VAERS 2021 Database www.vaers.hhs.gov

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

Total Manufacturer

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1563446
Sex: F
Age: 45
State: NJ

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: tested positive of COVID-19; very ill; tired; Fever; Runny nose; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (tested positive of COVID-19), RHINORRHOEA (Runny nose), ILLNESS (very ill), PYREXIA (Fever) and FATIGUE (tired) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Feb-2021, the patient experienced RHINORRHOEA (Runny nose) and PYREXIA (Fever). On 16-Feb-2021, the patient experienced ILLNESS (very ill) and FATIGUE (tired). On 17-Feb-2021, the patient experienced COVID-19 (tested positive of COVID-19). At the time of the report, COVID-19 (tested positive of COVID-19), RHINORRHOEA (Runny nose), ILLNESS (very ill), PYREXIA (Fever) and FATIGUE (tired) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Feb-2021, Coronavirus test: (Positive) Tested COVID-19 positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. no relevant concomitant medications was reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1563447
Sex: F
Age: 26
State: NJ

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: patient saw some vaccine drip on her arm, about the size of a quarter; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT ADMINISTRATION ERROR (patient saw some vaccine drip on her arm, about the size of a quarter) in a 26-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027A21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Mar-2021, the patient experienced PRODUCT ADMINISTRATION ERROR (patient saw some vaccine drip on her arm, about the size of a quarter). On 02-Mar-2021, PRODUCT ADMINISTRATION ERROR (patient saw some vaccine drip on her arm, about the size of a quarter) 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 medications are not provided. No treatment information was provided.; Sender's Comments: This report refers to a case of accidental underdose and product administration error for mRNA-1273 (lot/batch: 027A21A) with no associated AEs reported.

Other Meds:

Current Illness:

ID: 1563448
Sex: F
Age: 72
State: TN

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

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

Lab Data:

Allergies:

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

Symptoms: heart was beating "real fast" could "feel it in her chest"; feeling lousy; This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (heart was beating "real fast" could "feel it in her chest") and FEELING ABNORMAL (feeling lousy) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013A21A) for COVID-19 vaccination. Previously administered products included for an unreported indication: FLU VACCINE VII (She had received the flu vaccine in past years.). Concurrent medical conditions included Asthma and Hypertension. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 ml. On 03-Mar-2021, the patient experienced PALPITATIONS (heart was beating "real fast" could "feel it in her chest") and FEELING ABNORMAL (feeling lousy). At the time of the report, PALPITATIONS (heart was beating "real fast" could "feel it in her chest") was resolving and FEELING ABNORMAL (feeling lousy) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Heart rate: 88-90 88-90. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment provided.

Other Meds:

Current Illness: Asthma; Hypertension

ID: 1563449
Sex: F
Age:
State: PA

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

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: red patch below her deltoid; This spontaneous case was reported by a consumer and describes the occurrence of RASH MACULAR (red patch below her deltoid) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). On 01-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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On an unknown date, the patient experienced RASH MACULAR (red patch below her deltoid). At the time of the report, RASH MACULAR (red patch below her deltoid) outcome was unknown. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Reporter did not allow further contact; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1563450
Sex: F
Age: 58
State: TX

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: "huge round circle" rash swollen and dense; arm sore; This spontaneous case was reported by a nurse and describes the occurrence of VACCINATION SITE PAIN (arm sore) and VACCINATION SITE RASH ("huge round circle" rash swollen and dense) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included HYDROCHLOROTHIAZIDE and ATORVASTATIN CALCIUM (LIPITOR) for an unknown indication. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, the patient experienced VACCINATION SITE PAIN (arm sore). On 20-Feb-2021, the patient experienced VACCINATION SITE RASH ("huge round circle" rash swollen and dense). At the time of the report, VACCINATION SITE PAIN (arm sore) and VACCINATION SITE RASH ("huge round circle" rash swollen and dense) 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.

Other Meds: HYDROCHLOROTHIAZIDE; LIPITOR

Current Illness:

ID: 1563451
Sex: F
Age: 68
State: NC

Vax Date: 02/04/2021
Onset Date: 03/04/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: really cold last night; arm is really sore; fever 101; chills; headache; nausea; pain at the injection site; just feeling a little tired; This spontaneous pregnancy case was reported by a consumer and describes the occurrence of FEELING COLD (really cold last night), MYALGIA (arm is really sore), PYREXIA (fever 101), CHILLS (chills) and HEADACHE (headache) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 003A21A and 011M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history information was provided by the reporter. Concomitant products included ESCITALOPRAM, ARIPIPRAZOLE and ACETYLSALICYLIC ACID (BABY ASPIRIN) for an unknown indication. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On 04-Mar-2021, the patient experienced FEELING COLD (really cold last night), MYALGIA (arm is really sore), PYREXIA (fever 101), CHILLS (chills), HEADACHE (headache), NAUSEA (nausea), VACCINATION SITE PAIN (pain at the injection site) and FATIGUE (just feeling a little tired). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 500 mg. On 05-Mar-2021, FEELING COLD (really cold last night), PYREXIA (fever 101), CHILLS (chills), NAUSEA (nausea) and VACCINATION SITE PAIN (pain at the injection site) had resolved. At the time of the report, MYALGIA (arm is really sore), HEADACHE (headache) and FATIGUE (just feeling a little tired) outcome was unknown. Other concomitant medications include antidepressants. This case was linked to MOD21-046823 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 05-Aug-2021: Non-significant follow-up appended On 05-Aug-2021: Non significant Follow up

Other Meds: ESCITALOPRAM; ARIPIPRAZOLE; BABY ASPIRIN

Current Illness:

ID: 1563452
Sex: M
Age: 75
State: FL

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

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Flu like symptoms; restless; muscle pain; Shoulder pain; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu like symptoms), RESTLESSNESS (restless), MYALGIA (muscle pain) and ARTHRALGIA (Shoulder pain) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported). Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN 81) for an unknown indication. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, the patient experienced INFLUENZA LIKE ILLNESS (Flu like symptoms), RESTLESSNESS (restless), MYALGIA (muscle pain) and ARTHRALGIA (Shoulder pain). On 12-Feb-2021, INFLUENZA LIKE ILLNESS (Flu like symptoms), RESTLESSNESS (restless), MYALGIA (muscle pain) and ARTHRALGIA (Shoulder pain) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment provided. This case was linked to MOD21-046742, MOD-2021-035765 (Patient Link).

Other Meds: ASPIRIN 81

Current Illness:

ID: 1563453
Sex: F
Age: 40
State: ND

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Shoulder hurting; Diarrhea; Arm very sore; Big red patch; Itchy; Neck hurting; Fever; Severe body aches; Bad headache; Nauseous; Armpit hurting; This spontaneous case was reported by an other health care professional and describes the occurrence of DIARRHOEA (Diarrhea), PAIN IN EXTREMITY (Arm very sore), ERYTHEMA (Big red patch), PRURITUS (Itchy) and NECK PAIN (Neck hurting) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 29-Jan-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 29-Jan-2021, the patient experienced DIARRHOEA (Diarrhea), PAIN IN EXTREMITY (Arm very sore), ERYTHEMA (Big red patch), PRURITUS (Itchy), NECK PAIN (Neck hurting), PYREXIA (Fever), MYALGIA (Severe body aches), HEADACHE (Bad headache), NAUSEA (Nauseous) and AXILLARY PAIN (Armpit hurting). On an unknown date, the patient experienced ARTHRALGIA (Shoulder hurting). The patient was treated with PARACETAMOL (TYLENOL) for Pain, at an unspecified dose and frequency. At the time of the report, DIARRHOEA (Diarrhea), PAIN IN EXTREMITY (Arm very sore), ERYTHEMA (Big red patch), PRURITUS (Itchy), NECK PAIN (Neck hurting), PYREXIA (Fever), MYALGIA (Severe body aches), HEADACHE (Bad headache), NAUSEA (Nauseous), AXILLARY PAIN (Armpit hurting) and ARTHRALGIA (Shoulder hurting) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Action taken with mRNA-1273 was not applicable. This case was linked to MOD-2021-036553

Other Meds:

Current Illness:

ID: 1563454
Sex: F
Age:
State: FL

Vax Date: 03/04/2021
Onset Date: 03/06/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Sore tongue; difficulty chewing; This spontaneous case was reported by a consumer and describes the occurrence of GLOSSODYNIA (Sore tongue) and MASTICATION DISORDER (difficulty chewing) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 04-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-Mar-2021, the patient experienced GLOSSODYNIA (Sore tongue) and MASTICATION DISORDER (difficulty chewing). At the time of the report, GLOSSODYNIA (Sore tongue) and MASTICATION DISORDER (difficulty chewing) outcome was unknown. No concomitant medications were provided Treatment details included Tylenol.

Other Meds:

Current Illness:

ID: 1563455
Sex: F
Age: 42
State: NM

Vax Date: 02/05/2021
Onset Date: 02/11/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Tested positive for covid; This spontaneous case was reported by a pharmacist and describes the occurrence of SARS-COV-2 TEST POSITIVE (Tested positive for covid) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Feb-2021, the patient experienced SARS-COV-2 TEST POSITIVE (Tested positive for covid). At the time of the report, SARS-COV-2 TEST POSITIVE (Tested positive for covid) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. no relevant concomitant medications was reported. No treatment information was provided

Other Meds:

Current Illness:

ID: 1563456
Sex: F
Age: 53
State: NV

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

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

Lab Data:

Allergies:

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

Symptoms: Oily face skin; Acne; Mild pain at the site of injection; This spontaneous case was reported by a consumer and describes the occurrence of SEBORRHOEA (Oily face skin), ACNE (Acne) and INJECTION SITE PAIN (Mild pain at the site of injection) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. Concurrent medical conditions included Diabetic neuropathy. Concomitant products included VITAMIN D NOS for Supplementation therapy, ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) and PARACETAMOL (TYLENOL) for an unknown indication. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Feb-2021, the patient experienced SEBORRHOEA (Oily face skin), ACNE (Acne) and INJECTION SITE PAIN (Mild pain at the site of injection). At the time of the report, SEBORRHOEA (Oily face skin), ACNE (Acne) and INJECTION SITE PAIN (Mild pain at the site of injection) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment provided.

Other Meds: ASPIRIN (E.C.); TYLENOL; VITAMIN D NOS

Current Illness: Diabetic neuropathy

ID: 1563457
Sex: F
Age: 76
State: NJ

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: SWOLLEN RIGHT SIDE OF FACE/LOWER SIDE NOT CLEARED UP TILL NOW; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING FACE (SWOLLEN RIGHT SIDE OF FACE/LOWER SIDE NOT CLEARED UP TILL NOW) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001A21A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Feb-2021, the patient experienced SWELLING FACE (SWOLLEN RIGHT SIDE OF FACE/LOWER SIDE NOT CLEARED UP TILL NOW). At the time of the report, SWELLING FACE (SWOLLEN RIGHT SIDE OF FACE/LOWER SIDE NOT CLEARED UP TILL NOW) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Hypertension: (High) high. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. no relevant concomitant medications was reported. No treatment information was provided

Other Meds:

Current Illness:

ID: 1563458
Sex: F
Age: 68
State: MO

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: medicine taste in her mouth; intermittent burning feeling on her tongue; This spontaneous case was reported by a consumer and describes the occurrence of DYSGEUSIA (medicine taste in her mouth) and BURNING SENSATION (intermittent burning feeling on her tongue) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. Concurrent medical conditions included Medication after taste (Medication allergy- not specified). On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Feb-2021, the patient experienced DYSGEUSIA (medicine taste in her mouth) and BURNING SENSATION (intermittent burning feeling on her tongue). On 26-Feb-2021, DYSGEUSIA (medicine taste in her mouth) had resolved. At the time of the report, BURNING SENSATION (intermittent burning feeling on her tongue) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. no relevant concomitant medications was reported. No treatment information was provided

Other Meds:

Current Illness:

ID: 1563459
Sex: F
Age: 49
State: AL

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

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

Lab Data:

Allergies:

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

Symptoms: Felt stingy; Feels real cold; Arms, legs, neck, face, and body turned red; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Felt stingy), FEELING COLD (Feels real cold) and ERYTHEMA (Arms, legs, neck, face, and body turned red) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 003B21A and 030L20A) for COVID-19 vaccination. The patient's past medical history included Skin erythema since an unknown date and Stinging since an unknown date. Concomitant products included VITAMINS NOS, MULTIVITAMIN & MINERAL, IRON FERROUS SULFATE from 15-Feb-2019 to an unknown date, FISH OIL from 01-Feb-2020 to an unknown date, NIACIN from 01-Feb-2020 to an unknown date and MONASCUS PURPUREUS (RED YEAST RICE) from 15-Feb-2020 to an unknown date for an unknown indication. On 01-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 05-Mar-2021, the patient experienced FEELING ABNORMAL (Felt stingy), FEELING COLD (Feels real cold) and ERYTHEMA (Arms, legs, neck, face, and body turned red). At the time of the report, FEELING ABNORMAL (Felt stingy), FEELING COLD (Feels real cold) and ERYTHEMA (Arms, legs, neck, face, and body turned red) outcome was unknown. No treatment provided. Most recent FOLLOW-UP information incorporated above includes: On 12-May-2021: ADR Form,patient demographics, medical history was updated.

Other Meds: VITAMINS NOS; MULTIVITAMIN & MINERAL; IRON FERROUS SULFATE; FISH OIL; NIACIN; RED YEAST RICE

Current Illness: Skin erythema; Stinging

ID: 1563460
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Swelling in his arm; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swelling in his arm) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PERIPHERAL SWELLING (Swelling in his arm). At the time of the report, PERIPHERAL SWELLING (Swelling in his arm) had resolved. Concomitant medications were not provided. The patient began experiencing swelling in his arm two days after the vaccination that has now lasted 3 weeks. He consulted with doctors, but the swelling still persists. No treatment details reported.

Other Meds:

Current Illness:

ID: 1563461
Sex: F
Age: 63
State: NM

Vax Date: 02/05/2021
Onset Date: 02/16/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Tested positive for COVID-19; This spontaneous case was reported by a pharmacist (subsequently medically confirmed) and describes the occurrence of COVID-19 (Tested positive for COVID-19) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. No Medical History information was reported. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced COVID-19 (Tested positive for COVID-19). The patient was treated with steroid for COVID-19, at an unspecified dose and frequency and AZITHROMYCIN for COVID-19, at an unspecified dose and frequency. At the time of the report, COVID-19 (Tested positive for COVID-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Feb-2021, SARS-CoV-2 test: positive Positive. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1563462
Sex: F
Age:
State:

Vax Date: 02/27/2021
Onset Date: 03/07/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Injection site is hard; Injection site is itchy; Injection site swollen/Injection site is raised/Injection site is twice the size it was; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE INDURATION (Injection site is hard), VACCINATION SITE PRURITUS (Injection site is itchy) and VACCINATION SITE SWELLING (Injection site swollen/Injection site is raised/Injection site is twice the size it was) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported.). On 27-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 07-Mar-2021, the patient experienced VACCINATION SITE INDURATION (Injection site is hard), VACCINATION SITE PRURITUS (Injection site is itchy) and VACCINATION SITE SWELLING (Injection site swollen/Injection site is raised/Injection site is twice the size it was). At the time of the report, VACCINATION SITE INDURATION (Injection site is hard), VACCINATION SITE PRURITUS (Injection site is itchy) and VACCINATION SITE SWELLING (Injection site swollen/Injection site is raised/Injection site is twice the size it was) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. no relevant concomitant medications was reported. No treatment information was provided

Other Meds:

Current Illness:

ID: 1563463
Sex: M
Age: 73
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: The needle was not on tight enough and more than half the dose seemed to dribble down his arm; The needle was not on tight enough and more than half the dose seemed to dribble down his arm; Dribble down his left arm.; A spontaneous report was received from a pharmacist concerning a 73-years-old male patient, who while receiving Moderna's covid-19 vaccine (mRNA -1273), more than half the dose seemed to dribble down his left arm as the needle was not on tight enough/device connection issue, underdose, exposure via skin contact. The patient's medical history was not provided. Concomitant medications were not reported. On 07 Mar 2021, prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number: 011A21A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 07 Mar 2021, while vaccinating the patient, the needle was not on tight enough and more than half the dose seemed to dribble down his left arm. The pharmacist plans to administer another dose. Treatment details were not mentioned. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event more than half the dose seemed to dribble down his left arm as the needle was not on tight enough was resolved on 07 Mar 2021.; Reporter's Comments: This report refers to a case of underdose, device connection issue and exposure via skin contact for mRNA-1273 (lot # 011A21A) with no associated

Other Meds:

Current Illness:

ID: 1563464
Sex: F
Age: 66
State: MT

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: little chilly; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (little chilly) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. Concurrent medical conditions included Headache recurrent (Suffers from continuous headaches) and Arthritis. Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) and ACETAMINOPHEN 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 CHILLS (little chilly). At the time of the report, CHILLS (little chilly) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient reported she takes 500 mg aspirin and acetaminophen concomitantly for her continuous headaches and Arthritis, but now is taking 250 mg acetaminophen and 250 mg aspirin instead.

Other Meds: ASPIRIN (E.C.); ACETAMINOPHEN

Current Illness: Arthritis; Headache recurrent (Suffers from continuous headaches)

ID: 1563465
Sex: F
Age: 38
State: ND

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: raised welt at injection site; injection site tender; red raised welt at injection site; headache; nausea; run down; This spontaneous case was reported by an other health care professional and describes the occurrence of INJECTION SITE URTICARIA (raised welt at injection site), INJECTION SITE PAIN (injection site tender), INJECTION SITE ERYTHEMA (red raised welt at injection site), HEADACHE (headache) and NAUSEA (nausea) in a 38-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Allergic reaction to antibiotics (amoxicillin), Drug allergy (vioxx), Adhesive tape allergy (adhesive) and Drug allergy (celexa). On 26-Jan-2021 at 10:30 AM, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Jan-2021, the patient experienced INJECTION SITE URTICARIA (raised welt at injection site), INJECTION SITE PAIN (injection site tender), INJECTION SITE ERYTHEMA (red raised welt at injection site), HEADACHE (headache), NAUSEA (nausea) and FATIGUE (run down). At the time of the report, INJECTION SITE URTICARIA (raised welt at injection site), INJECTION SITE PAIN (injection site tender), INJECTION SITE ERYTHEMA (red raised welt at injection site), HEADACHE (headache), NAUSEA (nausea) and FATIGUE (run down) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were reported. This case was linked to MOD-2021-036553 (Patient Link).

Other Meds:

Current Illness:

ID: 1563466
Sex: F
Age: 35
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: Vaccine exposure during pregnancy; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy) in a 35-year-old female patient (gravida 2, para 1) who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concurrent medical conditions included Drug allergy. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. The patient's last menstrual period was in September 2020 and the estimated date of delivery was 17-Jul-2021. On 03-Mar-2021, the patient experienced EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) during pregnancy. At the time of the report, EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. no relevant concomitant medications was reported. No treatment information was provided Reporter did not allow further contact

Other Meds:

Current Illness: Drug allergy

ID: 1563467
Sex: M
Age:
State: MI

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

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Dental procedure; This spontaneous case was reported by a consumer and describes the occurrence of DENTAL OPERATION (Dental procedure) 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. 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 DENTAL OPERATION (Dental procedure). At the time of the report, DENTAL OPERATION (Dental procedure) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. no relevant concomitant medications was reported. No treatment information was provided

Other Meds:

Current Illness:

ID: 1563468
Sex: F
Age: 59
State: NM

Vax Date: 02/05/2021
Onset Date: 02/15/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Tested positive for COVID-19; This spontaneous case was reported by a pharmacist and describes the occurrence of COVID-19 (Tested positive for COVID-19) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. No Medical History information was reported. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Feb-2021, the patient experienced COVID-19 (Tested positive for COVID-19). At the time of the report, COVID-19 (Tested positive for COVID-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Feb-2021, Coronavirus test: positive (Positive) Tested positive for COVID-19. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications or treatment details reported.

Other Meds:

Current Illness:

ID: 1563469
Sex: F
Age: 73
State: IL

Vax Date: 02/04/2021
Onset Date: 03/04/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Fever; bodyaches; chills; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (bodyaches), CHILLS (chills) and PYREXIA (Fever) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 036A21A and 007M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included GABAPENTIN and ACETYLSALICYLIC ACID (ASPRIN) for an unknown indication. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-Mar-2021, the patient experienced PAIN (bodyaches) and CHILLS (chills). On 05-Mar-2021, the patient experienced PYREXIA (Fever). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and ACETYLSALICYLIC ACID (ASPRIN) at an unspecified dose and frequency. At the time of the report, PAIN (bodyaches), CHILLS (chills) and PYREXIA (Fever) outcome was unknown. concomitant medication provided was blood pressure medication, ZYRTEC. This case was linked to MOD-2021-037906 (Patient Link).

Other Meds: GABAPENTIN; ASPRIN

Current Illness:

ID: 1563470
Sex: F
Age: 44
State: ND

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: large raised red bump at injection site; flu-like symptoms; tired; sore joints; injection site redness; This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of VACCINATION SITE MASS (large raised red bump at injection site), INFLUENZA LIKE ILLNESS (flu-like symptoms), FATIGUE (tired), ARTHRALGIA (sore joints) and VACCINATION SITE ERYTHEMA (injection site redness) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy (Sulfa drug.). On 29-Jan-2021 at 10:30 AM, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Jan-2021, the patient experienced VACCINATION SITE MASS (large raised red bump at injection site), INFLUENZA LIKE ILLNESS (flu-like symptoms), FATIGUE (tired), ARTHRALGIA (sore joints) and VACCINATION SITE ERYTHEMA (injection site redness). The patient was treated with IBUPROFEN for Adverse event following immunisation, at an unspecified dose and frequency. At the time of the report, VACCINATION SITE MASS (large raised red bump at injection site), INFLUENZA LIKE ILLNESS (flu-like symptoms), FATIGUE (tired), ARTHRALGIA (sore joints) and VACCINATION SITE ERYTHEMA (injection site redness) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The concomitant medications used were not provided.

Other Meds:

Current Illness: Drug allergy (Sulfa drug.)

ID: 1563471
Sex: M
Age: 90
State: NC

Vax Date: 02/01/2021
Onset Date: 02/28/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: My husband fell down outside on out porch; My husbands right side of the body where is ribs are hurt; Patient arm is tinder in the right arm; My husband complained about a slight headache; A spontaneous report was received from a consumer concerning for Husband, a 90-Year-old male patient who received both doses of Moderna's COVID-19 vaccine (mRNA-1273) and fell down on his right side of the body and had his ribs/chest pain and headache along with vaccination site pain. The patient's medical history included disability and hypoacusis. Concomitant product use was not provided by the reporter. On 01Feb2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 032L20A) via Intramuscular route on Right Arm for prophylaxis of COVID-19 infection. On 28Feb2021, prior to the onset of the events the patient received second of two planned doses of mRNA-1273 (lot/batch: 003A21A) via Intramuscular route on Right Arm for prophylaxis of COVID-19 infection. On the same day of the second dose, patient fell down on his right side of the body and had ribs/chest pain and headache, he also had vaccination site pain. Self treated the chest pain with biofreeze. Action taken with mRNA-1273 in response to the events was Not applicable. The outcome of events was Unknown, at the time of this report.; Reporter's Comments: Very limited information regarding this event/s has been provided at this time. Further information has been requested.

Other Meds:

Current Illness: Disability NOS; Hard of hearing

ID: 1563472
Sex: F
Age: 42
State: NM

Vax Date: 02/05/2021
Onset Date: 02/15/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Tested positive for COVID-19; This spontaneous case was reported by a pharmacist (subsequently medically confirmed) and describes the occurrence of SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Feb-2021, the patient experienced SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19). At the time of the report, SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Feb-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patients treatment information included azithromycin (Z-pack) and Steroid. No concomitants provided

Other Meds:

Current Illness:

ID: 1563473
Sex: M
Age: 81
State: AZ

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Inflamed neck; Light headed; Flash and Tingling in upper body; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of DIZZINESS (Light headed), PARAESTHESIA (Flash and Tingling in upper body) and SWELLING (Inflamed neck) in an 81-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 015M20A) for COVID-19 vaccination. The patient's past medical history included Neck stiffness. Concomitant products included ADENOSINE (TRICOR [ADENOSINE]), VITAMIN 15, LOSARTAN and SIMVASTATIN for an unknown indication. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 13-Feb-2021, the patient experienced DIZZINESS (Light headed) and PARAESTHESIA (Flash and Tingling in upper body). On 20-Feb-2021, the patient experienced SWELLING (Inflamed neck). The patient was treated with IBUPROFEN at an unspecified dose and frequency. At the time of the report, DIZZINESS (Light headed), PARAESTHESIA (Flash and Tingling in upper body) and SWELLING (Inflamed neck) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds: TRICOR [ADENOSINE]; VITAMIN 15; LOSARTAN; SIMVASTATIN

Current Illness:

ID: 1563474
Sex: F
Age: 56
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: hard to lift her arm; itching on her shoulder; shoulder swelled up; shoulder hard; shoulder red; shoulder blotchy; arm hurt at vaccination site; hives on left forearm, then right forearm; tightness in her throat; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (hives on left forearm, then right forearm), THROAT TIGHTNESS (tightness in her throat), LIMB DISCOMFORT (hard to lift her arm), PRURITUS (itching on her shoulder) and SWELLING (shoulder swelled up) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse event. On 28-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Feb-2021, the patient experienced URTICARIA (hives on left forearm, then right forearm), THROAT TIGHTNESS (tightness in her throat) and VACCINATION SITE PAIN (arm hurt at vaccination site). On 07-Mar-2021, the patient experienced LIMB DISCOMFORT (hard to lift her arm), PRURITUS (itching on her shoulder), SWELLING (shoulder swelled up), MUSCULOSKELETAL DISCOMFORT (shoulder hard), ERYTHEMA (shoulder red) and RASH MACULAR (shoulder blotchy). The patient was treated with IBUPROFEN (ADVIL 12 HOUR) at an unspecified dose and frequency. On 28-Feb-2021, URTICARIA (hives on left forearm, then right forearm) and THROAT TIGHTNESS (tightness in her throat) had resolved. On 02-Mar-2021, LIMB DISCOMFORT (hard to lift her arm) and VACCINATION SITE PAIN (arm hurt at vaccination site) had resolved. At the time of the report, PRURITUS (itching on her shoulder), SWELLING (shoulder swelled up), MUSCULOSKELETAL DISCOMFORT (shoulder hard), ERYTHEMA (shoulder red) and RASH MACULAR (shoulder blotchy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant provided This case was linked to MOD21-047293 (E2B Linked Report).; Sender's Comments: MOD21-047293:Crosslink

Other Meds:

Current Illness:

ID: 1563475
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: swell up; redness; sore arm; fever; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING (swell up), ERYTHEMA (redness), MYALGIA (sore arm) and PYREXIA (fever) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 24-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced SWELLING (swell up), ERYTHEMA (redness), MYALGIA (sore arm) and PYREXIA (fever). At the time of the report, SWELLING (swell up), ERYTHEMA (redness), MYALGIA (sore arm) and PYREXIA (fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. no relevant concomitant medications was reported. No treatment information was provide

Other Meds:

Current Illness:

ID: 1563476
Sex: F
Age:
State: TX

Vax Date: 02/03/2021
Onset Date: 01/31/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Back pain-started Naproxen; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Back pain-started Naproxen) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). Concomitant products included NAPROXEN SODIUM for Back pain. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 31-Jan-2021, the patient experienced BACK PAIN (Back pain-started Naproxen). On 05-Mar-2021, BACK PAIN (Back pain-started Naproxen) had resolved. Treatment details included None. Reporter did not allow further contact

Other Meds: NAPROXEN SODIUM

Current Illness:

ID: 1563477
Sex: M
Age: 72
State: IL

Vax Date: 01/29/2021
Onset Date: 02/21/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Two weeks after the 1st dose, he got shingles; Rash; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HERPES ZOSTER (Two weeks after the 1st dose, he got shingles) and RASH (Rash) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026L20A) for COVID-19 vaccination. The patient's past medical history included Shingles (Shingles 55 years ago when he was 17). On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Feb-2021, the patient experienced HERPES ZOSTER (Two weeks after the 1st dose, he got shingles) and RASH (Rash). At the time of the report, HERPES ZOSTER (Two weeks after the 1st dose, he got shingles) and RASH (Rash) had resolved. Two weeks after receiving first dose of vaccine, this patient experienced a mild rash on his back below the waistline and it became larger. The patient went to an urgent facility and the doctor there diagnosed it as shingles. Treatment included Aspercreme with lidocaine and Gabapentin. This case was linked to MOD-2021-081965 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 20-Apr-2021: Follow-up information updated medical history, event start date changed and outcome updated.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1563478
Sex: F
Age:
State: NJ

Vax Date: 01/14/2021
Onset Date: 02/11/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: missed the second vaccination shot; A spontaneous report was received from a health care professional concerning a female patient who received Moderna's COVID-19 vaccine (mRNA-1273) but missed the second vaccination dose. The patient's medical history was not provided. Concomitant product use was not reported. On 14 -an-2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: not provided) intramuscularly for prophylaxis of COVID-19 infection. On 11-Feb-2021, she was scheduled for second dose but missed the vaccination dose due to being in quarantine. No adverse event were reported, and no treatment medications were reported. Action taken with mRNA-1273 in response to the events was unknown. The outcome of the event missed the second vaccination dose was considered resolved on 11 Feb 2021.; Reporter's Comments: This report refers to a case of Missed dose for mRNA-1273, lot # unknown with no associated AEs.

Other Meds:

Current Illness:

ID: 1563479
Sex: F
Age: 73
State: FL

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

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Breakout of hives down both her legs, thighs.; Rash on her mid back.; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (Breakout of hives down both her legs, thighs.) and RASH (Rash on her mid back.) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027A21A) for COVID-19 vaccination. The patient's past medical history included Hives in September 2020. On 04-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, the patient experienced URTICARIA (Breakout of hives down both her legs, thighs.) and RASH (Rash on her mid back.). At the time of the report, URTICARIA (Breakout of hives down both her legs, thighs.) and RASH (Rash on her mid back.) outcome was unknown. Concomitant product use was not provided by the reporter. Treatment medication included diphenhydramine topical cream.

Other Meds:

Current Illness:

ID: 1563480
Sex: F
Age: 83
State: NJ

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

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Having neck pain; This spontaneous case was reported by a consumer and describes the occurrence of NECK PAIN (Having neck pain) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026A21A) for COVID-19 vaccination. No Medical History information was reported. On 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 NECK PAIN (Having neck pain). At the time of the report, NECK PAIN (Having neck pain) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was included took acetaminophen for pain to help her sleep. Most recent FOLLOW-UP information incorporated above includes: On 30-Jun-2021: Follow up received including Event outcome was updated to recovered/resolved.

Other Meds:

Current Illness:

ID: 1563481
Sex: F
Age: 63
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Trouble swallowing; Rash from neck to torso; High fever of 102.3 F; Chills; Body aches; Headache; Nausea; Intermittent increased heart rate; Swollen face and neck; Swollen face and neck; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (High fever of 102.3 F), CHILLS (Chills), PAIN (Body aches), HEADACHE (Headache) and NAUSEA (Nausea) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Asthma and COVID-19. Concomitant products included METHIMAZOLE, ROSUVASTATIN, ACETYLSALICYLIC ACID (ASPIRIN (E.C.)), CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000), CYANOCOBALAMIN, PYRIDOXINE HYDROCHLORIDE, THIAMINE HYDROCHLORIDE (VITAMIN B 1-6-12), ASCORBIC ACID, ROSA CANINA FRUIT (VITAMIN C & ROSEHIP) and ZINC for an unknown indication. On 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Mar-2021, the patient experienced PYREXIA (High fever of 102.3 F), CHILLS (Chills), PAIN (Body aches), HEADACHE (Headache), NAUSEA (Nausea), PALPITATIONS (Intermittent increased heart rate), SWELLING FACE (Swollen face and neck), SWELLING (Swollen face and neck) and RASH (Rash from neck to torso). On 04-Mar-2021, the patient experienced DYSPHAGIA (Trouble swallowing). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date for Fever, at an unspecified dose and frequency and DL- LACTIC ACID (EUCERIN DERMO PURIFYER) ongoing since an unknown date for Rash, at an unspecified dose and frequency. On 04-Mar-2021, HEADACHE (Headache), NAUSEA (Nausea), PALPITATIONS (Intermittent increased heart rate) and DYSPHAGIA (Trouble swallowing) had resolved. On 05-Mar-2021, CHILLS (Chills), PAIN (Body aches), SWELLING FACE (Swollen face and neck) and SWELLING (Swollen face and neck) had resolved. At the time of the report, PYREXIA (High fever of 102.3 F) and RASH (Rash from neck to torso) outcome was unknown. No treatment information was provided. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds: METHIMAZOLE; ROSUVASTATIN; ASPIRIN (E.C.); VITAMIN D 2000; Vitamin B-12; VITAMIN C & ROSEHIP; ZINC

Current Illness:

ID: 1563482
Sex: F
Age: 66
State: FL

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

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

Lab Data:

Allergies:

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

Symptoms: mild pain in eye; This spontaneous case was reported by a consumer and describes the occurrence of EYE PAIN (mild pain in eye) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Unilateral blindness (at age 40; eye sight did come back), Viral meningitis (at age 40 (diagnosed via spinal tap)) and Optic neuritis (at age 40). Concurrent medical conditions included Rosacea, Degenerative disc disease and Prolapsed disc NOS. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Feb-2021, the patient experienced EYE PAIN (mild pain in eye). At the time of the report, EYE PAIN (mild pain in eye) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.

Other Meds: ADVIL [IBUPROFEN]; PREMPRO; LEVOXYL; TETRACYCLINE; VITAMINS NOS

Current Illness: Degenerative disc disease; Prolapsed disc NOS; Rosacea

ID: 1563483
Sex: F
Age:
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Vaccine leaked out while administering; Vaccine ran down arm; leaked out from patient's arm; A spontaneous report was received from a pharmacist concerning an unknown old, female patient, who received Moderna's COVID-19 Vaccine (mRNA-1273) and vaccine leaked out while administering. The patient's medical history and products known to have been used by the patient were not reported. The patient received their second of two planned doses of mRNA-1273 (Batch number: 029A21A) on 5 Feb 2021, intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 5 Feb 2021, while administering the Moderna COVID-19 Vaccine the vaccine leaked out, a lot of liquid came out of patient's arm. The patient did not developed symptoms. No treatment information was provided. No relevant laboratory details were included. The patient received both scheduled doses of mRNA-1273 prior to the event; therefore, action taken with the drug in response to the even is not applicable. The event, was considered recovered/resolved.; Reporter's Comments: This report refers to a case of underdose, exposure via skin contact and device connection issue for mRNA-1273 (lot # 029A21A) with no associated AEs reported.

Other Meds:

Current Illness:

ID: 1563484
Sex: F
Age:
State: NJ

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

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

Lab Data:

Allergies:

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

Symptoms: rash that spread from neck to chest; stress; This spontaneous case was reported by a physician and describes the occurrence of RASH (rash that spread from neck to chest) and STRESS (stress) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event and Rash (Developing rashes under stress). On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, the patient experienced RASH (rash that spread from neck to chest) and STRESS (stress). At the time of the report, RASH (rash that spread from neck to chest) and STRESS (stress) 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 relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1563485
Sex: M
Age: 69
State: NC

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

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

Lab Data:

Allergies:

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

Symptoms: Blood pressure was high today; Arm was hurting more; shoulder blades and back were hurting; shoulder blades and back were hurting; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm was hurting more), ARTHRALGIA (shoulder blades and back were hurting), BACK PAIN (shoulder blades and back were hurting) and HYPERTENSION (Blood pressure was high today) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. The patient's past medical history included No adverse event on 05-Mar-2021. Concurrent medical conditions included Diabetes. On 04-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) at an unspecified dose. On 04-Mar-2021, the patient experienced PAIN IN EXTREMITY (Arm was hurting more), ARTHRALGIA (shoulder blades and back were hurting) and BACK PAIN (shoulder blades and back were hurting). On 05-Mar-2021, the patient experienced HYPERTENSION (Blood pressure was high today). On 05-Mar-2021, PAIN IN EXTREMITY (Arm was hurting more), ARTHRALGIA (shoulder blades and back were hurting) and BACK PAIN (shoulder blades and back were hurting) had resolved. At the time of the report, HYPERTENSION (Blood pressure was high today) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was reported. This case was linked to MOD21-046711 (E2B Linked Report). Most recent FOLLOW-UP information incorporated above includes: On 02-May-2021: No specific follow-up information recorded.; Sender's Comments: MOD21-046711:Crosslinked

Other Meds:

Current Illness:

ID: 1563486
Sex: F
Age:
State: MN

Vax Date: 02/04/2021
Onset Date: 03/04/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Whole upper arm was red, sore and itchy; Whole upper arm was red, sore and itchy; Reaction site was very hot; Whole upper arm was red, sore and itchy; Developed a fairly large rash on her arm where the vaccine was given; Slept all day/ slept for many hours; Running a temp of 100.5 F; dizzy; nauseated; Major headache; Metallic taste in her mouth; This spontaneous case was reported by a consumer and describes the occurrence of DYSGEUSIA (Metallic taste in her mouth), HYPERSOMNIA (Slept all day/ slept for many hours), BODY TEMPERATURE INCREASED (Running a temp of 100.5 F), DIZZINESS (dizzy) and PAIN (Whole upper arm was red, sore and itchy) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 015MC0A and 010A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse event. No treatment information was reported. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-Mar-2021, the patient experienced DYSGEUSIA (Metallic taste in her mouth), BODY TEMPERATURE INCREASED (Running a temp of 100.5 F), DIZZINESS (dizzy), HEADACHE (Major headache) and NAUSEA (nauseated). On 05-Mar-2021, the patient experienced HYPERSOMNIA (Slept all day/ slept for many hours). On 06-Mar-2021, the patient experienced PAIN (Whole upper arm was red, sore and itchy), PRURITUS (Whole upper arm was red, sore and itchy), INJECTION SITE WARMTH (Reaction site was very hot), ERYTHEMA (Whole upper arm was red, sore and itchy) and VACCINATION SITE RASH (Developed a fairly large rash on her arm where the vaccine was given). On 05-Mar-2021, HYPERSOMNIA (Slept all day/ slept for many hours) had resolved. On 06-Mar-2021, DYSGEUSIA (Metallic taste in her mouth), BODY TEMPERATURE INCREASED (Running a temp of 100.5 F), DIZZINESS (dizzy), HEADACHE (Major headache) and NAUSEA (nauseated) had resolved. At the time of the report, PAIN (Whole upper arm was red, sore and itchy), PRURITUS (Whole upper arm was red, sore and itchy), INJECTION SITE WARMTH (Reaction site was very hot), ERYTHEMA (Whole upper arm was red, sore and itchy) and VACCINATION SITE RASH (Developed a fairly large rash on her arm where the vaccine was given) outcome was unknown.

Other Meds:

Current Illness:

ID: 1563487
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: very severe itching sensation; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (very severe itching sensation) 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. On 05-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In March 2021, the patient experienced PRURITUS (very severe itching sensation). At the time of the report, PRURITUS (very severe itching sensation) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1563488
Sex: M
Age:
State: IN

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

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

Lab Data:

Allergies:

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

Symptoms: dry heaving; shoulder feels like it's on fire; sick to his stomach; dizzy; afraid to eat; nauseated; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (dry heaving), MUSCULOSKELETAL DISCOMFORT (shoulder feels like it's on fire), ABDOMINAL DISCOMFORT (sick to his stomach), DIZZINESS (dizzy) and FOOD REFUSAL (afraid to eat) 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. Previously administered products included for an unreported indication: COVID-19 VACCINE (First dose received on unspecified date). Concomitant products included ONDANSETRON (ZOFRAN [ONDANSETRON]) for an unknown indication. On 04-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, the patient experienced DYSPNOEA (dry heaving), MUSCULOSKELETAL DISCOMFORT (shoulder feels like it's on fire), ABDOMINAL DISCOMFORT (sick to his stomach), DIZZINESS (dizzy), FOOD REFUSAL (afraid to eat) and NAUSEA (nauseated). At the time of the report, DYSPNOEA (dry heaving), MUSCULOSKELETAL DISCOMFORT (shoulder feels like it's on fire), ABDOMINAL DISCOMFORT (sick to his stomach), DIZZINESS (dizzy), FOOD REFUSAL (afraid to eat) and NAUSEA (nauseated) outcome was unknown. No treatment information was provided. Reporter did not allow further contact

Other Meds: ZOFRAN [ONDANSETRON]

Current Illness:

ID: 1563489
Sex: M
Age:
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: Had my blood pressure 190/97 and pulse was 83 for 5 hours; A spontaneous report was received from a consumer concerning a 62 years old male patient who experienced a blood pressure 190/97 (blood pressure increased). The patient's medical history included pacemaker insertion. Concomitant medications included metoprolol, lisinopril, fluticasone furoate, umeclidinium bromide, vilanterol trifenatate, and salbutamol sulfate. On 05 Mar 2021, prior to the onset of the events, the patient received the first of two planned doses of mRNA-1273 intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 05 Mar 2021, the patient experienced a blood pressure reading of 190/97 and his pulse was 83 for 5 hours. The patient called his cardiologist who placed a pacer in his heart, and he was advised to take an extra dose of metoprolol, 20 minutes later RR went down to 180. Treatment included extra dose of Metoprolol (05 Mar 2021). Action taken with mRNA-1273 in response to the event was not reported. The event, a blood pressure 190/97 (blood pressure increased), was considered recovering.

Other Meds: METOPROLOL; LISINOPRIL; TRELEGY ELLIPTA; PROAIR HFA

Current Illness: Pacemaker insertion (cardiac)

ID: 1563490
Sex: M
Age: 81
State: OR

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

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: very sick,very sick for atleast a week or more; problems with memory; blurred vision; Brain fog; have lost all since of time space and location; feeling of very hot sensation heat of some type passing through my intestines/passing some heat through my intestine; memory loss; gut discomfort/ very bad stomachic problems feels like hot claw marks in my intestines; Pain; Stomach on fire, very bad stomach problems; Chills; Very tired; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Pain), DYSPEPSIA (Stomach on fire, very bad stomach problems), ILLNESS (very sick,very sick for atleast a week or more), VISION BLURRED (blurred vision) and FEELING ABNORMAL (Brain fog) in an 81-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 06-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-Mar-2021, the patient experienced CHILLS (Chills) and FATIGUE (Very tired). On 07-Mar-2021, the patient experienced PAIN (Pain) and DYSPEPSIA (Stomach on fire, very bad stomach problems). On an unknown date, the patient experienced ILLNESS (very sick,very sick for atleast a week or more), VISION BLURRED (blurred vision), FEELING ABNORMAL (Brain fog), DISORIENTATION (have lost all since of time space and location), FEELING HOT (feeling of very hot sensation heat of some type passing through my intestines/passing some heat through my intestine), AMNESIA (memory loss) and ABDOMINAL DISCOMFORT (gut discomfort/ very bad stomachic problems feels like hot claw marks in my intestines). At the time of the report, PAIN (Pain), DYSPEPSIA (Stomach on fire, very bad stomach problems), ILLNESS (very sick,very sick for atleast a week or more), VISION BLURRED (blurred vision), FEELING ABNORMAL (Brain fog), DISORIENTATION (have lost all since of time space and location), FEELING HOT (feeling of very hot sensation heat of some type passing through my intestines/passing some heat through my intestine), CHILLS (Chills) and FATIGUE (Very tired) outcome was unknown and AMNESIA (memory loss) and ABDOMINAL DISCOMFORT (gut discomfort/ very bad stomachic problems feels like hot claw marks in my intestines) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medication was reported. No treatment information was reported. Most recent FOLLOW-UP information incorporated above includes: On 04-May-2021: Email On 18-May-2021: Email: New AEs added. Ongoing issues. On 10-Jul-2021: Email included additional events (temporo-spatial disorientation, feeling hot, memory loss, feeling abnormal, abdominal discomfort), outcome of events memory loss and abdominal discomfort.

Other Meds:

Current Illness:

ID: 1563491
Sex: F
Age: 79
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: An accident and fractured her toe and sprained her ankle; Vertigo; Drowsiness; Dizziness; Worst headache she had in 6 months; Extreme nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ACCIDENT AT HOME (An accident and fractured her toe and sprained her ankle), VERTIGO (Vertigo), SOMNOLENCE (Drowsiness), DIZZINESS (Dizziness) and HEADACHE (Worst headache she had in 6 months) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Knee replacement (She has a titanium knee), Arthritis and X-ray on 03-Mar-2021. On 01-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 2 dosage form. On 02-Mar-2021, the patient experienced ACCIDENT AT HOME (An accident and fractured her toe and sprained her ankle), VERTIGO (Vertigo), SOMNOLENCE (Drowsiness), HEADACHE (Worst headache she had in 6 months) and NAUSEA (Extreme nausea). 02-Mar-2021, the patient experienced DIZZINESS (Dizziness). At the time of the report, ACCIDENT AT HOME (An accident and fractured her toe and sprained her ankle), VERTIGO (Vertigo), SOMNOLENCE (Drowsiness), DIZZINESS (Dizziness) and HEADACHE (Worst headache she had in 6 months) outcome was unknown and NAUSEA (Extreme nausea) had not resolved. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1563492
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: red spot has become elongated and is traveling down the patient's arm; red spot on arm at injection site; 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 RASH MACULAR (red spot has become elongated and is traveling down the patient's arm) and VACCINATION SITE ERYTHEMA (red spot on arm at injection site) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 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 RASH MACULAR (red spot has become elongated and is traveling down the patient's arm) and VACCINATION SITE ERYTHEMA (red spot on arm at injection site). At the time of the report, RASH MACULAR (red spot has become elongated and is traveling down the patient's arm) and VACCINATION SITE ERYTHEMA (red spot on arm at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications or treatment details reported.

Other Meds:

Current Illness:

ID: 1563493
Sex: M
Age: 74
State: CA

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

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Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Lot of pressure in the brain; pain in head; R arm is in pain; A spontaneous report was received from a consumer (patient's son) concerning a 74-year-old elderly male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced "lot of pressure in the brain, pain in head and R arm is in pain. The patient's medical history included Parkinson, diabetes type 2 and thyroid. Concomitant product use was provided by the reporter. On 04 Mar 2021, prior to the onset of events, the patient received their first of two planned doses of mRNA-1273 (lot number 029A21A) via unknown route in right arm for COVID-19 infection prophylaxis. On 04 Mar 2021, after first dose of vaccine, the patient had lot of pressure in the brain, pain in his head and all the R arm is in pain. Treatment medication included Acetylsalicylic acid. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events lot of pressure in the brain, pain in his head and R arm is in pain was unknown at the time of this report.; Reporter's Comments: Very limited information regarding this events has been provided at this time. Further information has been requested.

Other Meds:

Current Illness: Parkinson's disease; Thyroid disorder NOS; Type 2 diabetes mellitus

ID: 1563494
Sex: F
Age:
State: NJ

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

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Allergies:

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

Symptoms: Palpitation; Her heartbeat is 20 bpm higher than usual.generally at 60 bpm but has increased to 80 to 90 bpm; This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (Palpitation) and HEART RATE INCREASED (Her heartbeat is 20 bpm higher than usual.generally at 60 bpm but has increased to 80 to 90 bpm) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 04-Mar-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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Mar-2021, the patient experienced PALPITATIONS (Palpitation) and HEART RATE INCREASED (Her heartbeat is 20 bpm higher than usual.generally at 60 bpm but has increased to 80 to 90 bpm). At the time of the report, PALPITATIONS (Palpitation) and HEART RATE INCREASED (Her heartbeat is 20 bpm higher than usual.generally at 60 bpm but has increased to 80 to 90 bpm) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 04-Mar-2021, Heart rate abnormal (60-60): increased 80-90 bpm. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Lab data : Heart beat increased by 20 bpm. Normal is 60 bpm, increased to 80-90 bpm. No concomitant medication information provided. Treatment information provided.

Other Meds:

Current Illness:

ID: 1563495
Sex: F
Age:
State:

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

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: slight headache this morning; sore arm; felt a chill last night; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm), CHILLS (felt a chill last night) and HEADACHE (slight headache this morning) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013A21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Mar-2021, the patient experienced PAIN IN EXTREMITY (sore arm) and CHILLS (felt a chill last night). On 05-Mar-2021, the patient experienced HEADACHE (slight headache this morning). On 04-Mar-2021, PAIN IN EXTREMITY (sore arm) and CHILLS (felt a chill last night) had resolved. On 05-Mar-2021, HEADACHE (slight headache this morning) had resolved. No concomitant medications provided. Treatment included 2 doses of Excedrin and increased water intake. Reporter did not allow further contact

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am