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: 1567157
Sex: F
Age: 77
State: TX

Vax Date: 03/13/2021
Onset Date: 03/01/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: vomitting; chills; feeling lousy; flu-like; pains; sick to her stomach; fever; achy joints; headache; feels like something is sitting on her chest; tired; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (feeling lousy), INFLUENZA LIKE ILLNESS (flu-like), CHEST DISCOMFORT (feels like something is sitting on her chest), PAIN (pains) and ABDOMINAL DISCOMFORT (sick to her stomach) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Mar-2021, the patient experienced FEELING ABNORMAL (feeling lousy), INFLUENZA LIKE ILLNESS (flu-like), PAIN (pains), ABDOMINAL DISCOMFORT (sick to her stomach), PYREXIA (fever), ARTHRALGIA (achy joints), HEADACHE (headache) and CHILLS (chills). On 14-Mar-2021, the patient experienced VOMITING (vomitting). In March 2021, the patient experienced CHEST DISCOMFORT (feels like something is sitting on her chest) and FATIGUE (tired). At the time of the report, FEELING ABNORMAL (feeling lousy), INFLUENZA LIKE ILLNESS (flu-like), PAIN (pains), ABDOMINAL DISCOMFORT (sick to her stomach), PYREXIA (fever), ARTHRALGIA (achy joints), HEADACHE (headache), VOMITING (vomitting) and CHILLS (chills) had resolved and CHEST DISCOMFORT (feels like something is sitting on her chest) and FATIGUE (tired) had not resolved. No concomitant medications were reported. No treatment was administered. Most recent FOLLOW-UP information incorporated above includes: On 16-Mar-2021: Events, patient details updated. Case became valid.

Other Meds:

Current Illness:

ID: 1567158
Sex: F
Age:
State: GA

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: hives; redness; itching; rise in the area size of a dime; body ache; chills; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (hives), ERYTHEMA (redness), PRURITUS (itching), GROWTH ACCELERATED (rise in the area size of a dime) and PAIN (body ache) in a female patient of an unknown age 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 information was reported. On 08-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Mar-2021, the patient experienced PAIN (body ache) and CHILLS (chills). On 15-Mar-2021, the patient experienced URTICARIA (hives), ERYTHEMA (redness), PRURITUS (itching) and GROWTH ACCELERATED (rise in the area size of a dime). On 10-Mar-2021, PAIN (body ache) and CHILLS (chills) had resolved. At the time of the report, URTICARIA (hives), ERYTHEMA (redness), PRURITUS (itching) and GROWTH ACCELERATED (rise in the area size of a dime) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment medication included cortisone cream Most recent FOLLOW-UP information incorporated above includes: On 24-May-2021: Follow Up received: Non Significant Information Received.

Other Meds:

Current Illness:

ID: 1567159
Sex: M
Age:
State: AZ

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

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

Lab Data:

Allergies:

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

Symptoms: Some of it is coming back out; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE EXTRAVASATION (Some of it is coming back out) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025S202A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INJECTION SITE EXTRAVASATION (Some of it is coming back out). At the time of the report, INJECTION SITE EXTRAVASATION (Some of it is coming back out) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications were not reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1567160
Sex: F
Age: 40
State: FL

Vax Date: 03/08/2021
Onset Date: 03/13/2021
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: Excruciating pain in arms; Tingling in fingers; Can not close fingers; Can not sleep; This spontaneous case was reported by a patient family member or friend and describes the occurrence of PAIN IN EXTREMITY (Excruciating pain in arms), PARAESTHESIA (Tingling in fingers), MUSCULOSKELETAL STIFFNESS (Can not close fingers) and INSOMNIA (Can not sleep) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010821A) for COVID-19 vaccination. No Medical History information was reported. On 08-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Mar-2021, the patient experienced PAIN IN EXTREMITY (Excruciating pain in arms), PARAESTHESIA (Tingling in fingers), MUSCULOSKELETAL STIFFNESS (Can not close fingers) and INSOMNIA (Can not sleep). The patient was treated with CYCLOBENZAPRINE for Adverse event, at a dose of 1 dosage form; LIDOCAINE for Adverse event, at a dose of 5 % patch and PREDNISONE for Adverse event, at a dose of 20 mg. At the time of the report, PAIN IN EXTREMITY (Excruciating pain in arms), PARAESTHESIA (Tingling in fingers), MUSCULOSKELETAL STIFFNESS (Can not close fingers) and INSOMNIA (Can not sleep) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Other Treatment details included Intravenous (IV) pain medication. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1567161
Sex: F
Age: 76
State: TX

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: 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: Patient believes the injection went under the skin not muscularly; Formed a knot; Feels hot, got heat in it; Got blister on skin; Increasingly worse; itching of skin; Injection site kind of burn; Spread bigger and red; This spontaneous case was reported by a consumer and describes the occurrence of INCORRECT ROUTE OF PRODUCT ADMINISTRATION (Patient believes the injection went under the skin not muscularly), VACCINATION SITE MASS (Formed a knot), VACCINATION SITE WARMTH (Feels hot, got heat in it), BLISTER (Got blister on skin) and CONDITION AGGRAVATED (Increasingly worse) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history were reported. Concomitant products included DIAZEPAM, DULOXETINE, TRAZODONE and METFORMIN for an unknown indication. On 06-Mar-2021 at 3:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Mar-2021, the patient experienced INCORRECT ROUTE OF PRODUCT ADMINISTRATION (Patient believes the injection went under the skin not muscularly), VACCINATION SITE MASS (Formed a knot), VACCINATION SITE WARMTH (Feels hot, got heat in it), BLISTER (Got blister on skin), CONDITION AGGRAVATED (Increasingly worse), PRURITUS (itching of skin), VACCINATION SITE PAIN (Injection site kind of burn) and VACCINATION SITE ERYTHEMA (Spread bigger and red). On 06-Mar-2021, INCORRECT ROUTE OF PRODUCT ADMINISTRATION (Patient believes the injection went under the skin not muscularly) had resolved. At the time of the report, VACCINATION SITE MASS (Formed a knot), VACCINATION SITE WARMTH (Feels hot, got heat in it), BLISTER (Got blister on skin), CONDITION AGGRAVATED (Increasingly worse), PRURITUS (itching of skin), VACCINATION SITE PAIN (Injection site kind of burn) and VACCINATION SITE ERYTHEMA (Spread bigger and red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication include vitamins. No treatment medication details was reported. Most recent FOLLOW-UP information incorporated above includes: On 17-Jun-2021: Follow-up information received on 17-JUN-2021. No new information was updated

Other Meds: DIAZEPAM; DULOXETINE; TRAZODONE; METFORMIN

Current Illness:

ID: 1567162
Sex: M
Age: 64
State: NY

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: shakes; chills; joint pain; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (shakes), CHILLS (chills) and ARTHRALGIA (joint pain) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038a21a) for COVID-19 vaccination. Concurrent medical conditions included Cholesterol. Concomitant products included ACETYLSALICYLIC ACID (BABY ASPIRIN), MULTIVITAMIN & MINERAL, NALTREXONE and PREDNISONE for an unknown indication. On 16-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Mar-2021, the patient experienced TREMOR (shakes), CHILLS (chills) and ARTHRALGIA (joint pain). At the time of the report, TREMOR (shakes), CHILLS (chills) and ARTHRALGIA (joint pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications included unspecified cholesterol medication and eye drops. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 07-May-2021: No new information was provided.

Other Meds: BABY ASPIRIN; MULTIVITAMIN & MINERAL; NALTREXONE; PREDNISONE

Current Illness: Cholesterol

ID: 1567163
Sex: M
Age: 75
State: MA

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

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: This spontaneous case was reported by a patient and describes the occurrence of HYPOAESTHESIA (Right side of his face was numb), DIZZINESS (Dizziness), ASTHENIA (Weak all over), RASH (Rash) and HEADACHE (Headache) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Heart valve replacement. Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) and VITAMINS NOS for an unknown indication. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Mar-2021, the patient experienced HYPOAESTHESIA (Right side of his face was numb), DIZZINESS (Dizziness), ASTHENIA (Weak all over), RASH (Rash) and HEADACHE (Headache). At the time of the report, HYPOAESTHESIA (Right side of his face was numb), DIZZINESS (Dizziness), ASTHENIA (Weak all over), RASH (Rash) and HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use included blood pressure medications. No treatment details were provided.

Other Meds: ASPIRIN (E.C.); VITAMINS NOS

Current Illness:

ID: 1567164
Sex: F
Age: 65
State: LA

Vax Date: 02/13/2021
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: Pharyngeal swelling

Symptoms: face swelling up; rash all over her body; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING FACE (face swelling up) and RASH (rash all over her body) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 032M20A and 007M20A) for COVID-19 vaccination. Concurrent medical conditions included Lupus syndrome and Autoimmune disorder. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 14-Mar-2021, the patient experienced SWELLING FACE (face swelling up) and RASH (rash all over her body). At the time of the report, SWELLING FACE (face swelling up) and RASH (rash all over her body) was resolving. The action taken with mRNA-1273(Moderna COVID-19 Vaccine) was not applicable Treatment details included antihistamines (names not specified). No concomitant medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 20-Jun-2021: Other relevant history in patient tab added, outcome of event changed from unknown to recovering.

Other Meds:

Current Illness: Autoimmune disorder; Lupus syndrome

ID: 1567165
Sex: U
Age: 55
State: NY

Vax Date: 02/12/2021
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: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Aches; Diarrhea; Headache; Fatigue; Muscle pain; Fever; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Aches), DIARRHOEA (Diarrhea), HEADACHE (Headache), FATIGUE (Fatigue) and MYALGIA (Muscle pain) in a 55-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 032M20A and 024M20A) 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) (Intramuscular) 1 dosage form. On 12-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 13-Mar-2021, the patient experienced PAIN (Aches), DIARRHOEA (Diarrhea), HEADACHE (Headache), FATIGUE (Fatigue), MYALGIA (Muscle pain), PYREXIA (Fever) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL) ongoing from 13-Mar-2021 for Adverse event, at a dose of 500 milligram, every 5 hours. At the time of the report, PAIN (Aches), DIARRHOEA (Diarrhea), HEADACHE (Headache), MYALGIA (Muscle pain) and PYREXIA (Fever) outcome was unknown and FATIGUE (Fatigue) and NAUSEA (Nausea) had not resolved. No concomitant medications reported by investigator

Other Meds:

Current Illness:

ID: 1567166
Sex: F
Age: 22
State: TX

Vax Date: 01/08/2021
Onset Date: 01/08/2021
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: Passed 37 days mark for second dose/didn't get the second dose yet; Really big knot at the side of the injection; Nausea; Headache; Chills; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Passed 37 days mark for second dose/didn't get the second dose yet), VACCINATION SITE MASS (Really big knot at the side of the injection), NAUSEA (Nausea), HEADACHE (Headache) and CHILLS (Chills) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included DULOXETINE HYDROCHLORIDE (CYMBALTA) and VENLAFAXINE HYDROCHLORIDE (EFFEXOR) for an unknown indication. On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Jan-2021, the patient experienced VACCINATION SITE MASS (Really big knot at the side of the injection), NAUSEA (Nausea), HEADACHE (Headache) and CHILLS (Chills). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Passed 37 days mark for second dose/didn't get the second dose yet). On 08-Jan-2021, NAUSEA (Nausea), HEADACHE (Headache) and CHILLS (Chills) had resolved. On 15-Jan-2021, VACCINATION SITE MASS (Really big knot at the side of the injection) had resolved. At the time of the report, PRODUCT DOSE OMISSION ISSUE (Passed 37 days mark for second dose/didn't get the second dose yet) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, Vaccination site mass, nausea, chills, headache, a causal relationship cannot be excluded. This report also refers to a case of product dose omission issue for mRNA-1273, lot # unknown.

Other Meds: CYMBALTA; EFFEXOR

Current Illness:

ID: 1567167
Sex: F
Age: 83
State: NM

Vax Date: 03/01/2021
Onset Date: 03/04/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: left side of face numb, and left eye; left side of face numb, and left eye; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (left side of face numb, and left eye) and HYPOAESTHESIA EYE (left side of face numb, and left eye) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Glaucoma. On 01-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 HYPOAESTHESIA (left side of face numb, and left eye) and HYPOAESTHESIA EYE (left side of face numb, and left eye). The patient was treated with PREDNISONE for Adverse event, at a dose of 1 dosage form. At the time of the report, HYPOAESTHESIA (left side of face numb, and left eye) and HYPOAESTHESIA EYE (left side of face numb, and left eye) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant information was reported.

Other Meds:

Current Illness: Glaucoma

ID: 1567168
Sex: F
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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: headaches; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headaches) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced HEADACHE (headaches). At the time of the report, HEADACHE (headaches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant or treatment information was reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1567169
Sex: U
Age:
State: MI

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: Received first dose of Vaccine on January 24th (About 50 days ago) and has not received; A Spontaneous report was received from a health care professional, concerning a patient of unspecified age and gender, who received Moderna's COVID-19 vaccine and has not received the second dose. The patients medical history was not provided. Concomitant product was not provided by reporter. On 24-JAN-2021, the patient received their first dose of two planned doses of mRNA-1273(lot number unknown) via unknown route for COVID-19 infection prophylaxis and is yet to receive second dose. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was Unknown. The outcome of the event, Inappropriate schedule of drug was resolved at the time of the report.; Reporter's Comments: This report refers to a case of Inappropriate schedule of product administration for mRNA-1273, lot # unknown with no associated Adverse Events.

Other Meds:

Current Illness:

ID: 1567170
Sex: M
Age:
State: OK

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: stuff neck; sore arm; headache; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULOSKELETAL STIFFNESS (stuff neck), PAIN IN EXTREMITY (sore arm) and HEADACHE (headache) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Jan-2021, the patient experienced MUSCULOSKELETAL STIFFNESS (stuff neck), PAIN IN EXTREMITY (sore arm) and HEADACHE (headache). At the time of the report, MUSCULOSKELETAL STIFFNESS (stuff neck), PAIN IN EXTREMITY (sore arm) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273(Moderna COVID-19 vaccine) was not apllicable No concomitant or treatment information was reported. This case was linked to MOD-2021-046335, MOD-2021-110283.

Other Meds:

Current Illness:

ID: 1567171
Sex: F
Age: 67
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: 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: Little dizziness; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Little dizziness) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included OXYCODONE HYDROCHLORIDE, OXYCODONE TEREPHTHALATE, PARACETAMOL (PERCOCET [OXYCODONE HYDROCHLORIDE;OXYCODONE TEREPHTHALATE;PARACETAMOL]), CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000) and ACETYLSALICYLIC ACID (ASPIRIN LOW) for an unknown indication. On 15-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Mar-2021, the patient experienced DIZZINESS (Little dizziness). At the time of the report, DIZZINESS (Little dizziness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information not provided.

Other Meds: PERCOCET [OXYCODONE HYDROCHLORIDE;OXYCODONE TEREPHTHALATE;PARACETAMOL]; VITAMIN D 2000; ASPIRIN LOW

Current Illness:

ID: 1567172
Sex: F
Age:
State: FL

Vax Date: 02/12/2021
Onset Date: 03/13/2021
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: Arm Pain; Headache; Fever; Chills; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm Pain), HEADACHE (Headache), PYREXIA (Fever), CHILLS (Chills) and NAUSEA (Nausea) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031L20A and 031A21A) for COVID-19 vaccination. Concurrent medical conditions included Acid reflux (esophageal). Concomitant products included FAMOTIDINE for Acid reflux (esophageal). On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 13-Mar-2021, the patient experienced PAIN IN EXTREMITY (Arm Pain), HEADACHE (Headache), PYREXIA (Fever), CHILLS (Chills) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. On 14-Mar-2021, PAIN IN EXTREMITY (Arm Pain), HEADACHE (Headache), PYREXIA (Fever), CHILLS (Chills) and NAUSEA (Nausea) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The action taken with mRNA-1273(Moderna COVID-19 vaccine) was not applicable Most recent FOLLOW-UP information incorporated above includes: On 07-May-2021: TCR

Other Meds: FAMOTIDINE

Current Illness: Acid reflux (esophageal)

ID: 1567173
Sex: F
Age: 65
State:

Vax Date: 02/26/2021
Onset Date:
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: itching in back; few hives/hives between knuckles; swamped in sweat during night; whole body was in pain; could not get out of bed; headache between neck and head; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (itching in back), URTICARIA (few hives/hives between knuckles), HYPERHIDROSIS (swamped in sweat during night), MYALGIA (whole body was in pain) and FATIGUE (could not get out of bed) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010421A) for COVID-19 immunisation. The occurrence of additional non-serious events is detailed below. Concomitant products included MULTIVITAMINS [VITAMINS NOS], VITAMIN D3, CYANOCOBALAMIN (B-12) and VITAMIN E [VITAMIN E NOS] for an unknown indication. On 26-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 PRURITUS (itching in back), URTICARIA (few hives/hives between knuckles), HYPERHIDROSIS (swamped in sweat during night), MYALGIA (whole body was in pain), FATIGUE (could not get out of bed) and HEADACHE (headache between neck and head). The patient was treated with DIPHENHYDRAMINE CITRATE, IBUPROFEN (ADVIL PM [DIPHENHYDRAMINE CITRATE;IBUPROFEN]) for Adverse event, at a dose of 1 dosage form. At the time of the report, PRURITUS (itching in back), URTICARIA (few hives/hives between knuckles), HYPERHIDROSIS (swamped in sweat during night), MYALGIA (whole body was in pain) and FATIGUE (could not get out of bed) had resolved and HEADACHE (headache between neck and head) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: MULTIVITAMINS [VITAMINS NOS]; VITAMIN D3; B-12; VITAMIN E [VITAMIN E NOS]

Current Illness:

ID: 1567174
Sex: F
Age: 50
State: KS

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: fever; chills; This spontaneous case was reported by an other health care professional and describes the occurrence of PYREXIA (fever) and CHILLS (chills) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M20A) for COVID-19 vaccination. No Medical History information was reported. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Mar-2021, the patient experienced PYREXIA (fever) and CHILLS (chills). At the time of the report, PYREXIA (fever) and CHILLS (chills) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Mar-2021, Body temperature: 105 f (High) 105 F. 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 and treatment medication was reported Most recent FOLLOW-UP information incorporated above includes: On 12-May-2021: NNI

Other Meds:

Current Illness:

ID: 1567175
Sex: F
Age: 91
State: FL

Vax Date: 03/04/2021
Onset Date: 03/06/2021
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: dropped her coffee cup, so she thought she had torn her rotator cuff; rash on the vaccination arm with the size of an apple; tired; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ROTATOR CUFF SYNDROME (dropped her coffee cup, so she thought she had torn her rotator cuff), VACCINATION SITE RASH (rash on the vaccination arm with the size of an apple) and FATIGUE (tired) in a 91-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) for COVID-19 vaccination. No reported medical history. Concomitant products included CHLOPHEDIANOL HCL, ATORVASTATIN, PROBIOTICS NOS, LISINOPRIL and METOPROLOL 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 06-Mar-2021, the patient experienced FATIGUE (tired). On 08-Mar-2021, the patient experienced ROTATOR CUFF SYNDROME (dropped her coffee cup, so she thought she had torn her rotator cuff) and VACCINATION SITE RASH (rash on the vaccination arm with the size of an apple). On 07-Mar-2021, FATIGUE (tired) had resolved. At the time of the report, ROTATOR CUFF SYNDROME (dropped her coffee cup, so she thought she had torn her rotator cuff) and VACCINATION SITE RASH (rash on the vaccination arm with the size of an apple) 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 information was provided. Patient got the first dose of the vaccine on 4Mar2021. She was tired over the weekend. On 8Mar2021 she noticed a rash on the vaccination arm with the size of an apple. Also, she dropped her coffee cup, so she thought she had torn her rotator cuff. She went to the doctor and the PA send her to get an MRI. Most recent FOLLOW-UP information incorporated above includes: On 06-May-2021: Follow Up received on 06-MAY-2021 Contains Non Significant Information

Other Meds: CHLOPHEDIANOL HCL; ATORVASTATIN; PROBIOTICS NOS; LISINOPRIL; METOPROLOL

Current Illness:

ID: 1567176
Sex: M
Age:
State: NY

Vax Date:
Onset Date:
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: Received 2 doses of the Moderna Vaccine and more than 2 weeks later tested positive with Covid-; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Received 2 doses of the Moderna Vaccine and more than 2 weeks later tested positive with Covid-) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received 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 COVID-19 (Received 2 doses of the Moderna Vaccine and more than 2 weeks later tested positive with Covid-). At the time of the report, COVID-19 (Received 2 doses of the Moderna Vaccine and more than 2 weeks later tested positive with Covid-) outcome was unknown. Not Provided No relevant concomitant medications were provided. No treatment information was provided. This case was linked to US-MODERNATX, INC.-MOD-2021-046434, US-MODERNATX, INC.-MOD-2021-046649 (Linked Report). Most recent FOLLOW-UP information incorporated above includes: On 06-May-2021: document updated; Sender's Comments: US-MODERNATX, INC.-MOD-2021-046434:cosslinked US-MODERNATX, INC.-MOD-2021-046649:cosslinked

Other Meds:

Current Illness:

ID: 1567177
Sex: F
Age: 79
State: FL

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: itchiness on scalp; itchiness on back; appearance of hives on the back; back appeared red; nausea; This spontaneous case was reported by a consumer and describes the occurrence of SKIN IRRITATION (itchiness on scalp), PRURITUS (itchiness on back), URTICARIA (appearance of hives on the back), ERYTHEMA (back appeared red) and NAUSEA (nausea) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. . On 07-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Mar-2021, the patient experienced SKIN IRRITATION (itchiness on scalp), PRURITUS (itchiness on back), URTICARIA (appearance of hives on the back), ERYTHEMA (back appeared red) and NAUSEA (nausea). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL A) at an unspecified dose and frequency. At the time of the report, SKIN IRRITATION (itchiness on scalp), PRURITUS (itchiness on back), URTICARIA (appearance of hives on the back), ERYTHEMA (back appeared red) and NAUSEA (nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant information was reported.

Other Meds:

Current Illness:

ID: 1567178
Sex: F
Age:
State: AZ

Vax Date: 03/15/2021
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: Unevaluable event

Symptoms: Pregnant; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (Pregnant) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 044M21A) for COVID-19 vaccination. Concurrent medical conditions included Pregnancy. On 15-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on 20-Nov-2020 and the estimated date of delivery was 27-Aug-2021. On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (Pregnant). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the sixteenth week of the pregnancy. At the time of the report, EXPOSURE DURING PREGNANCY (Pregnant) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Dec-2020, Pregnancy test: positive (Positive) Positive. On 18-Feb-2021, Ultrasound scan: normal (normal) normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient had 3 previous pregnancies which included one live full time birth and two miscarriages. Patient reported that this pregnancy resulted from fertility treatment. No concomitant or treatment information was reported.

Other Meds:

Current Illness: Pregnancy

ID: 1567179
Sex: F
Age: 70
State: MO

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Arm pain during injection/ arm pain is now a few inches from injection site shooting to hand; Unable to move arm without severe pain; Knot is forming a few inches away from injection site; Arm pain is now a few inches from injection site shooting to hand; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm pain during injection/ arm pain is now a few inches from injection site shooting to hand), PAIN (Unable to move arm without severe pain), VACCINATION SITE MASS (Knot is forming a few inches away from injection site) and VACCINATION SITE PAIN (Arm pain is now a few inches from injection site shooting to hand) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031A21A) for COVID-19 vaccination. No Medical History information was reported. On 16-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Mar-2021, the patient experienced PAIN IN EXTREMITY (Arm pain during injection/ arm pain is now a few inches from injection site shooting to hand), PAIN (Unable to move arm without severe pain), VACCINATION SITE MASS (Knot is forming a few inches away from injection site) and VACCINATION SITE PAIN (Arm pain is now a few inches from injection site shooting to hand). At the time of the report, PAIN IN EXTREMITY (Arm pain during injection/ arm pain is now a few inches from injection site shooting to hand), PAIN (Unable to move arm without severe pain), VACCINATION SITE MASS (Knot is forming a few inches away from injection site) and VACCINATION SITE PAIN (Arm pain is now a few inches from injection site shooting to hand) outcome was unknown. Unknown No relevant concomitant medications were reported. No treatment information was reported. Action taken with mRNA-1273 in response to the events was not applicable.

Other Meds:

Current Illness:

ID: 1567180
Sex: M
Age:
State: GA

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Invalid dose (less than 0.5mL); This spontaneous case was reported by a health care professional and describes the occurrence of INCORRECT DOSE ADMINISTERED (Invalid dose (less than 0.5mL)) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) for COVID-19 vaccination. No Medical History information was reported. On 15-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Mar-2021, the patient experienced INCORRECT DOSE ADMINISTERED (Invalid dose (less than 0.5mL)). On 15-Mar-2021, INCORRECT DOSE ADMINISTERED (Invalid dose (less than 0.5mL)) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Upon in internal review on 24 May 2021, the age was corrected to unknown age.

Other Meds:

Current Illness:

ID: 1567181
Sex: F
Age:
State: WV

Vax Date: 02/06/2021
Onset Date: 02/01/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was reported. Concomitant products included NAPROXEN SODIUM (ALEVE) and One A Day multivitamins for an unknown indication. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In February 2021, the patient experienced HEADACHE (Headache). At the time of the report, HEADACHE (Headache) had not resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No treatment medication was reported. This case was linked to MOD-2021-046329 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 07-May-2021: Follow-up received on 07-May-2021 included no new information.

Other Meds: ALEVE; One A Day multivitamins

Current Illness:

ID: 1567182
Sex: F
Age: 72
State: FL

Vax Date: 02/12/2021
Onset Date: 03/13/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Diarrhea; Nausea; felt very tired and achy whole day; Body Ache; Sore Arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore Arm), DIARRHOEA (Diarrhea), MYALGIA (Body Ache), NAUSEA (Nausea) and FATIGUE (felt very tired and achy whole day) in a 72-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-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Mar-2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 13-Mar-2021, the patient experienced PAIN IN EXTREMITY (Sore Arm), MYALGIA (Body Ache) and FATIGUE (felt very tired and achy whole day). On 15-Mar-2021, the patient experienced DIARRHOEA (Diarrhea) and NAUSEA (Nausea). At the time of the report, PAIN IN EXTREMITY (Sore Arm), DIARRHOEA (Diarrhea), MYALGIA (Body Ache), NAUSEA (Nausea) and FATIGUE (felt very tired and achy whole day) outcome was unknown. She was taking concomitant medication. She did not take any medicine for treatment.

Other Meds:

Current Illness:

ID: 1567183
Sex: M
Age:
State: FL

Vax Date:
Onset Date: 03/16/2021
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: Little soreness after vaccine; This spontaneous case was reported by a nurse and describes the occurrence of PAIN (Little soreness after vaccine) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Mar-2021, the patient experienced PAIN (Little soreness after vaccine). At the time of the report, PAIN (Little soreness after vaccine) 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. No concomitant medications were reported. Treatment information was not provided. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 07-May-2021: Reporter refused to give contact info and no need to follow up anymore.

Other Meds:

Current Illness:

ID: 1567184
Sex: M
Age:
State: WV

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: knot at injection site; arm was hard to lift; hard as a rock at injection site; goose egg at injection site; red at injection site; fever of 100; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 16-Mar-2021 and was forwarded to Moderna on 16-Mar-2021. This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE NODULE (knot at injection site), INJECTION SITE MOVEMENT IMPAIRMENT (arm was hard to lift), INJECTION SITE MASS (hard as a rock at injection site), INJECTION SITE SWELLING (goose egg at injection site) and INJECTION SITE ERYTHEMA (red at injection site) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, the patient experienced INJECTION SITE NODULE (knot at injection site), INJECTION SITE MOVEMENT IMPAIRMENT (arm was hard to lift), INJECTION SITE MASS (hard as a rock at injection site), INJECTION SITE SWELLING (goose egg at injection site), INJECTION SITE ERYTHEMA (red at injection site) and PYREXIA (fever of 100). On 10-Mar-2021, INJECTION SITE NODULE (knot at injection site), INJECTION SITE MOVEMENT IMPAIRMENT (arm was hard to lift), INJECTION SITE MASS (hard as a rock at injection site), INJECTION SITE SWELLING (goose egg at injection site), INJECTION SITE ERYTHEMA (red at injection site) and PYREXIA (fever of 100) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1567185
Sex: U
Age:
State: PA

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

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

Lab Data:

Allergies:

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

Symptoms: Tiredness; Achy; Had chills; 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 FATIGUE (Tiredness), MYALGIA (Achy) and CHILLS (Had chills) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) 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, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced FATIGUE (Tiredness), MYALGIA (Achy) and CHILLS (Had chills). At the time of the report, FATIGUE (Tiredness), MYALGIA (Achy) and CHILLS (Had chills) outcome was unknown. No relevant concomitant medications were provided. No treatment information was provided. The action taken for mRNA-1273 was not applicable.

Other Meds:

Current Illness:

ID: 1567186
Sex: F
Age:
State: WV

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Blurry vision; Light sensitivity; Fast heartrate; This spontaneous case was reported by a consumer and describes the occurrence of VISION BLURRED (Blurry vision), PHOTOPHOBIA (Light sensitivity) and TACHYCARDIA (Fast heartrate) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included NAPROXEN SODIUM (ALEVE) and MINERALS NOS, VITAMINS NOS (ONE A DAY [MINERALS NOS;VITAMINS NOS]) for an unknown indication. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-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 VISION BLURRED (Blurry vision), PHOTOPHOBIA (Light sensitivity) and TACHYCARDIA (Fast heartrate). At the time of the report, VISION BLURRED (Blurry vision), PHOTOPHOBIA (Light sensitivity) and TACHYCARDIA (Fast heartrate) outcome was unknown. After the second dose the patient experienced these events. No treatment information was reported. Action taken with mRNA-1273 in response to the events was not applicable. This case was linked to MOD-2021-046322 (Patient Link).

Other Meds: ALEVE; ONE A DAY [MINERALS NOS;VITAMINS NOS]

Current Illness:

ID: 1567187
Sex: F
Age:
State: OK

Vax Date: 01/07/2021
Onset Date: 02/17/2021
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: Skin look burnt and inch of size; Hives started on left side of chest/hives spread to stomach, bend of elbow inside of arms, palms of hands and in between fingers; Skin feels like leather to touch; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 16-Mar-2021 and was forwarded to Moderna on 16-Mar-2021. This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of SKIN BURNING SENSATION (Skin look burnt and inch of size), URTICARIA (Hives started on left side of chest/hives spread to stomach, bend of elbow inside of arms, palms of hands and in between fingers) and INDURATION (Skin feels like leather to touch) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 01M20A and 025J202A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension, Heart disease, unspecified (Was taking heart medication) and Seizure. Concomitant products included TOPIRAMATE (TOPAMAX) for Seizure, RANOLAZINE, VITAMIN B6, ACETYLSALICYLIC ACID (ASPIRIN LOW) and THYROID for an unknown indication. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Feb-2021, the patient experienced SKIN BURNING SENSATION (Skin look burnt and inch of size), URTICARIA (Hives started on left side of chest/hives spread to stomach, bend of elbow inside of arms, palms of hands and in between fingers) and INDURATION (Skin feels like leather to touch). At the time of the report, SKIN BURNING SENSATION (Skin look burnt and inch of size), URTICARIA (Hives started on left side of chest/hives spread to stomach, bend of elbow inside of arms, palms of hands and in between fingers) and INDURATION (Skin feels like leather to touch) outcome was unknown. Treatment medication were not provided. concomitant medication includes blood pressure medications. This case was linked to MOD-2021-046304, MOD-2021-110283.

Other Meds: RANOLAZINE; TOPAMAX; VITAMIN B6; ASPIRIN LOW; THYROID

Current Illness: Heart disease, unspecified (Was taking heart medication); Hypertension; Seizure

ID: 1567188
Sex: F
Age: 68
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: 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: Her injection arm swollen from her shoulder to her elbow; Extra sleepy the next day; A sore injection site for a day or two; This spontaneous case was reported by a consumer and describes the occurrence of HYPERSOMNIA (Extra sleepy the next day), VACCINATION SITE PAIN (A sore injection site for a day or two) and VACCINATION SITE SWELLING (Her injection arm swollen from her shoulder to her elbow) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013A21A) for COVID-19 vaccination. No medical history was provided by the reporter. 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 VACCINATION SITE PAIN (A sore injection site for a day or two). On 07-Mar-2021, the patient experienced HYPERSOMNIA (Extra sleepy the next day). On 12-Mar-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced VACCINATION SITE SWELLING (Her injection arm swollen from her shoulder to her elbow). On 07-Mar-2021, HYPERSOMNIA (Extra sleepy the next day) had resolved. On 08-Mar-2021, VACCINATION SITE PAIN (A sore injection site for a day or two) had resolved. At the time of the report, VACCINATION SITE SWELLING (Her injection arm swollen from her shoulder to her elbow) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications reported included supplements. Treatment medications were not provided.

Other Meds:

Current Illness:

ID: 1567189
Sex: F
Age:
State: CA

Vax Date: 02/14/2021
Onset Date: 02/24/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: upset stomach; developed rash inside elbow; broke out in hives on her right arm/hives looked like welts/hives was also under her feet; skin eruption started on the inside of her right elbow; hives looked like red, blistery, welts that itched.; hives looked like red, blistery, welts that itched.; hives looked like red, blistery, welts that itched.; hives looked like red, blistery, welts that itched.; difficult to walk; belched for 3 days; nauseated; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 16-Mar-2021 and was forwarded to Moderna on 16-Mar-2021. This spontaneous case was reported by a patient (subsequently medically confirmed) and describes the occurrence of URTICARIA (broke out in hives on her right arm/hives looked like welts/hives was also under her feet), RASH (skin eruption started on the inside of her right elbow), ERYTHEMA (hives looked like red, blistery, welts that itched.), BLISTER (hives looked like red, blistery, welts that itched.) and URTICARIA (hives looked like red, blistery, welts that itched.) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included COPD, Diabetes and Asthma. On 14-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 24-Feb-2021, the patient experienced URTICARIA (broke out in hives on her right arm/hives looked like welts/hives was also under her feet), RASH (skin eruption started on the inside of her right elbow), ERYTHEMA (hives looked like red, blistery, welts that itched.), BLISTER (hives looked like red, blistery, welts that itched.), URTICARIA (hives looked like red, blistery, welts that itched.), PRURITUS (hives looked like red, blistery, welts that itched.), GAIT DISTURBANCE (difficult to walk) and RASH (developed rash inside elbow). On an unknown date, the patient experienced ABDOMINAL DISCOMFORT (upset stomach), ERUCTATION (belched for 3 days) and NAUSEA (nauseated). At the time of the report, URTICARIA (broke out in hives on her right arm/hives looked like welts/hives was also under her feet), RASH (skin eruption started on the inside of her right elbow), ERYTHEMA (hives looked like red, blistery, welts that itched.), BLISTER (hives looked like red, blistery, welts that itched.), URTICARIA (hives looked like red, blistery, welts that itched.), PRURITUS (hives looked like red, blistery, welts that itched.), GAIT DISTURBANCE (difficult to walk), ABDOMINAL DISCOMFORT (upset stomach), ERUCTATION (belched for 3 days) and RASH (developed rash inside elbow) outcome was unknown and NAUSEA (nauseated) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. treatment medications includes Kenalog injection,oral antihistamine, prednisone.

Other Meds:

Current Illness: Asthma; COPD; Diabetes

ID: 1567190
Sex: M
Age:
State: FL

Vax Date:
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: sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history provided). On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (sore arm). At the time of the report, PAIN IN EXTREMITY (sore arm) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication reported No treatment medication reported

Other Meds:

Current Illness:

ID: 1567191
Sex: M
Age:
State: OK

Vax Date: 01/20/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Caller's father didn't receive 2nd dose on time; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Caller's father didn't receive 2nd dose on time) 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 20-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Caller's father didn't receive 2nd dose on time). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Caller's father didn't receive 2nd dose on time) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. On an unknown date, after receiving the first dose of mRNA-1273, patient underwent Brain surgery. Concomitant medication and treatment medication were not reported. Most recent FOLLOW-UP information incorporated above includes: On 24-Jun-2021: Follow up received on 24-Jun-2021 contains no new information.

Other Meds:

Current Illness:

ID: 1567192
Sex: M
Age: 72
State: FL

Vax Date: 01/04/2021
Onset Date:
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: Exacerbation of viral infection; short of breath from short walk from office to car; Short of breath while seated; Trouble going up short flight of stairs; perspiring; trouble catching breath; generate phlegm; head between knees trying to catch breath; Wheezing at night with cough; Wheezing at night with cough; symptoms got worse; little bit of nausea; This spontaneous case was reported by a consumer and describes the occurrence of VIRAL INFECTION (Exacerbation of viral infection), DYSPNOEA (short of breath from short walk from office to car), DYSPNOEA (Short of breath while seated), DYSPNOEA (Trouble going up short flight of stairs) and HYPERHIDROSIS (perspiring) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011L20A and 012M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Pneumonia (possible double pneumonia) from 08-Jan-2021 to 03-Apr-2021. Concurrent medical conditions included Type II diabetes mellitus (Type II Diabetes A1 C 5.0 to 6.0 Controlled), Congestive heart failure (5% to 10% Cardiac Ejection Fraction) on 20-Jan-2021, Stent insertion NOS since 20-Mar-2021 and Echocardiogram (31.5% Cardiac Ejection Fraction - a siugnificant inprovement.) since 31-Mar-2021. Concomitant products included METFORMIN and INSULIN ASPART (NOVOLOG) from 05-Jan-2021 to an unknown date for Type II diabetes mellitus, ACETYLSALICYLIC ACID (ASPIRIN (E.C.)), MILK OF MAGNESIA, TICAGRELOR from 05-Mar-2021 to an unknown date, APIXABAN from 05-Mar-2021 to an unknown date, FAMOTIDINE (FAMOTIDINE ACID REDUCER) from 05-Mar-2021 to an unknown date, FUROSEMIDE, GABAPENTIN, LISINOPRIL, METOPROLOL, POTASSIUM, SPIRONOLACTONE, ROSUVASTATIN, MULTIVITAMIN & MINERAL, VITAMIN D3, CYANOCOBALAMIN, FOLIC ACID (VITAMIN B12 & FOLIC ACID) and MELATONIN for an unknown indication. On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Feb-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 VIRAL INFECTION (Exacerbation of viral infection), DYSPNOEA (short of breath from short walk from office to car), DYSPNOEA (Short of breath while seated), DYSPNOEA (Trouble going up short flight of stairs), HYPERHIDROSIS (perspiring), DYSPNOEA (trouble catching breath), PRODUCTIVE COUGH (generate phlegm), DYSPNOEA (head between knees trying to catch breath), WHEEZING (Wheezing at night with cough), COUGH (Wheezing at night with cough), ADVERSE EVENT (symptoms got worse) and NAUSEA (little bit of nausea). At the time of the report, VIRAL INFECTION (Exacerbation of viral infection), DYSPNOEA (short of breath from short walk from office to car), DYSPNOEA (Short of breath while seated), DYSPNOEA (Trouble going up short flight of stairs), HYPERHIDROSIS (perspiring), DYSPNOEA (trouble catching breath), PRODUCTIVE COUGH (generate phlegm), DYSPNOEA (head between knees trying to catch breath), WHEEZING (Wheezing at night with cough), COUGH (Wheezing at night with cough), ADVERSE EVENT (symptoms got worse) and NAUSEA (little bit of nausea) outcome was unknown. Not Provided Concomitant drugs included diuretics too. No treatment information was reported. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 20-May-2021: Patient demographics,medical history and concomitant medications were added. Patient initial, gender, second dosing regimen added. Action taken updated to not applicable. Pulse rate deleted as event.

Other Meds: ASPIRIN (E.C.); MILK OF MAGNESIA; METFORMIN; NOVOLOG; TICAGRELOR; APIXABAN; FAMOTIDINE ACID REDUCER; FUROSEMIDE; GABAPENTIN; LISINOPRIL; METOPROLOL; POTASSIUM; SPIRONOLACTONE; ROSUVASTATIN; MULTIVITAMIN & MINERAL; VITAMIN D3; VITAMIN B12 &

Current Illness: Echocardiogram (31.5% Cardiac Ejection Fraction - a siugnificant inprovement.); Pneumonia (possible double pneumonia); Stent insertion NOS

ID: 1567193
Sex: M
Age: 67
State: AZ

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

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

Lab Data:

Allergies:

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

Symptoms: Dizziness; Night sweat; Fatigue; Headache; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), NIGHT SWEATS (Night sweat), FATIGUE (Fatigue), HEADACHE (Headache) and NAUSEA (Nausea) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003A21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 on 01-Feb-2021. On 08-Mar-2021 at 10:30 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021 at 4:30 PM, the patient experienced DIZZINESS (Dizziness), NIGHT SWEATS (Night sweat), FATIGUE (Fatigue), HEADACHE (Headache) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. At the time of the report, DIZZINESS (Dizziness), NIGHT SWEATS (Night sweat), FATIGUE (Fatigue), HEADACHE (Headache) and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided.

Other Meds:

Current Illness:

ID: 1567194
Sex: M
Age:
State: NM

Vax Date: 03/15/2021
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: accidentally got the Moderna COVID-19 vaccine on 15Mar2021 after receiving the Pfizer COVID-19 vaccine on 24Feb2021; This spontaneous case was reported by an other health care professional and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (accidentally got the Moderna COVID-19 vaccine on 15Mar2021 after receiving the Pfizer COVID-19 vaccine on 24Feb2021) in a 31-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001B21A) for COVID-19 vaccination. No medical history was provided by the reporter. On 15-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (accidentally got the Moderna COVID-19 vaccine on 15Mar2021 after receiving the Pfizer COVID-19 vaccine on 24Feb2021). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (accidentally got the Moderna COVID-19 vaccine on 15Mar2021 after receiving the Pfizer COVID-19 vaccine on 24Feb2021) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.; Sender's Comments: This report refers to a case of Inappropriate Schedule Of Product Administration for mRNA-1273 (Lot number: 001B21A) with no associated AEs.

Other Meds:

Current Illness:

ID: 1567195
Sex: F
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 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: raised red rash; This spontaneous case was reported by a consumer and describes the occurrence of RASH ERYTHEMATOUS (raised red rash) 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced RASH ERYTHEMATOUS (raised red rash). At the time of the report, RASH ERYTHEMATOUS (raised red rash) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1567196
Sex: F
Age: 71
State: OH

Vax Date: 02/04/2021
Onset Date: 03/14/2021
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: Got a hard pimple on middle knuckle that itches and hurts to the touch,Then another one developed on my index finger towards thumb; Itches and hurts to the touch.; Itches and hurts to the touch.; Soreness on ring finger on the pinky side; Then something hard developed that turned dark red; Swelling; Similar to a boil and the size of a pencil eraser; This spontaneous case was reported by a consumer and describes the occurrence of FURUNCLE (Similar to a boil and the size of a pencil eraser), ACNE (Got a hard pimple on middle knuckle that itches and hurts to the touch,Then another one developed on my index finger towards thumb), PRURITUS (Itches and hurts to the touch.), PAIN IN EXTREMITY (Itches and hurts to the touch.) and PAIN (Soreness on ring finger on the pinky side) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 022M20A and 028L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Mar-2021, the patient experienced FURUNCLE (Similar to a boil and the size of a pencil eraser), PAIN (Soreness on ring finger on the pinky side), INDURATION (Then something hard developed that turned dark red) and SWELLING (Swelling). On 15-Mar-2021, the patient experienced ACNE (Got a hard pimple on middle knuckle that itches and hurts to the touch,Then another one developed on my index finger towards thumb), PRURITUS (Itches and hurts to the touch.) and PAIN IN EXTREMITY (Itches and hurts to the touch.). At the time of the report, FURUNCLE (Similar to a boil and the size of a pencil eraser), ACNE (Got a hard pimple on middle knuckle that itches and hurts to the touch,Then another one developed on my index finger towards thumb), PRURITUS (Itches and hurts to the touch.), PAIN IN EXTREMITY (Itches and hurts to the touch.), PAIN (Soreness on ring finger on the pinky side), INDURATION (Then something hard developed that turned dark red) and SWELLING (Swelling) outcome was unknown. Concomitant medications were not provided. Treatment medications were not provided by the reporter.

Other Meds:

Current Illness:

ID: 1567197
Sex: F
Age: 62
State: MO

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

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: felt bad until 11 pm; vomiting; chills; headache; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (felt bad until 11 pm), VACCINATION SITE PAIN (sore arm), VOMITING (vomiting), CHILLS (chills) and HEADACHE (headache) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. No medical history was provided b the reporter. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced VACCINATION SITE PAIN (sore arm). On 15-Mar-2021, the patient experienced FEELING ABNORMAL (felt bad until 11 pm), VOMITING (vomiting), CHILLS (chills) and HEADACHE (headache). The patient was treated with IBUPROFEN (MOTRIN [IBUPROFEN]) at a dose of 1 dosage form. On 15-Mar-2021, FEELING ABNORMAL (felt bad until 11 pm), VOMITING (vomiting), CHILLS (chills) and HEADACHE (headache) had resolved. At the time of the report, VACCINATION SITE PAIN (sore arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication reported.

Other Meds:

Current Illness:

ID: 1567198
Sex: F
Age: 63
State: MN

Vax Date: 03/05/2021
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: low grade fever; tired; sleeping a lot; chills; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (sleeping a lot), CHILLS (chills), PYREXIA (low grade fever) and FATIGUE (tired) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013A21A) for COVID-19 vaccination. Concurrent medical conditions included Knee pain, Asthma, Chronic kidney disease stage 3 (Improved), Blood pressure high (Fairly stable), Depression (Increased Prozac dose), Allergic rhinitis, Drug allergy (Allergic to tylenol) and Environmental allergy (Allergic to (anything scented or fumes)). Concomitant products included NAPROXEN SODIUM (ALEVE) and PARACETAMOL (TYLENOL) for Knee pain. On 05-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 SOMNOLENCE (sleeping a lot) and CHILLS (chills). On 12-Mar-2021, the patient experienced PYREXIA (low grade fever) and FATIGUE (tired). At the time of the report, SOMNOLENCE (sleeping a lot) outcome was unknown and CHILLS (chills), PYREXIA (low grade fever) and FATIGUE (tired) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Mar-2021, Body temperature: 99.9 (High) 99.9 F low grade fever.. 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 informations were provided by the reporter. This case was linked to MOD-2021-114453 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: Follow up received on 14-Jul-2021. Event outcomes were updated. Current conditions and allergy were included.

Other Meds: ALEVE; TYLENOL

Current Illness: Allergic rhinitis; Asthma; Blood pressure high (Fairly stable); Chronic kidney disease stage 3 (Improved); Depression (Increased Prozac dose); Drug allergy (Allergic to tylenol); Environmental allergy (Allergic to (anything scented or fumes)); Knee pain

ID: 1567199
Sex: F
Age: 86
State: NY

Vax Date: 03/15/2020
Onset Date: 03/15/2021
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: I'm having difficulty breathing; My nose is very stuffy; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (I'm having difficulty breathing) and NASAL CONGESTION (My nose is very stuffy) in an 87-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024M20A) for COVID-19 vaccination. Concurrent medical conditions included COPD (Patient on oxygen for COPD from 10 months.), Blood pressure high, Diabetes, Gout, Restless leg syndrome and Neuropathy. Concomitant products included OXYGEN for COPD, OMEPRAZOLE MAGNESIUM (PRILOSEC [OMEPRAZOLE MAGNESIUM]) for an unknown indication. On 15-Mar-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Mar-2021, the patient experienced DYSPNOEA (I'm having difficulty breathing) and NASAL CONGESTION (My nose is very stuffy). The patient was treated with SODIUM CHLORIDE (SALINE SPRAY) at an unspecified dose and frequency and PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, DYSPNOEA (I'm having difficulty breathing) had resolved and NASAL CONGESTION (My nose is very stuffy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient's concomitant medications included unspecified medications for Blood pressure, Diabetes, Gout, Restless leg syndrome and Neuropathy. Stuffy nose was very common for the patient. Most recent FOLLOW-UP information incorporated above includes: On 07-May-2021: Form was added and outcome of an Event was updated

Other Meds: PRILOSEC [OMEPRAZOLE MAGNESIUM]; OXYGEN

Current Illness: Blood pressure high; COPD (Patient on oxygen for COPD from 10 months.); Diabetes; Gout; Neuropathy; Restless leg syndrome

ID: 1567200
Sex: F
Age: 65
State:

Vax Date: 01/12/2021
Onset Date: 01/18/2021
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: numbness in my arms, legs, and feet; Nerves felt like burning in arms and legs, and tongue; tingling; Nerves felt like burning in arms and legs, and tongue; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HYPOAESTHESIA (numbness in my arms, legs, and feet), TONGUE DISCOMFORT (Nerves felt like burning in arms and legs, and tongue), PARAESTHESIA (tingling) and BURNING SENSATION (Nerves felt like burning in arms and legs, and tongue) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Jan-2021, the patient experienced HYPOAESTHESIA (numbness in my arms, legs, and feet), TONGUE DISCOMFORT (Nerves felt like burning in arms and legs, and tongue), PARAESTHESIA (tingling) and BURNING SENSATION (Nerves felt like burning in arms and legs, and tongue). At the time of the report, HYPOAESTHESIA (numbness in my arms, legs, and feet), TONGUE DISCOMFORT (Nerves felt like burning in arms and legs, and tongue), PARAESTHESIA (tingling) and BURNING SENSATION (Nerves felt like burning in arms and legs, and tongue) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication not specified. Treatment medication were given by doctor.

Other Meds:

Current Illness:

ID: 1567201
Sex: M
Age:
State: SC

Vax Date:
Onset Date:
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: had a stomach flu or virus that has past around the whole family; diarrhea; fever; This spontaneous case was reported by a consumer and describes the occurrence of GASTROENTERITIS VIRAL (had a stomach flu or virus that has past around the whole family), DIARRHOEA (diarrhea) and PYREXIA (fever) in a 74-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, 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 GASTROENTERITIS VIRAL (had a stomach flu or virus that has past around the whole family), DIARRHOEA (diarrhea) and PYREXIA (fever). At the time of the report, GASTROENTERITIS VIRAL (had a stomach flu or virus that has past around the whole family), DIARRHOEA (diarrhea) and PYREXIA (fever) outcome was unknown. Not Provided Concomitant medications were not provided. Treatment medication was not provided by the reporter. Action taken with mRNA-1273 in response to events was not applicable.

Other Meds:

Current Illness:

ID: 1567202
Sex: F
Age: 64
State: VA

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient was administered dose 1 in her right arm more than 6 hours after first vial puncture; This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient was administered dose 1 in her right arm more than 6 hours after first vial puncture) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030A21A) 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 EXPIRED PRODUCT ADMINISTERED (Patient was administered dose 1 in her right arm more than 6 hours after first vial puncture). On 15-Mar-2021, EXPIRED PRODUCT ADMINISTERED (Patient was administered dose 1 in her right arm more than 6 hours after first vial puncture) 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. Concomitant products were not reported. Treatment medications were not provided by the reporter.

Other Meds:

Current Illness:

ID: 1567203
Sex: F
Age:
State: NY

Vax Date: 02/14/2021
Onset Date: 03/14/2021
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: chills; slight fever of 99.5; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (chills) and PYREXIA (slight fever of 99.5) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 14-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 14-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 UNK. On 14-Mar-2021, the patient experienced CHILLS (chills) and PYREXIA (slight fever of 99.5). At the time of the report, CHILLS (chills) and PYREXIA (slight fever of 99.5) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Mar-2021, Body temperature: increased (High) temperature went up just a little bit but not a lot.. On an unknown date, Body temperature: normal (normal) Today, his temperature dropped to normal.. No concomitant medication details were provided. No treatment medication details were provided.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1567204
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: lower lip was numb; rapid pulse; weakness; A spontaneous report was received from a consumer concerning a male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events lower lip was numb/Hypo aesthesia, rapid pulse/ heart rate increased, weakness/asthenia. The patient's medical history was not provided. No relevant concomitant medications were reported. On 3 Mar 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: didn't wanted to provide that) via unknown route for prophylaxis of COVID-19 infection. On 3 Mar 2021,10 minutes later the patient experienced the event lower lip was numb and one half later had a rapid pulse, weakness. Treatment was provided included Benadryl before second dose Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), lower lip was numb, rapid pulse, weakness was unknown.

Other Meds:

Current Illness:

ID: 1567205
Sex: F
Age:
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Bone aches; Body aches; Felt tired; Problems sleeping, cannot sleep deeply and has only 3-4 hour of sleep per night; This spontaneous case was reported by a consumer and describes the occurrence of POOR QUALITY SLEEP (Problems sleeping, cannot sleep deeply and has only 3-4 hour of sleep per night), BONE PAIN (Bone aches), MYALGIA (Body aches) and FATIGUE (Felt tired) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012A21A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high and Reflux gastritis. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, the patient experienced POOR QUALITY SLEEP (Problems sleeping, cannot sleep deeply and has only 3-4 hour of sleep per night). On 06-Mar-2021, the patient experienced BONE PAIN (Bone aches), MYALGIA (Body aches) and FATIGUE (Felt tired). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency and DEXTROMETHORPHAN HYDROBROMIDE, DOXYLAMINE SUCCINATE, EPHEDRINE SULFATE, ETHANOL, PARACETAMOL (NYQUIL) for Adverse event, at a dose of 1 dosage form. On 07-Mar-2021, BONE PAIN (Bone aches) and FATIGUE (Felt tired) had resolved. At the time of the report, POOR QUALITY SLEEP (Problems sleeping, cannot sleep deeply and has only 3-4 hour of sleep per night) and MYALGIA (Body aches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product include unspecified high blood pressure medication and reflux medication.

Other Meds:

Current Illness: Blood pressure high; Reflux gastritis

ID: 1567206
Sex: F
Age: 69
State: PA

Vax Date: 02/10/2021
Onset Date: 02/19/2021
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: pulsate tinnitus; red rash; itchy rash; hot rash; arm rash (2x3 inches); This spontaneous case was reported by a consumer and describes the occurrence of TINNITUS (pulsate tinnitus), RASH ERYTHEMATOUS (red rash), RASH (hot rash), RASH PRURITIC (itchy rash) and RASH (arm rash (2x3 inches)) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was reported by the reporter. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, the patient experienced RASH ERYTHEMATOUS (red rash), RASH (hot rash), RASH PRURITIC (itchy rash) and RASH (arm rash (2x3 inches)). On 03-Mar-2021, the patient experienced TINNITUS (pulsate tinnitus). On 25-Feb-2021, RASH ERYTHEMATOUS (red rash), RASH (hot rash) and RASH PRURITIC (itchy rash) had resolved. At the time of the report, TINNITUS (pulsate tinnitus) and RASH (arm rash (2x3 inches)) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information included muscle relaxer. Concomitant medications included muscle relaxer. This case was linked to MOD-2021-046388 (Patient Link).

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm