN EXTREMITY (Sore arm), SOMNOLENCE (She slept a lot), FEELING HOT (her face was hot), HYPERHIDROSIS (sweating), FATIGUE (Feeling tired) and PYREXIA (Low grade fever) outcome was unknown. patient was treated with Tylenol. This case was linked to MOD-2021-090374 (Patient Link).

Other Meds:

Current Illness: Chronic kidney disease

ID: 1611512
Sex: M
Age:
State: OK

Vax Date: 01/06/2021
Onset Date: 01/17/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: got the second dose on 23/Apr/2021 (day 108); tested positive for COVID-19 11 days after receiving the first dose; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (tested positive for COVID-19 11 days after receiving the first dose) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (got the second dose on 23/Apr/2021 (day 108)) in a 30-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 06-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Jan-2021, the patient experienced COVID-19 (tested positive for COVID-19 11 days after receiving the first dose). On 23-Apr-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (got the second dose on 23/Apr/2021 (day 108)). The patient was treated with BAMLANIVIMAB at a dose of 1 dosage form. On 23-Apr-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (got the second dose on 23/Apr/2021 (day 108)) had resolved. At the time of the report, COVID-19 (tested positive for COVID-19 11 days after receiving the first dose) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Jan-2021, SARS-CoV-2 test: positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported.

Other Meds:

Current Illness:

ID: 1611513
Sex: F
Age: 77
State: FL

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: cough that will not go away and is aggravating; feeling miserable; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (cough that will not go away and is aggravating) and FEELING ABNORMAL (feeling miserable) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001A21A) for COVID-19 vaccination. Concomitant products included PARACETAMOL (TYLENOL) for an unknown indication. On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Mar-2021, the patient experienced COUGH (cough that will not go away and is aggravating) and FEELING ABNORMAL (feeling miserable). At the time of the report, COUGH (cough that will not go away and is aggravating) and FEELING ABNORMAL (feeling miserable) 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 information not provided. This case was linked to US-MODERNATX, INC.-MOD-2021-090264, US-MODERNATX, INC.-MOD-2021-090279 (E2B Linked Report). This case was linked to MOD-2021-090392 (Patient Link).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-090264:Husband Dose 1 case US-MODERNATX, INC.-MOD-2021-090279:Husband dose 2 case

Other Meds: TYLENOL

Current Illness:

ID: 1611514
Sex: M
Age: 76
State: CA

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Sore right arm; Sleepiness; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of LIMB DISCOMFORT (Sore right arm), SOMNOLENCE (Sleepiness) and FATIGUE (Fatigue) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016C21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in January 2021. On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Apr-2021, the patient experienced LIMB DISCOMFORT (Sore right arm), SOMNOLENCE (Sleepiness) and FATIGUE (Fatigue). At the time of the report, LIMB DISCOMFORT (Sore right arm), SOMNOLENCE (Sleepiness) and FATIGUE (Fatigue) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was provided. No treatment medication was provided. Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: Follow-up information included no new information. On 03-Aug-2021: Event outcome updated.

Other Meds:

Current Illness:

ID: 1611515
Sex: F
Age: 72
State: VA

Vax Date: 03/01/2021
Onset Date: 04/24/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: solid whole neck rash that was confined to neck and shoulder; This spontaneous case was reported by a consumer and describes the occurrence of RASH (solid whole neck rash that was confined to neck and shoulder) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026A21A) for COVID-19 vaccination. The patient's past medical history included Rash from 14-Feb-2021 to 15-Feb-2021. On 01-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Apr-2021, the patient experienced RASH (solid whole neck rash that was confined to neck and shoulder). At the time of the report, RASH (solid whole neck rash that was confined to neck and shoulder) outcome was unknown. This case was linked to US-MODERNATX, INC.-MOD-2021-029248 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 31-May-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1611516
Sex: F
Age: 77
State: FL

Vax Date: 03/04/2021
Onset Date: 04/02/2021
Rec V Date: 08/22/2021
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Symptoms: Fever of 99 degrees; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever of 99 degrees) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 001A21A and 011A21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included PARACETAMOL (TYLENOL) for an unknown indication. On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 02-Apr-2021, the patient experienced PYREXIA (Fever of 99 degrees). At the time of the report, PYREXIA (Fever of 99 degrees) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment information was not provided. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) was not applicable. This case was linked to US-MODERNATX, INC.-MOD-2021-090264, US-MODERNATX, INC.-MOD-2021-090279 (E2B Linked Report). This case was linked to MOD-2021-090387 (Patient Link).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-090264:Husband dose 1 case US-MODERNATX, INC.-MOD-2021-090279:Husband dose 2 case

Other Meds: TYLENOL

Current Illness:

ID: 1611517
Sex: F
Age: 68
State: NY

Vax Date: 03/02/2021
Onset Date: 04/22/2021
Rec V Date: 08/22/2021
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Symptoms: Felt ill; Low grade fever; Chills; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (Felt ill), PYREXIA (Low grade fever) and CHILLS (Chills) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 22-Apr-2021, the patient experienced MALAISE (Felt ill), PYREXIA (Low grade fever) and CHILLS (Chills). At the time of the report, MALAISE (Felt ill), PYREXIA (Low grade fever) and CHILLS (Chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provider by the reporter. Treatment information was not provided. This case was linked to MOD-2021-090192.

Other Meds:

Current Illness:

ID: 1611518
Sex: M
Age: 58
State: NY

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 08/22/2021
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Symptoms: Pain in the spine; Numbness on the left of the spine; Sore shoulder; This spontaneous case was reported by a consumer and describes the occurrence of SPINAL PAIN (Pain in the spine), HYPOAESTHESIA (Numbness on the left of the spine) and ARTHRALGIA (Sore shoulder) in a 57-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037B21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Apr-2021, the patient experienced SPINAL PAIN (Pain in the spine), HYPOAESTHESIA (Numbness on the left of the spine) and ARTHRALGIA (Sore shoulder). At the time of the report, SPINAL PAIN (Pain in the spine), HYPOAESTHESIA (Numbness on the left of the spine) and ARTHRALGIA (Sore shoulder) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications were not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1611519
Sex: F
Age: 61
State: NE

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 08/22/2021
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Symptoms: Experienced chest tightness; Right arm swelled up to the size of a baseball; Really warm to the touch; This spontaneous case was reported by a consumer and describes the occurrence of CHEST DISCOMFORT (Experienced chest tightness), PERIPHERAL SWELLING (Right arm swelled up to the size of a baseball) and FEELING HOT (Really warm to the touch) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026C21A) for COVID-19 vaccination. The patient's past medical history included Traumatic injury (brain damage from a traumatic injury she had 14 years ago). Concurrent medical conditions included Penicillin allergy, Drug allergy, Drug allergy, Sulfonamide allergy, Blood pressure high, Food allergy and Handicap. On 01-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Apr-2021, the patient experienced CHEST DISCOMFORT (Experienced chest tightness), PERIPHERAL SWELLING (Right arm swelled up to the size of a baseball) and FEELING HOT (Really warm to the touch). The patient was treated with METOPROLOL ongoing since an unknown date at a dose of 1 dosage form. At the time of the report, CHEST DISCOMFORT (Experienced chest tightness), PERIPHERAL SWELLING (Right arm swelled up to the size of a baseball) and FEELING HOT (Really warm to the touch) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood test: negative (Negative) Negative. On an unknown date, Chest X-ray: normal (normal) normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Other relevant lab investigations included looked at heart and was found to be normal. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 26-Apr-2021: Significant follow up added. New events,History added.

Other Meds:

Current Illness: Blood pressure high; Drug allergy; Food allergy; Handicap; Penicillin allergy; Sulfonamide allergy

ID: 1611520
Sex: F
Age: 32
State: NV

Vax Date: 04/13/2021
Onset Date: 04/20/2021
Rec V Date: 08/22/2021
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Symptoms: diarrhea; neck has been very itchy, numb, hot and swollen; neck has been very itchy, numb, hot and swollen; neck has been very itchy, numb, hot and swollen; neck has been very itchy, numb, hot and swollen; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (neck has been very itchy, numb, hot and swollen), HYPOAESTHESIA (neck has been very itchy, numb, hot and swollen), SKIN WARM (neck has been very itchy, numb, hot and swollen), SWELLING (neck has been very itchy, numb, hot and swollen) and DIARRHOEA (diarrhea) in a 32-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027321A) for COVID-19 vaccination. No Medical History information was reported. On 13-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Apr-2021, the patient experienced PRURITUS (neck has been very itchy, numb, hot and swollen), HYPOAESTHESIA (neck has been very itchy, numb, hot and swollen), SKIN WARM (neck has been very itchy, numb, hot and swollen) and SWELLING (neck has been very itchy, numb, hot and swollen). On an unknown date, the patient experienced DIARRHOEA (diarrhea). At the time of the report, PRURITUS (neck has been very itchy, numb, hot and swollen), HYPOAESTHESIA (neck has been very itchy, numb, hot and swollen), SKIN WARM (neck has been very itchy, numb, hot and swollen) and SWELLING (neck has been very itchy, numb, hot and swollen) 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. Concomitant product use was unknown by the reporter. Treatment medication included some antibiotics. Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: Follow up received on 27-may-2021 added health care professional details.

Other Meds:

Current Illness:

ID: 1611521
Sex: F
Age:
State: MA

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 08/22/2021
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Symptoms: itchy from top of chest and neck; it's warm but not rash; she had little bit soreness; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (itchy from top of chest and neck), FEELING HOT (it's warm but not rash) and MYALGIA (she had little bit soreness) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 02-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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Mar-2021, the patient experienced MYALGIA (she had little bit soreness). On an unknown date, the patient experienced PRURITUS (itchy from top of chest and neck) and FEELING HOT (it's warm but not rash). On 04-Mar-2021, MYALGIA (she had little bit soreness) had resolved. At the time of the report, PRURITUS (itchy from top of chest and neck) and FEELING HOT (it's warm but not rash) outcome was unknown. No concomitant medication was reported.Treatment medication was not provided. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was not applicable.

Other Meds:

Current Illness:

ID: 1611522
Sex: F
Age: 52
State: MN

Vax Date: 04/01/2021
Onset Date:
Rec V Date: 08/22/2021
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Symptoms: felt hot; weird feeling of standing inside the body leaning onto herself; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (felt hot) and FEELING ABNORMAL (weird feeling of standing inside the body leaning onto herself) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Previously administered products included for an unreported indication: FLU (fibromyalgia). Concurrent medical conditions included Drug allergy (Thimerosal). On 01-Apr-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 FEELING HOT (felt hot) and FEELING ABNORMAL (weird feeling of standing inside the body leaning onto herself). At the time of the report, FEELING HOT (felt hot) and FEELING ABNORMAL (weird feeling of standing inside the body leaning onto herself) 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. This case was linked to US-MODERNATX, INC.-MOD-2021-090430 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-090430:dose 2

Other Meds:

Current Illness: Drug allergy (Thimerosal allergy)

ID: 1611523
Sex: F
Age: 39
State: FL

Vax Date: 04/07/2021
Onset Date: 04/20/2021
Rec V Date: 08/22/2021
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Symptoms: Pinching feeling spread to both forearms; Weakness in both knees; Pinching feeling in right foot; Tingling to both feet/spread to both ankles and both calves,both hands involved; This spontaneous case was reported by a pharmacist and describes the occurrence of NERVE COMPRESSION (Pinching feeling in right foot), NERVE COMPRESSION (Pinching feeling spread to both forearms), PARAESTHESIA (Tingling to both feet/spread to both ankles and both calves,both hands involved) and ARTHRALGIA (Weakness in both knees) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 ml. On 20-Apr-2021, the patient experienced NERVE COMPRESSION (Pinching feeling in right foot) and PARAESTHESIA (Tingling to both feet/spread to both ankles and both calves,both hands involved). On 23-Apr-2021, the patient experienced ARTHRALGIA (Weakness in both knees). On 24-Apr-2021, the patient experienced NERVE COMPRESSION (Pinching feeling spread to both forearms). At the time of the report, NERVE COMPRESSION (Pinching feeling in right foot), NERVE COMPRESSION (Pinching feeling spread to both forearms), PARAESTHESIA (Tingling to both feet/spread to both ankles and both calves,both hands involved) and ARTHRALGIA (Weakness in both knees) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 24-Apr-2021, Blood glucose: abnormal (abnormal) Diagnosed her with paresthesia after completing a glucose test. On 24-Apr-2021, Thyroid function test: abnormal (abnormal) Diagnosed her with paresthesia after completing a thyroid blood test. 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. The patient was prescribed prednisone by their physician. No Concomitant product use was reported. The reporter was a pharmacist who was vaccinated with their first dose of Moderna vaccine and was breastfeeding their 13-month-old child at the time of receiving their vaccine. On 20-Apr-2021, the patient began to experience pinching feeling in their right foot, and then started to experience tingling to both feet. On 22-Apr-2021, the tingling spread to both ankles and both calves and on 23-Apr-2021 night, both hands and both knees were involved which the patient described as weakness in both knees. On 24-Apr-2021, the patient saw the Physician, who diagnosed the patient with paresthesia after completing a glucose and thyroid blood tests, and prescribed prednisone. Also, on 24-Apr-2021, the patient reported that the pinching feeling spread to both forearms. This case was linked to US-MODERNATX, INC.-MOD-2021-090391, US-MODERNATX, INC.-MOD-2021-090153 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-090391:Created for baby US-MODERNATX, INC.-MOD-2021-090153:Same reporter

Other Meds:

Current Illness:

ID: 1611524
Sex: F
Age: 31
State: TX

Vax Date: 03/22/2021
Onset Date: 04/22/2021
Rec V Date: 08/22/2021
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Symptoms: Congestion; She is breastfeeding; Itching; Redness; Red itchy eyes; Numbness; Feeling hot; Rash; Hives all over her body but primarily on forearms, elbows and hairline; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (Hives all over her body but primarily on forearms, elbows and hairline), NASAL CONGESTION (Congestion), MATERNAL EXPOSURE DURING BREAST FEEDING (She is breastfeeding), PRURITUS (Itching) and ERYTHEMA (Redness) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046B21A and 008B12A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Hay fever. Concomitant products included MINERALS NOS, VITAMINS NOS (PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]) from 08-Jan-2018 to an unknown date for an unknown indication. On 22-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 22-Apr-2021, the patient experienced FATIGUE (Fatigue). On 23-Apr-2021, the patient experienced URTICARIA (Hives all over her body but primarily on forearms, elbows and hairline). On an unknown date, the patient experienced NASAL CONGESTION (Congestion), MATERNAL EXPOSURE DURING BREAST FEEDING (She is breastfeeding), PRURITUS (Itching), ERYTHEMA (Redness), OCULAR HYPERAEMIA (Red itchy eyes), HYPOAESTHESIA (Numbness), FEELING HOT (Feeling hot) and RASH (Rash). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) from 04-May-2021 to 2021 for Hives, at a dose of 1 dosage form; OATMEAL for Hives, at a dose of 1 UNK and ASCORBIC ACID (VITAMIN C CITRUS) at a dose of 1 dosage form. On 26-Apr-2021, URTICARIA (Hives all over her body but primarily on forearms, elbows and hairline) had resolved. At the time of the report, NASAL CONGESTION (Congestion), MATERNAL EXPOSURE DURING BREAST FEEDING (She is breastfeeding), PRURITUS (Itching), ERYTHEMA (Redness), OCULAR HYPERAEMIA (Red itchy eyes), HYPOAESTHESIA (Numbness), FEELING HOT (Feeling hot), RASH (Rash) and FATIGUE (Fatigue) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) Negative. This case was linked to MOD-2021-271601 (Parent-Child Link). See case MOD-2021-271601 for details regarding the child case. Most recent FOLLOW-UP information incorporated above includes: On 29-Jul-2021: FU received: Added events, outcome updated, con med added, patient demographics.

Other Meds: PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]

Current Illness: Hay fever

ID: 1611525
Sex: F
Age: 12
State: TX

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 08/22/2021
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Symptoms: administered vaccine to a 12 year old; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (administered vaccine to a 12 year old) in a 12-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Apr-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (administered vaccine to a 12 year old). On 24-Apr-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (administered vaccine to a 12 year old) had resolved. 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. No concomitant medications were provided. No treatment drugs were reported.

Other Meds:

Current Illness:

ID: 1611526
Sex: M
Age: 51
State: CO

Vax Date: 04/07/2021
Onset Date:
Rec V Date: 08/22/2021
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Symptoms: Ringing in ears; This spontaneous case was reported by a consumer and describes the occurrence of TINNITUS (Ringing in ears) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030B21A) for COVID-19 vaccination. No Medical History information was reported. On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced TINNITUS (Ringing in ears). The patient was treated with PREDNISONE for Ringing in ears, at a dose of UNK 6 days. At the time of the report, TINNITUS (Ringing in ears) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported.

Other Meds:

Current Illness:

ID: 1611527
Sex: F
Age: 67
State: CA

Vax Date: 03/31/2021
Onset Date: 04/08/2021
Rec V Date: 08/22/2021
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Symptoms: rash swelled slightly; rash on top half of her left arm where she was vaccinated/ rash on upper arm where vaccinated/rash responds to heat and gets red again; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (rash on top half of her left arm where she was vaccinated/ rash on upper arm where vaccinated/rash responds to heat and gets red again) and VACCINATION SITE SWELLING (rash swelled slightly) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039A21A) for COVID-19 vaccination. Concurrent medical conditions included Rubella (she had shot in 30's when planning to get pregnant - got Rubella for the full 3 days over full body). On 31-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Apr-2021, the patient experienced VACCINATION SITE RASH (rash on top half of her left arm where she was vaccinated/ rash on upper arm where vaccinated/rash responds to heat and gets red again). On an unknown date, the patient experienced VACCINATION SITE SWELLING (rash swelled slightly). The patient was treated with HYDROCORTISONE (BACTINE [HYDROCORTISONE]) at a dose of 1 dosage form. On 12-May-2021, VACCINATION SITE RASH (rash on top half of her left arm where she was vaccinated/ rash on upper arm where vaccinated/rash responds to heat and gets red again) had resolved. At the time of the report, VACCINATION SITE SWELLING (rash swelled slightly) had resolved. Not Provided NO Concomitant products were provided. treatment medications were provided This case was linked to MOD-2021-185872 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: events updated; second dose information updated, patient demographic details updated, outcome updated

Other Meds:

Current Illness: Rubella (she had shot in 30's when planning to get pregnant - got Rubella for the full 3 days over full body)

ID: 1611528
Sex: F
Age: 65
State: KY

Vax Date: 04/10/2021
Onset Date:
Rec V Date: 08/22/2021
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Symptoms: A little stiff; injection site is swollen; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULOSKELETAL STIFFNESS (A little stiff) and VACCINATION SITE SWELLING (injection site is swollen) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. On 10-Apr-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 MUSCULOSKELETAL STIFFNESS (A little stiff) and VACCINATION SITE SWELLING (injection site is swollen). At the time of the report, MUSCULOSKELETAL STIFFNESS (A little stiff) and VACCINATION SITE SWELLING (injection site is swollen) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient took thyroid, cholesterol and antidepressant medication (unspecified). Most recent FOLLOW-UP information incorporated above includes: On 02-Aug-2021: Report received contains no significant information.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1611529
Sex: F
Age:
State: FL

Vax Date: 04/13/2021
Onset Date:
Rec V Date: 08/22/2021
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Allergies:

Symptom List:

Symptoms: Swelling at the injection site; Pain at the injection site; Tired for a day; The injection site on the left arm started swelling; Tender to touch; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE SWELLING (Swelling at the injection site), VACCINATION SITE PAIN (Pain at the injection site), FATIGUE (Tired for a day), VACCINATION SITE SWELLING (The injection site on the left arm started swelling) and VACCINATION SITE PAIN (Tender to touch) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Apr-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 VACCINATION SITE SWELLING (Swelling at the injection site), VACCINATION SITE PAIN (Pain at the injection site), FATIGUE (Tired for a day), VACCINATION SITE SWELLING (The injection site on the left arm started swelling) and VACCINATION SITE PAIN (Tender to touch). At the time of the report, VACCINATION SITE SWELLING (Swelling at the injection site), VACCINATION SITE PAIN (Pain at the injection site) and FATIGUE (Tired for a day) had resolved and VACCINATION SITE SWELLING (The injection site on the left arm started swelling) and VACCINATION SITE PAIN (Tender to touch) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. Treatment information was not provided. After vaccination Patient was tired and experienced swelling and pain at the injection site, after 2-3 days the patient felt fine and arm became normal. She reported that again after 10 days of vaccination, the injection site on the left arm started swelling and it is tender to touch. Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: No new information. Patient declined the consent for follow-up.

Other Meds:

Current Illness:

ID: 1611530
Sex: F
Age: 54
State: FL

Vax Date: 03/26/2021
Onset Date: 04/25/2021
Rec V Date: 08/22/2021
Hospital:

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Lab Data:

Allergies:

Symptom List:

Symptoms: Swelling up at the base of my neck on the left side; Neck pain; Don't feel good; Arm pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm pain), SWELLING (Swelling up at the base of my neck on the left side), NECK PAIN (Neck pain) and FEELING ABNORMAL (Don't feel good) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003B21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Apr-2021, the patient experienced PAIN IN EXTREMITY (Arm pain) and FEELING ABNORMAL (Don't feel good). On 26-Apr-2021, the patient experienced SWELLING (Swelling up at the base of my neck on the left side) and NECK PAIN (Neck pain). The patient was treated with ACETYLSALICYLIC ACID, CAFFEINE, PARACETAMOL, SALICYLAMIDE (EXCEDRIN [ACETYLSALICYLIC ACID;CAFFEINE;PARACETAMOL;SALICYLAMIDE]) on 25-Apr-2021 for Adverse event, at a dose of 2 dosage form. At the time of the report, PAIN IN EXTREMITY (Arm pain), SWELLING (Swelling up at the base of my neck on the left side), NECK PAIN (Neck pain) and FEELING ABNORMAL (Don't feel good) outcome was unknown. Not Provided No relevant concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1611531
Sex: F
Age:
State: NJ

Vax Date: 03/21/2021
Onset Date: 04/23/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Not her normal self; Can't drive the way she is currently, does not remember too much lately; Memory loss; Always confused now and never was like this before; Feels slow; Having bad joint pain; No energy always; Can't do anything; Big pain in finger, can't lift; Pain is every bone; One moment sweating and cold; Something in my head not regular headache feel something in my head/Head is not working; Red cheeks; Not able to sleep; Every point on body is painful/big pain/body hurts; Can't stop shaking; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (Can't stop shaking), BONE PAIN (Pain is every bone), COLD SWEAT (One moment sweating and cold), HEAD DISCOMFORT (Something in my head not regular headache feel something in my head/Head is not working) and ERYTHEMA (Red cheeks) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 48B21A and 038A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Surgery (2 years prior to reporting time). Family history included Glaucoma (Patient's mother had glaucoma.) since an unknown date. Concurrent medical conditions included Arthritis and Optic nerve damage. On 21-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 23-Apr-2021, the patient experienced TREMOR (Can't stop shaking), COLD SWEAT (One moment sweating and cold), HEAD DISCOMFORT (Something in my head not regular headache feel something in my head/Head is not working), ERYTHEMA (Red cheeks), INSOMNIA (Not able to sleep) and MYALGIA (Every point on body is painful/big pain/body hurts). On 26-Apr-2021, the patient experienced BONE PAIN (Pain is every bone), HELPLESSNESS (Can't do anything), PAIN IN EXTREMITY (Big pain in finger, can't lift) and FATIGUE (No energy always). On an unknown date, the patient experienced FEELING ABNORMAL (Not her normal self), MEMORY IMPAIRMENT (Can't drive the way she is currently, does not remember too much lately), AMNESIA (Memory loss), CONFUSIONAL STATE (Always confused now and never was like this before), BRADYKINESIA (Feels slow) and ARTHRALGIA (Having bad joint pain). On 24-Apr-2021, TREMOR (Can't stop shaking), COLD SWEAT (One moment sweating and cold), HEAD DISCOMFORT (Something in my head not regular headache feel something in my head/Head is not working), ERYTHEMA (Red cheeks), INSOMNIA (Not able to sleep) and MYALGIA (Every point on body is painful/big pain/body hurts) had resolved. At the time of the report, BONE PAIN (Pain is every bone), HELPLESSNESS (Can't do anything), PAIN IN EXTREMITY (Big pain in finger, can't lift), FEELING ABNORMAL (Not her normal self), MEMORY IMPAIRMENT (Can't drive the way she is currently, does not remember too much lately), AMNESIA (Memory loss), BRADYKINESIA (Feels slow), ARTHRALGIA (Having bad joint pain) and FATIGUE (No energy always) had not resolved and CONFUSIONAL STATE (Always confused now and never was like this before) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: high (High) High. Patient reported to feel like she is 100 years old Treatment medication included acetaminophen. Most recent FOLLOW-UP information incorporated above includes: On 30-Apr-2021: Reporter contact information and additional events (Joint pain, Feels slow, Confused, Memory disturbance, Feeling abnormal) were updated. On 30-Apr-2021: Included first dose details. On 18-Jun-2021: Follow up additional document attached. Added memory loss as an event and updated event outcomes.

Other Meds:

Current Illness: Arthritis; Glaucoma (Patient's mother had glaucoma.); Optic nerve damage

ID: 1611532
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/22/2021
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Symptom List:

Symptoms: Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Fatigue) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced FATIGUE (Fatigue). At the time of the report, FATIGUE (Fatigue) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Relevant concomitant medications was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1611533
Sex: F
Age:
State: CA

Vax Date: 03/11/2021
Onset Date:
Rec V Date: 08/22/2021
Hospital:

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Symptom List:

Symptoms: received first dose in 11March2021; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (received first dose in 11March2021) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 11-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 PRODUCT DOSE OMISSION ISSUE (received first dose in 11March2021). At the time of the report, PRODUCT DOSE OMISSION ISSUE (received first dose in 11March2021) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1611534
Sex: F
Age: 65
State:

Vax Date: 03/31/2021
Onset Date:
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Arm Pain; Tingling/Numbness; sleepy; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm Pain), HYPOAESTHESIA ORAL (Tingling/Numbness) and SOMNOLENCE (sleepy) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020B21A) for COVID-19 vaccination. No Medical History information was reported. On 31-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 PAIN IN EXTREMITY (Arm Pain), HYPOAESTHESIA ORAL (Tingling/Numbness) and SOMNOLENCE (sleepy). At the time of the report, PAIN IN EXTREMITY (Arm Pain), HYPOAESTHESIA ORAL (Tingling/Numbness) and SOMNOLENCE (sleepy) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications included Vitamins.

Other Meds:

Current Illness:

ID: 1611535
Sex: F
Age: 72
State: NY

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptoms: patient got sick; passed the 42 days window; This spontaneous case was reported by a physician and describes the occurrence of ILLNESS (patient got sick) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (passed the 42 days window) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (passed the 42 days window). On an unknown date, the patient experienced ILLNESS (patient got sick). At the time of the report, ILLNESS (patient got sick) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (passed the 42 days window) 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. This case was linked to MOD21-081725 (E2B Linked Report).; Sender's Comments: MOD21-081725:

Other Meds:

Current Illness:

ID: 1611536
Sex: F
Age: 59
State: WI

Vax Date: 03/12/2021
Onset Date: 04/09/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: right arm pain; deep muscle ache (right arm); feelings of "pulled tendon" (right arm); difficulty lifting right arm/inability to lift right arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (right arm pain), MYALGIA (deep muscle ache (right arm)), TENDON INJURY (feelings of "pulled tendon" (right arm)) and LIMB DISCOMFORT (difficulty lifting right arm/inability to lift right arm) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 038B21A and 011B21A) for COVID-19 vaccination. Concomitant products included AZITHROMYCIN (AZO) for an unknown indication. On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 09-Apr-2021, the patient experienced PAIN IN EXTREMITY (right arm pain), MYALGIA (deep muscle ache (right arm)), TENDON INJURY (feelings of "pulled tendon" (right arm)) and LIMB DISCOMFORT (difficulty lifting right arm/inability to lift right arm). At the time of the report, PAIN IN EXTREMITY (right arm pain), MYALGIA (deep muscle ache (right arm)), TENDON INJURY (feelings of "pulled tendon" (right arm)) and LIMB DISCOMFORT (difficulty lifting right arm/inability to lift right arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was not applicable. Treatment information was not provided. This case was linked to MOD21-082172 (E2B Linked Report).; Sender's Comments: MOD21-082172:Case for dose 1

Other Meds: AZO

Current Illness:

ID: 1611537
Sex: F
Age: 46
State: FL

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: The arm got swollen again; Lost appetite; Even the fingertips were pilled off from being swollen; It got really impressed, it was horrible, got very decompensated; Spend 2 days resting; The pain and also the fever came back; Felt a little bit better and today more animated; Blood pressure lowered; Urticaria on the whole body; Pain in the arm; Arm was warm; First night started to feel uncomfortable; Extremities were swollen; Couldn't lift the arm; Lots of head aches; Chills; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of BLOOD PRESSURE DECREASED (Blood pressure lowered), URTICARIA (Urticaria on the whole body), PAIN IN EXTREMITY (Pain in the arm), FEELING HOT (Arm was warm) and FEELING ABNORMAL (First night started to feel uncomfortable) in a 46-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 46B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Apr-2021, the patient experienced BLOOD PRESSURE DECREASED (Blood pressure lowered), URTICARIA (Urticaria on the whole body), PAIN IN EXTREMITY (Pain in the arm), FEELING HOT (Arm was warm), FEELING ABNORMAL (First night started to feel uncomfortable), SWELLING (Extremities were swollen), LIMB DISCOMFORT (Couldn't lift the arm), HEADACHE (Lots of head aches), CHILLS (Chills) and NAUSEA (Nausea). On 25-Apr-2021, the patient experienced FEELING OF RELAXATION (Felt a little bit better and today more animated). On an unknown date, the patient experienced PERIPHERAL SWELLING (The arm got swollen again), DECREASED APPETITE (Lost appetite), SKIN EXFOLIATION (Even the fingertips were pilled off from being swollen), FEELING ABNORMAL (It got really impressed, it was horrible, got very decompensated), FEELING OF RELAXATION (Spend 2 days resting) and PYREXIA (The pain and also the fever came back). The patient was treated with ACETAMINOPHEN for Adverse event, at an unspecified dose and frequency and IBUPROFEN for Adverse event, at an unspecified dose and frequency. At the time of the report, BLOOD PRESSURE DECREASED (Blood pressure lowered), URTICARIA (Urticaria on the whole body), PAIN IN EXTREMITY (Pain in the arm), FEELING HOT (Arm was warm), FEELING ABNORMAL (First night started to feel uncomfortable), PERIPHERAL SWELLING (The arm got swollen again), DECREASED APPETITE (Lost appetite), SKIN EXFOLIATION (Even the fingertips were pilled off from being swollen), FEELING OF RELAXATION (Felt a little bit better and today more animated), FEELING ABNORMAL (It got really impressed, it was horrible, got very decompensated), FEELING OF RELAXATION (Spend 2 days resting), SWELLING (Extremities were swollen), LIMB DISCOMFORT (Couldn't lift the arm), HEADACHE (Lots of head aches), CHILLS (Chills), NAUSEA (Nausea) and PYREXIA (The pain and also the fever came back) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Treatment also included steroids.

Other Meds:

Current Illness:

ID: 1611538
Sex: F
Age: 30
State: KS

Vax Date: 03/19/2021
Onset Date: 04/16/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: loses the strength on her right hand; loses the strength on her whole body; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (loses the strength on her right hand) and ASTHENIA (loses the strength on her whole body) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 0391321A and 037A2113) for COVID-19 vaccination. No Medical History information was reported. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1. On 16-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 2 dosage form. On 16-Apr-2021, the patient experienced ASTHENIA (loses the strength on her right hand) and ASTHENIA (loses the strength on her whole body). At the time of the report, ASTHENIA (loses the strength on her right hand) and ASTHENIA (loses the strength on her whole body) outcome was unknown. Not Provided No concomitant medications reported. No treatment information provided. This case was linked to MOD-2021-090355, MOD-2021-090355 (Patient Link).

Other Meds:

Current Illness:

ID: 1611539
Sex: M
Age: 72
State: CA

Vax Date: 04/15/2021
Onset Date: 04/20/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: shortness of breath; fatigue; This spontaneous case was reported by a health care professional and describes the occurrence of DYSPNOEA (shortness of breath) and FATIGUE (fatigue) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included METHOTREXATE, ALLOPURINOL, FOLIC ACID, GABAPENTIN, IBUPROFEN, MAGNESIUM, IPRATROPIUM BROMIDE (ATROVENT), ALBUTEROL [SALBUTAMOL], METFORMIN, METOPROLOL, VITAMIN D [VITAMIN D NOS] and IRON for an unknown indication. On 15-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Apr-2021, the patient experienced DYSPNOEA (shortness of breath) and FATIGUE (fatigue). At the time of the report, DYSPNOEA (shortness of breath) and FATIGUE (fatigue) 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. Concomitant medication include steroid cream and immunomodulator methotrexate. No treatment medication details was reported.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds: METHOTREXATE; ALLOPURINOL; FOLIC ACID; GABAPENTIN; IBUPROFEN; MAGNESIUM; ATROVENT; ALBUTEROL [SALBUTAMOL]; METFORMIN; METOPROLOL; VITAMIN D [VITAMIN D NOS]; IRON

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm