VAERS 2021 Database www.vaers.hhs.gov

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

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

Incidents per State

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

ID: 1566857
Sex: F
Age: 54
State: PA

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Shipment of the 2nd dose to the facility had been delayed; at that point I was beyond the 42 day mark; Shipment of the 2nd dose to the facility had been delayed; at that point I was beyond the 42 day mark; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT AVAILABILITY ISSUE (Shipment of the 2nd dose to the facility had been delayed; at that point I was beyond the 42 day mark) and PRODUCT ADMINISTRATION INTERRUPTED (Shipment of the 2nd dose to the facility had been delayed; at that point I was beyond the 42 day mark) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. No Medical History information was reported. On 04-Feb-2021 at 11:35 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PRODUCT AVAILABILITY ISSUE (Shipment of the 2nd dose to the facility had been delayed; at that point I was beyond the 42 day mark) and PRODUCT ADMINISTRATION INTERRUPTED (Shipment of the 2nd dose to the facility had been delayed; at that point I was beyond the 42 day mark). At the time of the report, PRODUCT AVAILABILITY ISSUE (Shipment of the 2nd dose to the facility had been delayed; at that point I was beyond the 42 day mark) and PRODUCT ADMINISTRATION INTERRUPTED (Shipment of the 2nd dose to the facility had been delayed; at that point I was beyond the 42 day mark) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing was delayed on an unknown date. Concomitant medications were not provided by the reporter. Treatment information was not reported. Most recent FOLLOW-UP information incorporated above includes: On 12-May-2021: The completed Form includes an update to patient's race and additional event details, the patient had not received 2nd dose at the time of the FU report

Other Meds:

Current Illness:

ID: 1566858
Sex: M
Age: 65
State: KY

Vax Date: 03/13/2021
Onset Date: 03/15/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Dizziness; head feels like its numb; feels like he is in "drunk mode"; Nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of DIZZINESS (Dizziness), HYPOAESTHESIA (head feels like its numb), SOMNOLENCE (feels like he is in "drunk mode") and NAUSEA (Nausea) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026A21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Mar-2021, the patient experienced DIZZINESS (Dizziness), HYPOAESTHESIA (head feels like its numb), SOMNOLENCE (feels like he is in "drunk mode") and NAUSEA (Nausea). At the time of the report, DIZZINESS (Dizziness), HYPOAESTHESIA (head feels like its numb), SOMNOLENCE (feels like he is in "drunk mode") and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. The patient reached primary care professional (PCP) who advised him to wait for 48 hours for events to subside. No treatment was taken by the patient.

Other Meds:

Current Illness:

ID: 1566859
Sex: F
Age:
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (arm was sore) and FATIGUE (extremely fatigue) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. Concurrent medical conditions included Atrial fibrillation. Concomitant products included DILTIAZEM for Atrial fibrillation, APIXABAN (ELIQUIS) for an unknown indication. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Feb-2021, the patient experienced MYALGIA (arm was sore). On 07-Feb-2021, the patient experienced FATIGUE (extremely fatigue). At the time of the report, MYALGIA (arm was sore) and FATIGUE (extremely fatigue) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessment. Treatment information was not provided. This case was linked to MOD-2021-045433 (Patient Link).

Other Meds: ELIQUIS; DILTIAZEM

Current Illness: Atrial fibrillation

ID: 1566860
Sex: F
Age: 69
State: OR

Vax Date: 03/14/2021
Onset Date: 03/01/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031A21A) for COVID-19 vaccination. No medical history was reported. On 14-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In March 2021, the patient experienced HEADACHE (Headache). At the time of the report, HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1566861
Sex: F
Age:
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: Weak; Flu like symptoms; Sore arm; chills really bad; Really tired; Fever; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Weak), INFLUENZA LIKE ILLNESS (Flu like symptoms), PAIN IN EXTREMITY (Sore arm), CHILLS (chills really bad) and FATIGUE (Really tired) in an 82-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 was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ASTHENIA (Weak), INFLUENZA LIKE ILLNESS (Flu like symptoms), PAIN IN EXTREMITY (Sore arm), CHILLS (chills really bad), FATIGUE (Really tired) and PYREXIA (Fever). At the time of the report, ASTHENIA (Weak), INFLUENZA LIKE ILLNESS (Flu like symptoms), PAIN IN EXTREMITY (Sore arm), CHILLS (chills really bad), FATIGUE (Really tired) and PYREXIA (Fever) outcome was unknown. Concomitant medication was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1566862
Sex: M
Age:
State: PR

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

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

Lab Data:

Allergies:

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

Symptoms: received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion; This spontaneous case was reported by a pharmacist (subsequently medically confirmed) and describes the occurrence of PRODUCT TEMPERATURE EXCURSION ISSUE (received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027L20A) for COVID-19 vaccination. No medical history 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 PRODUCT TEMPERATURE EXCURSION ISSUE (received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion). At the time of the report, PRODUCT TEMPERATURE EXCURSION ISSUE (received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment medications were not provided.

Other Meds:

Current Illness:

ID: 1566863
Sex: F
Age: 79
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Hard on Injection Site; Itchiness; Rash; Swollen; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE INDURATION (Hard on Injection Site), VACCINATION SITE PRURITUS (Itchiness), VACCINATION SITE RASH (Rash) and VACCINATION SITE SWELLING (Swollen) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20-2A) for COVID-19 vaccination. No Medical History information was reported. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jan-2021, the patient experienced VACCINATION SITE INDURATION (Hard on Injection Site), VACCINATION SITE PRURITUS (Itchiness), VACCINATION SITE RASH (Rash) and VACCINATION SITE SWELLING (Swollen). At the time of the report, VACCINATION SITE INDURATION (Hard on Injection Site), VACCINATION SITE PRURITUS (Itchiness), VACCINATION SITE RASH (Rash) and VACCINATION SITE SWELLING (Swollen) outcome was unknown. 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 16-Apr-2021: Follow up received on 16-Apr-2021, email id received. On 20-Apr-2021: Follow up received on 20-Apr-2021, no new information was recorded

Other Meds:

Current Illness:

ID: 1566864
Sex: F
Age: 91
State: NJ

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Vaccination site discolouration; Vaccination site hemorrhage; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOLOURATION (Vaccination site discolouration) and VACCINATION SITE HAEMORRHAGE (Vaccination site hemorrhage) in a 92-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048a21a) for COVID-19 vaccination. No Medical History information was reported. On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, the patient experienced VACCINATION SITE DISCOLOURATION (Vaccination site discolouration) and VACCINATION SITE HAEMORRHAGE (Vaccination site hemorrhage). At the time of the report, VACCINATION SITE DISCOLOURATION (Vaccination site discolouration) and VACCINATION SITE HAEMORRHAGE (Vaccination site hemorrhage) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medication were provided. No concomitant medication were provided.

Other Meds:

Current Illness:

ID: 1566865
Sex: U
Age:
State: MI

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 1 dose Moderna / second dose Johnson and Johnson; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a health care professional and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (1 dose Moderna / second dose Johnson and Johnson) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INTERCHANGE OF VACCINE PRODUCTS (1 dose Moderna / second dose Johnson and Johnson). At the time of the report, INTERCHANGE OF VACCINE PRODUCTS (1 dose Moderna / second dose Johnson and Johnson) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided. No specific patient information was provided.

Other Meds:

Current Illness:

ID: 1566866
Sex: M
Age:
State: PR

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT TEMPERATURE EXCURSION ISSUE (Patient received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027L20A) 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 PRODUCT TEMPERATURE EXCURSION ISSUE (Patient received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion). At the time of the report, PRODUCT TEMPERATURE EXCURSION ISSUE (Patient received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1566867
Sex: F
Age:
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of JOINT SWELLING (Knee swelling) and ARTHRALGIA (Knee pain) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced JOINT SWELLING (Knee swelling) and ARTHRALGIA (Knee pain). At the time of the report, JOINT SWELLING (Knee swelling) and ARTHRALGIA (Knee pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatment was reported for the events. The reporter noted that the patient did not have any chronic medical problems.

Other Meds:

Current Illness:

ID: 1566868
Sex: F
Age: 65
State: NE

Vax Date: 03/03/2021
Onset Date: 03/11/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Red itchy rash under the armpits of both arms, groin area, and under her breasts.; Red itchy rash under the armpits of both arms, groin area, and under her breasts.; This spontaneous case was reported by a consumer and describes the occurrence of RASH ERYTHEMATOUS (Red itchy rash under the armpits of both arms, groin area, and under her breasts.) and RASH PRURITIC (Red itchy rash under the armpits of both arms, groin area, and under her breasts.) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. No Medical History information was reported. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Mar-2021, the patient experienced RASH ERYTHEMATOUS (Red itchy rash under the armpits of both arms, groin area, and under her breasts.) and RASH PRURITIC (Red itchy rash under the armpits of both arms, groin area, and under her breasts.). At the time of the report, RASH ERYTHEMATOUS (Red itchy rash under the armpits of both arms, groin area, and under her breasts.) and RASH PRURITIC (Red itchy rash under the armpits of both arms, groin area, and under her breasts.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. No treatment was reported for the events.

Other Meds:

Current Illness:

ID: 1566869
Sex: M
Age: 64
State: CO

Vax Date: 01/24/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: A friend's bad reaction, so weird; He had a pop/knot raised in the shot arm; the pain grew and grew/within a couple of hours he couldn't raise the arm/pain was great; Radiating up and down his spine/radiating up and down his head; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE EVENT (A friend's bad reaction, so weird), VACCINATION SITE MASS (He had a pop/knot raised in the shot arm), PAIN IN EXTREMITY (the pain grew and grew/within a couple of hours he couldn't raise the arm/pain was great) and PAIN (Radiating up and down his spine/radiating up and down his head) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L020A) for COVID-19 vaccination. The patient's past medical history included COVID-19 from 15-Jan-2021 to 21-Jan-2021. On 24-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 ADVERSE EVENT (A friend's bad reaction, so weird), VACCINATION SITE MASS (He had a pop/knot raised in the shot arm), PAIN IN EXTREMITY (the pain grew and grew/within a couple of hours he couldn't raise the arm/pain was great) and PAIN (Radiating up and down his spine/radiating up and down his head). The patient was treated with MELATONIN at an unspecified dose and frequency. At the time of the report, ADVERSE EVENT (A friend's bad reaction, so weird), VACCINATION SITE MASS (He had a pop/knot raised in the shot arm), PAIN IN EXTREMITY (the pain grew and grew/within a couple of hours he couldn't raise the arm/pain was great) and PAIN (Radiating up and down his spine/radiating up and down his head) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Heart rate: 102 (High) heart rate was 102. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant product information was reported. No treatment information was reported. This case was linked to MOD-2021-059391 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 06-Apr-2021: Secondary reporter information, Patient's medical history, Batch/Lot number of vaccine and treatment medicine were added.

Other Meds:

Current Illness:

ID: 1566870
Sex: U
Age:
State: NC

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

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

Lab Data:

Allergies:

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

Symptoms: Got sick after second shot; 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 ILLNESS (Got sick after second shot) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ILLNESS (Got sick after second shot). At the time of the report, ILLNESS (Got sick after second shot) outcome was unknown. No relevant concomitant medications were reported. No treatment information was provided. This case was linked to MOD21-053335, MOD21-053410 (E2B Linked Report).; Sender's Comments: MOD21-053335:Cross link MOD21-053410:Cross link

Other Meds:

Current Illness:

ID: 1566871
Sex: F
Age: 71
State: PA

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

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

Lab Data:

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Site of injection started itching; site of injection started itching and developed red mark/Red mark is 2 inches by 3inches; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Site of injection started itching) and VACCINATION SITE ERYTHEMA (site of injection started itching and developed red mark/Red mark is 2 inches by 3inches) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Mar-2021, the patient experienced VACCINATION SITE PRURITUS (Site of injection started itching) and VACCINATION SITE ERYTHEMA (site of injection started itching and developed red mark/Red mark is 2 inches by 3inches). At the time of the report, VACCINATION SITE PRURITUS (Site of injection started itching) and VACCINATION SITE ERYTHEMA (site of injection started itching and developed red mark/Red mark is 2 inches by 3inches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 07-May-2021: Non significant follow up appended.

Other Meds:

Current Illness:

ID: 1566872
Sex: M
Age:
State: NJ

Vax Date: 03/05/2021
Onset Date: 03/01/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Headache; Joint Pain; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache), ARTHRALGIA (Joint Pain) and FATIGUE (Fatigue) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In March 2021, the patient experienced HEADACHE (Headache), ARTHRALGIA (Joint Pain) and FATIGUE (Fatigue). At the time of the report, HEADACHE (Headache), ARTHRALGIA (Joint Pain) and FATIGUE (Fatigue) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant drugs was provided No treatment information was provided.

Other Meds:

Current Illness:

ID: 1566873
Sex: M
Age: 90
State: WA

Vax Date: 03/10/2021
Onset Date: 03/14/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Itchiness on different parts of his Body; Dizziness; I am not my usual self / everything is turned upside down; Pain on his right knee; Usually walk a mild daily and now i can not get out of my house / I am very tired; morning when i went to have breakfast y laid down, did not loose my conscious; It is hard to sleep, last night i was up and down all night, did not get my sleep; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (morning when i went to have breakfast y laid down, did not loose my conscious), PRURITUS (Itchiness on different parts of his Body), DIZZINESS (Dizziness), DEPRESSED MOOD (I am not my usual self / everything is turned upside down) and INSOMNIA (It is hard to sleep, last night i was up and down all night, did not get my sleep) in an 89-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by reporter. Concomitant products included VITAMINS NOS for an unknown indication. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) .5 ml. On 14-Mar-2021, the patient experienced INSOMNIA (It is hard to sleep, last night i was up and down all night, did not get my sleep). On 15-Mar-2021, the patient experienced ASTHENIA (morning when i went to have breakfast y laid down, did not loose my conscious). On an unknown date, the patient experienced PRURITUS (Itchiness on different parts of his Body), DIZZINESS (Dizziness), DEPRESSED MOOD (I am not my usual self / everything is turned upside down), ARTHRALGIA (Pain on his right knee) and FATIGUE (Usually walk a mild daily and now i can not get out of my house / I am very tired). The patient was treated with CORTISOL [HYDROCORTISONE] (topical) ongoing since an unknown date for Itching, at a dose of UNK dosage form. At the time of the report, ASTHENIA (morning when i went to have breakfast y laid down, did not loose my conscious), PRURITUS (Itchiness on different parts of his Body), DIZZINESS (Dizziness), DEPRESSED MOOD (I am not my usual self / everything is turned upside down), INSOMNIA (It is hard to sleep, last night i was up and down all night, did not get my sleep), ARTHRALGIA (Pain on his right knee) and FATIGUE (Usually walk a mild daily and now i can not get out of my house / I am very tired) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient take concomitant cholesterol medicine. The Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 22-Jun-2021: TCR received on 22-Jun-21 Updated all the first dose events are resolved, Patient did not experience anything after his second Dose.

Other Meds: VITAMINS NOS

Current Illness:

ID: 1566874
Sex: F
Age: 28
State: MD

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Dizzy; Low Grade Fever; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizzy) and PYREXIA (Low Grade Fever) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013A21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Mar-2021, the patient experienced DIZZINESS (Dizzy) and PYREXIA (Low Grade Fever). At the time of the report, DIZZINESS (Dizzy) had not resolved and PYREXIA (Low Grade Fever) outcome was unknown. No concomitant medications were provided. No treatment was reported for the events.

Other Meds:

Current Illness:

ID: 1566875
Sex: M
Age: 66
State: FL

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: feet swelling; yellow bumps; fever; arm pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm pain), PERIPHERAL SWELLING (feet swelling), MASS (yellow bumps) and PYREXIA (fever) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. Concurrent medical conditions included Thalassemia. 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 PAIN IN EXTREMITY (arm pain) and PYREXIA (fever). On 06-Mar-2021, the patient experienced PERIPHERAL SWELLING (feet swelling) and MASS (yellow bumps). The patient was treated with NAPROXEN SODIUM (ALEVE) at an unspecified dose and frequency and DICLOFENAC DIETHYLAMINE (VOLTAREN EMULGEL) at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (arm pain), PERIPHERAL SWELLING (feet swelling), MASS (yellow bumps) and PYREXIA (fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter.

Other Meds:

Current Illness: Thalassemia

ID: 1566876
Sex: F
Age:
State: OR

Vax Date: 03/04/2021
Onset Date: 03/14/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: Arm got sore; Red circle 1-1/2 inches in diameter around the injection site; Swollen at the injection site; Itchy at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm got sore), VACCINATION SITE ERYTHEMA (Red circle 1-1/2 inches in diameter around the injection site), VACCINATION SITE SWELLING (Swollen at the injection site) and VACCINATION SITE PRURITUS (Itchy at the injection site) in an 86-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029A21A) for COVID-19 vaccination. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID) and LETROZOLE 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 14-Mar-2021, the patient experienced PAIN IN EXTREMITY (Arm got sore), VACCINATION SITE ERYTHEMA (Red circle 1-1/2 inches in diameter around the injection site), VACCINATION SITE SWELLING (Swollen at the injection site) and VACCINATION SITE PRURITUS (Itchy at the injection site). At the time of the report, PAIN IN EXTREMITY (Arm got sore), VACCINATION SITE ERYTHEMA (Red circle 1-1/2 inches in diameter around the injection site), VACCINATION SITE SWELLING (Swollen at the injection site) and VACCINATION SITE PRURITUS (Itchy at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. treatment information not provided.

Other Meds: SYNTHROID; LETROZOLE

Current Illness:

ID: 1566877
Sex: F
Age: 52
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: stiff neck; numbness; neuritis; pain on the shoulder; pain on the neck area; nerve pain still through my left shoulder,nerve pain still through my neck,nerve pain still all the way down my arm - left arm; This spontaneous case was reported by a consumer and describes the occurrence of NECK PAIN (pain on the neck area), NEURALGIA (nerve pain still through my left shoulder,nerve pain still through my neck,nerve pain still all the way down my arm - left arm), MUSCULOSKELETAL STIFFNESS (stiff neck), HYPOAESTHESIA (numbness) and NEURITIS (neuritis) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Arthritis (history of arthritis in the shoulder and neck), Allergy to antibiotic (Sulfa allergy) and Seasonal allergy (seasonal allergies). Concomitant products included MULTIVITAMINS [VITAMINS NOS] for an unknown indication. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Mar-2021, the patient experienced NECK PAIN (pain on the neck area), NEURALGIA (nerve pain still through my left shoulder,nerve pain still through my neck,nerve pain still all the way down my arm - left arm) and ARTHRALGIA (pain on the shoulder). On an unknown date, the patient experienced MUSCULOSKELETAL STIFFNESS (stiff neck), HYPOAESTHESIA (numbness) and NEURITIS (neuritis). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) at an unspecified dose and frequency. At the time of the report, NECK PAIN (pain on the neck area), NEURALGIA (nerve pain still through my left shoulder,nerve pain still through my neck,nerve pain still all the way down my arm - left arm) and MUSCULOSKELETAL STIFFNESS (stiff neck) had not resolved and HYPOAESTHESIA (numbness), NEURITIS (neuritis) and ARTHRALGIA (pain on the shoulder) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. MRI lab test was performed and it presented as neuritis. Muscle relaxer and anit- inflammatory were used as treatment medication. Most recent FOLLOW-UP information incorporated above includes: On 10-May-2021: Follow up received on 10 May 2021: lad details, medical history, concomitant medication, events and event outcome were updated. On 15-Jul-2021: followup was received on 15 Jul 2021: contains no new information

Other Meds: MULTIVITAMINS [VITAMINS NOS]

Current Illness: Allergy to antibiotic (Sulfa allergy); Seasonal allergy (seasonal allergies)

ID: 1566878
Sex: F
Age: 74
State: OH

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Bruise started developing with black and blue spots in the middle (about 1.5 inches diameter; Arm was sore; This spontaneous case was reported by a consumer and describes the occurrence of CONTUSION (Bruise started developing with black and blue spots in the middle (about 1.5 inches diameter) and PAIN IN EXTREMITY (Arm was sore) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001A21A) for COVID-19 vaccination. Concomitant products included LEVOTHYROXINE and ATORVASTATIN for an unknown indication. On 24-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, the patient experienced CONTUSION (Bruise started developing with black and blue spots in the middle (about 1.5 inches diameter) and PAIN IN EXTREMITY (Arm was sore). At the time of the report, CONTUSION (Bruise started developing with black and blue spots in the middle (about 1.5 inches diameter) and PAIN IN EXTREMITY (Arm was sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided.

Other Meds: LEVOTHYROXINE; ATORVASTATIN

Current Illness:

ID: 1566879
Sex: M
Age:
State: PR

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

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

Lab Data:

Allergies:

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

Symptoms: Received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion; A spontaneous report was received from Pharmacist concerning a 58-years old, male patient who received Moderna's COVID-19 Vaccine (mRNA-1273) from a vial that went through a temperature excursion/product storage error. The patient's medical history was not provided. Concomitant medications were not provided. On an unknown date, the patient received their first of the two planned doses of mRNA-1273 (lot number: 027L20A) intramuscularly for the prophylaxis of COVID-19 infection. It was reported that patient received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion. Treatment medication included none. No lab tests were mentioned. Action taken with mRNA-1273 in response to the event was not applicable. The outcome of the event received a dose of the Moderna COVID19 vaccine from a vial that went through a temperature excursion was considered resolved.; Reporter's Comments: This report refers to a case of Product storage error for mRNA-1273, lot # 027L20A with no associated Adverse Events.

Other Meds:

Current Illness:

ID: 1566880
Sex: F
Age: 76
State: NY

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: As of today, the rash is starting to fade,; still I have the dull headache; very red; hot; very itchy; this time the rash wasn't as bad, it was contained to just in the middle area; my lymph nodes were swollen; still the soreness in the arm; like it was having a flu that lasted for another 24 hours; I was nauseated; fever; I had chills; I had dull headache; I vomited; fatigue; By nighttime, around 10pm its started getting very sore that lasted for 48 hours; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (By nighttime, around 10pm its started getting very sore that lasted for 48 hours), INFLUENZA LIKE ILLNESS (like it was having a flu that lasted for another 24 hours), PAIN IN EXTREMITY (still the soreness in the arm), ERYTHEMA (very red) and FEELING HOT (hot) in a 76-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 was reported. Concomitant products included SIMVASTATIN (ZOCOR) and LISINOPRIL for an unknown indication. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 09-Mar-2021, the patient experienced PAIN (By nighttime, around 10pm its started getting very sore that lasted for 48 hours). On 10-Mar-2021, the patient experienced INFLUENZA LIKE ILLNESS (like it was having a flu that lasted for another 24 hours), HEADACHE (I had dull headache), VOMITING (I vomited), FATIGUE (fatigue), NAUSEA (I was nauseated), PYREXIA (fever) and CHILLS (I had chills). On 11-Mar-2021, the patient experienced PAIN IN EXTREMITY (still the soreness in the arm). On 12-Mar-2021, the patient experienced ERYTHEMA (very red), FEELING HOT (hot), PRURITUS (very itchy), RASH (this time the rash wasn't as bad, it was contained to just in the middle area) and LYMPHADENOPATHY (my lymph nodes were swollen). On 14-Mar-2021, the patient experienced RASH (As of today, the rash is starting to fade,) and HEADACHE (still I have the dull headache). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 5 UNK, qd and ACETYLSALICYLIC ACID (BABY ASPIRIN) at a dose of UNK dosage form. At the time of the report, PAIN (By nighttime, around 10pm its started getting very sore that lasted for 48 hours), INFLUENZA LIKE ILLNESS (like it was having a flu that lasted for another 24 hours), PAIN IN EXTREMITY (still the soreness in the arm), ERYTHEMA (very red), FEELING HOT (hot), PRURITUS (very itchy), RASH (this time the rash wasn't as bad, it was contained to just in the middle area), LYMPHADENOPATHY (my lymph nodes were swollen), HEADACHE (I had dull headache), VOMITING (I vomited), RASH (As of today, the rash is starting to fade,), NAUSEA (I was nauseated), PYREXIA (fever), CHILLS (I had chills) and HEADACHE (still I have the dull headache) outcome was unknown and FATIGUE (fatigue) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Action taken with mRNA-1273 (Moderna COVID-19 Vaccine) in response to the events was not applicable.

Other Meds: ZOCOR; LISINOPRIL

Current Illness:

ID: 1566881
Sex: U
Age:
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: 20 patients rceeived vaccine with possible temperature ecursion; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist (subsequently medically confirmed) and describes the occurrence of PRODUCT STORAGE ERROR (20 patients rceeived vaccine with possible temperature ecursion) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029A21A) for COVID-19 vaccination. No Medical History information was reported. On 15-Mar-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 STORAGE ERROR (20 patients rceeived vaccine with possible temperature ecursion). On 15-Mar-2021, PRODUCT STORAGE ERROR (20 patients rceeived vaccine with possible temperature ecursion) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1566882
Sex: F
Age: 71
State: KY

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

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

Lab Data:

Allergies:

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

Symptoms: Body pain; Blood in ears; Shortness of breath; Congested; Flu-like symptoms; Sore and red at injection site; Sore and red at injection site; Headaches in temples and across head; Low grade fever; Really tired; Throwing up; Nauseous; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Body pain), EAR HAEMORRHAGE (Blood in ears), DYSPNOEA (Shortness of breath), NASAL CONGESTION (Congested) and INFLUENZA LIKE ILLNESS (Flu-like symptoms) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 029K20A and 039V20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form(s). On 12-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN (Body pain), EAR HAEMORRHAGE (Blood in ears), DYSPNOEA (Shortness of breath), NASAL CONGESTION (Congested), INFLUENZA LIKE ILLNESS (Flu-like symptoms), VACCINATION SITE PAIN (Sore and red at injection site), VACCINATION SITE ERYTHEMA (Sore and red at injection site), HEADACHE (Headaches in temples and across head), PYREXIA (Low grade fever), FATIGUE (Really tired), VOMITING (Throwing up) and NAUSEA (Nauseous). The patient was treated with ACETYLSALICYLIC ACID (ALKA-SELTZER) at an unspecified dose and frequency. At the time of the report, PAIN (Body pain), EAR HAEMORRHAGE (Blood in ears), DYSPNOEA (Shortness of breath), NASAL CONGESTION (Congested), INFLUENZA LIKE ILLNESS (Flu-like symptoms), VACCINATION SITE PAIN (Sore and red at injection site), VACCINATION SITE ERYTHEMA (Sore and red at injection site), HEADACHE (Headaches in temples and across head), PYREXIA (Low grade fever), FATIGUE (Really tired), VOMITING (Throwing up) and NAUSEA (Nauseous) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: low (Low) Low. No concomitant medications were reported. Action taken with mRNA-1273 in response to the events was not Applicable. Action taken with mRNA-1273 in response to the events was not applicable.

Other Meds:

Current Illness:

ID: 1566883
Sex: F
Age: 72
State: AZ

Vax Date: 02/09/2021
Onset Date: 03/11/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Sore; Red; 2.5 inches round circle; Swollen; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Sore), ERYTHEMA (Red), SKIN DISORDER (2.5 inches round circle) and SWELLING (Swollen) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031A21A and 015M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 11-Mar-2021, the patient experienced PAIN (Sore), ERYTHEMA (Red), SKIN DISORDER (2.5 inches round circle) and SWELLING (Swollen). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, PAIN (Sore), ERYTHEMA (Red), SKIN DISORDER (2.5 inches round circle) and SWELLING (Swollen) outcome was unknown. Concomitant product use was not provided by the reporter. Action taken with mRNA-1273 in response to the events was not Applicable.

Other Meds:

Current Illness:

ID: 1566884
Sex: F
Age: 46
State: NV

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Sore arm; Swollen arm; Red arm; Itchy arm; Left eye is swollen; Fatigue; A little pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (A little pain), PAIN IN EXTREMITY (Sore arm), PERIPHERAL SWELLING (Swollen arm), ERYTHEMA (Red arm) and PRURITUS (Itchy arm) in a 46-year-old female 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. No Medical History information was reported. On 06-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Mar-2021, the patient experienced PAIN (A little pain) and FATIGUE (Fatigue). On 14-Mar-2021, the patient experienced PAIN IN EXTREMITY (Sore arm), PERIPHERAL SWELLING (Swollen arm), ERYTHEMA (Red arm), PRURITUS (Itchy arm) and EYE SWELLING (Left eye is swollen). At the time of the report, PAIN (A little pain), PAIN IN EXTREMITY (Sore arm), PERIPHERAL SWELLING (Swollen arm), ERYTHEMA (Red arm), PRURITUS (Itchy arm), EYE SWELLING (Left eye is swollen) and FATIGUE (Fatigue) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant medications were provided. No treatment was reported for the events. Patient stated that she took second dose on an unknown date. This case was linked to MOD-2021-114193 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 06-May-2021: Updated all events outcome from unknown to recovered on an unknown date and provided the second dose details.

Other Meds:

Current Illness:

ID: 1566885
Sex: F
Age: 71
State: MA

Vax Date: 02/10/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Scar tissue from 14 years ago inside lower lip swelled up, was bright red and raw; Scar tissue from 14 years ago inside lower lip swelled up, was bright red and raw; itchy at the injection site; rash at injection site; burning at the injection site; Muscle ache; fatigue; This spontaneous case was reported by a consumer and describes the occurrence of LIP SWELLING (Scar tissue from 14 years ago inside lower lip swelled up, was bright red and raw), LIP ERYTHEMA (Scar tissue from 14 years ago inside lower lip swelled up, was bright red and raw), INJECTION SITE PRURITUS (itchy at the injection site), INJECTION SITE RASH (rash at injection site) and INJECTION SITE PAIN (burning at the injection site) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID) and ESCITALOPRAM OXALATE (AVESTALO) for an unknown indication. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 10-Mar-2021, the patient experienced MYALGIA (Muscle ache) and FATIGUE (fatigue). On 12-Mar-2021, the patient experienced LIP SWELLING (Scar tissue from 14 years ago inside lower lip swelled up, was bright red and raw), INJECTION SITE PRURITUS (itchy at the injection site), INJECTION SITE RASH (rash at injection site) and INJECTION SITE PAIN (burning at the injection site). 12-Mar-2021, the patient experienced LIP ERYTHEMA (Scar tissue from 14 years ago inside lower lip swelled up, was bright red and raw). The patient was treated with HYDROCORTISONE at an unspecified dose and frequency. On 12-Mar-2021, MYALGIA (Muscle ache) had resolved. At the time of the report, LIP SWELLING (Scar tissue from 14 years ago inside lower lip swelled up, was bright red and raw) and LIP ERYTHEMA (Scar tissue from 14 years ago inside lower lip swelled up, was bright red and raw) was resolving, INJECTION SITE PRURITUS (itchy at the injection site) and INJECTION SITE PAIN (burning at the injection site) outcome was unknown and INJECTION SITE RASH (rash at injection site) and FATIGUE (fatigue) had resolved. Concomitant medications were not provided. Action taken with mRNA-1273 in response to the event was not applicable This case was linked to MOD-2021-079367 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 10-May-2021: Provided the Email address.

Other Meds: SYNTHROID; AVESTALO

Current Illness:

ID: 1566886
Sex: F
Age: 83
State: KY

Vax Date: 02/28/2021
Onset Date: 03/13/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Redness on site of vaccination; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (Redness on site of vaccination) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high and Heart disease, unspecified. On 28-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Mar-2021, the patient experienced VACCINATION SITE ERYTHEMA (Redness on site of vaccination). At the time of the report, VACCINATION SITE ERYTHEMA (Redness on site of vaccination) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications includes unspecified high blood pressure medications and heart medications. No treatment information was provided.

Other Meds:

Current Illness: Blood pressure high; Heart disease, unspecified

ID: 1566887
Sex: F
Age: 54
State: PA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: tongue is cracking and sore; Face red and hot; This spontaneous case was reported by a consumer and describes the occurrence of PLICATED TONGUE (tongue is cracking and sore) and FLUSHING (Face red and hot) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002B21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Mar-2021, the patient experienced PLICATED TONGUE (tongue is cracking and sore) and FLUSHING (Face red and hot). On 14-Mar-2021, FLUSHING (Face red and hot) outcome was unknown. At the time of the report, PLICATED TONGUE (tongue is cracking and sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. No treatment medications were provided

Other Meds:

Current Illness:

ID: 1566888
Sex: F
Age: 58
State: IL

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

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

Lab Data:

Allergies:

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

Symptoms: diarrhea; light headed; nausea; fatigue; fever of 99 F; body aches; chills; dull headache; Sore arm; This spontaneous case was reported by a patient and describes the occurrence of DIARRHOEA (diarrhea), DIZZINESS (light headed), PAIN IN EXTREMITY (Sore arm), PYREXIA (fever of 99 F) and MYALGIA (body aches) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 08-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced PAIN IN EXTREMITY (Sore arm) and HEADACHE (dull headache). On 10-Mar-2021, the patient experienced CHILLS (chills). On 12-Mar-2021, the patient experienced PYREXIA (fever of 99 F), MYALGIA (body aches) and FATIGUE (fatigue). On 13-Mar-2021, the patient experienced DIARRHOEA (diarrhea), DIZZINESS (light headed) and NAUSEA (nausea). At the time of the report, DIARRHOEA (diarrhea), DIZZINESS (light headed), PAIN IN EXTREMITY (Sore arm), PYREXIA (fever of 99 F), MYALGIA (body aches), HEADACHE (dull headache), CHILLS (chills), FATIGUE (fatigue) and NAUSEA (nausea) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 99 (Inconclusive) 99 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant and treatment medications were reported. This case was linked to MOD-2021-045281.

Other Meds:

Current Illness:

ID: 1566889
Sex: M
Age:
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: Got sick; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Got sick) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 immunisation. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ILLNESS (Got sick). At the time of the report, ILLNESS (Got sick) outcome was unknown. No concomitant medications were provided. No treatment medications were provided.

Other Meds:

Current Illness:

ID: 1566890
Sex: F
Age:
State: IL

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

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Still has a little bump from the first dose at the vaccination site; A little diarrhea; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE MASS (Still has a little bump from the first dose at the vaccination site), DIARRHOEA (A little diarrhea) and FATIGUE (Fatigue) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006M20A) for COVID-19 vaccination. Concomitant products included LIRAGLUTIDE (VICTOZA), METFORMIN, LOSARTAN, CLOPIDOGREL and ROSUVASTATIN for an unknown indication. On 28-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 VACCINATION SITE MASS (Still has a little bump from the first dose at the vaccination site), DIARRHOEA (A little diarrhea) and FATIGUE (Fatigue). At the time of the report, VACCINATION SITE MASS (Still has a little bump from the first dose at the vaccination site) had not resolved and DIARRHOEA (A little diarrhea) and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment medications were reported.

Other Meds: VICTOZA; METFORMIN; LOSARTAN; CLOPIDOGREL; ROSUVASTATIN

Current Illness:

ID: 1566891
Sex: U
Age:
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: some of the vaccine leaked out and syringe part; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of UNDERDOSE (some of the vaccine leaked out and syringe part) 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 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 UNDERDOSE (some of the vaccine leaked out and syringe part). At the time of the report, UNDERDOSE (some of the vaccine leaked out and syringe part) 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 medication provided by the reporter no treatment information reported by the reporter Most recent FOLLOW-UP information incorporated above includes: On 15-Jun-2021: Follow up received on 15-jun-2021, contains No New information

Other Meds:

Current Illness:

ID: 1566892
Sex: M
Age:
State: WA

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

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

Lab Data:

Allergies:

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

Symptoms: feels weak; felt warm; he could not stay awake; fatigue and tired; pain in his lower abdomen; Could not sleep last night because the pain was so bad; little dizzy; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN LOWER (pain in his lower abdomen), ASTHENIA (feels weak), FEELING HOT (felt warm), DIZZINESS (little dizzy) and SOMNOLENCE (he could not stay awake) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 5AW1-U56-MH22) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Mar-2021, the patient experienced DIZZINESS (little dizzy). On 14-Mar-2021, the patient experienced ABDOMINAL PAIN LOWER (pain in his lower abdomen) and INSOMNIA (Could not sleep last night because the pain was so bad). On 15-Mar-2021, the patient experienced ASTHENIA (feels weak), FEELING HOT (felt warm), SOMNOLENCE (he could not stay awake) and FATIGUE (fatigue and tired). At the time of the report, ABDOMINAL PAIN LOWER (pain in his lower abdomen), ASTHENIA (feels weak), FEELING HOT (felt warm), DIZZINESS (little dizzy), SOMNOLENCE (he could not stay awake) and FATIGUE (fatigue and tired) had not resolved and INSOMNIA (Could not sleep last night because the pain was so bad) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. Reportedly, the patient could not sleep because the pain in his lower abdomen was very bad.

Other Meds:

Current Illness:

ID: 1566893
Sex: F
Age: 47
State: NJ

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Runny nose; Fever; exhaustion; This spontaneous case was reported by a consumer and describes the occurrence of RHINORRHOEA (Runny nose), PYREXIA (Fever) and FATIGUE (exhaustion) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was reported. On 01-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Mar-2021, the patient experienced RHINORRHOEA (Runny nose), PYREXIA (Fever) and FATIGUE (exhaustion). At the time of the report, RHINORRHOEA (Runny nose), PYREXIA (Fever) and FATIGUE (exhaustion) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1566894
Sex: M
Age:
State: VA

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

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore arms; Headaches; Muscle aches; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arms), HEADACHE (Headaches) and MYALGIA (Muscle aches) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was reported. On 24-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arms), HEADACHE (Headaches) and MYALGIA (Muscle aches). At the time of the report, PAIN IN EXTREMITY (Sore arms), HEADACHE (Headaches) and MYALGIA (Muscle aches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product used was not provided by the reporter. Treatment information was not provided by the reporter.

Other Meds:

Current Illness:

ID: 1566895
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: minor bleeding after the administration of her 2nd dose; This spontaneous case was reported by an other health care professional and describes the occurrence of VACCINATION SITE HAEMORRHAGE (minor bleeding after the administration of her 2nd dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE HAEMORRHAGE (minor bleeding after the administration of her 2nd dose). At the time of the report, VACCINATION SITE HAEMORRHAGE (minor bleeding after the administration of her 2nd dose) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Action taken with mRNA-1273 in response to the event was not applicable. No concomitant medications were reported. Treatment information was unknown. Most recent FOLLOW-UP information incorporated above includes: On 24-May-2021: Follow-up information received on 24-MAY-2021, contains no new information.

Other Meds:

Current Illness:

ID: 1566896
Sex: F
Age: 84
State: FL

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Felling really bad; has been in bed for 2 days, only goes to the bathroom and straight to bed again.; Usually has difficulty breathing but once she takes her inhalators she can breath better again, this is not happening now, the difficulty is ongoing/felt like an elephant foot on my chest, when breathing; Diarrhea; stomach sick, cannot eat; Feels very very weak; Headache; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (Felling really bad), IMPAIRED WORK ABILITY (has been in bed for 2 days, only goes to the bathroom and straight to bed again.), DYSPNOEA (Usually has difficulty breathing but once she takes her inhalators she can breath better again, this is not happening now, the difficulty is ongoing/felt like an elephant foot on my chest, when breathing), DIARRHOEA (Diarrhea) and ABDOMINAL DISCOMFORT (stomach sick, cannot eat) in an 84-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included COPD (She has COPD and usually has difficulty breathing but once she takes her inhalators she can breath better again). Concomitant products included LOSARTAN and LORAZEPAM for an unknown indication. On 13-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Mar-2021, the patient experienced MALAISE (Felling really bad), IMPAIRED WORK ABILITY (has been in bed for 2 days, only goes to the bathroom and straight to bed again.), DYSPNOEA (Usually has difficulty breathing but once she takes her inhalators she can breath better again, this is not happening now, the difficulty is ongoing/felt like an elephant foot on my chest, when breathing), DIARRHOEA (Diarrhea), ABDOMINAL DISCOMFORT (stomach sick, cannot eat), ASTHENIA (Feels very very weak) and HEADACHE (Headache). At the time of the report, MALAISE (Felling really bad), IMPAIRED WORK ABILITY (has been in bed for 2 days, only goes to the bathroom and straight to bed again.), DYSPNOEA (Usually has difficulty breathing but once she takes her inhalators she can breath better again, this is not happening now, the difficulty is ongoing/felt like an elephant foot on my chest, when breathing), DIARRHOEA (Diarrhea), ABDOMINAL DISCOMFORT (stomach sick, cannot eat), ASTHENIA (Feels very very weak) and HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Additional concomitant medications included unspecified pain medications (as needed, not daily) and inhalers (unspecified). The patient received treatment with "peptize".

Other Meds: LOSARTAN; LORAZEPAM

Current Illness: COPD (She has COPD and usually has difficulty breathing but once she takes her inhalators she can breath better again)

ID: 1566897
Sex: F
Age: 68
State: CO

Vax Date: 02/10/2021
Onset Date: 03/10/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: sore headache; rush all over her body, is bad in her ankles; really sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (really sore arm), RASH (rush all over her body, is bad in her ankles) and HEADACHE (sore headache) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 032M20A and 013M20A) for COVID-19 vaccination. No Medical History information was reported. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 10-Mar-2021, the patient experienced PAIN IN EXTREMITY (really sore arm). On 11-Mar-2021, the patient experienced RASH (rush all over her body, is bad in her ankles). On an unknown date, the patient experienced HEADACHE (sore headache). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) (oral) for Adverse event, at an unspecified dose and frequency and PARACETAMOL (TYLENOL) for Headache, at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (really sore arm), RASH (rush all over her body, is bad in her ankles) and HEADACHE (sore headache) outcome was unknown. Concomitant medications included blood thinner medications.

Other Meds:

Current Illness:

ID: 1566898
Sex: F
Age: 81
State: PA

Vax Date: 03/01/2021
Onset Date: 03/11/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Lump in her armpit (injection side), it's about 2 inches large and hot; Lump in her armpit (injection side), it's about 2 inches large and hot; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (Lump in her armpit (injection side), it's about 2 inches large and hot) and LYMPHADENOPATHY (Lump in her armpit (injection side), it's about 2 inches large and hot) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. The patient's past medical history included Breast cancer in 1988. Concomitant products included ATORVASTATIN CALCIUM (LIPTOR [ATORVASTATIN CALCIUM]), VITAMIN A [RETINOL], ACETYLSALICYLIC ACID (BABY ASPIRIN) and CLONAZEPAM for an unknown indication. On 01-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Mar-2021, the patient experienced FEELING HOT (Lump in her armpit (injection side), it's about 2 inches large and hot) and LYMPHADENOPATHY (Lump in her armpit (injection side), it's about 2 inches large and hot). The patient was treated with PARACETAMOL (TYLENOL) at a dose of UNK, prn. At the time of the report, FEELING HOT (Lump in her armpit (injection side), it's about 2 inches large and hot) and LYMPHADENOPATHY (Lump in her armpit (injection side), it's about 2 inches large and hot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Additional concomitant products used included Hydrops, Systemin and Sorect.

Other Meds: LIPTOR [ATORVASTATIN CALCIUM]; VITAMIN A [RETINOL]; BABY ASPIRIN; CLONAZEPAM

Current Illness:

ID: 1566899
Sex: F
Age: 78
State: GA

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: cough; mild shortness of breath; Fever; Chills; Nausea; Fatigue/tiredness; joint pain; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (cough), DYSPNOEA (mild shortness of breath), PYREXIA (Fever), CHILLS (Chills) and NAUSEA (Nausea) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported. Concomitant products included INSULIN and PANTOPRAZOLE for an unknown indication. On 11-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, the patient experienced COUGH (cough), DYSPNOEA (mild shortness of breath), PYREXIA (Fever), CHILLS (Chills), NAUSEA (Nausea), FATIGUE (Fatigue/tiredness) and ARTHRALGIA (joint pain). At the time of the report, COUGH (cough), DYSPNOEA (mild shortness of breath), PYREXIA (Fever), CHILLS (Chills), NAUSEA (Nausea), FATIGUE (Fatigue/tiredness) and ARTHRALGIA (joint pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment medications were reported.

Other Meds: INSULIN; PANTOPRAZOLE

Current Illness:

ID: 1566900
Sex: M
Age:
State: IN

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Nausea; fatigue; This spontaneous case was reported by a nurse and describes the occurrence of NAUSEA (Nausea) and FATIGUE (fatigue) in a 27-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) for COVID-19 vaccination. No medical history was reported. On 14-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Mar-2021 at 11:00 AM, the patient experienced NAUSEA (Nausea) and FATIGUE (fatigue). At the time of the report, NAUSEA (Nausea) and FATIGUE (fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 07-May-2021: Initiative, email from reporter asking for patient identifiers.

Other Meds:

Current Illness:

ID: 1566901
Sex: F
Age: 60
State: AZ

Vax Date: 01/16/2021
Onset Date: 02/13/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: tachycardia; less dizziness; very little overall muscle pain; This spontaneous case was reported by a physician and describes the occurrence of TACHYCARDIA (tachycardia), DIZZINESS (less dizziness) and MYALGIA (very little overall muscle pain) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013m20a and 025L20A) for COVID-19 vaccination. Concurrent medical conditions included Sulfonamide allergy, Lymphoma (non-Hodgkin's) (Recurring) since 2011 and Lymphoma (non-Hodgkin's) (First diagnosis) since 2004. Concomitant products included ASA, FISH OIL, MINERALS NOS, VITAMINS NOS (MULTIVITAMIN AND MINERAL SUPPLEMENT), schizandra and UBIDECARENONE (Q10) for an unknown indication. On 16-Jan-2021 at 8:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 13-Feb-2021, the patient experienced MYALGIA (very little overall muscle pain). On an unknown date, the patient experienced TACHYCARDIA (tachycardia) and DIZZINESS (less dizziness). At the time of the report, TACHYCARDIA (tachycardia), DIZZINESS (less dizziness) and MYALGIA (very little overall muscle pain) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Patient states that his heart rate was up 150 bpm, saturation was 99 to 97%. Patient did not seek medical attention as she being a doctor herself. She has taken lots of water and electrolytes. Treatment information not provided. This case was linked to MOD-2021-006185, MOD-2021-006185 (Patient Link).

Other Meds: ASA; FISH OIL; MULTIVITAMIN AND MINERAL SUPPLEMENT; schizandra; Q10

Current Illness: Lymphoma (non-Hodgkin's) (Recurring); Lymphoma (non-Hodgkin's) (First diagnosis); Sulfonamide allergy

ID: 1566902
Sex: M
Age: 72
State: MI

Vax Date: 02/24/2021
Onset Date: 03/12/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: COVID Positive; This spontaneous case was reported by a consumer and describes the occurrence of SARS-COV-2 TEST POSITIVE (COVID Positive) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) for COVID-19 vaccination. No Medical History information was reported. On 24-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, the patient experienced SARS-COV-2 TEST POSITIVE (COVID Positive). At the time of the report, SARS-COV-2 TEST POSITIVE (COVID Positive) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product used was not provided by the reporter. Treatment information was not provided by the reporter.

Other Meds:

Current Illness:

ID: 1566903
Sex: F
Age:
State: VA

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

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

Lab Data:

Allergies:

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

Symptoms: her tongue on the right side and lip on right side being funny, tingl/had paresthesia of tongue; her tongue on the right side and lip on right side being funny, tingly, weird feeling; Chills; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of PARAESTHESIA ORAL (her tongue on the right side and lip on right side being funny, tingl/had paresthesia of tongue), FEELING ABNORMAL (her tongue on the right side and lip on right side being funny, tingly, weird feeling) and CHILLS (Chills) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030A21A and 021B21A) for COVID-19 vaccination. Previously administered products included for Product used for unknown indication: Cortisone. Past adverse reactions to the above products included Flushing with Cortisone. Concurrent medical conditions included Acid reflux (oesophageal) since 01-Jan-2010, Diverticulitis since 01-Jan-1996, Allergy to antibiotic (Allergy to Bactrim antibiotic) and Pain. Concomitant products included OMEPRAZOLE MAGNESIUM (PRILOSEC [OMEPRAZOLE MAGNESIUM]) from 01-Jan-2010 to an unknown date for Reflux oesophagitis. On 06-Mar-2021 at 9:16 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Apr-2021 at 9:20 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 06-Mar-2021, the patient experienced PARAESTHESIA ORAL (her tongue on the right side and lip on right side being funny, tingl/had paresthesia of tongue), FEELING ABNORMAL (her tongue on the right side and lip on right side being funny, tingly, weird feeling) and CHILLS (Chills). The patient was treated with PARACETAMOL (TYLENOL) (oral) ongoing since an unknown date for Pain, at a dose of 500 UNK. On 06-Mar-2021, PARAESTHESIA ORAL (her tongue on the right side and lip on right side being funny, tingl/had paresthesia of tongue), FEELING ABNORMAL (her tongue on the right side and lip on right side being funny, tingly, weird feeling) and CHILLS (Chills) had resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 06-Mar-2021, Blood pressure measurement: 180/100 (Inconclusive) 180/100. On 06-Mar-2021, Heart rate: rapid (High) Rapid. On 06-Mar-2021, Oxygen saturation: 96-99 (normal) 96-99. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Description: A physician checked patient's airways and said they looked beautiful but for safety was sent to emergency room. The patient was sent home with her blood pressure and heart rate back to normal from emergency room. . She had been fine since then. The patient emailed her physician wondering if what she experienced was because of a panic attack but he didn't thought so, and suggested her taking the second shot and taking Epinephrine Pen with her. The patient had computerized tomography (CT) scan done on an unknown date with unknown results. No treatment information provided. Most recent FOLLOW-UP information incorporated above includes: On 06-May-2021: TCR follow-up received is non-significant. Updated email address of the reporter. On 13-May-2021: Follow-up received updated patient details, second dose information, medical history, concomitant medications, action taken updated.

Other Meds: PRILOSEC [OMEPRAZOLE MAGNESIUM]

Current Illness: Acid reflux (oesophageal); Allergy to antibiotic (Allergy to Bactrim antibiotic); Diverticulitis; Pain

ID: 1566904
Sex: F
Age: 26
State: IN

Vax Date: 03/14/2021
Onset Date: 03/15/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Dizziness; Nausea/vomiting; Nausea/vomiting; This spontaneous case was reported by a nurse (subsequently medically confirmed) and describes the occurrence of DIZZINESS (Dizziness), NAUSEA (Nausea/vomiting) and VOMITING (Nausea/vomiting) in a 26-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) for COVID-19 vaccination. No Medical History information was reported. On 14-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Mar-2021 at 2:15 AM, the patient experienced DIZZINESS (Dizziness), NAUSEA (Nausea/vomiting) and VOMITING (Nausea/vomiting). At the time of the report, DIZZINESS (Dizziness), NAUSEA (Nausea/vomiting) and VOMITING (Nausea/vomiting) 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. Treatments and concomitant medications were not provided. Most recent FOLLOW-UP information incorporated above includes: On 26-May-2021: Non Significant FU, Additional information included Anatomical location,Patient initials, Date of birth, event start date and time updated.

Other Meds:

Current Illness:

ID: 1566905
Sex: M
Age: 68
State: MI

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Violent chills after 1st dose; Fever after 1st dose; Shaking after 1st dose; Whole body hurts after 1st dose; No appetite after 1st dose; Armpits hurt after 1st dose; Slightly sore arm after 1st dose; Very tired after 1st dose; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Slightly sore arm after 1st dose), FATIGUE (Very tired after 1st dose), CHILLS (Violent chills after 1st dose), PYREXIA (Fever after 1st dose) and TREMOR (Shaking after 1st dose) in a 68-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 11-Mar-2021 at 8:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Mar-2021, the patient experienced PAIN IN EXTREMITY (Slightly sore arm after 1st dose) and FATIGUE (Very tired after 1st dose). On an unknown date, the patient experienced CHILLS (Violent chills after 1st dose), PYREXIA (Fever after 1st dose), TREMOR (Shaking after 1st dose), PAIN (Whole body hurts after 1st dose), DECREASED APPETITE (No appetite after 1st dose) and AXILLARY PAIN (Armpits hurt after 1st dose). At the time of the report, PAIN IN EXTREMITY (Slightly sore arm after 1st dose), FATIGUE (Very tired after 1st dose), CHILLS (Violent chills after 1st dose), PYREXIA (Fever after 1st dose), TREMOR (Shaking after 1st dose), PAIN (Whole body hurts after 1st dose), DECREASED APPETITE (No appetite after 1st dose) and AXILLARY PAIN (Armpits hurt after 1st dose) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In December 2019, SARS-CoV-2 test positive: positive (Positive) positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No Treatments were reported.

Other Meds:

Current Illness:

ID: 1566906
Sex: F
Age: 58
State: IL

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

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

Lab Data:

Allergies:

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

Symptoms: chills; Low grade fever; fatigue; headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headache), CHILLS (chills), PYREXIA (Low grade fever) and FATIGUE (fatigue) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 08-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 09-Mar-2021, the patient experienced HEADACHE (headache). On 11-Mar-2021, the patient experienced CHILLS (chills), PYREXIA (Low grade fever) and FATIGUE (fatigue). At the time of the report, HEADACHE (headache), CHILLS (chills), PYREXIA (Low grade fever) and FATIGUE (fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. This case was linked to MOD-2021-045117 (Linked Report).; Sender's Comments: MOD-2021-045117:Wife case

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm