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: 1571024
Sex: M
Age: 53
State: FL

Vax Date: 03/19/2021
Onset Date: 03/20/2021
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: Tachycardia; Nausea; Fatigue; Body aches; Headache; This spontaneous case was reported by a patient and describes the occurrence of TACHYCARDIA (Tachycardia), NAUSEA (Nausea), FATIGUE (Fatigue), MYALGIA (Body aches) and HEADACHE (Headache) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was reported. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Mar-2021, the patient experienced TACHYCARDIA (Tachycardia), NAUSEA (Nausea), FATIGUE (Fatigue), MYALGIA (Body aches) and HEADACHE (Headache). At the time of the report, TACHYCARDIA (Tachycardia), NAUSEA (Nausea), FATIGUE (Fatigue), MYALGIA (Body aches) and HEADACHE (Headache) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. It was reported that the patient not taking any medication.

Other Meds:

Current Illness:

ID: 1571025
Sex: F
Age: 46
State: MA

Vax Date: 01/15/2021
Onset Date: 03/23/2021
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: COVID-19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (COVID-19) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026L20A and 006M20A) for COVID-19 vaccination. No reported medical history. Concomitant products included ESCITALOPRAM, LAMOTRIGINE and CLONAZEPAM for an unknown indication. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 23-Mar-2021, the patient experienced COVID-19 (COVID-19). At the time of the report, COVID-19 (COVID-19) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Mar-2021, SARS-CoV-2 test: positive (Positive) positive. Patient called on 23March 2021 to report testing positive for COVID-19 after completing the Moderna COVID-19 vaccination series. According to patient, two of her family members who have not been vaccinated tested positive for COVID-19 and that is why she went to get tested. She did the test yesterday and got the results as positive today. Patient asked if she the vaccine can give her the virus and why did she tested positive if she has completed the series and has antibodies. No treatment information were provided.

Other Meds: ESCITALOPRAM; LAMOTRIGINE; CLONAZEPAM

Current Illness:

ID: 1571026
Sex: M
Age: 33
State: MO

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: the vaccine came out of the syringe while it was being administered to the patient; the vaccine came out of the syringe while it was being administered to the patient; This spontaneous case was reported by a pharmacist and describes the occurrence of UNDERDOSE (the vaccine came out of the syringe while it was being administered to the patient) and DEVICE CONNECTION ISSUE (the vaccine came out of the syringe while it was being administered to the patient) in a 33-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 23-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Mar-2021, the patient experienced UNDERDOSE (the vaccine came out of the syringe while it was being administered to the patient) and DEVICE CONNECTION ISSUE (the vaccine came out of the syringe while it was being administered to the patient). On 23-Mar-2021, UNDERDOSE (the vaccine came out of the syringe while it was being administered to the patient) and DEVICE CONNECTION ISSUE (the vaccine came out of the syringe while it was being administered to the patient) 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 medication use was not provided. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1571027
Sex: M
Age:
State: ID

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: sweating; Feeling hot; Sleeping a lot; cold sweating; Fatigue; chills; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (sweating), FEELING HOT (Feeling hot), HYPERSOMNIA (Sleeping a lot), COLD SWEAT (cold sweating) and FATIGUE (Fatigue) in an 88-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 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 HYPERHIDROSIS (sweating), FEELING HOT (Feeling hot), HYPERSOMNIA (Sleeping a lot), COLD SWEAT (cold sweating), FATIGUE (Fatigue) and CHILLS (chills). At the time of the report, HYPERHIDROSIS (sweating), FEELING HOT (Feeling hot), HYPERSOMNIA (Sleeping a lot), COLD SWEAT (cold sweating), FATIGUE (Fatigue) and CHILLS (chills) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Treatment information was not provided. It was reported the side effects lasted for about 5 days and on 22-MAR-2021 the patient felt much better and did not take anything to alleviate the symptoms

Other Meds:

Current Illness:

ID: 1571028
Sex: F
Age: 54
State: OH

Vax Date: 03/12/2021
Onset Date: 03/18/2021
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: extremely ill starting on the 18mar2021; joint stiffness; mild cough; sore throat; unbearable itching like crazy at injection site; extreme shivering; Temperature 99.8; intense headache; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (extremely ill starting on the 18mar2021), JOINT STIFFNESS (joint stiffness), COUGH (mild cough), OROPHARYNGEAL PAIN (sore throat) and INJECTION SITE PRURITUS (unbearable itching like crazy at injection site) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Mar-2021, the patient experienced ILLNESS (extremely ill starting on the 18mar2021), JOINT STIFFNESS (joint stiffness), COUGH (mild cough), OROPHARYNGEAL PAIN (sore throat), INJECTION SITE PRURITUS (unbearable itching like crazy at injection site), CHILLS (extreme shivering), PYREXIA (Temperature 99.8) and HEADACHE (intense headache). At the time of the report, ILLNESS (extremely ill starting on the 18mar2021), JOINT STIFFNESS (joint stiffness), COUGH (mild cough), OROPHARYNGEAL PAIN (sore throat), INJECTION SITE PRURITUS (unbearable itching like crazy at injection site), CHILLS (extreme shivering), PYREXIA (Temperature 99.8) and HEADACHE (intense headache) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Mar-2021, Body temperature: 99.8 High. On 19-Mar-2021, SARS-CoV-2 test: negative. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant drugs were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1571029
Sex: M
Age:
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Pee has change its color, it is like bloodier, darker and reddish; Dizziness; Did not have any appetite; Itchiness in different part of their body at different moments (feet, legs, chest, back); Throat is closing some times, like when one gets the flu; Tired; Headache; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of CHROMATURIA (Pee has change its color, it is like bloodier, darker and reddish), DIZZINESS (Dizziness), DECREASED APPETITE (Did not have any appetite), PRURITUS (Itchiness in different part of their body at different moments (feet, legs, chest, back)) and OROPHARYNGEAL DISCOMFORT (Throat is closing some times, like when one gets the flu) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 immunisation. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced CHROMATURIA (Pee has change its color, it is like bloodier, darker and reddish), DIZZINESS (Dizziness), DECREASED APPETITE (Did not have any appetite), PRURITUS (Itchiness in different part of their body at different moments (feet, legs, chest, back)), OROPHARYNGEAL DISCOMFORT (Throat is closing some times, like when one gets the flu), FATIGUE (Tired) and HEADACHE (Headache). At the time of the report, CHROMATURIA (Pee has change its color, it is like bloodier, darker and reddish), DIZZINESS (Dizziness), DECREASED APPETITE (Did not have any appetite), PRURITUS (Itchiness in different part of their body at different moments (feet, legs, chest, back)), OROPHARYNGEAL DISCOMFORT (Throat is closing some times, like when one gets the flu), FATIGUE (Tired) and HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication and treatment information were not reported. This case was linked to MOD-2021-054925 (E2B Linked Report).; Sender's Comments: MOD-2021-054925:Same reporter; Primary reporter case

Other Meds:

Current Illness:

ID: 1571030
Sex: M
Age: 66
State:

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: Pyrexia, White blood cell count decreased

Symptoms: Vomited 3 times; Whole body started trembling and could not stop it; Severe chills/still freezing; A little bit of arm pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (A little bit of arm pain), TREMOR (Whole body started trembling and could not stop it), CHILLS (Severe chills/still freezing) and VOMITING (Vomited 3 times) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Splenectomy (5-6 years ago had his spleen remove to stop proteins from attaching to his platelets.). Concurrent medical conditions included CLL (10 years now). Concomitant products included METFORMIN and INSULIN GLARGINE (LANTUS) for an unknown indication. 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 PAIN IN EXTREMITY (A little bit of arm pain). On 16-Mar-2021, the patient experienced TREMOR (Whole body started trembling and could not stop it) and CHILLS (Severe chills/still freezing). On 17-Mar-2021 at 2:00 AM, the patient experienced VOMITING (Vomited 3 times). At the time of the report, PAIN IN EXTREMITY (A little bit of arm pain), TREMOR (Whole body started trembling and could not stop it) and CHILLS (Severe chills/still freezing) outcome was unknown and VOMITING (Vomited 3 times) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In March 2021, Blood test: normal (normal) Normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medications were not reported. Concomitant medication includes- ultra 2 vitamins. Patient weight-213

Other Meds: METFORMIN; LANTUS

Current Illness: CLL (10 years now)

ID: 1571031
Sex: M
Age:
State: CA

Vax Date: 02/07/2021
Onset Date:
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: received first vaccination on 07 Feb 2021; not able to schedule the second appointment due to no vacant spaces; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (received first vaccination on 07 Feb 2021; not able to schedule the second appointment due to no vacant spaces) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. No Medical History information was reported. On 07-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 PRODUCT DOSE OMISSION ISSUE (received first vaccination on 07 Feb 2021; not able to schedule the second appointment due to no vacant spaces). At the time of the report, PRODUCT DOSE OMISSION ISSUE (received first vaccination on 07 Feb 2021; not able to schedule the second appointment due to no vacant spaces) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant drugs were reported. No treatment medications were reported. This case was linked to MOD21-060091 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1571032
Sex: M
Age:
State: KY

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: cold; really sick; chills; body aches; This spontaneous case was reported by a consumer and describes the occurrence of NASOPHARYNGITIS (cold), ILLNESS (really sick), CHILLS (chills) and MYALGIA (body aches) in a 60-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003A21A) for COVID-19 vaccination. No Medical History information was reported. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Mar-2021, the patient experienced NASOPHARYNGITIS (cold), ILLNESS (really sick), CHILLS (chills) and MYALGIA (body aches). The patient was treated with IBUPROFEN at an unspecified dose and frequency. At the time of the report, NASOPHARYNGITIS (cold), ILLNESS (really sick), CHILLS (chills) and MYALGIA (body aches) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medications included ibuprofen. Concomitant medication was not reported.

Other Meds:

Current Illness:

ID: 1571033
Sex: F
Age: 40
State: MI

Vax Date: 03/14/2021
Onset Date: 03/22/2021
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: Red itchy bump on injection site; Red itchy bump on injection site; Red itchy bump on injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (Red itchy bump on injection site), VACCINATION SITE INDURATION (Red itchy bump on injection site) and VACCINATION SITE PRURITUS (Red itchy bump on injection site) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 03A21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Mar-2021, the patient experienced VACCINATION SITE ERYTHEMA (Red itchy bump on injection site), VACCINATION SITE INDURATION (Red itchy bump on injection site) and VACCINATION SITE PRURITUS (Red itchy bump on injection site). At the time of the report, VACCINATION SITE ERYTHEMA (Red itchy bump on injection site), VACCINATION SITE INDURATION (Red itchy bump on injection site) and VACCINATION SITE PRURITUS (Red itchy bump on injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. patient reported delayed adverse events after getting the 1st shot on 14Mar2021. Last night on22Mar2021 she noticed the large red bump on injection site which is 1 inch wide and 1.5 inch long and itches quite a bit. No treatment info provided

Other Meds:

Current Illness:

ID: 1571034
Sex: F
Age: 89
State: MA

Vax Date: 02/13/2021
Onset Date: 03/19/2021
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: difficulty walking due to pain from the hips down her entire legs; Developed body aches; Tired; Couldn't lift injected arm; Injection arm hurt; This spontaneous case was reported by a consumer and describes the occurrence of MOVEMENT DISORDER (Couldn't lift injected arm), PAIN IN EXTREMITY (Injection arm hurt), GAIT DISTURBANCE (difficulty walking due to pain from the hips down her entire legs), FATIGUE (Tired) and MYALGIA (Developed body aches) in an 89-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007B21A and 016M20A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension, Hyperlipidemia and Drug allergy (Allergy to ACE-Inhibitors.). On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 19-Mar-2021, the patient experienced MOVEMENT DISORDER (Couldn't lift injected arm) and PAIN IN EXTREMITY (Injection arm hurt). On 22-Mar-2021, the patient experienced FATIGUE (Tired). On 23-Mar-2021, the patient experienced MYALGIA (Developed body aches). On an unknown date, the patient experienced GAIT DISTURBANCE (difficulty walking due to pain from the hips down her entire legs). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, MOVEMENT DISORDER (Couldn't lift injected arm), PAIN IN EXTREMITY (Injection arm hurt), GAIT DISTURBANCE (difficulty walking due to pain from the hips down her entire legs) and MYALGIA (Developed body aches) had resolved and FATIGUE (Tired) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, X-ray: (normal) x-ray results were normal. Concomitant medications included high blood pressure and anti-hyperlipidemic meds. Most recent FOLLOW-UP information incorporated above includes: On 10-May-2021: Updated the outcome of the events (movement disorder, pain in arm, myalgia, leg pain) from unknown to recovered. Added the concomitant medications. Added the lab test ( X-ray).

Other Meds: ATORVASTATIN; AMLODIPINE; LABETALOL; SERTRALINE; BAYER ASPIRIN; LORAZEPAM

Current Illness: Drug allergy (Allergy to ACE-Inhibitors.); Hyperlipidemia; Hypertension

ID: 1571035
Sex: M
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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: arm soreness at injection site; vaccine was brownish in color; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (arm soreness at injection site) and PRODUCT COLOUR ISSUE (vaccine was brownish in color) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) 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 08-Mar-2021, the patient experienced VACCINATION SITE PAIN (arm soreness at injection site) and PRODUCT COLOUR ISSUE (vaccine was brownish in color). At the time of the report, VACCINATION SITE PAIN (arm soreness at injection site) and PRODUCT COLOUR ISSUE (vaccine was brownish in color) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant details provided No treatment details provided Most recent FOLLOW-UP information incorporated above includes: On 10-May-2021: Follow up information received on 10-MAY-2021,Contact information updated

Other Meds:

Current Illness:

ID: 1571036
Sex: F
Age:
State: TX

Vax Date: 03/22/2021
Onset Date: 03/22/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Redness in face and clavicle; Fatigue; Headache; Achy; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Redness in face and clavicle), FATIGUE (Fatigue), HEADACHE (Headache) and MYALGIA (Achy) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008B21A) for COVID-19 vaccination. Concomitant products included AMFETAMINE ASPARTATE, AMFETAMINE SULFATE, DEXAMFETAMINE SACCHARATE, DEXAMFETAMINE SULFATE (ADDERALL) for an unknown indication. On 22-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Mar-2021, the patient experienced ERYTHEMA (Redness in face and clavicle), FATIGUE (Fatigue), HEADACHE (Headache) and MYALGIA (Achy). At the time of the report, ERYTHEMA (Redness in face and clavicle), FATIGUE (Fatigue), HEADACHE (Headache) and MYALGIA (Achy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medication was not provided.

Other Meds: ADDERALL

Current Illness:

ID: 1571037
Sex: F
Age: 54
State: PA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: felt so dizzy; spent 24 hours in bed; tongue did feel itchy and tingling, but that went away after a few minutes; tongue did feel itchy and tingling, but that went away after a few minutes; This spontaneous case was reported by a consumer and describes the occurrence of TONGUE PRURITUS (tongue did feel itchy and tingling, but that went away after a few minutes), PARAESTHESIA ORAL (tongue did feel itchy and tingling, but that went away after a few minutes), DIZZINESS (felt so dizzy) and BED REST (spent 24 hours in bed) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007B21A) for COVID-19 vaccination. No Medical History information was reported. On 20-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Mar-2021, the patient experienced TONGUE PRURITUS (tongue did feel itchy and tingling, but that went away after a few minutes) and PARAESTHESIA ORAL (tongue did feel itchy and tingling, but that went away after a few minutes). On 22-Mar-2021, the patient experienced DIZZINESS (felt so dizzy) and BED REST (spent 24 hours in bed). The patient was treated with Bed rest for Dizziness. On 20-Mar-2021, TONGUE PRURITUS (tongue did feel itchy and tingling, but that went away after a few minutes) and PARAESTHESIA ORAL (tongue did feel itchy and tingling, but that went away after a few minutes) had resolved. On 23-Mar-2021, DIZZINESS (felt so dizzy) and BED REST (spent 24 hours in bed) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment info was provided. No concomitant medications were given.

Other Meds:

Current Illness:

ID: 1571038
Sex: M
Age: 54
State: GA

Vax Date: 03/22/2021
Onset Date: 03/22/2021
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: it is itching; it is burning; he has knots on his face, neck and chest, and ears; it feels like its on fire; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (it is itching), BURNING SENSATION (it is burning), NODULE (he has knots on his face, neck and chest, and ears) and VACCINATION SITE WARMTH (it feels like its on fire) in a 54-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013A21A) for COVID-19 vaccination. No Medical History information was reported. On 22-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Mar-2021, the patient experienced PRURITUS (it is itching), BURNING SENSATION (it is burning), NODULE (he has knots on his face, neck and chest, and ears) and VACCINATION SITE WARMTH (it feels like its on fire). At the time of the report, PRURITUS (it is itching), BURNING SENSATION (it is burning), NODULE (he has knots on his face, neck and chest, and ears) and VACCINATION SITE WARMTH (it feels like its on fire) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications was not provided by the reporter. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 10-May-2021: Follow up information was received on 10 May 2021 wherein no new information was added.

Other Meds:

Current Illness:

ID: 1571039
Sex: F
Age:
State: SC

Vax Date: 03/11/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Arm started swelling and became very swollen; Arm hot to touch; Extremely itchy and looks sort of like tracks; Underneath the armpit was really sore; Red; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Arm started swelling and became very swollen), FEELING HOT (Arm hot to touch), PRURITUS (Extremely itchy and looks sort of like tracks), AXILLARY PAIN (Underneath the armpit was really sore) and ERYTHEMA (Red) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) for COVID-19 vaccination. No medical history information reported . Concomitant products included AMFETAMINE ASPARTATE, AMFETAMINE SULFATE, DEXAMFETAMINE SACCHARATE, DEXAMFETAMINE SULFATE (ADDERALL) for an unknown indication. On 11-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PERIPHERAL SWELLING (Arm started swelling and became very swollen), FEELING HOT (Arm hot to touch), PRURITUS (Extremely itchy and looks sort of like tracks), AXILLARY PAIN (Underneath the armpit was really sore) and ERYTHEMA (Red). At the time of the report, PERIPHERAL SWELLING (Arm started swelling and became very swollen), FEELING HOT (Arm hot to touch), PRURITUS (Extremely itchy and looks sort of like tracks), AXILLARY PAIN (Underneath the armpit was really sore) and ERYTHEMA (Red) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient followed up with PCP and placed her on antibiotics. No other treatment information was provided.

Other Meds: ADDERALL

Current Illness:

ID: 1571040
Sex: M
Age:
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: headache; sore arm; Loss apetite; body ache; nausea; Fever; Chills; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm), DECREASED APPETITE (Loss apetite), HEADACHE (headache), MYALGIA (body ache) and NAUSEA (nausea) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Asthma since 1950. Concomitant products included ALBUTEROL SULFATE from 01-Jan-2020 to an unknown date for Wheezing. On 18-Feb-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Feb-2021, the patient experienced DECREASED APPETITE (Loss apetite), MYALGIA (body ache), NAUSEA (nausea), PYREXIA (Fever) and CHILLS (Chills). On an unknown date, the patient experienced PAIN IN EXTREMITY (sore arm) and HEADACHE (headache). On 19-Feb-2021, DECREASED APPETITE (Loss apetite), MYALGIA (body ache), NAUSEA (nausea), PYREXIA (Fever) and CHILLS (Chills) had resolved with sequelae. At the time of the report, PAIN IN EXTREMITY (sore arm) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. This case was linked to MOD-2021-054508 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 16-May-2021: Reporters address added. Patients race and ethnicity added. Current condition added. Concomitant drug added. Outcome updated to recovered/resolved with residual effects. Causality of events updated.

Other Meds: ALBUTEROL SULFATE

Current Illness: Asthma

ID: 1571041
Sex: M
Age: 71
State: WI

Vax Date: 01/25/2021
Onset Date: 01/29/2021
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: Sore throat only in evening of 29th Jan/Worsening sore throat in evening of 31st jan; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (Sore throat only in evening of 29th Jan/Worsening sore throat in evening of 31st jan) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy (Allergy to one of the statins , Rhabdomyolysis.). Concomitant products included ACETYLSALICYLIC ACID (BABY ASPIRIN), METOPROLOL and ROSUVASTATIN for an unknown indication. On 25-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jan-2021, the patient experienced OROPHARYNGEAL PAIN (Sore throat only in evening of 29th Jan/Worsening sore throat in evening of 31st jan). On 01-Feb-2021, OROPHARYNGEAL PAIN (Sore throat only in evening of 29th Jan/Worsening sore throat in evening of 31st jan) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. This case was linked to MOD-2021-054823, MOD-2021-054823 (Patient Link).

Other Meds: BABY ASPIRIN; METOPROLOL; ROSUVASTATIN

Current Illness: Drug allergy (Allergy to one of the statins , Rhabdomyolysis.)

ID: 1571042
Sex: F
Age: 89
State: NJ

Vax Date: 03/13/2021
Onset Date: 03/22/2021
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: itchiness at injection site/thought something bit her; Quite red; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (itchiness at injection site/thought something bit her) and VACCINATION SITE ERYTHEMA (Quite red) in an 89-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 13-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Mar-2021, the patient experienced VACCINATION SITE PRURITUS (itchiness at injection site/thought something bit her) and VACCINATION SITE ERYTHEMA (Quite red). At the time of the report, VACCINATION SITE PRURITUS (itchiness at injection site/thought something bit her) and VACCINATION SITE ERYTHEMA (Quite red) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment included some cream. The area was still a little red but less itching.

Other Meds:

Current Illness:

ID: 1571043
Sex: F
Age: 56
State: NY

Vax Date: 03/20/2021
Onset Date: 03/22/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 2 days after the vaccine tip of her right thumb was purple; look like finger got slammed by door; This spontaneous case was reported by a health care professional and describes the occurrence of CYANOSIS (2 days after the vaccine tip of her right thumb was purple; look like finger got slammed by door) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 20-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Mar-2021, the patient experienced CYANOSIS (2 days after the vaccine tip of her right thumb was purple; look like finger got slammed by door). At the time of the report, CYANOSIS (2 days after the vaccine tip of her right thumb was purple; look like finger got slammed by door) 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 included Tylenol.

Other Meds:

Current Illness:

ID: 1571044
Sex: F
Age: 50
State: CA

Vax Date: 03/08/2021
Onset Date:
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: Cannot go up and downstair; Both hands pain; Both hands weakness; Pain similar to arthritis; This spontaneous case was reported by a patient and describes the occurrence of GAIT DISTURBANCE (Cannot go up and downstair), PAIN IN EXTREMITY (Both hands pain), MUSCULAR WEAKNESS (Both hands weakness) and ARTHRALGIA (Pain similar to arthritis) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 08-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced GAIT DISTURBANCE (Cannot go up and downstair), PAIN IN EXTREMITY (Both hands pain), MUSCULAR WEAKNESS (Both hands weakness) and ARTHRALGIA (Pain similar to arthritis). The patient was treated with PARACETAMOL (TYLENOL) for Arthritic pains, at an unspecified dose and frequency and IBUPROFEN for Arthritic pains, at an unspecified dose and frequency. At the time of the report, GAIT DISTURBANCE (Cannot go up and downstair), PAIN IN EXTREMITY (Both hands pain), MUSCULAR WEAKNESS (Both hands weakness) and ARTHRALGIA (Pain similar to arthritis) outcome was unknown. The action taken with mRNA-1273 in response to the event is not applicable. It was reported that Tylenol and Ibuprofen did not help relieve the symptoms.

Other Meds:

Current Illness:

ID: 1571045
Sex: F
Age:
State: WI

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

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: pain; lethargy; Headache; severe joint pain; vaccination site soreness; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (pain), LETHARGY (lethargy), HEADACHE (Headache), ARTHRALGIA (severe joint pain) and VACCINATION SITE PAIN (vaccination site soreness) in a 52-year-old female 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) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN (pain), LETHARGY (lethargy), HEADACHE (Headache), ARTHRALGIA (severe joint pain) and VACCINATION SITE PAIN (vaccination site soreness). At the time of the report, PAIN (pain), LETHARGY (lethargy), HEADACHE (Headache), ARTHRALGIA (severe joint pain) and VACCINATION SITE PAIN (vaccination site soreness) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment medication was taken. No concomitant medication was taken. Most recent FOLLOW-UP information incorporated above includes: On 10-May-2021: Follow up received on 10-MAY-2021. Events was reported. Outcome was reported.

Other Meds:

Current Illness:

ID: 1571046
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: large induration/ indurated middle; pruritus; erythema; pain; target rash; This spontaneous case was reported by a physician and describes the occurrence of VACCINATION SITE INDURATION (large induration/ indurated middle), VACCINATION SITE PRURITUS (pruritus), VACCINATION SITE ERYTHEMA (erythema), VACCINATION SITE PAIN (pain) and VACCINATION SITE RASH (target rash) in an adult female 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) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE INDURATION (large induration/ indurated middle), VACCINATION SITE PRURITUS (pruritus), VACCINATION SITE ERYTHEMA (erythema), VACCINATION SITE PAIN (pain) and VACCINATION SITE RASH (target rash). At the time of the report, VACCINATION SITE INDURATION (large induration/ indurated middle), VACCINATION SITE PRURITUS (pruritus), VACCINATION SITE ERYTHEMA (erythema), VACCINATION SITE PAIN (pain) and VACCINATION SITE RASH (target rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Treatment information was not provided. Lab details were not provided. Most recent FOLLOW-UP information incorporated above includes: On 10-May-2021: follow up received on 10-may -2021 and does not contain any significant information

Other Meds:

Current Illness:

ID: 1571047
Sex: M
Age:
State: CA

Vax Date: 02/18/2021
Onset Date: 03/18/2021
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: Very little strength; Joint pain; Headache; Fatigue; Chills; Nausea; Temperature of 102; Loss appetite; Intense body aches; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Very little strength), DECREASED APPETITE (Loss appetite), MYALGIA (Intense body aches), ARTHRALGIA (Joint pain) and PYREXIA (Temperature of 102) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 003B21A and 029L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19 in December 2020. Concurrent medical conditions included Asthma since 1950. Concomitant products included ALBUTEROL SULFATE from 01-Jan-2020 to an unknown date for Wheezing. On 18-Feb-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Mar-2021 at 9:00 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Mar-2021 at 4:00 PM, the patient experienced DECREASED APPETITE (Loss appetite), MYALGIA (Intense body aches), PYREXIA (Temperature of 102), CHILLS (Chills) and NAUSEA (Nausea). On an unknown date, the patient experienced ASTHENIA (Very little strength), ARTHRALGIA (Joint pain), HEADACHE (Headache) and FATIGUE (Fatigue). On 21-Mar-2021, DECREASED APPETITE (Loss appetite), MYALGIA (Intense body aches), PYREXIA (Temperature of 102), CHILLS (Chills) and NAUSEA (Nausea) had resolved. At the time of the report, ASTHENIA (Very little strength), ARTHRALGIA (Joint pain), HEADACHE (Headache) and FATIGUE (Fatigue) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Mar-2021, Body temperature: 102 (High) Increased. No treatment information was provided. Patient stated that, he have been left with from having been sick from the corona virus is reoccurring pain (and cramping) in his left hand. This case was linked to MOD-2021-054796 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 16-May-2021: Updated reporter information, patient demographics, historical condition, vaccine information, concomitant medication, additional event (Decreased appetite) and outcome of the events was updated. On 15-Jul-2021: Updated past medical history (Corona virus in December 2020).

Other Meds: ALBUTEROL SULFATE

Current Illness: Asthma

ID: 1571048
Sex: M
Age:
State: FL

Vax Date: 03/03/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Moderate pain from shoulder to the elbow; This spontaneous case was reported by a patient and describes the occurrence of ARTHRALGIA (Moderate pain from shoulder to the elbow) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. Concurrent medical conditions included Heart disorder (Heart Condition). Concomitant products included MIRABEGRON (MYRBETRIQ), METOPROLOL, CLOPIDOGREL, LOSARTAN, ISOSORBIDE and FINASTERIDE for an unknown indication. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Mar-2021, the patient experienced ARTHRALGIA (Moderate pain from shoulder to the elbow). At the time of the report, ARTHRALGIA (Moderate pain from shoulder to the elbow) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment information was provided. It was reported that the pain has become very strong during the last 4 - 5 days

Other Meds: MYRBETRIQ; METOPROLOL; CLOPIDOGREL; LOSARTAN; ISOSORBIDE; FINASTERIDE

Current Illness: Heart disorder (Heart Condition)

ID: 1571049
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: High pulse; Raised BP; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE INCREASED (High pulse) and BLOOD PRESSURE INCREASED (Raised BP) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. No Medical History information was reported. On 01-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 01-Mar-2021, the patient experienced HEART RATE INCREASED (High pulse) and BLOOD PRESSURE INCREASED (Raised BP). On 01-Mar-2021, HEART RATE INCREASED (High pulse) and BLOOD PRESSURE INCREASED (Raised BP) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Mar-2021, Heart rate: 108 (High) 108. No concomitant medicines were reported. No treatment information were reported. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the drug in response to the events is not applicable.

Other Meds:

Current Illness:

ID: 1571050
Sex: M
Age: 55
State: FL

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: Stomach was turning; Nauseated; Feels fatigued; Threw up in the afternoon; Felt very bad all day; Could not keep food down; Headache; Felt like someone punched him in the arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Felt like someone punched him in the arm), MALAISE (Felt very bad all day), DYSPHAGIA (Could not keep food down), ABDOMINAL DISCOMFORT (Stomach was turning) and HEADACHE (Headache) in a 55-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Mar-2021, the patient experienced PAIN IN EXTREMITY (Felt like someone punched him in the arm). On 20-Mar-2021, the patient experienced HEADACHE (Headache). On 21-Mar-2021, the patient experienced MALAISE (Felt very bad all day), DYSPHAGIA (Could not keep food down) and VOMITING (Threw up in the afternoon). On 22-Mar-2021, the patient experienced ABDOMINAL DISCOMFORT (Stomach was turning), NAUSEA (Nauseated) and FATIGUE (Feels fatigued). The patient was treated with ACETAMINOPHEN at a dose of 500 milligram. At the time of the report, PAIN IN EXTREMITY (Felt like someone punched him in the arm), MALAISE (Felt very bad all day), DYSPHAGIA (Could not keep food down) and VOMITING (Threw up in the afternoon) outcome was unknown and ABDOMINAL DISCOMFORT (Stomach was turning), HEADACHE (Headache), NAUSEA (Nauseated) and FATIGUE (Feels fatigued) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1571051
Sex: M
Age: 67
State: CA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
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: arm swelling; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (arm swelling) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 15-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 PERIPHERAL SWELLING (arm swelling). At the time of the report, PERIPHERAL SWELLING (arm swelling) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Treatment details included diphenhydramine.

Other Meds:

Current Illness:

ID: 1571052
Sex: F
Age: 26
State: CA

Vax Date: 07/25/2021
Onset Date: 08/13/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pain and Bell?s palsy on right side of face can?t smile and teary eyes

Other Meds:

Current Illness:

ID: 1571053
Sex: F
Age: 27
State: MT

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

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

Lab Data:

Allergies: TOMATOES

Symptom List: Nausea

Symptoms: Approximately 7 minutes after the patient received the Pfizer COVID-19 vaccine, she reported feeling very hot, was sweating, had visual disturbances (tunnel vision), and ringing in her ears. She was seated at the time, was conscious, and aware of her surroundings. She was provided cold water and a towel, and was given and agreed to take 10mL of diphenhydramine based on a possible injection arm reaction. After about 5 minutes of me talking with her, the sweating resolved and her body temperature returned to normal, including the color in her arm. I kept her for observation for an additional 15-20 minutes and confirmed she was ok upon leaving the pharmacy.

Other Meds:

Current Illness:

ID: 1571054
Sex: F
Age: 33
State: TX

Vax Date: 01/07/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Injection site pain

Symptoms: I had my 2nd does of the Pfizer COVID vaccine on Jan 7th. Ovulated and became pregnant on Jan 18th. Started bleeding on Feb 1. I had a positive pregnancy test Friday Feb 5th. Serial blood draws at the doctor the next week confirmed I was pregnant with low chance for a viable pregnancy. Later blood work confirmed I had a miscarriage.

Other Meds: Prenatal vitamins

Current Illness: No

ID: 1571055
Sex: F
Age: 54
State:

Vax Date: 01/27/2021
Onset Date: 02/23/2021
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: Allergic to the flu vaccine,morphine, latex.

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

Symptoms: Bell?s Palsy with severe headache & severe dizziness for more than 2 months.Dizziness was so severe that even lying down in bed & turning from side to side ,I got dizzy. This is 6 months since it occurred & my full eye blinking has not return & slight facial droop & decrease sensation on the affected side of face still present.

Other Meds: Propranolol,Zyrtec , Vit.C & Folic acid .

Current Illness: None.Healthy.

ID: 1571056
Sex: F
Age: 17
State: FL

Vax Date: 04/16/2021
Onset Date: 05/13/2021
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: omnicef, seaweed, cats, dogs, pollen, and mold

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

Symptoms: Vaccinations left one blackish-blue dot per vaccine in arm (about size of needle). No pain nor swelling. Will not go away even after exfoliation, scrubbing with soap, scraping, etc.

Other Meds: Hailey 1.5/30 and Zoloft

Current Illness:

ID: 1571057
Sex: F
Age: 66
State: GA

Vax Date: 01/19/2021
Onset Date: 05/10/2021
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: Shell fish, IVP dye, Fire Ants, Latex, Ancef, Keflex, Ceclor, Doxycycline, Sulfur products, Lexapro, Gabitril, Limbrel, Dexilant, Reglan, Cymbalta, Wellbutrin, Trintellix, Zoloft

Symptom List: Tremor

Symptoms: Extreme fatigue, sleeplessness, aching, flushing, chills, nausea, depression and lights flashing around both eyes. This started roughly three months after the 2nd vaccination. Is still going on six months after the second vaccination. I have run little or no fever with it. I am now having depression related to my husband's Dementia. On August 9, 2021 I finally contacted my doctor. I was not having depression when these symptoms started. I cannot function and spend most days in bed.

Other Meds: Flonase 16GM, Nexium 40mg,Singular 10mg, Percocet 10-325mg, Flector Path 1.3mg, Norvase 5mg,Celebrex 200mg, Amitriptalin 50mg, Neurontin 800mg, Zyrtec 10mg, Vitamin E 400IU, Multivitamin, Calcium 600mg, Probiotic, Pepcid 20mg

Current Illness: none

ID: 1571058
Sex: F
Age: 55
State: TX

Vax Date: 05/04/2021
Onset Date: 05/10/2021
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: Erhythromycin, penicillin, morphine, hydrochloroquinine

Symptom List: Erythema, Pruritus

Symptoms: Contracted Spasms / numbness tingling lasting 30 minutes to hours. Incidents occurred on 1) 05/10/21 @9:45 pm - foot pain resulting in rolling thigh spasm / muscle contraction for ~45 minutes, 2) 7/16/21 @ 10:30 pm - foot spasm resulting in rolling thigh spasm / muscle contraction for ~ 30 minutes and 3) 8/15/21 @ ~5:30 pm - foot pain with numbness on top / spasms. Spasms passed after ~ 1 hour. Numbness and tingles radiated up leg immediately following incident for about an hour. Tingling sensation throughout body persisting for over 3 hours, as of the time of this reporting.

Other Meds: Amlodopine, azelastine, atorvastatin, clopidogrel, emgality, folic acid, fluticasone, lansoprazole, np thyroid, progesterone, restados, vitamin d-2

Current Illness: None

ID: 1571059
Sex: F
Age: 38
State: WA

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

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

Lab Data:

Allergies: Enbrel

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

Symptoms: Sore arm, fever, headache, fatigue

Other Meds: Humira, Zoloft, buspirone, multivitamin, Claritin, trazodone,

Current Illness: No

ID: 1571060
Sex: M
Age: 32
State: AZ

Vax Date: 05/26/2021
Onset Date: 05/27/2021
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: Onions

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

Symptoms: Complete loss of appetite, nausea, vomiting when I try to eat as I did before Painful muscle cramps in my chest and abdomen, heart palpitations, shoulder/neck/back pain for 3 months following vaccination Persistent fatigue

Other Meds: None

Current Illness: None

ID: 1571061
Sex: F
Age: 56
State: NY

Vax Date: 08/13/2021
Onset Date: 08/13/2021
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: PCN- Anaphylaxis

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: About 6 to 7 hours post-vaccine, I developed large baseball-sized swelling, either lymph node or mammary gland in the LEFT AXILLA (left armpit), painful and tender to touch. At first, I felt I had a mild reaction to the vaccine, but symptoms did not dissipate; instead, swelling increased. I am currently applying COLD COMPRESS to site with no relief. I will see my Doctor on 8/16/2021 for further evaluation - I am scared and regret taking the Pfizer vaccine. Looking forward to hearing from theCDC

Other Meds: Imitrex Vitamin C, E, Zinc, Omega

Current Illness: None

ID: 1571062
Sex: F
Age: 54
State: OH

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

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

Lab Data:

Allergies: None

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

Symptoms: Chest pain, cough, fever, extreme fatigue, headache, fast heart rate The chest pain still hasn?t subsided. It gets worse with any kind of movement- walking, washing dishes, bending over. I still get tired very easily. Still have a cough, though not as bad, but daily. Still get fast heart rate.

Other Meds: Levoxyl Zyrtec Singulair Iron tablet

Current Illness: None

ID: 1571063
Sex: M
Age: 30
State: CA

Vax Date: 08/15/2021
Onset Date: 08/15/2021
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: Client reported dizziness. The client ambulated and sat down in the anti-gravity chair. Vitals obtained at 1:25 PM were as follows: BP 128/83, HR 93, O2 98%. The client reported a history of anxiety, which he stopped taking his medications for. Repeat vitals obtained at 1:30 PM were as follows: O2 95%, HR 91, BP 139/79. The client stated the dizziness was getting better and was sitting upright in the anti-gravity chair. Repeat vitals obtained at 1:37PM were as follows: O2 97%, HR 94, BP 140/88. The client denied any persistent dizziness and stated he was calm. The client asked to leave at 1:44 PM. At that time the client stated he was feeling better and stated his anxiety was under control.

Other Meds:

Current Illness:

ID: 1571064
Sex: F
Age: 39
State: MD

Vax Date: 07/17/2021
Onset Date: 07/17/2021
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: White hickory tree Dust mites

Symptom List: Pain in extremity

Symptoms: It was the 17 of July, Saturday, when I received my second dose, about 5 mins from receiving the vaccine my heart started pounding. I was feeling warm all my limbs, chest and abdomen. I was trying to remain calm, alert and awake. I didn?t want to pass out because I won?t be able to tell them what?s happening to me. They checked my blood pressure it was 164/106mmHg 114bpm. They gave my 1L of water to drink. I was shivering a little, I?m not sure if it was from the water but it was room temperature though. They kept me there for about hour until it went down some but it was still high when I left 149/101mmHg 88bpm. My activity tolerance went down. I had to sit down in the middle of getting dressed and had to walk slower than my walking pace walking from room to room at home. I had a second episode on Wednesday, July 21, I was getting ready to sleep around 11:45pm, I felt dizzy at first then warm sensation all over my body, abdomen and chest followed by my heart pounding again. 106-119bpm and BP 157/93. I tried to take it manually 160/100 bc I couldn?t believe the machine. I just drank lots of water and tried to calm down. BP went up higher than that but I?m not sure if I believe the reading on the machine. Then I started shivering again. Again I?m not sure if the shivers is from drinking water or something else. It lasted more than an hour until I fell asleep. On week 3 and 4, I woke up with a chest pain on 3 different occasions and one occasion I woke up with my heart beating fast, i remember looking at the clock it was 2:50am. I willed myself back to sleep because I didn?t want a repeat of what had hadn?t before.

Other Meds: Amlodipine 5mg Vit d Garlic Extract Chlorpheniramine Maleate

Current Illness: Hypertension after the first vaccine without history of hypertension prior to the first dose

ID: 1571065
Sex: M
Age: 44
State: MI

Vax Date: 07/02/2021
Onset Date: 07/24/2021
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: None

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

Symptoms: 2 weeks after vaccine I experienced chest pain, bilateral foot pain and swelling, it felt like something was stuck in my throat, and a large raised itchy rash that moves from different places every day (wrist, feet, arms, hands, neck andlower back).

Other Meds: None

Current Illness: None

ID: 1571066
Sex: M
Age: 59
State: WA

Vax Date: 12/20/2020
Onset Date: 12/17/2020
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: Tentinus

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

Symptoms: I had swollen Lymph nodes down the left side of my body. It went from my head down to my neck, chest, under my arm and back areas. It lasted about a month until it stoped.

Other Meds: Gabapentin, Methocarbinal, Testostrone

Current Illness: None

ID: 1571067
Sex: F
Age: 49
State: ND

Vax Date: 08/12/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Patient called me at 9:00 pm 8/15/2021. She got her vaccine on Thursday and had a fever Saturday. Today she woke up with a swollen arm with a welt going up toward the shoulder 6" long and 3" wide. . Trouble moving arm. Had COVID-19 on October 31st. Lungs are burning. I told her to call the emergency room and talk to them. I told her if she needed to go to the emergency room and couldn't get a ride that I would take her.

Other Meds: none

Current Illness: none

ID: 1571068
Sex: F
Age: 28
State: FL

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

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Tachycardia and heart palpitations

Other Meds:

Current Illness:

ID: 1571069
Sex: F
Age: 64
State: MN

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

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

Lab Data:

Allergies: Penacillins and sulfa drugs

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Discomfort in abdomen and lower back, which started shortly after the second vaccination shot in May. Got a physical to rule out other causes. Discomfort has pretty much gone away now, which makes me think it was related to that second vaccine shot. Thought it was important to report.

Other Meds: One-a-day vitamin, cranberry tablets, calcium +D3

Current Illness: None

Date Died: 08/04/2021

ID: 1571070
Sex: M
Age: 83
State: CA

Vax Date: 03/23/2021
Onset Date:
Rec V Date: 08/15/2021
Hospital: Y

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: My father died on Oct 4, 2021 24 hours after testing positive for covid, despite being vaccinated twice in March and then April 2021. He came into contact with another individual a 4 days prior who also was fully vaccinated, but then became ill and tested positive for Covid.

Other Meds:

Current Illness:

ID: 1571072
Sex: F
Age: 54
State: PA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Recurrence of breast cancer

Other Meds: Atorvastatin, Farxiga, Carvedilol, Dexilant, Trulicity, Vascepa, Losartan, Metformin

Current Illness: None

ID: 1571073
Sex: M
Age: 30
State: IL

Vax Date: 05/05/2021
Onset Date: 06/15/2021
Rec V Date: 08/15/2021
Hospital:

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

Lab Data:

Allergies: Adhesive Tape - Dermatological

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

Symptoms: Tingling in left foot, began in June, then resolved. Resumed in August w/ pins + needles sensations, as well as periodic sensations of cold. Sought treatment from pediatrist to confirm if sensations were musculo-skeletal, confirmed they were not. Recommended following up with neurologist.

Other Meds: None

Current Illness: Severe abdominal pains (near appendix), gastritis, ibs Visual abnormalities, unsteady vision, anxiety Quit smoking ?1 month prior to vaccination event

ID: 1571074
Sex: F
Age: 17
State: TX

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

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

Lab Data:

Allergies: Not sure, maybe food allergy, had lip swelling about 3 years ago

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

Symptoms: Upper Lip very swollen with second dose. (Lower lip was slightly swollen with first dose and PCP advised to take Benadryl day before second dose and some days after second dose). Took Benadryl by mouth 25mg (2tabs) on 8/13/21 by 8:20am and also Bluebonnet NAC 500mg (2 capsules) by mouth on 8/13/21 by 7:15pm. In the morning of 8/14/21, the swelling was gone.

Other Meds: Multivitamins Benadryl

Current Illness: No

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm