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: 1580129
Sex: F
Age: 55
State: OH

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/18/2021
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: felt off and weak; Flushed; heart rate went up; whole body started shaking; This spontaneous case was reported by a consumer and describes the occurrence of FLUSHING (Flushed), HEART RATE INCREASED (heart rate went up), TREMOR (whole body started shaking) and ASTHENIA (felt off and weak) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Jan-2021, the patient experienced FLUSHING (Flushed), HEART RATE INCREASED (heart rate went up) and TREMOR (whole body started shaking). On 15-Jan-2021, the patient experienced ASTHENIA (felt off and weak). On 14-Jan-2021, FLUSHING (Flushed), HEART RATE INCREASED (heart rate went up) and TREMOR (whole body started shaking) had resolved. On 15-Jan-2021, ASTHENIA (felt off and weak) 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. She was not treated any medication, rather she was given some juice. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1580130
Sex: F
Age:
State: VA

Vax Date:
Onset Date:
Rec V Date: 08/18/2021
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: Breastfeeding; This spontaneous case was reported by a physician assistant (subsequently medically confirmed) and describes the occurrence of MATERNAL EXPOSURE DURING BREAST FEEDING (Breastfeeding) in a female patient of an unknown age exposed to mRNA-1273 (Moderna COVID-19 Vaccine) , while the mother received the product for COVID-19 vaccination. No medical history was provided by the reporter. On an unknown date, the mother received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On an unknown date, the patient was diagnosed with MATERNAL EXPOSURE DURING BREAST FEEDING (Breastfeeding). At the time of the report, MATERNAL EXPOSURE DURING BREAST FEEDING (Breastfeeding) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment information provided.

Other Meds:

Current Illness:

ID: 1580131
Sex: M
Age: 70
State: FL

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

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

Lab Data:

Allergies:

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

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of NASAL CONGESTION (nasal congestion), CHILLS (Chills), FATIGUE (Severe fatigue), PYREXIA (Fever) and MYALGIA (body aches) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 18-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 NASAL CONGESTION (nasal congestion), CHILLS (Chills), FATIGUE (Severe fatigue), PYREXIA (Fever) and MYALGIA (body aches). At the time of the report, NASAL CONGESTION (nasal congestion), CHILLS (Chills), FATIGUE (Severe fatigue), PYREXIA (Fever) and MYALGIA (body aches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatment information provided.

Other Meds:

Current Illness:

ID: 1580132
Sex: F
Age:
State: CA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 08/18/2021
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: Bruise; Pain; This spontaneous case was reported by a consumer and describes the occurrence of CONTUSION (Bruise) and PAIN (Pain) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Jan-2021, the patient experienced CONTUSION (Bruise) and PAIN (Pain). At the time of the report, CONTUSION (Bruise) and PAIN (Pain) outcome was unknown. Unknown The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. No treatment information provided.

Other Meds:

Current Illness:

ID: 1580133
Sex: M
Age: 69
State: NJ

Vax Date: 01/26/2021
Onset Date:
Rec V Date: 08/18/2021
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: soreness at injection site; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (soreness at injection site) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product IBUPROFEN (ADVIL [IBUPROFEN]) for Muscle soreness. No medical history was provided by the reporter. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient started IBUPROFEN (ADVIL [IBUPROFEN]) (unknown route) at an unspecified dose. On an unknown date, the patient experienced INJECTION SITE PAIN (soreness at injection site). At the time of the report, INJECTION SITE PAIN (soreness at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1580134
Sex: F
Age: 70
State: NJ

Vax Date: 01/28/2021
Onset Date: 02/04/2021
Rec V Date: 08/18/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE WARMTH (my arm (inj site) was warm to touch), VACCINATION SITE SWELLING (my arm (inj site) was swollen), VACCINATION SITE ERYTHEMA (my arm (inj site) was bright red) and VACCINATION SITE PRURITUS (my arm (inj site) was itchy) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced INJECTION SITE WARMTH (my arm (inj site) was warm to touch), VACCINATION SITE SWELLING (my arm (inj site) was swollen), VACCINATION SITE ERYTHEMA (my arm (inj site) was bright red) and VACCINATION SITE PRURITUS (my arm (inj site) was itchy). The patient was treated with IBUPROFEN at an unspecified dose and frequency; DIPHENHYDRAMINE at an unspecified dose and frequency; AMMONIUM CHLORIDE at an unspecified dose and frequency and SODIUM CITRATE at an unspecified dose and frequency. At the time of the report, INJECTION SITE WARMTH (my arm (inj site) was warm to touch), VACCINATION SITE SWELLING (my arm (inj site) was swollen), VACCINATION SITE ERYTHEMA (my arm (inj site) was bright red) and VACCINATION SITE PRURITUS (my arm (inj site) was itchy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Most recent FOLLOW-UP information incorporated above includes: On 08-Feb-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1580135
Sex: F
Age: 86
State: FL

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/18/2021
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: Injection site turned from red to pink; Painful; Inflamed shoulder; Limited range of motion; A spontaneous report (United States) was received from a consumer concerning a 86-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events inflamed shoulder/arthritis, painful/arthralgia, limited range of motion/mobility decreased, injection site turned from red to pink/injection site erythema. The patient's medical history was not provided. No relevant concomitant medications were reported. On 02 Feb 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot/batch: unknown) via unknown route in the left arm for prophylaxis of COVID-19 infection. On 02 FEB 2021 patient experienced inflamed shoulder that is painful, limited range of motion on same day of injection. Site of injection turned red to pink. Treatment for the event included aspirin and iced it. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), inflamed shoulder/arthritis, painful/arthralgia, limited range of motion/mobility decreased, injection site turned from red to pink/injection site erythema was unknown.

Other Meds:

Current Illness:

ID: 1580136
Sex: M
Age: 72
State: PA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 08/18/2021
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: pain in his left hand, pain in his left fingers; pain in his left wrist; A spontaneous report was received from a consumer concerning a 72-years-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events pain in his left hand and pain in his left fingers/pain in extremity, pain in his left wrist/arthralgia. The patient's medical history included pneumonia and COVID-19 infection November 2020 (hospitalized for 5 days). Past/current medical conditions include carpal tunnel of left hand (diagnosed 10 to 15 years ago). No relevant concomitant medications were reported. On 18 Feb 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (batch no: 006M20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 18 FEB 2021 patient experienced pain in his left hand, wrist and fingers. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), pain in his left hand, wrist and fingers that is ongoing.

Other Meds:

Current Illness: Carpal tunnel syndrome (diagnosed 10 to 15 years ago)

ID: 1580137
Sex: F
Age: 57
State: GA

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 08/18/2021
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: low grade fever; chills; body ache; joint pain; Pain; Recurring headaches; This spontaneous case was reported by a dental hygienist and describes the occurrence of HEADACHE (Recurring headaches), PYREXIA (low grade fever), CHILLS (chills), MYALGIA (body ache) and ARTHRALGIA (joint pain) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. On 30-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Jan-2021, the patient experienced HEADACHE (Recurring headaches). On an unknown date, the patient experienced PYREXIA (low grade fever), CHILLS (chills), MYALGIA (body ache), ARTHRALGIA (joint pain) and INJECTION SITE PAIN (Pain). The patient was treated with IBUPROFEN at an unspecified dose and frequency. At the time of the report, HEADACHE (Recurring headaches), PYREXIA (low grade fever), CHILLS (chills), MYALGIA (body ache), ARTHRALGIA (joint pain) and INJECTION SITE PAIN (Pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1580138
Sex: F
Age: 37
State: IL

Vax Date: 02/11/2021
Onset Date: 02/16/2021
Rec V Date: 08/18/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Soreness in her right arm) and HYPOAESTHESIA (Numbness on right side of body) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013620A) for COVID-19 vaccination. Concurrent medical conditions included Kidney transplant (The patient has a history of kidney transplant). On 11-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced PAIN IN EXTREMITY (Soreness in her right arm) and HYPOAESTHESIA (Numbness on right side of body). At the time of the report, PAIN IN EXTREMITY (Soreness in her right arm) and HYPOAESTHESIA (Numbness on right side of body) outcome was unknown.

Other Meds:

Current Illness: Kidney transplant (The patient has a history of kidney transplant)

ID: 1580139
Sex: M
Age: 71
State: TX

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 08/18/2021
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: Fever ranging 99F-102F; This spontaneous case was reported by a consumer and describes the occurrence of in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1580140
Sex: F
Age: 69
State: VA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 08/18/2021
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: nasal congestion; Fatigue; tired; A spontaneous report was received from a consumer concerning herself, a female patient of 69-years-old who received Moderna (mRNA-1273) vaccine and experienced tiredness, fatigue and nasal congestion. The patient's medical history was not provided. No relevant concomitant medications was reported. The patient received their first of two planned doses of mRNA-1273 (Batch no: unknown) on 18-FEB-2021 intramuscularly in an unspecified site for the prophylaxis of COVID-19 infection. On 19-FEB-2021, the patient experienced feeling of tired, fatigue and nasal congestion. Laboratory details was not provided. No treatment information was provided. Action taken with mRNA-1273 in response to the events was unknown. The outcome of the events, tiredness, fatigue, nasal congestion was not recovered/ resolved.

Other Meds:

Current Illness: Allergy (The patient reported of having some allergic reactions after vaccination.)

ID: 1580141
Sex: F
Age: 89
State: AL

Vax Date: 01/21/2021
Onset Date: 02/18/2021
Rec V Date: 08/18/2021
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: back pain; headache; Case reference number MOD-2021-017271 is a spontaneous case report sent by a Non-Health Professional on 19-FEB-2021 00:00:00 , which refers to a Female aged 90 Years The following drugs are known to have been taken by the patient prior to the event: ASPIRIN (E.C.)[] . The patient was administered the second dose of Moderna COVID-19 Vaccine for COVID-19 immunization on 18Feb2021. Some 29 days later, the patient developed back pain. Since the administration, the patient experienced back pain and headache. The eventual diagnosis made on was Back pain. The patient was treated for the event with Tylenol and heating pad. The medical reviewer may provide a case evaluation statement, including other possible etiological and confounding factors, e.g. (only limited information has been obtained so far, it is difficult to assess the cause and effect relationship Follow-up required. . Terse Narrative (for narratives and signal review) Brief 3 line summary of above for listing: Report Source- Non-Health Professional, Age- 90 Years, Sex- Female, Suspect Drug- Moderna COVID-19 Vaccine, Treatment- Diagnosis\Outcome- back pain - Unknown,headache - Unknown.

Other Meds: ASPIRIN (E.C.)

Current Illness:

ID: 1580142
Sex: M
Age: 84
State: FL

Vax Date: 01/19/2021
Onset Date:
Rec V Date: 08/18/2021
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: Diagnosed with Fibromyalgia; Arm was achy; Shoulder was achy; A spontaneous report was received from a consumer concerning a 84-year-old male patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced shoulder ache/arthralgia, arm ache/pain in extremity and fibromyalgia.. The patient's medical history, was not provided by the reporter. No concomitant medications reported. On 19 Jan 2021 prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced shoulder and arm ache. The patient states that he was diagnosed with fibromyalgia. Treatment for the events were not reported. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events, shoulder and arm ache and fibromyalgia were unknown.

Other Meds:

Current Illness:

ID: 1580143
Sex: F
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 08/18/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm), ABDOMINAL PAIN (intestinal discomfort) and HEADACHE (headache) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. No medical history was provided by the reporter. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (sore arm), ABDOMINAL PAIN (intestinal discomfort) and HEADACHE (headache). At the time of the report, PAIN IN EXTREMITY (sore arm), ABDOMINAL PAIN (intestinal discomfort) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to US-MODERNATX, INC.-MOD-2021-016906 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-016906:

Other Meds:

Current Illness:

ID: 1580144
Sex: F
Age: 52
State: OH

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 08/18/2021
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: Tingling in the face and lips; Tingling face; itching face and arm(not at the injection site); a little fast heart beat; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA ORAL (Tingling in the face and lips), PARAESTHESIA (Tingling face), PRURITUS (itching face and arm(not at the injection site)) and HEART RATE INCREASED (a little fast heart beat) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) for COVID-19 vaccination. Concomitant products included SECUKINUMAB (COSENTYX) for Psoriatic arthritis, METOPROLOL for Sinus tachycardia. On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Jan-2021, the patient experienced PARAESTHESIA ORAL (Tingling in the face and lips), PARAESTHESIA (Tingling face), PRURITUS (itching face and arm(not at the injection site)) and HEART RATE INCREASED (a little fast heart beat). At the time of the report, PARAESTHESIA ORAL (Tingling in the face and lips), PARAESTHESIA (Tingling face), PRURITUS (itching face and arm(not at the injection site)) and HEART RATE INCREASED (a little fast heart beat) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Reporter did not allow further contact

Other Meds: COSENTYX; METOPROLOL

Current Illness:

ID: 1580145
Sex: F
Age:
State:

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 08/18/2021
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: fatigue; swelling at the injection site; injection site soreness; Injection site redness; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (fatigue), VACCINATION SITE SWELLING (swelling at the injection site), VACCINATION SITE PAIN (injection site soreness) and VACCINATION SITE ERYTHEMA (Injection site redness) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20a) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 16-Jan-2021 at 9:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Jan-2021, the patient experienced FATIGUE (fatigue), VACCINATION SITE SWELLING (swelling at the injection site), VACCINATION SITE PAIN (injection site soreness) and VACCINATION SITE ERYTHEMA (Injection site redness). On 26-Jan-2021, FATIGUE (fatigue), VACCINATION SITE SWELLING (swelling at the injection site), VACCINATION SITE PAIN (injection site soreness) and VACCINATION SITE ERYTHEMA (Injection site redness) had resolved. Possible The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580146
Sex: F
Age: 87
State: NC

Vax Date: 12/29/2020
Onset Date: 01/26/2021
Rec V Date: 08/18/2021
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: The injection site swollen; The injection site red; Raised up below the injection site; Soreness in arm/more tender; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Soreness in arm/more tender), VACCINATION SITE SWELLING (The injection site swollen), VACCINATION SITE ERYTHEMA (The injection site red) and VACCINATION SITE INDURATION (Raised up below the injection site) in an 87-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037K20A and 043620A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No prior medical history reported.). Concomitant products included ACETYLSALICYLIC ACID (ASPIRIN (E.C.)), VITAMIN C [ASCORBIC ACID], CALCIUM and ATORVASTATIN CALCIUM, EZETIMIBE (STATIN EZ) for an unknown indication. On 29-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Jan-2021 at 5:00 PM, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Jan-2021, the patient experienced VACCINATION SITE PAIN (Soreness in arm/more tender). On 27-Jan-2021, the patient experienced VACCINATION SITE SWELLING (The injection site swollen), VACCINATION SITE ERYTHEMA (The injection site red) and VACCINATION SITE INDURATION (Raised up below the injection site). At the time of the report, VACCINATION SITE PAIN (Soreness in arm/more tender), VACCINATION SITE SWELLING (The injection site swollen), VACCINATION SITE ERYTHEMA (The injection site red) and VACCINATION SITE INDURATION (Raised up below the injection site) had not resolved. Not provided. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments. Reporter did not allow further contact

Other Meds: ASPIRIN; VITAMIN C [ASCORBIC ACID]; CALCIUM; STATIN EZ

Current Illness:

ID: 1580147
Sex: F
Age: 77
State: TX

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 08/18/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Sore arm), FATIGUE (LITTLE TIRED), HEADACHE (Headache), ABDOMINAL PAIN UPPER (Stomach ache) and OROPHARYNGEAL PAIN (Sore throat) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Blood pressure high and Arthritis. Concomitant products included arthritis medications for Arthritis, high blood pressure medications for Hypertension, BROMAZEPAM (LEXOTAN) for an unknown indication. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Jan-2021, the patient experienced VACCINATION SITE PAIN (Sore arm) and FATIGUE (LITTLE TIRED). On 20-Jan-2021, the patient experienced HEADACHE (Headache), ABDOMINAL PAIN UPPER (Stomach ache), OROPHARYNGEAL PAIN (Sore throat) and CHEST DISCOMFORT (Chest congestion). On 15-Jan-2021, VACCINATION SITE PAIN (Sore arm) had resolved. On 25-Jan-2021, HEADACHE (Headache), ABDOMINAL PAIN UPPER (Stomach ache), OROPHARYNGEAL PAIN (Sore throat) and CHEST DISCOMFORT (Chest congestion) had resolved. At the time of the report, FATIGUE (LITTLE TIRED) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test negative: negative. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: high blood pressure medications; arthritis medications; LEXOTAN

Current Illness: Arthritis; Blood pressure high

ID: 1580148
Sex: M
Age:
State: CA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 08/18/2021
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: tired all day; headache that came and went; chills; fever; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (tired all day), HEADACHE (headache that came and went), CHILLS (chills) and PYREXIA (fever) 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 17-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, the patient experienced FATIGUE (tired all day), HEADACHE (headache that came and went), CHILLS (chills) and PYREXIA (fever). At the time of the report, FATIGUE (tired all day) and HEADACHE (headache that came and went) had not resolved and CHILLS (chills) and PYREXIA (fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Feb-2021, Body temperature: 99.5.

Other Meds:

Current Illness:

ID: 1580149
Sex: F
Age: 29
State: VA

Vax Date: 01/19/2021
Onset Date: 01/26/2021
Rec V Date: 08/18/2021
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: The injection site area red; The injection site area raised; Vaccination site pruritus; small bumps on arm / rash is 6 inches in diameter; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (small bumps on arm / rash is 6 inches in diameter), VACCINATION SITE ERYTHEMA (The injection site area red), VACCINATION SITE INDURATION (The injection site area raised) and VACCINATION SITE PRURITUS (Vaccination site pruritus) in a 29-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026L20A) for COVID-19 vaccination. The patient's past medical history included No adverse reaction. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Jan-2021, the patient experienced VACCINATION SITE RASH (small bumps on arm / rash is 6 inches in diameter) and VACCINATION SITE PRURITUS (Vaccination site pruritus). On 27-Jan-2021, the patient experienced VACCINATION SITE ERYTHEMA (The injection site area red) and VACCINATION SITE INDURATION (The injection site area raised). At the time of the report, VACCINATION SITE RASH (small bumps on arm / rash is 6 inches in diameter), VACCINATION SITE ERYTHEMA (The injection site area red), VACCINATION SITE INDURATION (The injection site area raised) and VACCINATION SITE PRURITUS (Vaccination site pruritus) 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.

Other Meds:

Current Illness:

ID: 1580150
Sex: F
Age: 40
State: AL

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 08/18/2021
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: Tested positive for covid, Headache, Minimum loss of smell, Minimum loss of taste, Abdominal pain, Back pain, Diarrhea; Headache; loss of smell; Abdominal pain; Diarrhea; This spontaneous case was reported by a nurse and describes the occurrence of COVID-19 (Tested positive for covid, Headache, Minimum loss of smell, Minimum loss of taste, Abdominal pain, Back pain, Diarrhea), HEADACHE (Headache), ANOSMIA (loss of smell), ABDOMINAL PAIN (Abdominal pain) and DIARRHOEA (Diarrhea) in a 40-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 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Jan-2021, the patient experienced HEADACHE (Headache), ANOSMIA (loss of smell), ABDOMINAL PAIN (Abdominal pain) and DIARRHOEA (Diarrhea). On an unknown date, the patient experienced COVID-19 (Tested positive for covid, Headache, Minimum loss of smell, Minimum loss of taste, Abdominal pain, Back pain, Diarrhea). At the time of the report, COVID-19 (Tested positive for covid, Headache, Minimum loss of smell, Minimum loss of taste, Abdominal pain, Back pain, Diarrhea) outcome was unknown and HEADACHE (Headache), ANOSMIA (loss of smell), ABDOMINAL PAIN (Abdominal pain) and DIARRHOEA (Diarrhea) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1580151
Sex: F
Age: 80
State: MD

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 08/18/2021
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: Legs felt heavy; Left arm was sore; felt tired, fatigue; This spontaneous case was reported by a consumer and describes the occurrence of LIMB DISCOMFORT (Legs felt heavy), VACCINATION SITE PAIN (Left arm was sore) and FATIGUE (felt tired, fatigue) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. The patient's past medical history included Migraine since an unknown date. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Jan-2021, the patient experienced LIMB DISCOMFORT (Legs felt heavy), VACCINATION SITE PAIN (Left arm was sore) and FATIGUE (felt tired, fatigue). At the time of the report, LIMB DISCOMFORT (Legs felt heavy), VACCINATION SITE PAIN (Left arm was sore) and FATIGUE (felt tired, fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Reporter did not allow further contact

Other Meds:

Current Illness: Migraine

ID: 1580152
Sex: F
Age: 45
State: MD

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 08/18/2021
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: Positive for COVID-19; severe fatigue; severe brain fog; hyperventilated and had trouble breathing; hyperventilated and had trouble breathing; abdominal pain; Pain in the arm; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Positive for COVID-19), HYPERVENTILATION (hyperventilated and had trouble breathing), DYSPNOEA (hyperventilated and had trouble breathing), ABDOMINAL PAIN (abdominal pain) and VACCINATION SITE PAIN (Pain in the arm) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) 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 reported medical history). On 08-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Jan-2021, the patient experienced HYPERVENTILATION (hyperventilated and had trouble breathing), DYSPNOEA (hyperventilated and had trouble breathing), ABDOMINAL PAIN (abdominal pain) and VACCINATION SITE PAIN (Pain in the arm). On 09-Jan-2021, the patient experienced FATIGUE (severe fatigue) and FEELING ABNORMAL (severe brain fog). On 20-Jan-2021, the patient experienced COVID-19 (Positive for COVID-19). At the time of the report, COVID-19 (Positive for COVID-19), HYPERVENTILATION (hyperventilated and had trouble breathing), DYSPNOEA (hyperventilated and had trouble breathing), ABDOMINAL PAIN (abdominal pain), VACCINATION SITE PAIN (Pain in the arm), FATIGUE (severe fatigue) and FEELING ABNORMAL (severe brain fog) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1580153
Sex: F
Age:
State:

Vax Date: 01/15/2021
Onset Date:
Rec V Date: 08/18/2021
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: pain in arm; skin reaction on arm red; skin reaction on arm swollen; skin reaction on arm itch; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (pain in arm), VACCINATION SITE ERYTHEMA (skin reaction on arm red), VACCINATION SITE SWELLING (skin reaction on arm swollen) and VACCINATION SITE PRURITUS (skin reaction on arm itch) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025J20-2A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE PAIN (pain in arm), VACCINATION SITE ERYTHEMA (skin reaction on arm red), VACCINATION SITE SWELLING (skin reaction on arm swollen) and VACCINATION SITE PRURITUS (skin reaction on arm itch). At the time of the report, VACCINATION SITE PAIN (pain in arm), VACCINATION SITE ERYTHEMA (skin reaction on arm red), VACCINATION SITE SWELLING (skin reaction on arm swollen) and VACCINATION SITE PRURITUS (skin reaction on arm itch) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580154
Sex: F
Age: 48
State: OH

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 08/18/2021
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: This spontaneous case reported by a consumer, describes the occurrence of vaccination site pain (her arm is very sore and she can not even raise it) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch# 012L20A) for COVID-19 vaccination. The patient's past medical history included no adverse event. On Feb 17, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. On Feb 17, 2021, patient experienced vaccination site pain (her arm is very sore and she can not even raise it). At the time of the report, vaccination site pain (her arm is very sore and she can not even raise it) outcome: unknown. The action taken with mRNA-1273 (Moderna COVID-19 vaccine), intramuscular: unknown.

Other Meds:

Current Illness:

ID: 1580155
Sex: M
Age: 89
State: FL

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 08/18/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itching) and BLOOD URINE PRESENT (last night started urinating blood and still going on) in a 90-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included FOLIC ACID, LOVASTATIN, LOSARTAN, APIXABAN (ELIQUIS), METOPROLOL SUCCINATE and FESOTERODINE FUMARATE (TOVIAZ) for an unknown indication. On 11-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Feb-2021, the patient experienced BLOOD URINE PRESENT (last night started urinating blood and still going on). On an unknown date, the patient experienced VACCINATION SITE PRURITUS (Itching). At the time of the report, VACCINATION SITE PRURITUS (Itching) outcome was unknown and BLOOD URINE PRESENT (last night started urinating blood and still going on) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds: FOLIC ACID; LOVASTATIN; LOSARTAN; ELIQUIS; METOPROLOL SUCCINATE; TOVIAZ

Current Illness:

ID: 1580156
Sex: F
Age:
State: TX

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 08/18/2021
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: Body aches; chills; This spontaneous case was reported by a patient and describes the occurrence of MYALGIA (Body aches) and CHILLS (chills) 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 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Jan-2021, the patient experienced MYALGIA (Body aches) and CHILLS (chills). At the time of the report, MYALGIA (Body aches) and CHILLS (chills) had not 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. Most recent FOLLOW-UP information incorporated above includes: On 25-May-2021: NNI

Other Meds:

Current Illness:

ID: 1580157
Sex: F
Age: 63
State: MI

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 08/18/2021
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: Headache; fever Registered a 102F Temperature Taken on Neck; Body fatigue; arm/joint pain; chills; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache), PYREXIA (fever Registered a 102F Temperature Taken on Neck), FATIGUE (Body fatigue), ARTHRALGIA (arm/joint pain) and CHILLS (chills) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 25-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Jan-2021, the patient experienced HEADACHE (Headache), PYREXIA (fever Registered a 102F Temperature Taken on Neck), FATIGUE (Body fatigue), ARTHRALGIA (arm/joint pain) and CHILLS (chills). At the time of the report, HEADACHE (Headache), PYREXIA (fever Registered a 102F Temperature Taken on Neck), FATIGUE (Body fatigue), ARTHRALGIA (arm/joint pain) and CHILLS (chills) had not resolved. Possible DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 25-Jan-2021, Body temperature: 102 102F. 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.

Other Meds:

Current Illness:

ID: 1580158
Sex: F
Age:
State: NC

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: diarrhea; sick of the stomach; headache; pain in hte "Cheekbutts"; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (diarrhea), VACCINATION SITE PAIN (sore arm), ABDOMINAL DISCOMFORT (sick of the stomach), HEADACHE (headache) and MYALGIA (pain in hte "Cheekbutts") in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024J20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, the patient experienced VACCINATION SITE PAIN (sore arm). On 20-Feb-2021, the patient experienced DIARRHOEA (diarrhea), ABDOMINAL DISCOMFORT (sick of the stomach), HEADACHE (headache) and MYALGIA (pain in hte "Cheekbutts"). At the time of the report, DIARRHOEA (diarrhea), VACCINATION SITE PAIN (sore arm), ABDOMINAL DISCOMFORT (sick of the stomach), HEADACHE (headache) and MYALGIA (pain in hte "Cheekbutts") outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580159
Sex: F
Age: 53
State: MD

Vax Date: 02/09/2012
Onset Date: 02/17/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Big rash at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (Big rash at the injection site) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no medical history provided). On 09-Feb-2012, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Feb-2021, the patient experienced VACCINATION SITE RASH (Big rash at the injection site). At the time of the report, VACCINATION SITE RASH (Big rash at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580160
Sex: M
Age: 67
State:

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: sluggish; blood sugar rose each day; Arm pain; This spontaneous case was reported by a consumer and describes the occurrence of HYPERGLYCAEMIA (blood sugar rose each day), VACCINATION SITE PAIN (Arm pain) and SLUGGISHNESS (sluggish) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Type 2 diabetes mellitus. On 20-Jan-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Jan-2021, the patient experienced VACCINATION SITE PAIN (Arm pain). On 25-Jan-2021, the patient experienced HYPERGLYCAEMIA (blood sugar rose each day). On an unknown date, the patient experienced SLUGGISHNESS (sluggish). On 22-Jan-2021, VACCINATION SITE PAIN (Arm pain) had resolved. At the time of the report, HYPERGLYCAEMIA (blood sugar rose each day) and SLUGGISHNESS (sluggish) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1580161
Sex: M
Age:
State: TX

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Slight Cough; hot and cold; headache; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (Slight Cough), FEELING OF BODY TEMPERATURE CHANGE (hot and cold) and HEADACHE (headache) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 05-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Jan-2021, the patient experienced COUGH (Slight Cough), FEELING OF BODY TEMPERATURE CHANGE (hot and cold) and HEADACHE (headache). At the time of the report, COUGH (Slight Cough), FEELING OF BODY TEMPERATURE CHANGE (hot and cold) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1580162
Sex: F
Age:
State:

Vax Date: 01/18/2021
Onset Date: 01/25/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Rash; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (Rash) 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 information). On 18-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Jan-2021, the patient experienced VACCINATION SITE RASH (Rash). At the time of the report, VACCINATION SITE RASH (Rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown.

Other Meds:

Current Illness:

ID: 1580163
Sex: F
Age: 64
State: AL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of HYPOACUSIS (Experiencing hearing loss), EAR PAIN (Pain in ears), TINNITUS (Ear ringing), VACCINATION SITE SWELLING (Mild swelling at injection site) and EAR DISORDER (Pressure in ears) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042220A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no relevant medical history reported). 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 HYPOACUSIS (Experiencing hearing loss), EAR PAIN (Pain in ears), TINNITUS (Ear ringing), VACCINATION SITE SWELLING (Mild swelling at injection site) and EAR DISORDER (Pressure in ears). At the time of the report, HYPOACUSIS (Experiencing hearing loss), EAR PAIN (Pain in ears), TINNITUS (Ear ringing), VACCINATION SITE SWELLING (Mild swelling at injection site) and EAR DISORDER (Pressure in ears) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1580164
Sex: F
Age: 74
State: SC

Vax Date: 01/21/2021
Onset Date:
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: itch; rash; fatigue; Vaccination site pain; injection site bump; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (itch), VACCINATION SITE RASH (rash), FATIGUE (fatigue), VACCINATION SITE PAIN (Vaccination site pain) and VACCINATION SITE INDURATION (injection site bump) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026L20A) for COVID-19 vaccination. Concurrent medical conditions included Cataract (Surgery scheduled on 27-JAN-2021). On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE PRURITUS (itch), VACCINATION SITE RASH (rash), FATIGUE (fatigue), VACCINATION SITE PAIN (Vaccination site pain) and VACCINATION SITE INDURATION (injection site bump). At the time of the report, VACCINATION SITE PRURITUS (itch), VACCINATION SITE RASH (rash), FATIGUE (fatigue), VACCINATION SITE PAIN (Vaccination site pain) and VACCINATION SITE INDURATION (injection site bump) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness: Cataract (Surgery scheduled on 27-JAN-2021)

ID: 1580165
Sex: F
Age: 90
State: TX

Vax Date: 02/10/2021
Onset Date:
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Itchy; Red; Red rash around the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itchy), VACCINATION SITE ERYTHEMA (Red) and VACCINATION SITE RASH (Red rash around the injection site) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0301420A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No prior medical history was reported.). On 10-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 VACCINATION SITE PRURITUS (Itchy), VACCINATION SITE ERYTHEMA (Red) and VACCINATION SITE RASH (Red rash around the injection site). At the time of the report, VACCINATION SITE PRURITUS (Itchy), VACCINATION SITE ERYTHEMA (Red) and VACCINATION SITE RASH (Red rash around the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1580166
Sex: F
Age: 79
State: IN

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pinkish spot on her arm around the injection site; Arm became sore; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE DISCOLOURATION (Pinkish spot on her arm around the injection site) and PAIN IN EXTREMITY (Arm became sore) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0326204) for COVID-19 vaccination. Concomitant products included LISINOPRIL for an unknown indication. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Jan-2021, the patient experienced INJECTION SITE DISCOLOURATION (Pinkish spot on her arm around the injection site) and PAIN IN EXTREMITY (Arm became sore). At the time of the report, INJECTION SITE DISCOLOURATION (Pinkish spot on her arm around the injection site) had not resolved and PAIN IN EXTREMITY (Arm became sore) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: LISINOPRIL

Current Illness:

ID: 1580167
Sex: F
Age: 78
State: FL

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: pain from her neck to her arm; unable to sleep; feels down; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (pain from her neck to her arm), SLEEP DISORDER (unable to sleep) and DEPRESSED MOOD (feels down) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0136204) for COVID-19 vaccination. Concomitant products included THYROID, MULTIVITAMINS, PLAIN and FOLIC ACID for an unknown indication. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Jan-2021, the patient experienced PAIN (pain from her neck to her arm), SLEEP DISORDER (unable to sleep) and DEPRESSED MOOD (feels down). At the time of the report, PAIN (pain from her neck to her arm), SLEEP DISORDER (unable to sleep) and DEPRESSED MOOD (feels down) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: THYROID; MULTIVITAMINS, PLAIN; FOLIC ACID

Current Illness:

ID: 1580168
Sex: F
Age: 72
State: CA

Vax Date: 01/15/2021
Onset Date: 01/21/2021
Rec V Date: 08/18/2021
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: injection site itching; rough patich (on top of inj site); clear rash,little bubbles; large circular place; hard; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE INDURATION (large circular place; hard), INJECTION SITE PRURITUS (injection site itching), INJECTION SITE PLAQUE (rough patich (on top of inj site)) and INJECTION SITE RASH (clear rash,little bubbles) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L02A) for COVID-19 vaccination. No Medical History information was reported. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Jan-2021, the patient experienced INJECTION SITE INDURATION (large circular place; hard). On an unknown date, the patient experienced INJECTION SITE PRURITUS (injection site itching), INJECTION SITE PLAQUE (rough patich (on top of inj site)) and INJECTION SITE RASH (clear rash,little bubbles). At the time of the report, INJECTION SITE INDURATION (large circular place; hard), INJECTION SITE PRURITUS (injection site itching), INJECTION SITE PLAQUE (rough patich (on top of inj site)) and INJECTION SITE RASH (clear rash,little bubbles) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580169
Sex: F
Age: 88
State: OH

Vax Date: 01/23/2021
Onset Date: 01/27/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: both sides of her arms were itchy; A spontaneous report was received from a consumer, concerning herself a female patient of age 42 years, who had received her first dose on (23-Jan-2021) Moderna's COVID-19 and experienced both arms itchy. The patient's medical history includes hypertension and asthma, concomitant medication was not provided by reporter. On 23 Jan 2021 patient received her first dose of two planned doses of mRNA-1273 (lot number:0121204) via unknown route for COVID-19 infection prophylaxis. On 23 Jan 2021 she experienced her arms were itchy and indicated that she ate shrimp a week later and experienced the same reaction but has no history but being allergic shrimp. Action taken with mRNA-1273 in response to the event was unknown. The outcome of the event both arms itchy was not resolved at time of reporting.

Other Meds:

Current Illness: Blood pressure

ID: 1580170
Sex: F
Age:
State: AZ

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

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

Lab Data:

Allergies:

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

Symptoms: Arm was hurting; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm was hurting) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, the patient experienced PAIN IN EXTREMITY (Arm was hurting). At the time of the report, PAIN IN EXTREMITY (Arm was hurting) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580171
Sex: F
Age: 38
State: PR

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vomiting phlegm; difficulty breathing; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (difficulty breathing) and VOMITING (vomiting phlegm) in a 38-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030L20A) for COVID-19 vaccination. The patient's past medical history included Hypothyroidism and Multiple sclerosis. Concurrent medical conditions included Allergy to topical drugs (Allergies to aspirin, penicillin and gadolinium). Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID) and Jelena for an unknown indication. On 20-Jan-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Jan-2021, the patient experienced DYSPNOEA (difficulty breathing). On 27-Jan-2021, the patient experienced VOMITING (vomiting phlegm). At the time of the report, DYSPNOEA (difficulty breathing) and VOMITING (vomiting phlegm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: SYNTHROID; Jelena

Current Illness: Allergy to topical drugs (Allergies to aspirin, penicillin and gadolinium)

ID: 1580172
Sex: M
Age: 74
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/18/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Itchiness at the site of the injection; Swelling at the site of the injection; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itchiness at the site of the injection) and VACCINATION SITE SWELLING (Swelling at the site of the injection) in a 74-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031ML0A) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, the patient experienced VACCINATION SITE PRURITUS (Itchiness at the site of the injection) and VACCINATION SITE SWELLING (Swelling at the site of the injection). At the time of the report, VACCINATION SITE PRURITUS (Itchiness at the site of the injection) and VACCINATION SITE SWELLING (Swelling at the site of the injection) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580173
Sex: M
Age: 86
State: GA

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 08/18/2021
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: trouble getting out of bed; pain in his arm; head felt weird; wobbly on his feet; This spontaneous case was reported by a consumer and describes the occurrence of DYSSTASIA (trouble getting out of bed), PAIN IN EXTREMITY (pain in his arm), HEAD DISCOMFORT (head felt weird) and LIMB DISCOMFORT (wobbly on his feet) in an 86-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, the patient experienced DYSSTASIA (trouble getting out of bed), PAIN IN EXTREMITY (pain in his arm), HEAD DISCOMFORT (head felt weird) and LIMB DISCOMFORT (wobbly on his feet). At the time of the report, DYSSTASIA (trouble getting out of bed), PAIN IN EXTREMITY (pain in his arm), HEAD DISCOMFORT (head felt weird) and LIMB DISCOMFORT (wobbly on his feet) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment details was reported. Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: Follow up document was received. The outcome of adverse event was updated to recovered/resolved. It contains significant information.

Other Meds:

Current Illness:

ID: 1580174
Sex: F
Age: 37
State: RI

Vax Date: 01/16/2021
Onset Date: 01/18/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: injection site redness; Injection site swelling; injection site swelling; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE SWELLING (injection site swelling), INJECTION SITE ERYTHEMA (injection site redness) and INJECTION SITE SWELLING (Injection site swelling) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026L20A) for COVID-19 vaccination. Concomitant products included MELATONIN for an unknown indication. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Jan-2021, the patient experienced INJECTION SITE SWELLING (injection site swelling). On 25-Jan-2021, the patient experienced INJECTION SITE ERYTHEMA (injection site redness) and INJECTION SITE SWELLING (Injection site swelling). On 22-Jan-2021, INJECTION SITE SWELLING (injection site swelling) had resolved. At the time of the report, INJECTION SITE ERYTHEMA (injection site redness) and INJECTION SITE SWELLING (Injection site swelling) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: MELATONIN

Current Illness:

ID: 1580175
Sex: M
Age: 83
State: PA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: injection site pain/his arm was sore; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (injection site pain/his arm was sore) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. No Medical History information was reported. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Jan-2021, the patient experienced INJECTION SITE PAIN (injection site pain/his arm was sore). At the time of the report, INJECTION SITE PAIN (injection site pain/his arm was sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580176
Sex: F
Age: 81
State: IL

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

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Sty in her eye; This spontaneous case was reported by a consumer and describes the occurrence of HORDEOLUM (Sty in her eye) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. No Medical History information was reported. On 02-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 HORDEOLUM (Sty in her eye). At the time of the report, HORDEOLUM (Sty in her eye) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1580177
Sex: F
Age: 51
State: NH

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: still has a bruise; itching; then had hives; entire upper arm started to swell; painful; chills; felt like she got stung by a bee; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (itching), VACCINATION SITE URTICARIA (then had hives), PERIPHERAL SWELLING (entire upper arm started to swell), PAIN (painful) and CHILLS (chills) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Allergy to insect sting. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jan-2021, the patient experienced VACCINATION SITE PRURITUS (itching), VACCINATION SITE URTICARIA (then had hives), PERIPHERAL SWELLING (entire upper arm started to swell), PAIN (painful), CHILLS (chills) and FEELING ABNORMAL (felt like she got stung by a bee). On 27-Jan-2021, the patient experienced VACCINATION SITE BRUISING (still has a bruise). At the time of the report, VACCINATION SITE PRURITUS (itching), VACCINATION SITE URTICARIA (then had hives), PAIN (painful), CHILLS (chills), FEELING ABNORMAL (felt like she got stung by a bee) and VACCINATION SITE BRUISING (still has a bruise) outcome was unknown and PERIPHERAL SWELLING (entire upper arm started to swell) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness: Allergy to insect sting

ID: 1580178
Sex: F
Age:
State:

Vax Date:
Onset Date: 01/25/2021
Rec V Date: 08/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of RASH (Patient has a rash after getting the Moderna covid shot) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Jan-2021, the patient experienced RASH (Patient has a rash after getting the Moderna covid shot). At the time of the report, RASH (Patient has a rash after getting the Moderna covid shot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm