VAERS 2021 Database www.vaers.hhs.gov

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

Total Manufacturer

Incidents per State

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

ID: 1572097
Sex: F
Age: 66
State:

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Warm sensation at the injection site; Injection site itchiness; Injection site redness; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Warm sensation at the injection site), VACCINATION SITE PRURITUS (Injection site itchiness) and VACCINATION SITE ERYTHEMA (Injection site redness) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032H20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history.). On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced VACCINATION SITE WARMTH (Warm sensation at the injection site), VACCINATION SITE PRURITUS (Injection site itchiness) and VACCINATION SITE ERYTHEMA (Injection site redness). At the time of the report, VACCINATION SITE WARMTH (Warm sensation at the injection site), VACCINATION SITE PRURITUS (Injection site itchiness) and VACCINATION SITE ERYTHEMA (Injection site redness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. No treatment was received. Reporter did not allow further contact; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1572098
Sex: M
Age: 52
State: ID

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

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Backache; Headache; Pain in the injection site; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Backache), HEADACHE (Headache) and INJECTION SITE PAIN (Pain in the injection site) in a 52-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in April 2020. 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 BACK PAIN (Backache), HEADACHE (Headache) and INJECTION SITE PAIN (Pain in the injection site). At the time of the report, BACK PAIN (Backache), HEADACHE (Headache) and INJECTION SITE PAIN (Pain in the injection site) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported by investigator o No treatment medications provided by the reporter.; Sender's Comments: Very limited information regarding this events has been provided at this time. Further information has been requested. Company assessed the events to be unlikely related to company product.

Other Meds:

Current Illness:

ID: 1572099
Sex: F
Age:
State:

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

Vax Type:
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Symptom List:

Symptoms: Loose bowel; Runny eyes; Runny nose; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Loose bowel), LACRIMATION INCREASED (Runny eyes) and RHINORRHOEA (Runny nose) in a 93-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (Medical history not reported.). On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Jan-2021, the patient experienced DIARRHOEA (Loose bowel), LACRIMATION INCREASED (Runny eyes) and RHINORRHOEA (Runny nose). At the time of the report, DIARRHOEA (Loose bowel), LACRIMATION INCREASED (Runny eyes) and RHINORRHOEA (Runny nose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. Company Comment: Very limited information regarding this events has been provided at this time. Further information has been requested. Company assessed the events to be unlikely related to company product.; Sender's Comments: Very limited information regarding this events has been provided at this time. Further information has been requested. Company assessed the events to be unlikely related to company product.

Other Meds:

Current Illness:

ID: 1572100
Sex: F
Age: 42
State: MI

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Lab Data:

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Symptom List:

Symptoms: shingles; itchy hives on the stomach; soreness at the injection site; redness at the injection site; This spontaneous case was reported by an other health care professional and describes the occurrence of VACCINATION SITE PAIN (soreness at the injection site), VACCINATION SITE ERYTHEMA (redness at the injection site), URTICARIA (itchy hives on the stomach) and HERPES ZOSTER (shingles) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) for COVID-19 vaccination. No Medical History information was reported. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Jan-2021, the patient experienced VACCINATION SITE PAIN (soreness at the injection site) and VACCINATION SITE ERYTHEMA (redness at the injection site). On 15-Jan-2021, the patient experienced URTICARIA (itchy hives on the stomach). On 22-Jan-2021, the patient experienced HERPES ZOSTER (shingles). The patient was treated with PREDNISONE for Adverse event, at an unspecified dose and frequency. At the time of the report, VACCINATION SITE PAIN (soreness at the injection site), VACCINATION SITE ERYTHEMA (redness at the injection site), URTICARIA (itchy hives on the stomach) and HERPES ZOSTER (shingles) was resolving. 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. Treatment medications include antiviral medication. Concomitant product use was not provided by the reporter.

Other Meds:

Current Illness:

ID: 1572101
Sex: F
Age: 24
State: NY

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Lab Data:

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Symptom List:

Symptoms: rash appearing on my arm yesterday where I got the vaccine; soreness; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE RASH (rash appearing on my arm yesterday where I got the vaccine) and INJECTION SITE PAIN (soreness) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. Concurrent medical conditions included Injection site rash on 17-Feb-2021 and Pain injection site on 11-Feb-2021. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Feb-2021, the patient experienced INJECTION SITE PAIN (soreness). On 17-Feb-2021, the patient experienced INJECTION SITE RASH (rash appearing on my arm yesterday where I got the vaccine). On 12-Feb-2021, INJECTION SITE PAIN (soreness) outcome was unknown. At the time of the report, INJECTION SITE RASH (rash appearing on my arm yesterday where I got the vaccine) 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. Treatment and concomitant product use were not provided by the reporter.

Other Meds:

Current Illness: Pain injection site

ID: 1572102
Sex: F
Age: 50
State:

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: itchiness and redness at the injection site; fatigue; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (itchiness and redness at the injection site) and FATIGUE (fatigue) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Jan-2021, the patient experienced FATIGUE (fatigue). On 16-Jan-2021, the patient experienced VACCINATION SITE PRURITUS (itchiness and redness at the injection site). On 14-Jan-2021, FATIGUE (fatigue) had resolved. At the time of the report, VACCINATION SITE PRURITUS (itchiness and redness at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment include cortisone cream.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1572103
Sex: F
Age:
State:

Vax Date: 01/07/2021
Onset Date: 01/18/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptoms: Tested positive for COVID-19; This spontaneous case was reported by a consumer and describes the occurrence of SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19) 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 07-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 SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19). At the time of the report, SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Jan-2021, SARS-CoV-2 test positive: Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1572104
Sex: F
Age: 61
State: WI

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

Vax Type:
Manufacturer:
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Lab Data:

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Symptom List:

Symptoms: Arm was sore and painful; Index finger/fingers tingly; Elbow area is fatigue; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm was sore and painful), PARAESTHESIA (Index finger/fingers tingly) and MUSCLE FATIGUE (Elbow area is fatigue) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported). On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In January 2021, the patient experienced PAIN IN EXTREMITY (Arm was sore and painful), PARAESTHESIA (Index finger/fingers tingly) and MUSCLE FATIGUE (Elbow area is fatigue). At the time of the report, PAIN IN EXTREMITY (Arm was sore and painful), PARAESTHESIA (Index finger/fingers tingly) and MUSCLE FATIGUE (Elbow area is fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1572105
Sex: F
Age: 73
State: TX

Vax Date: 01/06/2021
Onset Date: 01/09/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: itching; I broke out in welts around the injection site; I broke out in a rash around the injection site; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (itching), VACCINATION SITE URTICARIA (I broke out in welts around the injection site) and VACCINATION SITE RASH (I broke out in a rash around the injection site) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure raised, Diabetes and Restless legs. On 06-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 PRURITUS (itching), VACCINATION SITE URTICARIA (I broke out in welts around the injection site) and VACCINATION SITE RASH (I broke out in a rash around the injection site). At the time of the report, PRURITUS (itching), VACCINATION SITE URTICARIA (I broke out in welts around the injection site) and VACCINATION SITE RASH (I broke out in a rash around the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications included unspecified medication for blood pressure, diabetes and restless legs were noted. Treatment information was not provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 27-Jul-2021: Follow up received included no new information was provided.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness: Blood pressure raised; Diabetes; Restless legs

ID: 1572106
Sex: F
Age: 54
State: OH

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Warm touch at the injection site; rump at injection site; Red rump at the injection site; Swollen rump at site of injection; This spontaneous case was reported by a health care professional and describes the occurrence of INJECTION SITE WARMTH (Warm touch at the injection site), INJECTION SITE MASS (rump at injection site), INJECTION SITE ERYTHEMA (Red rump at the injection site) and INJECTION SITE SWELLING (Swollen rump at site of injection) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20-2A) for COVID-19 vaccination. No Medical History information was reported. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Jan-2021, the patient experienced INJECTION SITE WARMTH (Warm touch at the injection site), INJECTION SITE MASS (rump at injection site), INJECTION SITE ERYTHEMA (Red rump at the injection site) and INJECTION SITE SWELLING (Swollen rump at site of injection). At the time of the report, INJECTION SITE WARMTH (Warm touch at the injection site), INJECTION SITE MASS (rump at injection site), INJECTION SITE ERYTHEMA (Red rump at the injection site) and INJECTION SITE SWELLING (Swollen rump at site of injection) 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. Concomitant product use was not provided by the reporter. The patient was treated with Benadryl and applied Hydrocortisone.

Other Meds:

Current Illness:

ID: 1572107
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever of 107) and CHILLS (chills) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 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 PYREXIA (fever of 107) and CHILLS (chills). At the time of the report, PYREXIA (fever of 107) and CHILLS (chills) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature (107-Unknown):. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. No treatment information was provided. No relevant concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1572108
Sex: F
Age:
State: NY

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: neck pain; shoulder pain; This spontaneous case was reported by a consumer and describes the occurrence of in an 87-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Arm fracture. On 13-Jan-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1572109
Sex: F
Age: 34
State: TX

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: 4 and a half months pregnant; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (4 and a half months pregnant) in a 34-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 (no reported medical history.). Concomitant products included ALCOHOL and PRENATAL VITAMINS [ASCORBIC ACID;BETACAROTENE;CALCIUM SULFATE;COLECALCIFEROL;CYANOCOBALAMIN;FERROUS FUMARATE;FOLIC ACID;NICOTINAMIDE;PYRIDOXINE HYDROCHLORIDE;RETINOL ACETATE;RIBOFLAVIN;THIAMINE MONONITRATE;TOCOPHERYL ACETATE;ZINC OXIDE] for an unknown indication. On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) at an unspecified dose. The patient's last menstrual period was on 19-Sep-2020 and the estimated date of delivery was 29-Jun-2021. On 23-Jan-2021, the patient experienced EXPOSURE DURING PREGNANCY (4 and a half months pregnant). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the eighteenth week of the pregnancy. On 23-Jan-2021, EXPOSURE DURING PREGNANCY (4 and a half months pregnant) had resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood test normal: normal (normal) normal. On an unknown date, Ultrasound abdomen normal: normal (normal) normal. 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. This is a case of product exposure during pregnancy with no associated AEs for this 34-year-old female patient. Patient will continue to be contacted for further monitoring of AEs during the pregnancy.; Sender's Comments: This is a case of product exposure during pregnancy with no associated AEs for this 34-year-old female patient. Patient will continue to be contacted for further monitoring of AEs during the pregnancy.

Other Meds: ALCOHOL; PRENATAL VITAMINS [ASCORBIC ACID;BETACAROTENE;CALCIUM SULFATE;COLECALCIFEROL;CYANOCOBALAMIN;FERROUS

Current Illness:

ID: 1572110
Sex: M
Age: 81
State: VA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Stomach ache; Leg pain; Pain in extremity; Fatigue; Nausea; Headache; Feeling bad / aching; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (Stomach ache), PAIN IN EXTREMITY (Leg pain), PAIN IN EXTREMITY (Pain in extremity), FATIGUE (Fatigue) and NAUSEA (Nausea) in an 81-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 03AX20A) 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 Allergy (allergies to Sulfur and Kflex) and Hypertension. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Jan-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach ache), PAIN IN EXTREMITY (Leg pain), PAIN IN EXTREMITY (Pain in extremity), FATIGUE (Fatigue), NAUSEA (Nausea), HEADACHE (Headache) and MYALGIA (Feeling bad / aching). At the time of the report, ABDOMINAL PAIN UPPER (Stomach ache), PAIN IN EXTREMITY (Leg pain), PAIN IN EXTREMITY (Pain in extremity), FATIGUE (Fatigue), NAUSEA (Nausea), HEADACHE (Headache) and MYALGIA (Feeling bad / aching) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness: Allergy (allergies to Sulfur and Kflex); Hypertension

ID: 1572111
Sex: M
Age: 35
State: NJ

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Eyes are closed with pain; Unable to sleep; Body aches; Shaking chills; Fever; Headache; Cold; This spontaneous case was reported by a consumer and describes the occurrence of FEELING COLD (Cold), EYE PAIN (Eyes are closed with pain), INSOMNIA (Unable to sleep), MYALGIA (Body aches) and CHILLS (Shaking chills) in a 35-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 14-Jan-2021 at 11:15 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Jan-2021, the patient experienced FEELING COLD (Cold), INSOMNIA (Unable to sleep), MYALGIA (Body aches), CHILLS (Shaking chills), PYREXIA (Fever) and HEADACHE (Headache). On 15-Jan-2021, the patient experienced EYE PAIN (Eyes are closed with pain). At the time of the report, FEELING COLD (Cold), EYE PAIN (Eyes are closed with pain), INSOMNIA (Unable to sleep), MYALGIA (Body aches), CHILLS (Shaking chills), PYREXIA (Fever) and HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was provided.; Reporter's Comments: Based on the current available information and temporal association between the product and the start date of the events a causal relational cannot be excluded.

Other Meds:

Current Illness:

ID: 1572112
Sex: F
Age: 73
State:

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Rash, vert heavy rash; Itching and very itchy; This spontaneous case was reported by a consumer and describes the occurrence of RASH (Rash, vert heavy rash) and PRURITUS (Itching and very itchy) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) for COVID-19 vaccination. Concurrent medical conditions included Asthma, Thyroid disorder NOS and Drug allergy (Patient cannot take Benadryl.). Concomitant products included MONTELUKAST for Asthma, LEVOTHYROXINE SODIUM (SYNTHROID) for Thyroid therapy, FAMOTIDINE (PEPCID [FAMOTIDINE]) for an unknown indication. On 12-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 RASH (Rash, vert heavy rash) and PRURITUS (Itching and very itchy). The patient was treated with OXYMETAZOLINE HYDROCHLORIDE (CLARITIN ALLERGIC) at an unspecified dose and frequency. On 15-Jan-2021, RASH (Rash, vert heavy rash) and PRURITUS (Itching and very itchy) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Reporter did not allow further contact; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded

Other Meds: PEPCID [FAMOTIDINE]; SYNTHROID; MONTELUKAST

Current Illness: Asthma; Thyroid disorder NOS

ID: 1572113
Sex: F
Age: 66
State: TX

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 08/16/2021
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Symptoms: Shivery; Felt tired; Fever; Chills; Low grade headache; Arm soreness; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of VACCINATION SITE PAIN (Arm soreness), CHILLS (Chills), HEADACHE (Low grade headache), FATIGUE (Felt tired) and PYREXIA (Fever) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025L20A) 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 medical history reported.). On 05-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Jan-2021, the patient experienced VACCINATION SITE PAIN (Arm soreness). On 06-Jan-2021, the patient experienced CHILLS (Chills) and HEADACHE (Low grade headache). On 11-Jan-2021, the patient experienced FATIGUE (Felt tired) and PYREXIA (Fever). On 12-Jan-2021, the patient experienced CHILLS (Shivery). On 08-Jan-2021, VACCINATION SITE PAIN (Arm soreness) had resolved. At the time of the report, CHILLS (Chills) and HEADACHE (Low grade headache) had not resolved and FATIGUE (Felt tired), PYREXIA (Fever) and CHILLS (Shivery) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 11-Jan-2021, Body temperature: 98.8. On 12-Jan-2021, Body temperature:. On 12-Jan-2021, COVID-19: Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1572114
Sex: M
Age:
State:

Vax Date: 01/12/2021
Onset Date: 01/01/2021
Rec V Date: 08/16/2021
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Symptoms: Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching; Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching; Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching), PRURITUS (Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching) and RASH (Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In January 2021, the patient experienced ERYTHEMA (Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching), PRURITUS (Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching) and RASH (Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching). At the time of the report, ERYTHEMA (Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching), PRURITUS (Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching) and RASH (Extensive body rash on chest, stomach, back, forearms, bicep, thighs pretty red with a lot of itching) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. Treatment medications were unknown.; Sender's Comments: Based on the current available information which shows a temporal association between the use of the mRNA-1273 and the reported events, a causal relationship with the events cannot be excluded. Rash is consistent with the product safety profile.

Other Meds:

Current Illness:

ID: 1572115
Sex: F
Age: 30
State: KS

Vax Date: 12/30/2020
Onset Date: 01/05/2021
Rec V Date: 08/16/2021
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Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of PARANASAL SINUS DISCOMFORT (sinus pressure behined her eyes), AGEUSIA (loss of taste and smell) and ANOSMIA (loss of taste and smell) in a 30-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) for COVID-19 vaccination. Concurrent medical conditions included COVID-19 since 08-Jan-2021. On 30-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Jan-2021, the patient experienced PARANASAL SINUS DISCOMFORT (sinus pressure behined her eyes), AGEUSIA (loss of taste and smell) and ANOSMIA (loss of taste and smell). At the time of the report, PARANASAL SINUS DISCOMFORT (sinus pressure behined her eyes), AGEUSIA (loss of taste and smell) and ANOSMIA (loss of taste and smell) had not resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Jan-2021, SARS-CoV-2 test: (Positive) positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds:

Current Illness: COVID-19

ID: 1572116
Sex: F
Age: 31
State: TX

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 08/16/2021
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Symptoms: Injection site redness; INjection site itchiness; Injection site warmth; Flu like symptoms; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu like symptoms), INJECTION SITE ERYTHEMA (Injection site redness), INJECTION SITE PRURITUS (INjection site itchiness) and INJECTION SITE WARMTH (Injection site warmth) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Jan-2021, the patient experienced INFLUENZA LIKE ILLNESS (Flu like symptoms). On 15-Jan-2021, the patient experienced INJECTION SITE ERYTHEMA (Injection site redness), INJECTION SITE PRURITUS (INjection site itchiness) and INJECTION SITE WARMTH (Injection site warmth). At the time of the report, INFLUENZA LIKE ILLNESS (Flu like symptoms), INJECTION SITE ERYTHEMA (Injection site redness), INJECTION SITE PRURITUS (INjection site itchiness) and INJECTION SITE WARMTH (Injection site warmth) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572117
Sex: F
Age:
State: MS

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/16/2021
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Symptoms: Fever 100.7F; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever 100.7F) 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 14-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 PYREXIA (Fever 100.7F). The patient was treated with PARACETAMOL (TYLENOL) for Fever, at an unspecified dose and frequency. On 15-Jan-2021, PYREXIA (Fever 100.7F) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Jan-2021, Body temperature: 100.7f (High) 100.7F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Reporter did not allow further contact; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1572118
Sex: F
Age: 52
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 08/16/2021
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Symptoms: Burning Sensation in the Right Eye; Itchy around Right Eye; Swollen Face; Red Face; Drooping Right Eye; Headache; This spontaneous case was reported by a consumer and describes the occurrence of EYE IRRITATION (Burning Sensation in the Right Eye), EYE PRURITUS (Itchy around Right Eye), SWELLING FACE (Swollen Face), ERYTHEMA (Red Face) and EYELID PTOSIS (Drooping Right Eye) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027L20A) 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 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Jan-2021, the patient experienced EYE IRRITATION (Burning Sensation in the Right Eye), EYE PRURITUS (Itchy around Right Eye), SWELLING FACE (Swollen Face), ERYTHEMA (Red Face), EYELID PTOSIS (Drooping Right Eye) and HEADACHE (Headache). At the time of the report, EYE IRRITATION (Burning Sensation in the Right Eye), EYE PRURITUS (Itchy around Right Eye), SWELLING FACE (Swollen Face), ERYTHEMA (Red Face), EYELID PTOSIS (Drooping Right Eye) and HEADACHE (Headache) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572119
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 08/16/2021
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Symptoms: fever; chills; muscle aches; left arm red; left arm swollen; This spontaneous case was reported by a health care professional and describes the occurrence of PYREXIA (fever), CHILLS (chills), MYALGIA (muscle aches), ERYTHEMA (left arm red) and PERIPHERAL SWELLING (left arm swollen) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037KZOA) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historic conditions for the patient.). 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 PYREXIA (fever), CHILLS (chills), MYALGIA (muscle aches), ERYTHEMA (left arm red) and PERIPHERAL SWELLING (left arm swollen). At the time of the report, PYREXIA (fever), CHILLS (chills), MYALGIA (muscle aches), ERYTHEMA (left arm red) and PERIPHERAL SWELLING (left arm swollen) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 101 101. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1572120
Sex: M
Age: 58
State: NY

Vax Date: 01/07/2021
Onset Date:
Rec V Date: 08/16/2021
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Symptoms: Rapid heart beat and pulse; Fever; Diarrhea; Lightheadedness; This spontaneous case was reported by a physician and describes the occurrence of HEART RATE INCREASED (Rapid heart beat and pulse), PYREXIA (Fever), DIARRHOEA (Diarrhea) and DIZZINESS (Lightheadedness) in a 58-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 07-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 HEART RATE INCREASED (Rapid heart beat and pulse), PYREXIA (Fever), DIARRHOEA (Diarrhea) and DIZZINESS (Lightheadedness). At the time of the report, HEART RATE INCREASED (Rapid heart beat and pulse), PYREXIA (Fever), DIARRHOEA (Diarrhea) and DIZZINESS (Lightheadedness) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100-101 100-101F. 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. Most recent FOLLOW-UP information incorporated above includes: On 15-Jan-2021: New events added

Other Meds:

Current Illness:

ID: 1572121
Sex: F
Age:
State:

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/16/2021
Hospital:

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Symptoms: Temperature of 99.7?F; Pain in the arm; Joint pains; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of BODY TEMPERATURE INCREASED (Temperature of 99.7?F), PAIN IN EXTREMITY (Pain in the arm), ARTHRALGIA (Joint pains) and NAUSEA (Nausea) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported.). On 14-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 BODY TEMPERATURE INCREASED (Temperature of 99.7?F), PAIN IN EXTREMITY (Pain in the arm), ARTHRALGIA (Joint pains) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, BODY TEMPERATURE INCREASED (Temperature of 99.7?F), PAIN IN EXTREMITY (Pain in the arm), ARTHRALGIA (Joint pains) and NAUSEA (Nausea) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Jan-2021, Body temperature: 99.7?f (High) 99.7?F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1572122
Sex: F
Age:
State: NJ

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

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Symptoms: This spontaneous case reported by an other healthcare professional, describes the occurrence of vaccination site movement impairment (could not move arm after receiving the vaccine) in a female patient, of an unknown age, who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. On an unknown date, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. On an unknown date, patient experienced vaccination site movement impairment (could not move arm after receiving the vaccine). At the time of the report, vaccination site movement impairment (could not move arm after receiving the vaccine): unresolved. The action taken with mRNA-1273 (Moderna COVID-19 vaccine), intramuscular: unknown. The reporter did not provide any causality assessments or concomitant medications. The patient is currently on physical therapy. Sender's comments: Based on the current available information, which includes a temporal association between the use of the product and the start date of the reported events, and excluding any other etiology, a causal relationship with the event cannot be excluded.

Other Meds:

Current Illness:

ID: 1572123
Sex: M
Age: 29
State: CT

Vax Date: 01/14/2021
Onset Date:
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Diarrhea; This spontaneous case was reported by a patient and describes the occurrence of DIARRHOEA (Diarrhea) in a 29-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 14-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 DIARRHOEA (Diarrhea). At the time of the report, DIARRHOEA (Diarrhea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided. Treatment details were not provided.; Sender's Comments: Very limited information regarding this events has been provided at this time. Further information has been requested. Company assessed the events to be unlikely related to company product.

Other Meds:

Current Illness:

ID: 1572124
Sex: F
Age:
State:

Vax Date: 01/03/2021
Onset Date: 01/07/2021
Rec V Date: 08/16/2021
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Symptom List:

Symptoms: Hair started falling in clumps; This spontaneous case was reported by a consumer and describes the occurrence of ALOPECIA (Hair started falling in clumps) 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 03-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Jan-2021, the patient experienced ALOPECIA (Hair started falling in clumps). At the time of the report, ALOPECIA (Hair started falling in clumps) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1572125
Sex: M
Age:
State: TX

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: dizziness; very shaky; extremely weak; chills; headache; fever 99.3 F; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizziness), TREMOR (very shaky), ASTHENIA (extremely weak) and CHILLS (chills) in an 87-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 (no reported medical history). On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced DIZZINESS (dizziness), TREMOR (very shaky), ASTHENIA (extremely weak) and CHILLS (chills). At the time of the report, DIZZINESS (dizziness), TREMOR (very shaky), ASTHENIA (extremely weak) and CHILLS (chills) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572126
Sex: F
Age: 83
State: CO

Vax Date: 01/06/2021
Onset Date: 01/15/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Allergies:

Symptom List:

Symptoms: Swollen arm; red; Itchy really bad; This spontaneous case was reported by a patient and describes the occurrence of PERIPHERAL SWELLING (Swollen arm), ERYTHEMA (red) and VACCINATION SITE PRURITUS (Itchy really bad) in an 83-year-old female patient 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 historical condition reported.). On 06-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced PERIPHERAL SWELLING (Swollen arm), ERYTHEMA (red) and VACCINATION SITE PRURITUS (Itchy really bad). At the time of the report, PERIPHERAL SWELLING (Swollen arm), ERYTHEMA (red) and VACCINATION SITE PRURITUS (Itchy really bad) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572127
Sex: M
Age:
State: CA

Vax Date: 01/04/2021
Onset Date:
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: cold like mild side effects; This spontaneous case was reported by a consumer and describes the occurrence of FEELING COLD (cold like mild side effects) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 04-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 FEELING COLD (cold like mild side effects). At the time of the report, FEELING COLD (cold like mild side effects) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572128
Sex: F
Age: 67
State: MI

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Shaking; Chills; Headache; Tired; Swelling at injection site; Soreness at injection site; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (Shaking), CHILLS (Chills), HEADACHE (Headache), FATIGUE (Tired) and VACCINATION SITE SWELLING (Swelling at injection site) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 03ZHZUA) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse event. On 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 TREMOR (Shaking), CHILLS (Chills), HEADACHE (Headache), FATIGUE (Tired), VACCINATION SITE SWELLING (Swelling at injection site) and VACCINATION SITE PAIN (Soreness at injection site). At the time of the report, TREMOR (Shaking), CHILLS (Chills), HEADACHE (Headache), FATIGUE (Tired), VACCINATION SITE SWELLING (Swelling at injection site) and VACCINATION SITE PAIN (Soreness at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572129
Sex: F
Age: 36
State: CA

Vax Date: 12/25/2020
Onset Date: 12/25/2020
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Got administered both doses of vaccine while being pregnant; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (Got administered both doses of vaccine while being pregnant) in a 36-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025J202A) for COVID-19 vaccination. No Medical History information was reported. On 25-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. The patient's last menstrual period was on an unknown date and the estimated date of delivery was 11-May-2021. On 25-Dec-2020, the patient experienced EXPOSURE DURING PREGNANCY (Got administered both doses of vaccine while being pregnant). On 22-Jan-2021, EXPOSURE DURING PREGNANCY (Got administered both doses of vaccine while being pregnant) had resolved. Not Provided Concomitant medication not provided. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 15-Mar-2021: Follow up received patient's address, date of birth, vaccine dates updated; Sender's Comments: This is a case of product exposure during pregnancy with no associated AEs for this 36-year-old female patient. Patient will continue to be contacted for further monitoring of AEs during the pregnancy.

Other Meds:

Current Illness:

ID: 1572130
Sex: M
Age: 74
State: FL

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Shoulder pain; Fever; This spontaneous case was reported by a patient and describes the occurrence of ARTHRALGIA (Shoulder pain) and PYREXIA (Fever) in a 74-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No medical history reported). On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced ARTHRALGIA (Shoulder pain) and PYREXIA (Fever). At the time of the report, ARTHRALGIA (Shoulder pain) and PYREXIA (Fever) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572131
Sex: F
Age: 42
State: TX

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: This spontaneous case reported by a consumer, describes the occurrence of pruritus (itching), pain in extremity (arm feels achy and a little bit tender), myalgia (felt soreness) and lymphadenopathy (underneath her arm was swollen) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. The patient's past medical history included no adverse event. On Jan 7, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. On Jan 7, 2021, patient experienced myalgia (felt soreness). On Jan 9, 2021, patient experienced lymphadenopathy (underneath her arm was swollen). On Jan 14, 2021, patient experienced pruritus (itching). On an unknown date, patient experienced pain in extremity (arm feels achy and a little bit tender). At the time of the report, pruritus (itching), pain in extremity (arm feels achy and a little bit tender), myalgia (felt soreness) and lymphadenopathy (underneath her arm was swollen) outcome: unknown. The action taken with mRNA-1273 (Moderna COVID-19 vaccine), intramuscular: unknown. The reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1572132
Sex: F
Age: 78
State: GA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Felt like fainting, did not faint; Felt like it was anxiety; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Felt like fainting, did not faint) and ANXIETY (Felt like it was anxiety) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 12-Jan-2021, the patient experienced DIZZINESS (Felt like fainting, did not faint) and ANXIETY (Felt like it was anxiety). At the time of the report, DIZZINESS (Felt like fainting, did not faint) and ANXIETY (Felt like it was anxiety) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572133
Sex: F
Age:
State:

Vax Date: 01/14/2021
Onset Date:
Rec V Date: 08/16/2021
Hospital:

Vax Type:
Manufacturer:
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Symptom List:

Symptoms: Soreness at administration site; This spontaneous case was reported by a non-health professional and describes the occurrence of VACCINATION SITE PAIN (Soreness at administration site) 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 relevant medical history reported). On 14-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 PAIN (Soreness at administration site). At the time of the report, VACCINATION SITE PAIN (Soreness at administration site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to MOD-2021-008560 (Linked Report).; Sender's Comments: MOD-2021-008560:2 patients (father case), crosslinked case- Same reporter

Other Meds:

Current Illness:

ID: 1572134
Sex: F
Age: 43
State: MS

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptoms: Rash; This spontaneous case was reported by a consumer and describes the occurrence of RASH (Rash) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. Concurrent medical conditions included Kidney stones and Thyroid nodule. 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 RASH (Rash). At the time of the report, RASH (Rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness: Kidney stones; Thyroid nodule

ID: 1572135
Sex: F
Age:
State:

Vax Date: 01/04/2021
Onset Date: 01/15/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: warm to the touch; redness around injection site; a little itchy; This spontaneous case was reported by a consumer and describes the occurrence of INFUSION SITE WARMTH (warm to the touch), INJECTION SITE ERYTHEMA (redness around injection site) and INJECTION SITE PRURITUS (a little itchy) 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 Abscess on 15-Jan-2021, Pruritus on 15-Jan-2021 and Erythema on 15-Jan-2021. On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced INFUSION SITE WARMTH (warm to the touch), INJECTION SITE ERYTHEMA (redness around injection site) and INJECTION SITE PRURITUS (a little itchy). At the time of the report, INFUSION SITE WARMTH (warm to the touch), INJECTION SITE ERYTHEMA (redness around injection site) and INJECTION SITE PRURITUS (a little itchy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572136
Sex: F
Age: 39
State: PA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: History of PDC and is happening again; This spontaneous case was reported by a physical therapist and describes the occurrence of ANXIETY DISORDER (History of PDC and is happening again) in a 39-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 (no historical condition was reported). On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Jan-2021, the patient experienced ANXIETY DISORDER (History of PDC and is happening again). At the time of the report, ANXIETY DISORDER (History of PDC and is happening again) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1572137
Sex: M
Age: 75
State: FL

Vax Date: 01/09/2021
Onset Date: 01/11/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Ringing in ear with increasing volume; This spontaneous case was reported by a consumer and describes the occurrence of TINNITUS (Ringing in ear with increasing volume) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Jan-2021, the patient experienced TINNITUS (Ringing in ear with increasing volume). At the time of the report, TINNITUS (Ringing in ear with increasing volume) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572138
Sex: M
Age: 65
State: TX

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: slight sore throat; slight headache; This spontaneous case was reported by a consumer and describes the occurrence of in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No adverse event reported). On 14-Jan-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. No concomitant medications were provided. No treatment medications were provided.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information has been requested

Other Meds:

Current Illness:

ID: 1572139
Sex: M
Age:
State:

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

Vax Type:
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Allergies:

Symptom List:

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of NAUSEA (nausea), VOMITING (Vomiting) and CHILLS (Chilling) 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 Heart attack and Stent placement. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Jan-2021, the patient experienced NAUSEA (nausea), VOMITING (Vomiting) and CHILLS (Chilling). At the time of the report, NAUSEA (nausea), VOMITING (Vomiting) and CHILLS (Chilling) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Concomitant medication was not reported. Treatment medication was not reported. Reporter did not allow further contact; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1572140
Sex: F
Age: 75
State: CA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Allergies:

Symptom List:

Symptoms: Hard time sleeping; Lacks full breath; Feels fatigued; This spontaneous case was reported by a consumer and describes the occurrence of INSOMNIA (Hard time sleeping), DYSPNOEA (Lacks full breath) and FATIGUE (Feels fatigued) in a 75-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 Lung cancer and Polio. 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 INSOMNIA (Hard time sleeping), DYSPNOEA (Lacks full breath) and FATIGUE (Feels fatigued). At the time of the report, INSOMNIA (Hard time sleeping), DYSPNOEA (Lacks full breath) and FATIGUE (Feels fatigued) had not 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.

Other Meds:

Current Illness:

ID: 1572141
Sex: F
Age: 36
State: NJ

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Pregnant and received Moderna COVID-19 vaccine; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of MATERNAL EXPOSURE DURING PREGNANCY (Pregnant and received Moderna COVID-19 vaccine) in a 36-year-old female patient (gravida 2, para 1) who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. The patient's past medical history included Alcohol use (prior use, 1-2 servings a week). Concomitant products included PRENATAL VITAMINS [ASCORBIC ACID;BETACAROTENE;CALCIUM SULFATE;COLECALCIFEROL;CYANOCOBALAMIN;FERROUS FUMARATE;FOLIC ACID;NICOTINAMIDE;PYRIDOXINE HYDROCHLORIDE;RETINOL ACETATE;RIBOFLAVIN;THIAMINE MONONITRATE;TOCOPHERYL ACETATE;ZINC OXIDE] for an unknown indication. On 22-Jan-2021 at 10:45 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on 27-Jul-2020 and the estimated date of delivery was 28-Apr-2021. On 22-Jan-2021, the patient experienced MATERNAL EXPOSURE DURING PREGNANCY (Pregnant and received Moderna COVID-19 vaccine). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the twenty-fifth week of the pregnancy. On 22-Jan-2021, MATERNAL EXPOSURE DURING PREGNANCY (Pregnant and received Moderna COVID-19 vaccine) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 02-Oct-2020, Pregnancy test: positive (Positive) positive. On an unknown date, Ultrasound scan: normal (normal) anatomical was normal at 20 weeks. Treatment medication was not reported. This is a case of product exposure during pregnancy with no associated AEs for this 36-year-old female patient. Patient will continue to be contacted for further monitoring of AEs during the pregnancy.; Sender's Comments: This is a case of product exposure during pregnancy with no associated AEs for this 36-year-old female patient. Patient will continue to be contacted for further monitoring of AEs during the pregnancy.

Other Meds: PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]

Current Illness:

ID: 1572142
Sex: F
Age: 65
State: FL

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: parotid gland inflamed and swollen; acute onset parotid pain; This spontaneous case was reported by a physician and describes the occurrence of SALIVARY GLAND PAIN (acute onset parotid pain) and NONINFECTIVE SIALOADENITIS (parotid gland inflamed and swollen) in a 65-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 event (no historical condition reported). On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced SALIVARY GLAND PAIN (acute onset parotid pain). On 16-Jan-2021, the patient experienced NONINFECTIVE SIALOADENITIS (parotid gland inflamed and swollen). On 16-Jan-2021, SALIVARY GLAND PAIN (acute onset parotid pain) had resolved. At the time of the report, NONINFECTIVE SIALOADENITIS (parotid gland inflamed and swollen) had not 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.

Other Meds:

Current Illness:

ID: 1572143
Sex: F
Age: 74
State: NY

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

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Not feeling 100%; Throat closing; BP 200/something; This spontaneous case was reported by a consumer and describes the occurrence of THROAT TIGHTNESS (Throat closing), BLOOD PRESSURE ABNORMAL (BP 200/something) and MALAISE (Not feeling 100%) in a 74-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 event (no historical condition was reported). On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced THROAT TIGHTNESS (Throat closing) and BLOOD PRESSURE ABNORMAL (BP 200/something). On 16-Jan-2021, the patient experienced MALAISE (Not feeling 100%). At the time of the report, THROAT TIGHTNESS (Throat closing), BLOOD PRESSURE ABNORMAL (BP 200/something) and MALAISE (Not feeling 100%) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Jan-2021, Blood pressure measurement: 200 mmHg. On 16-Jan-2021, Blood pressure measurement: high mmHg. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572144
Sex: M
Age: 81
State: TN

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: This spontaneous case was reported by a physician and describes the occurrence of FATIGUE (really knocked down) in an 81-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). Concomitant products included POTASSIUM CHLORIDE, VALSARTAN, CABERGOLINE, FUROSEMIDE, ALLOPURINOL, PANTOPRAZOLE, APIXABAN, SOTALOL, CARVEDILOL and ROSUVASTATIN for an unknown indication. On 11-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Jan-2021, the patient experienced FATIGUE (really knocked down). At the time of the report, FATIGUE (really knocked down) 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: POTASSIUM CHLORIDE; VALSARTAN; CABERGOLINE; FUROSEMIDE; ALLOPURINOL; PANTOPRAZOLE; APIXABAN; SOTALOL; CARVEDILOL; ROSUVASTATIN

Current Illness:

ID: 1572145
Sex: F
Age: 69
State: FL

Vax Date: 01/07/2021
Onset Date:
Rec V Date: 08/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: swelling, raised, red where she got the shot; swelling, raised, red where she got the shot; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE SWELLING (swelling, raised, red where she got the shot) and VACCINATION SITE ERYTHEMA (swelling, raised, red where she got the shot) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no historical condition was reported). On 07-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 SWELLING (swelling, raised, red where she got the shot) and VACCINATION SITE ERYTHEMA (swelling, raised, red where she got the shot). At the time of the report, VACCINATION SITE SWELLING (swelling, raised, red where she got the shot) and VACCINATION SITE ERYTHEMA (swelling, raised, red where she got the shot) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1572146
Sex: F
Age:
State: GA

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

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Eyes swell; Lips started to swell; Sore and swollen; Injection site swelling; Felt really tired during three days; This spontaneous case was reported by a consumer and describes the occurrence of EYE SWELLING (Eyes swell), LIP SWELLING (Lips started to swell), INFLAMMATION (Sore and swollen), INJECTION SITE SWELLING (Injection site swelling) and FATIGUE (Felt really tired during three days) 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 Anaphylaxis (Anaphylaxis with other medications.). Concurrent medical conditions included Rheumatoid arthritis and Drug allergy (Lot of medication (Unspecified)). Concomitant products included RITUXIMAB for Rheumatoid arthritis. On 13-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 EYE SWELLING (Eyes swell), LIP SWELLING (Lips started to swell), INFLAMMATION (Sore and swollen), INJECTION SITE SWELLING (Injection site swelling) and FATIGUE (Felt really tired during three days). At the time of the report, EYE SWELLING (Eyes swell), LIP SWELLING (Lips started to swell), INFLAMMATION (Sore and swollen), INJECTION SITE SWELLING (Injection site swelling) and FATIGUE (Felt really tired during three days) 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: RITUXIMAB

Current Illness: Rheumatoid arthritis

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm