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: 1612240
Sex: F
Age: 47
State: IN

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 08/22/2021
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Symptoms: sore arm at injection site; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm at injection site) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013A21A and 007B21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in November 2020. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Mar-2021, the patient experienced PAIN IN EXTREMITY (sore arm at injection site). On 04-Mar-2021, PAIN IN EXTREMITY (sore arm at injection site) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication were reported. No treatment medication were reported. This case was linked to MOD-2021-094935 (Patient Link).

Other Meds:

Current Illness:

ID: 1612241
Sex: F
Age: 69
State: CA

Vax Date: 04/02/2021
Onset Date:
Rec V Date: 08/22/2021
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Symptoms: fever; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever) in a 69-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 02-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 PYREXIA (fever). At the time of the report, PYREXIA (fever) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment drugs were reported. This case was linked to US-MODERNATX, INC.-MOD-2021-095360 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-095360:

Other Meds:

Current Illness:

ID: 1612242
Sex: M
Age: 80
State: IA

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 08/22/2021
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Symptoms: Slept for three days; Lethergic; Headache; This spontaneous case was reported by a consumer and describes the occurrence of BEDRIDDEN (Slept for three days), LETHARGY (Lethergic) and HEADACHE (Headache) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004C21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included BUPROPION for Antidepressant therapy, LOSARTAN for Hypertension, LEVOTHYROXINE for Hypothyroidism. On 23-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 BEDRIDDEN (Slept for three days), LETHARGY (Lethergic) and HEADACHE (Headache). On 27-Apr-2021, BEDRIDDEN (Slept for three days), LETHARGY (Lethergic) and HEADACHE (Headache) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. This case was linked to US-MODERNATX, INC.-MOD-2021-095733 (Patient Link).

Other Meds: LEVOTHYROXINE; LOSARTAN; BUPROPION

Current Illness:

ID: 1612243
Sex: F
Age: 31
State: OH

Vax Date: 03/29/2021
Onset Date: 04/26/2021
Rec V Date: 08/22/2021
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Symptoms: Swollen lymph nodes left arm; Body aches; Chills; Shortness of breath; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Shortness of breath), LYMPHADENOPATHY (Swollen lymph nodes left arm), MYALGIA (Body aches) and CHILLS (Chills) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025B21A and 026A21A) 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 26-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 26-Apr-2021, the patient experienced DYSPNOEA (Shortness of breath), MYALGIA (Body aches) and CHILLS (Chills). On 28-Apr-2021, the patient experienced LYMPHADENOPATHY (Swollen lymph nodes left arm). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 28-Apr-2021, DYSPNOEA (Shortness of breath), MYALGIA (Body aches) and CHILLS (Chills) had resolved. At the time of the report, LYMPHADENOPATHY (Swollen lymph nodes left arm) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications reported. This case was linked to MOD-2021-094812 (Patient Link).

Other Meds:

Current Illness:

ID: 1612244
Sex: F
Age: 49
State: NY

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 08/22/2021
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Symptoms: Missed the appointment of the second dose/ 42 days period had passed; Swollen arm; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Missed the appointment of the second dose/ 42 days period had passed) and PERIPHERAL SWELLING (Swollen arm) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038A21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included SIMVASTATIN, TOPIRAMATE (TOPAMAX) and VITAMIN D [VITAMIN D NOS] for an unknown indication. On 07-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Mar-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Missed the appointment of the second dose/ 42 days period had passed). 07-Mar-2021, the patient experienced PERIPHERAL SWELLING (Swollen arm). On 07-Mar-2021, PRODUCT DOSE OMISSION ISSUE (Missed the appointment of the second dose/ 42 days period had passed) had resolved. On 09-Mar-2021, PERIPHERAL SWELLING (Swollen arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications included Claritin, Motrin. No treatment medications were taken by the patient.

Other Meds: SIMVASTATIN; TOPAMAX; VITAMIN D [VITAMIN D NOS]

Current Illness:

ID: 1612245
Sex: F
Age: 62
State: CA

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

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Symptoms: Metallic taste in mouth; Red, itchy rash on her chest, neck area; Red rash on her chest, neck area; Mouth felt weird (tongue and throat); Itchy rash on the vaccination site; Felt fatigue; Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm), DYSGEUSIA (Metallic taste in mouth), RASH PRURITIC (Red, itchy rash on her chest, neck area), RASH ERYTHEMATOUS (Red rash on her chest, neck area) and FEELING ABNORMAL (Mouth felt weird (tongue and throat)) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Stroke. Concomitant products included CLOBETASOL PROPIONATE (CLOBETASOL 0.05%) for Psoriasis, FOLIC ACID, METHOTREXATE SODIUM, FLUTICASONE PROPIONATE (FLONASE [FLUTICASONE PROPIONATE]), SIMVASTATIN, MONTELUKAST SODIUM (SINGULAIR), LISINOPRIL, DULOXETINE HYDROCHLORIDE (CYMBALTA), LORATADINE (CLARITIN [LORATADINE]), OMEPRAZOLE MAGNESIUM (PRILOSEC [OMEPRAZOLE MAGNESIUM]) and BETAMETHASONE DIPROPIONATE, CALCIPOTRIOL (CALCIPOTRIENE AND BETAMETHASONE DIPROPIONATE) for an unknown indication. On 03-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Apr-2021, the patient experienced PAIN IN EXTREMITY (Sore arm) and FATIGUE (Felt fatigue). On 10-Apr-2021, the patient experienced DYSGEUSIA (Metallic taste in mouth), RASH PRURITIC (Red, itchy rash on her chest, neck area), RASH ERYTHEMATOUS (Red rash on her chest, neck area), FEELING ABNORMAL (Mouth felt weird (tongue and throat)) and VACCINATION SITE RASH (Itchy rash on the vaccination site). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 10-Apr-2021, DYSGEUSIA (Metallic taste in mouth) had resolved. At the time of the report, PAIN IN EXTREMITY (Sore arm), RASH PRURITIC (Red, itchy rash on her chest, neck area), RASH ERYTHEMATOUS (Red rash on her chest, neck area), FEELING ABNORMAL (Mouth felt weird (tongue and throat)), VACCINATION SITE RASH (Itchy rash on the vaccination site) and FATIGUE (Felt fatigue) outcome was unknown. The action taken with 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.

Other Meds: FOLIC ACID; METHOTREXATE SODIUM; CLOBETASOL 0.05%; FLONASE [FLUTICASONE PROPIONATE]; SIMVASTATIN; SINGULAIR; LISINOPRIL; CYMBALTA; CLARITIN [LORATADINE]; PRILOSEC [OMEPRAZOLE MAGNESIUM]; CALCIPOTRIENE AND BETAMETHASONE DIPROPIONATE

Current Illness:

ID: 1612246
Sex: F
Age:
State: WA

Vax Date:
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Rec V Date: 08/22/2021
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Symptoms: dizziness; hot flashes; This spontaneous case was reported by a nurse (subsequently medically confirmed) and describes the occurrence of DIZZINESS (dizziness) and HOT FLUSH (hot flashes) 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 DIZZINESS (dizziness) and HOT FLUSH (hot flashes). At the time of the report, DIZZINESS (dizziness) and HOT FLUSH (hot flashes) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. no treatment information was provided no concomitant medication were reported This case was linked to US-MODERNATX, INC.-MOD-2021-095209, US-MODERNATX, INC.-MOD-2021-095268 (E2B Linked Report). Most recent FOLLOW-UP information incorporated above includes: On 28-May-2021: NNI; Sender's Comments: US-MODERNATX, INC.-MOD-2021-095209: US-MODERNATX, INC.-MOD-2021-095268:

Other Meds:

Current Illness:

ID: 1612247
Sex: F
Age: 61
State: NY

Vax Date: 04/22/2021
Onset Date: 04/26/2021
Rec V Date: 08/22/2021
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Symptoms: Neck is a little bit stiff, like when you are having a massage; Bad headache; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULOSKELETAL STIFFNESS (Neck is a little bit stiff, like when you are having a massage) and HEADACHE (Bad headache) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002C21A) 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) (unknown route) 1 dosage form. On 26-Apr-2021, the patient experienced MUSCULOSKELETAL STIFFNESS (Neck is a little bit stiff, like when you are having a massage) and HEADACHE (Bad headache). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, MUSCULOSKELETAL STIFFNESS (Neck is a little bit stiff, like when you are having a massage) and HEADACHE (Bad headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Relevant concomitant medications was reported.

Other Meds:

Current Illness:

ID: 1612248
Sex: F
Age: 47
State: IN

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

Vax Type:
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Symptoms: Loss of taste; Loss of smell; She tastes burnt onion; This spontaneous case was reported by a consumer and describes the occurrence of AGEUSIA (Loss of taste), ANOSMIA (Loss of smell) and TASTE DISORDER (She tastes burnt onion) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007B21A and 013A21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in November 2020. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 12-Apr-2021, the patient experienced AGEUSIA (Loss of taste), ANOSMIA (Loss of smell) and TASTE DISORDER (She tastes burnt onion). At the time of the report, AGEUSIA (Loss of taste), ANOSMIA (Loss of smell) and TASTE DISORDER (She tastes burnt onion) outcome was unknown. Not Provided Concomitant medication list was not provided. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not applicable. This case was linked to MOD-2021-094912 (Patient Link).

Other Meds:

Current Illness:

ID: 1612249
Sex: M
Age: 62
State: CA

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 08/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Headache; Body aches; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache) and MYALGIA (Body aches) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001C21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Apr-2021 at 3:30 PM, 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 28-Apr-2021, the patient experienced HEADACHE (Headache) and MYALGIA (Body aches). At the time of the report, HEADACHE (Headache) and MYALGIA (Body aches) outcome was unknown. Not Provided No concomitant medications reported by investigator No treatment medications provided by the reporter.

Other Meds:

Current Illness:

ID: 1612250
Sex: F
Age: 63
State: MN

Vax Date: 04/16/2021
Onset Date: 04/20/2021
Rec V Date: 08/22/2021
Hospital:

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Symptoms: Start experiencing hives, intermittently was experiencing hives; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (Start experiencing hives, intermittently was experiencing hives) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001c21a) for COVID-19 vaccination. No Medical History information was reported. On 16-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 URTICARIA (Start experiencing hives, intermittently was experiencing hives). At the time of the report, URTICARIA (Start experiencing hives, intermittently was experiencing hives) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided. Treatment details were not provided. Most recent FOLLOW-UP information incorporated above includes: On 02-Jun-2021: Follow up received on 02-Jun-2021 as email address of the reporter was added.

Other Meds:

Current Illness:

ID: 1612251
Sex: F
Age: 52
State: SC

Vax Date: 04/22/2021
Onset Date: 04/25/2021
Rec V Date: 08/22/2021
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Symptoms: loss of appetite; Chills; joint pain; leg muscles are aching; This spontaneous case was reported by a consumer and describes the occurrence of DECREASED APPETITE (loss of appetite), CHILLS (Chills), ARTHRALGIA (joint pain) and MYALGIA (leg muscles are aching) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026A21A) 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 DECREASED APPETITE (loss of appetite), CHILLS (Chills), ARTHRALGIA (joint pain) and MYALGIA (leg muscles are aching). At the time of the report, DECREASED APPETITE (loss of appetite), CHILLS (Chills), ARTHRALGIA (joint pain) and MYALGIA (leg muscles are aching) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 28-Apr-2021, Chest X-ray: normal (normal) normal. 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 28-May-2021: Non significant follow up received on 28-MAY-2021, no new information

Other Meds:

Current Illness:

ID: 1612252
Sex: F
Age:
State:

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

Vax Type:
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Lab Data:

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Symptom List:

Symptoms: worst side effects; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (worst side effects) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (worst side effects). At the time of the report, VACCINATION COMPLICATION (worst side effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment information was reported. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 12-Jun-2021: Follow-up received on 12-Jun-2021, contains no new information.

Other Meds:

Current Illness:

ID: 1612253
Sex: M
Age:
State: IL

Vax Date: 02/05/2021
Onset Date:
Rec V Date: 08/22/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

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Symptom List:

Symptoms: Swollen and red hands; Swollen and red hands; Late for the second dose; This spontaneous case was reported by a nurse and describes the occurrence of PERIPHERAL SWELLING (Swollen and red hands), ERYTHEMA (Swollen and red hands) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Late for the second dose) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PERIPHERAL SWELLING (Swollen and red hands), ERYTHEMA (Swollen and red hands) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Late for the second dose). At the time of the report, PERIPHERAL SWELLING (Swollen and red hands) and ERYTHEMA (Swollen and red hands) outcome was unknown and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Late for the second dose) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications reported. No treatment information provided.

Other Meds:

Current Illness:

ID: 1612254
Sex: M
Age: 80
State: GA

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 08/22/2021
Hospital:

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Symptoms: dont feel like themselves; lymph node in the right arm, looks prominent like an egg; temperature came back; lymph node in the left arm; pale looking in the face; temperature of 101.3 for three days; arm was sore; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 28-Apr-2021 and was forwarded to Moderna on 28-Apr-2021. This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm was sore), PALLOR (pale looking in the face), FEELING ABNORMAL (dont feel like themselves), PYREXIA (temperature of 101.3 for three days) and LYMPHADENOPATHY (lymph node in the right arm, looks prominent like an egg) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included METFORMIN, LISINOPRIL, CARVEDILOL, ATORVASTATIN and ACETYLSALICYLIC ACID (BABY ASPIRIN) for an unknown indication. On 25-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Feb-2021, the patient experienced PAIN IN EXTREMITY (arm was sore). On 27-Feb-2021, the patient experienced PYREXIA (temperature of 101.3 for three days). On 02-Mar-2021, the patient experienced PALLOR (pale looking in the face). On an unknown date, the patient experienced FEELING ABNORMAL (dont feel like themselves), LYMPHADENOPATHY (lymph node in the right arm, looks prominent like an egg), PYREXIA (temperature came back) and LYMPHADENOPATHY (lymph node in the left arm). On 02-Mar-2021, PYREXIA (temperature of 101.3 for three days) had resolved. On 03-Mar-2021, PALLOR (pale looking in the face) had resolved, LYMPHADENOPATHY (lymph node in the right arm, looks prominent like an egg) outcome was unknown. At the time of the report, PAIN IN EXTREMITY (arm was sore), FEELING ABNORMAL (dont feel like themselves), PYREXIA (temperature came back) and LYMPHADENOPATHY (lymph node in the left arm) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Feb-2021, Body temperature: 101.3 (High) fever- 101.3. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment medication included paracetamol. Most recent FOLLOW-UP information incorporated above includes: On 30-Apr-2021: Follow up received on 30 April 2021 NNI

Other Meds: METFORMIN; LISINOPRIL; CARVEDILOL; ATORVASTATIN; BABY ASPIRIN

Current Illness:

ID: 1612255
Sex: F
Age:
State: CA

Vax Date: 04/27/2021
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Rec V Date: 08/22/2021
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Symptoms: Body aches; Chills; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Body aches) and CHILLS (Chills) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 27-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN (Body aches) and CHILLS (Chills). At the time of the report, PAIN (Body aches) and CHILLS (Chills) outcome was unknown. No concomitant medications provided. No treatment information provided.

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Current Illness:

ID: 1612256
Sex: M
Age: 84
State: TN

Vax Date: 03/17/2021
Onset Date: 04/16/2021
Rec V Date: 08/22/2021
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Symptoms: not want to get out of bed; blood pressure increased; This spontaneous case was reported by a consumer and describes the occurrence of BLOOD PRESSURE INCREASED (blood pressure increased) and FATIGUE (not want to get out of bed) in an 84-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 018L32A and 044A21A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension and Blood pressure (High blood pressure). Concomitant products included DILTIAZEM for Hypertension. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Apr-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced BLOOD PRESSURE INCREASED (blood pressure increased). On an unknown date, the patient experienced FATIGUE (not want to get out of bed). At the time of the report, BLOOD PRESSURE INCREASED (blood pressure increased) had not resolved and FATIGUE (not want to get out of bed) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Apr-2021, Blood pressure measurement: (High) High. Concomitant medication included high blood pressure medications. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not applicable. Action taken with mRNA-1273 in response to the events was not applicable. This case was linked to US-MODERNATX, INC.-MOD-2021-094869 (E2B Linked Report). Most recent FOLLOW-UP information incorporated above includes: On 28-Apr-2021: Follow-up added on 28-APR-2021, Vaccine date and batch no. added, concomitant medication added and event date updated.; Sender's Comments: US-MODERNATX, INC.-MOD-2021-094869:Daughter's case

Other Meds: DILTIAZEM

Current Illness: Blood pressure (High blood pressure); Hypertension

ID: 1612257
Sex: M
Age: 55
State: IN

Vax Date: 03/17/2021
Onset Date: 04/12/2021
Rec V Date: 08/22/2021
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Symptoms: Tested negative for antibodies; This spontaneous case was reported by a consumer and describes the occurrence of THERAPEUTIC PRODUCT INEFFECTIVE (Tested negative for antibodies) in a 55-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure increased since 2008, Anxiety since 2008, ADHD since 2003 and Shoulder injury since 2008. Concomitant products included COLECALCIFEROL (ADDERA D3) for ADHD, LORAZEPAM (ATIVAN) for Anxiety, LISINOPRIL for Hypertension, TIZANIDINE for Injury. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Apr-2021, the patient experienced THERAPEUTIC PRODUCT INEFFECTIVE (Tested negative for antibodies). At the time of the report, THERAPEUTIC PRODUCT INEFFECTIVE (Tested negative for antibodies) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Apr-2021, SARS-CoV-2 antibody test: negative (Negative) negative. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. No treatment information provided. This report refers to a case of therapeutic product ineffective for mRNA-1273, ( lot # not provided) with no associated AEs. This case was linked to US-MODERNATX, INC.-MOD-2021-094824 (E2B Linked Report). Most recent FOLLOW-UP information incorporated above includes: On 28-Jul-2021: Concomitant medication information and historical condition was updated; Sender's Comments: This report refers to a case of therapeutic product ineffective for mRNA-1273, ( lot # not provided) with no associated AEs. US-MODERNATX, INC.-MOD-2021-094824:Wife Case

Other Meds: LISINOPRIL; ATIVAN; ADDERA D3; TIZANIDINE

Current Illness: ADHD; Anxiety; Blood pressure increased; Shoulder injury

ID: 1612258
Sex: F
Age:
State: NJ

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 08/22/2021
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Symptoms: injecion site swollen; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE SWELLING (injecion site swollen) 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 23-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Apr-2021, the patient experienced INJECTION SITE SWELLING (injecion site swollen). At the time of the report, INJECTION SITE SWELLING (injecion site swollen) outcome was unknown. Not Provided No concomitant medications were provided. Treatment with ice packs pertained to the events, was provided by the patient.

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Current Illness:

ID: 1612259
Sex: F
Age: 76
State: MS

Vax Date: 04/15/2021
Onset Date: 04/28/2021
Rec V Date: 08/22/2021
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Symptoms: Tested positive for Covid-19; This spontaneous case was reported by a nurse and describes the occurrence of COVID-19 (Tested positive for Covid-19) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041B21A) for COVID-19 vaccination. No medical history was provided by the reporter. On 15-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Apr-2021, the patient experienced COVID-19 (Tested positive for Covid-19). At the time of the report, COVID-19 (Tested positive for Covid-19) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 28-Apr-2021, SARS-CoV-2 test: Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitants include High blood pressure medicine, Medicine for high cholesterol, Diabetes medication and Heart medicine. No treatment medication included. Most recent FOLLOW-UP information incorporated above includes: On 28-May-2021: Non significant follow up received, No new information

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Current Illness:

ID: 1612260
Sex: F
Age: 76
State: NY

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 08/22/2021
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Symptoms: she got her first shot on 19th march( more that 36 days have passed); This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (she got her first shot on 19th march( more that 36 days have passed)) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) 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) (unknown route) 1 dosage form. On 19-Mar-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (she got her first shot on 19th march( more that 36 days have passed)). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (she got her first shot on 19th march( more that 36 days have passed)) outcome was unknown. Not Provided No concomitant medication was reported. Treatment medication was not provided. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was not applicable. Most recent FOLLOW-UP information incorporated above includes: On 28-May-2021: Nonsignificant Follow-up

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Current Illness:

ID: 1612261
Sex: M
Age: 17
State: MN

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 08/22/2021
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Symptoms: patient 17 years of age received first dose; This spontaneous case was reported by a physician and describes the occurrence of UNEVALUABLE EVENT (patient 17 years of age received first dose) in a 17-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) 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 24-Apr-2021, the patient experienced UNEVALUABLE EVENT (patient 17 years of age received first dose). At the time of the report, UNEVALUABLE EVENT (patient 17 years of age received first dose) 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.

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Current Illness:

ID: 1612262
Sex: F
Age: 75
State: CA

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 08/22/2021
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Symptoms: egg shape bump on arm; flu like sympotoms; fever , <100F; headache; chills; nausea; fatigue; fever , <100F; headache; chills; nausea; fatigue; This spontaneous case was reported by an other health care professional and describes the occurrence of the first episode of PYREXIA (fever , <100F), the first episode of HEADACHE (headache), the first episode of CHILLS (chills), the first episode of NAUSEA (nausea) and the first episode of FATIGUE (fatigue) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included CLONAZEPAM, PRAMIPEXOLE and GABAPENTIN for an unknown indication. On 23-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 2 dosage form. On 24-Feb-2021, the patient experienced the first episode of PYREXIA (fever , <100F), the first episode of HEADACHE (headache), the first episode of CHILLS (chills), the first episode of NAUSEA (nausea) and the first episode of FATIGUE (fatigue). On 23-Mar-2021, the patient experienced the second episode of PYREXIA (fever , <100F), the second episode of HEADACHE (headache), the second episode of CHILLS (chills), the second episode of NAUSEA (nausea) and the second episode of FATIGUE (fatigue). On an unknown date, the patient experienced MASS (egg shape bump on arm) and INFLUENZA LIKE ILLNESS (flu like sympotoms). On 24-Mar-2021, last episode of PYREXIA (fever , <100F), the last episode of HEADACHE (headache), the last episode of CHILLS (chills), the last episode of NAUSEA (nausea) and the last episode of FATIGUE (fatigue) had resolved. At the time of the report, MASS (egg shape bump on arm) and INFLUENZA LIKE ILLNESS (flu like sympotoms) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The Treatment information was not provided. This case was linked to MOD-2021-093096 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 27-May-2021: New events added.FU for both Dose Case On 27-May-2021: FU of second dose case

Other Meds: CLONAZEPAM; PRAMIPEXOLE; GABAPENTIN

Current Illness:

ID: 1612263
Sex: M
Age: 26
State: NY

Vax Date: 03/19/2021
Onset Date: 04/16/2021
Rec V Date: 08/22/2021
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Symptoms: Slightly odd, maybe dizzy; headache; Migraine with aura; Light flashes; Sudden loss of vision; foggy vision; migraine with aura; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE WITH AURA (migraine with aura), PHOTOPSIA (Light flashes), BLINDNESS (Sudden loss of vision), VISION BLURRED (foggy vision) and MIGRAINE WITH AURA (Migraine with aura) in a 26-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046B21A and 047A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-Apr-2021 at 11:00 PM, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced MIGRAINE WITH AURA (migraine with aura). On 27-Apr-2021, the patient experienced PHOTOPSIA (Light flashes), BLINDNESS (Sudden loss of vision) and VISION BLURRED (foggy vision). On 04-May-2021 at 2:30 PM, the patient experienced MIGRAINE WITH AURA (Migraine with aura). On an unknown date, the patient experienced DIZZINESS (Slightly odd, maybe dizzy) and HEADACHE (headache). The patient was treated with IBUPROFEN for Headache, at a dose of UNK, bid. On 17-Apr-2021, MIGRAINE WITH AURA (migraine with aura) had resolved. On 04-May-2021, MIGRAINE WITH AURA (Migraine with aura) had resolved. At the time of the report, PHOTOPSIA (Light flashes), BLINDNESS (Sudden loss of vision), VISION BLURRED (foggy vision), DIZZINESS (Slightly odd, maybe dizzy) and HEADACHE (headache) had resolved. Action taken with mRNA-1273 in response to the event was not applicable. No concomitant medication were reported. Patient reported of being nearsighted and wears usual glasses. Most recent FOLLOW-UP information incorporated above includes: On 02-Jun-2021: Added patient's demographics, treatment drug and events(migraine with aura, dizziness and headache). Updated outcome of events from unknown to resolved. On 19-Jul-2021: FU Received - No new information was received.

Other Meds:

Current Illness:

ID: 1612264
Sex: M
Age: 78
State: OH

Vax Date: 02/05/2021
Onset Date: 02/25/2021
Rec V Date: 08/22/2021
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Symptoms: Red Dots all over the Body; Swell Up Red Dot area; Blisters on Foot, and Finger; Blisters on Gums; itching local; Redness local; Red/itchy eyes; This spontaneous case was reported by a consumer and describes the occurrence of RASH ERYTHEMATOUS (Red Dots all over the Body), SWELLING (Swell Up Red Dot area), RASH ERYTHEMATOUS (Redness local), EYE PRURITUS (Red/itchy eyes) and BLISTER (Blisters on Foot, and Finger) in a 78-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012A21A and 013M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Stent placement on 27-Mar-2020. Concomitant products included CLOPIDOGREL for Anticoagulant therapy, CARVEDILOL and OLMESARTAN for Blood pressure high, ATORVASTATIN for Cholesterol, PANTOPRAZOLE for Indigestion, LEVOTHYROXINE for Thyroid disorder NOS. On 05-Feb-2021 at 1:00 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 25-Feb-2021, the patient experienced RASH ERYTHEMATOUS (Redness local), EYE PRURITUS (Red/itchy eyes) and PRURITUS (itching local). On 21-Mar-2021, the patient experienced RASH ERYTHEMATOUS (Red Dots all over the Body), SWELLING (Swell Up Red Dot area), BLISTER (Blisters on Foot, and Finger) and GINGIVAL BLISTER (Blisters on Gums). At the time of the report, RASH ERYTHEMATOUS (Red Dots all over the Body) had not resolved and SWELLING (Swell Up Red Dot area), RASH ERYTHEMATOUS (Redness local), EYE PRURITUS (Red/itchy eyes), BLISTER (Blisters on Foot, and Finger), GINGIVAL BLISTER (Blisters on Gums) and PRURITUS (itching local) outcome was unknown. No treatment medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 03-Jun-2021: Follow up received on 03-JUNE-2021 and does not contain any new information. On 09-Jun-2021: Follow up received on 09-JUNE-2021 and does not contain any new information. On 22-Jul-2021: Added patient demographics, concomitant medications and new events.

Other Meds: PANTOPRAZOLE; CARVEDILOL; ATORVASTATIN; CLOPIDOGREL; OLMESARTAN; LEVOTHYROXINE

Current Illness:

ID: 1612265
Sex: F
Age: 65
State: CA

Vax Date: 03/29/2021
Onset Date: 04/28/2021
Rec V Date: 08/22/2021
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Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), EATING DISORDER (cannot eat), BEDRIDDEN (bed ridden), HEADACHE (headache) and VOMITING (vomiting) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 003C21A and 028A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included LATANOPROST for an unknown indication. On 29-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 28-Apr-2021, the patient experienced DIZZINESS (Dizziness), EATING DISORDER (cannot eat), BEDRIDDEN (bed ridden), HEADACHE (headache), FATIGUE (weary) and ASTHENIA (lapse in energy). 28-Apr-2021, the patient experienced VOMITING (vomiting). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. At the time of the report, DIZZINESS (Dizziness), EATING DISORDER (cannot eat), BEDRIDDEN (bed ridden), HEADACHE (headache), VOMITING (vomiting), FATIGUE (weary) and ASTHENIA (lapse in energy) outcome was unknown. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds: LATANOPROST

Current Illness:

ID: 1612266
Sex: M
Age:
State: CA

Vax Date: 03/12/2021
Onset Date:
Rec V Date: 08/22/2021
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Symptoms: past the recommended window; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (past the recommended window) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. On 12-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 (past the recommended window). At the time of the report, PRODUCT DOSE OMISSION ISSUE (past the recommended window) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1612267
Sex: M
Age: 33
State: MS

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 08/22/2021
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Symptoms: Severe arm soreness; Fever; Headache; Shivers; Body aches; Dizziness; Confusion; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), CONFUSIONAL STATE (Confusion), VACCINATION SITE PAIN (Severe arm soreness), PYREXIA (Fever) and HEADACHE (Headache) in a 33-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 27-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Apr-2021, the patient experienced DIZZINESS (Dizziness), CONFUSIONAL STATE (Confusion), PYREXIA (Fever), HEADACHE (Headache), CHILLS (Shivers) and MYALGIA (Body aches). On an unknown date, the patient experienced VACCINATION SITE PAIN (Severe arm soreness). The patient was treated with PARACETAMOL (TYLENOL) for Headache, Vaccination site pain, Fever, Shivers and Myalgia, at an unspecified dose and frequency. At the time of the report, DIZZINESS (Dizziness), CONFUSIONAL STATE (Confusion), VACCINATION SITE PAIN (Severe arm soreness), PYREXIA (Fever), HEADACHE (Headache), CHILLS (Shivers) and MYALGIA (Body aches) outcome was unknown. Action taken with mRNA-1273 in response to the event was not applicable. No concomitant medications provided.

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Current Illness:

ID: 1612268
Sex: F
Age: 72
State: NJ

Vax Date: 03/26/2021
Onset Date:
Rec V Date: 08/22/2021
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Symptoms: COVID arm; Injection site faded to a tan color; redness down the elbow and arm; hardness down the elbow and arm; Injection site Itchy; Arm at injection site hard, down to elbow and lower arm; arm at the injection site was red, down to elbow and lower arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (COVID arm), VACCINATION SITE DISCOLOURATION (Injection site faded to a tan color), ERYTHEMA (redness down the elbow and arm), INDURATION (hardness down the elbow and arm) and VACCINATION SITE PRURITUS (Injection site Itchy) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 009CZIA and 018B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 26-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 an unknown date, the patient experienced VACCINATION COMPLICATION (COVID arm), VACCINATION SITE DISCOLOURATION (Injection site faded to a tan color), ERYTHEMA (redness down the elbow and arm), INDURATION (hardness down the elbow and arm), VACCINATION SITE PRURITUS (Injection site Itchy), VACCINATION SITE INDURATION (Arm at injection site hard, down to elbow and lower arm) and VACCINATION SITE ERYTHEMA (arm at the injection site was red, down to elbow and lower arm). At the time of the report, VACCINATION COMPLICATION (COVID arm), VACCINATION SITE DISCOLOURATION (Injection site faded to a tan color), ERYTHEMA (redness down the elbow and arm), INDURATION (hardness down the elbow and arm), VACCINATION SITE PRURITUS (Injection site Itchy), VACCINATION SITE INDURATION (Arm at injection site hard, down to elbow and lower arm) and VACCINATION SITE ERYTHEMA (arm at the injection site was red, down to elbow and lower arm) outcome was unknown. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment information is provided.

Other Meds:

Current Illness:

ID: 1612269
Sex: M
Age: 63
State: MI

Vax Date: 02/15/2021
Onset Date: 03/15/2021
Rec V Date: 08/22/2021
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Symptoms: Missed second dose of Moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION IN ERROR (Missed second dose of Moderna vaccine) in a 63-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 015M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concurrent medical conditions included Blood pressure. Concomitant products included LISINOPRIL, AMLODIPIN [AMLODIPINE] and METOPROLOL for an unknown indication. On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Mar-2021, the patient experienced PRODUCT DOSE OMISSION IN ERROR (Missed second dose of Moderna vaccine). At the time of the report, PRODUCT DOSE OMISSION IN ERROR (Missed second dose of Moderna vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment details were provided.

Other Meds: LISINOPRIL; AMLODIPIN [AMLODIPINE]; METOPROLOL

Current Illness: Blood pressure

ID: 1612270
Sex: M
Age:
State: NE

Vax Date: 03/08/2021
Onset Date: 04/01/2021
Rec V Date: 08/22/2021
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Symptoms: He cannot use hisright hand while using computer, can not hold computer mouse, and can not type; Excruciating pain in all of the patient's joints; pain in any body part that bends including shoulder, elbow, wrist, fingers, ankle, and hips; This spontaneous case was reported by a consumer and describes the occurrence of ARTHRALGIA (Excruciating pain in all of the patient's joints), MYALGIA (pain in any body part that bends including shoulder, elbow, wrist, fingers, ankle, and hips) and MOBILITY DECREASED (He cannot use hisright hand while using computer, can not hold computer mouse, and can not type) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 014MWA and 026B21A) for COVID-19 vaccination. No Medical History information was reported. On 08-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 2 dosage form. In April 2021, the patient experienced ARTHRALGIA (Excruciating pain in all of the patient's joints) and MYALGIA (pain in any body part that bends including shoulder, elbow, wrist, fingers, ankle, and hips). On an unknown date, the patient experienced MOBILITY DECREASED (He cannot use hisright hand while using computer, can not hold computer mouse, and can not type). At the time of the report, ARTHRALGIA (Excruciating pain in all of the patient's joints), MYALGIA (pain in any body part that bends including shoulder, elbow, wrist, fingers, ankle, and hips) and MOBILITY DECREASED (He cannot use hisright hand while using computer, can not hold computer mouse, and can not type) had not resolved. Not Provided no treatment medication were provided no concomitants were provided

Other Meds:

Current Illness:

ID: 1612271
Sex: F
Age: 73
State: TX

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 08/22/2021
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Symptoms: little itching; rash located on left side between shoulder and neck around two weeks after/as mosquito bites localized on left side; arm soreness; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm soreness), PRURITUS (little itching) and RASH (rash located on left side between shoulder and neck around two weeks after/as mosquito bites localized on left side) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007B21A) for COVID-19 vaccination. Concomitant products included FLUTICASONE, AZELASTINE, SALBUTAMOL (ALBUTEROL HFA) and FLUTICASONE PROPIONATE, SALMETEROL XINAFOATE (ADVAIR) for an unknown indication. On 08-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Apr-2021, the patient experienced PAIN IN EXTREMITY (arm soreness). On 22-Apr-2021, the patient experienced PRURITUS (little itching) and RASH (rash located on left side between shoulder and neck around two weeks after/as mosquito bites localized on left side). On 09-Apr-2021, PAIN IN EXTREMITY (arm soreness) outcome was unknown. At the time of the report, PRURITUS (little itching) and RASH (rash located on left side between shoulder and neck around two weeks after/as mosquito bites localized on left side) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medication information was provided.

Other Meds: FLUTICASONE; AZELASTINE; ALBUTEROL HFA; ADVAIR

Current Illness:

ID: 1612272
Sex: U
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 08/22/2021
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Symptoms: Arm pain lasting 4 weeks; difficulty moving the arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm pain lasting 4 weeks) and LIMB DISCOMFORT (difficulty moving the arm) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (The patient's medical history was not provided.). 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 PAIN IN EXTREMITY (Arm pain lasting 4 weeks) and LIMB DISCOMFORT (difficulty moving the arm). The patient was treated with IBUPROFEN (ADVIL 12 HOUR) at an unspecified dose and frequency and IBUPROFEN (MOTRIN [IBUPROFEN]) at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (Arm pain lasting 4 weeks) and LIMB DISCOMFORT (difficulty moving the arm) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Treatment for the event included ibuprofen (Advil )and ibuprofen (Motrin) Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1612273
Sex: F
Age:
State:

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Rec V Date: 08/22/2021
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Symptoms: itching; Skin eruption; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (itching) and RASH (Skin eruption) 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 PRURITUS (itching) and RASH (Skin eruption). At the time of the report, PRURITUS (itching) and RASH (Skin eruption) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1612274
Sex: M
Age: 0
State: MA

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 08/22/2021
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Symptoms: arm is puffed up and swollen; significant pain in arm and underarm is significantly sore; soreness; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (arm is puffed up and swollen), PAIN IN EXTREMITY (significant pain in arm and underarm is significantly sore) and PAIN (soreness) in a 5-day-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009C21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included AMFETAMINE ASPARTATE, AMFETAMINE SULFATE, DEXAMFETAMINE SACCHARATE, DEXAMFETAMINE SULFATE (ADDERALL) and GABAPENTIN for an unknown indication. On 25-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 PERIPHERAL SWELLING (arm is puffed up and swollen), PAIN IN EXTREMITY (significant pain in arm and underarm is significantly sore) and PAIN (soreness). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and IBUPROFEN at an unspecified dose and frequency. At the time of the report, PERIPHERAL SWELLING (arm is puffed up and swollen), PAIN IN EXTREMITY (significant pain in arm and underarm is significantly sore) and PAIN (soreness) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment details included paracetamol and ibuprofen. Upon internal review on 21 Jun 2021, the patient age is captured as unknown due to unclear information in source document.

Other Meds: ADDERALL; GABAPENTIN

Current Illness:

ID: 1612275
Sex: M
Age:
State: NJ

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 08/22/2021
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Symptoms: fever of 100.9 F; Chill; pain in left hand; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in left hand), PYREXIA (fever of 100.9 F) and CHILLS (Chill) in a 25-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 018B21A and 009C21A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1. On 30-Mar-2021, the patient experienced PAIN IN EXTREMITY (pain in left hand). On 28-Apr-2021, the patient experienced PYREXIA (fever of 100.9 F) and CHILLS (Chill). On 31-Mar-2021, PAIN IN EXTREMITY (pain in left hand) had resolved. At the time of the report, PYREXIA (fever of 100.9 F) and CHILLS (Chill) outcome was unknown. Not Provided This case was linked to US-MODERNATX, INC.-MOD-2021-095068 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-095068:Case for dose 2

Other Meds:

Current Illness:

ID: 1612276
Sex: M
Age: 33
State: AL

Vax Date: 04/01/2021
Onset Date: 04/07/2021
Rec V Date: 08/22/2021
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Symptoms: Giant patch on head, getting bigger; This spontaneous case was reported by a consumer and describes the occurrence of SKIN DISORDER (Giant patch on head, getting bigger) in a 33-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017B21A) for COVID-19 vaccination. No medical history was reported by the physician. Concomitant products included DICLOFENAC SODIUM for an unknown indication. On 01-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Apr-2021, the patient experienced SKIN DISORDER (Giant patch on head, getting bigger). At the time of the report, SKIN DISORDER (Giant patch on head, getting bigger) 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 Flexeril Treatment medication was not provided

Other Meds: DICLOFENAC SODIUM

Current Illness:

ID: 1612277
Sex: F
Age: 42
State: TX

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 08/22/2021
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Symptoms: Redness/size of quarter and now it is size of hand; Hot and warm; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Redness/size of quarter and now it is size of hand) and FEELING HOT (Hot and warm) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 20-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 ERYTHEMA (Redness/size of quarter and now it is size of hand) and FEELING HOT (Hot and warm). At the time of the report, ERYTHEMA (Redness/size of quarter and now it is size of hand) and FEELING HOT (Hot and warm) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1612278
Sex: F
Age: 17
State: MD

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 08/22/2021
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Symptoms: inappropriate age at vaccine administration; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (inappropriate age at vaccine administration) in a 17-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025B21A) 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 31-Mar-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (inappropriate age at vaccine administration). At the time of the report, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (inappropriate age at vaccine administration) 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. No concomitant medications reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1612279
Sex: U
Age:
State: PA

Vax Date: 03/31/2021
Onset Date:
Rec V Date: 08/22/2021
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Symptoms: lymph node swelling under arm of side that had received the vaccine; This spontaneous case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (lymph node swelling under arm of side that had received the vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 31-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 LYMPHADENOPATHY (lymph node swelling under arm of side that had received the vaccine). At the time of the report, LYMPHADENOPATHY (lymph node swelling under arm of side that had received the vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1612280
Sex: F
Age:
State: MI

Vax Date: 03/19/2021
Onset Date: 04/16/2021
Rec V Date: 08/22/2021
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Symptoms: heart palpitation; chest tightness; flu like symptoms; lost 8lbs; fever; has no energy, has only been able to go from bed to couch; This spontaneous case was reported by a physician and describes the occurrence of PALPITATIONS (heart palpitation), CHEST DISCOMFORT (chest tightness), INFLUENZA LIKE ILLNESS (flu like symptoms), WEIGHT DECREASED (lost 8lbs) and PYREXIA (fever) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Apr-2021, the patient experienced PALPITATIONS (heart palpitation), INFLUENZA LIKE ILLNESS (flu like symptoms), WEIGHT DECREASED (lost 8lbs), PYREXIA (fever) and FATIGUE (has no energy, has only been able to go from bed to couch). 16-Apr-2021, the patient experienced CHEST DISCOMFORT (chest tightness). At the time of the report, PALPITATIONS (heart palpitation), CHEST DISCOMFORT (chest tightness), INFLUENZA LIKE ILLNESS (flu like symptoms), WEIGHT DECREASED (lost 8lbs), PYREXIA (fever) and FATIGUE (has no energy, has only been able to go from bed to couch) had not resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: (Negative) negative. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications provided. Treatment included drinking water and juice, getting at least 12 cups of water a day and taking Tylenol for fever.

Other Meds:

Current Illness:

ID: 1612281
Sex: F
Age: 49
State: TX

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 08/22/2021
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Symptoms: Extreme pain in my left ring finger; injection site arm was swollen; entire left side is swollen from my neck to my toes; Feel like I have a Fever but my body temperature is normal; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Extreme pain in my left ring finger), PERIPHERAL SWELLING (injection site arm was swollen), SWELLING (entire left side is swollen from my neck to my toes) and PYREXIA (Feel like I have a Fever but my body temperature is normal) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C211A) for COVID-19 vaccination. No Medical History information was reported. On 23-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 PAIN IN EXTREMITY (Extreme pain in my left ring finger), PERIPHERAL SWELLING (injection site arm was swollen), SWELLING (entire left side is swollen from my neck to my toes) and PYREXIA (Feel like I have a Fever but my body temperature is normal). At the time of the report, PAIN IN EXTREMITY (Extreme pain in my left ring finger), PERIPHERAL SWELLING (injection site arm was swollen), SWELLING (entire left side is swollen from my neck to my toes) and PYREXIA (Feel like I have a Fever but my body temperature is normal) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 24-Apr-2021, Body temperature: 98.6 f normal. 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 was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1612282
Sex: F
Age: 58
State: CA

Vax Date: 03/27/2021
Onset Date: 04/26/2021
Rec V Date: 08/22/2021
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Symptoms: Left tip of nose has an intermittent tickle/tingling which is annoying; Lips have intermittent tingling; Slight numbness (like weakened muscle) in left cheek of face; Massive migraine; Body aches /Achiness; Tiredness; Fever; Migraine Headache; Tingling on the left side of the face / tingling sensation; Numbness on the left side of the face from the mouth to the eye to nose; Back pain; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of MIGRAINE (Migraine Headache), PARAESTHESIA (Tingling on the left side of the face / tingling sensation), HYPOAESTHESIA (Numbness on the left side of the face from the mouth to the eye to nose), BACK PAIN (Back pain) and MIGRAINE (Massive migraine) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007C21A and 016B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Penicillin allergy. No medical history was provided by reporter. No concomitant medication reported. On 27-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 26-Apr-2021, the patient experienced MIGRAINE (Migraine Headache), PARAESTHESIA (Tingling on the left side of the face / tingling sensation), HYPOAESTHESIA (Numbness on the left side of the face from the mouth to the eye to nose), BACK PAIN (Back pain), MYALGIA (Body aches /Achiness), FATIGUE (Tiredness) and PYREXIA (Fever). On 24-May-2021, the patient experienced MIGRAINE (Massive migraine). On 02-Jun-2021, the patient experienced PARAESTHESIA (Left tip of nose has an intermittent tickle/tingling which is annoying), PARAESTHESIA ORAL (Lips have intermittent tingling) and HYPOAESTHESIA (Slight numbness (like weakened muscle) in left cheek of face). The patient was treated with PARACETAMOL (TYLENOL) for Fever, Tiredness and Ache, at a dose of 1 dosage form and ACYCLOVIR [ACICLOVIR] at a dose of 800 mg three times a day. On 29-Apr-2021, BACK PAIN (Back pain), MYALGIA (Body aches /Achiness), FATIGUE (Tiredness) and PYREXIA (Fever) had resolved. At the time of the report, MIGRAINE (Migraine Headache), PARAESTHESIA (Tingling on the left side of the face / tingling sensation), HYPOAESTHESIA (Numbness on the left side of the face from the mouth to the eye to nose), MIGRAINE (Massive migraine), PARAESTHESIA (Left tip of nose has an intermittent tickle/tingling which is annoying), PARAESTHESIA ORAL (Lips have intermittent tingling) and HYPOAESTHESIA (Slight numbness (like weakened muscle) in left cheek of face) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided. Action taken with mRNA-1273 in response to the events was not applicable. Most recent FOLLOW-UP information incorporated above includes: On 02-Jun-2021: Follow-up information received on 02-JUN-2021 contains significant information: Added patient demographics, lot number and site of vaccine administration, treatment medication (Acyclovir). New events "Left tip of nose tingling", "Slight numbness in left cheek of face" and "Lips have intermittent tingling' were added. The outcome of the events (tingling on the left side of face/ tingling sensation, numbness on the left side of the face from mouth to eye) changed from unknown to not resolved.

Other Meds:

Current Illness: Penicillin allergy

ID: 1612283
Sex: M
Age:
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 08/22/2021
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Symptoms: memory loss; This spontaneous case was reported by a consumer and describes the occurrence of AMNESIA (memory loss) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by reporter. No concomitant medication reported. 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 AMNESIA (memory loss). At the time of the report, AMNESIA (memory loss) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

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Current Illness:

ID: 1612284
Sex: F
Age: 42
State: CO

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 08/22/2021
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Symptoms: arm red and swollen; Tenderness and swelling of the lymph nodes; swelling of the lymph nodes in the same arm of the injection; i fell like a ball; cramps on my legs \ cramps; very bad body aches; knots in the legs \ in the thigh above the knee \ in the foot; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (arm red and swollen), LYMPH NODE PAIN (Tenderness and swelling of the lymph nodes), VACCINATION SITE LYMPHADENOPATHY (swelling of the lymph nodes in the same arm of the injection), FEELING ABNORMAL (i fell like a ball) and MYALGIA (very bad body aches) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by reporter. No concomitant medication reported. On 24-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Apr-2021, the patient experienced MYALGIA (very bad body aches) and MASS (knots in the legs \ in the thigh above the knee \ in the foot). On 27-Apr-2021, the patient experienced MUSCLE SPASMS (cramps on my legs \ cramps). On 28-Apr-2021, the patient experienced FEELING ABNORMAL (i fell like a ball). On an unknown date, the patient experienced ERYTHEMA (arm red and swollen), LYMPH NODE PAIN (Tenderness and swelling of the lymph nodes) and VACCINATION SITE LYMPHADENOPATHY (swelling of the lymph nodes in the same arm of the injection). At the time of the report, ERYTHEMA (arm red and swollen), VACCINATION SITE LYMPHADENOPATHY (swelling of the lymph nodes in the same arm of the injection), FEELING ABNORMAL (i fell like a ball), MYALGIA (very bad body aches), MASS (knots in the legs \ in the thigh above the knee \ in the foot) and MUSCLE SPASMS (cramps on my legs \ cramps) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided. Treatment with Ibuprofen on 25 an 26 April 2021 ,pertained to the events , were provided. This case was linked to MOD-2021-095235 (E2B Linked Report).; Sender's Comments: MOD-2021-095235:First dose

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Current Illness:

ID: 1612285
Sex: M
Age:
State: NJ

Vax Date: 03/30/2021
Onset Date: 04/28/2021
Rec V Date: 08/22/2021
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Symptoms: he had a fever of 100.9 F/fever of 101.3 F; chills; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (he had a fever of 100.9 F/fever of 101.3 F) and CHILLS (chills) in a 25-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 009C21A and 018B21A) for COVID-19 vaccination. No medical history was provided by reporter. No concomitant medication reported. On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 28-Apr-2021, the patient experienced CHILLS (chills). On 28-Apr-2021 at 5:00 AM, the patient experienced PYREXIA (he had a fever of 100.9 F/fever of 101.3 F). At the time of the report, PYREXIA (he had a fever of 100.9 F/fever of 101.3 F) and CHILLS (chills) outcome was unknown. It was reported that the patient took acetaminophen for the adverse events. This case was linked to US-MODERNATX, INC.-MOD-2021-095036 (Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-095036:Case for dose 1

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Current Illness:

ID: 1612286
Sex: M
Age: 73
State: PA

Vax Date: 01/28/2021
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Rec V Date: 08/22/2021
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Symptoms: weakness; feeling out of balance; missed second dose (88 days since first one); This spontaneous case was reported by a physician and describes the occurrence of ASTHENIA (weakness), BALANCE DISORDER (feeling out of balance) and PRODUCT DOSE OMISSION ISSUE (missed second dose (88 days since first one)) in a 79-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. M20A) for COVID-19 vaccination. No medical history was provided by reporter. No concomitant medication reported. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced ASTHENIA (weakness), BALANCE DISORDER (feeling out of balance) and PRODUCT DOSE OMISSION ISSUE (missed second dose (88 days since first one)). At the time of the report, ASTHENIA (weakness), BALANCE DISORDER (feeling out of balance) and PRODUCT DOSE OMISSION ISSUE (missed second dose (88 days since first one)) 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.

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Current Illness:

ID: 1612287
Sex: F
Age: 69
State: MI

Vax Date: 02/11/2021
Onset Date: 03/10/2021
Rec V Date: 08/22/2021
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Symptoms: Really bad chills; fatigue; 3 inch rash on right arm, which itched for a little while; 3 inch rash on right arm; High fever of 101.3 degrees Fahrenheit; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (3 inch rash on right arm, which itched for a little while), VACCINATION SITE RASH (3 inch rash on right arm), PYREXIA (High fever of 101.3 degrees Fahrenheit), CHILLS (Really bad chills) and FATIGUE (fatigue) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030A21A and 007MZ0A) for COVID-19 vaccination. No Medical History information was reported. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Mar-2021, the patient experienced VACCINATION SITE PRURITUS (3 inch rash on right arm, which itched for a little while), VACCINATION SITE RASH (3 inch rash on right arm) and PYREXIA (High fever of 101.3 degrees Fahrenheit). On an unknown date, the patient experienced CHILLS (Really bad chills) and FATIGUE (fatigue). On 11-Mar-2021, PYREXIA (High fever of 101.3 degrees Fahrenheit) had resolved. On 25-Apr-2021, CHILLS (Really bad chills) had resolved. At the time of the report, VACCINATION SITE PRURITUS (3 inch rash on right arm, which itched for a little while) and VACCINATION SITE RASH (3 inch rash on right arm) had resolved and FATIGUE (fatigue) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 10-Mar-2021, Body temperature: 101.3 (High) High fever of 101.3 degrees fahrenheit. No concomitant medication was reported It was reported that patient had persistent really bad chills and fatigue 'to beat the band', which started after the first dose of Moderna COVID-19 vaccine, that continued after second dose No treatment medication was reported This case was linked to MOD-2021-020152 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 07-Jun-2021: No new information

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Current Illness:

ID: 1612288
Sex: F
Age:
State: NJ

Vax Date:
Onset Date: 04/27/2021
Rec V Date: 08/22/2021
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Symptoms: Chills; FEVER; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Chills) and PYREXIA (FEVER) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported.No concomitant medication was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Apr-2021, the patient experienced CHILLS (Chills) and PYREXIA (FEVER). At the time of the report, CHILLS (Chills) and PYREXIA (FEVER) outcome was unknown. Treatment medication was not provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was not applicable For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

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Current Illness:

ID: 1612289
Sex: U
Age:
State: CA

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Rec V Date: 08/22/2021
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Symptoms: headache lasted 2 to 3 days; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by reporter. No concomitant medication 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 HEADACHE (Headache). Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. This case was linked to US-MODERNATX, INC.-MOD-2021-094881 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-094881:

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Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm