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: 1589714
Sex: M
Age: 19
State:

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/20/2021
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: On 7 June 2021, member received an initial dose of Pfizer. On 13 August 2021, member presented to COVID-19 Vaccination Line to receive a dose of Janssen. Member document that he did not receive prior doses of any COVID-19 vaccine during patient screening. Upon record reviews on 20 August 2021, it was revealed that member did receive an initial dose of Pfizer.

Other Meds:

Current Illness:

ID: 1589715
Sex: F
Age: 39
State: OH

Vax Date: 08/11/2021
Onset Date: 08/16/2021
Rec V Date: 08/20/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Heaviest period I?ve ever had, early in cycle. Large clots. Extreme cramping. On day 5 and still large clots and cramping that has kept me up all night long almost unbearable. Bleeding through tampons in less than an hour.

Other Meds: None

Current Illness: None

ID: 1589716
Sex: M
Age: 18
State: TX

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/20/2021
Hospital: Y

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: none

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

Symptoms: Myositis

Other Meds: None

Current Illness: None

ID: 1589717
Sex: F
Age: 35
State: UT

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Acid reflux, gas/bloating, pelvic pain, stomach pain and headache since first dose, daily, not resolved. Menstrual period is also 9 days late, never irregular and not pregnant.

Other Meds: None

Current Illness: None

ID: 1590068
Sex: M
Age: 81
State: CA

Vax Date: 06/16/2021
Onset Date: 08/20/2021
Rec V Date: 08/20/2021
Hospital: Y

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

Lab Data:

Allergies: Lisinopril

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

Symptoms: Breakthrough infection despite vaccination

Other Meds: Acetaminophen (Mapap) 325 mg Oral Tab Takes Occasionally Atenolol (TENORMIN) 25 mg Oral Tab Takes Regularly Atorvastatin (LIPITOR) 40 mg Oral Tab Takes Regularly Calcitriol (ROCALTROL) 0.25 mcg Oral Cap Takes Regularly Clopidogrel (PLAVIX)

Current Illness: None

ID: 1590069
Sex: F
Age: 35
State: NY

Vax Date: 07/13/2021
Onset Date: 07/13/2021
Rec V Date: 08/20/2021
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: None known, gluten intolerance

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

Symptoms: Headache, body aches, sharp pains along lower ribs/diaphragm into chest, numbness of left lateral lower and upper lip

Other Meds: Multivitamin, fish oil

Current Illness: None

ID: 1590136
Sex: M
Age:
State: MN

Vax Date: 03/24/2021
Onset Date:
Rec V Date: 08/20/2021
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: Sore arm; Fatigue; mild headache; worsening of existing eye symptoms; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA, FATIGUE, HEADACHE, and EYE SYMPTOM in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 0403214 and 0183214) for COVID-19 vaccination. The patient's past medical history included Vision abnormal since an unknown date. On 24-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) at an unspecified dose. On 15-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced MYALGIA, FATIGUE, HEADACHE, and EYE SYMPTOM. At the time of the report, MYALGIA, FATIGUE, HEADACHE, and EYE SYMPTOM outcome was unknown. Not Provided. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. patient reported that he had some vision problem in the past and does the vaccination have anything to do with the worsening of the existing eye symptoms. No concomitant medications were provided. No treatments medications were provided. This case was linked to US-MODERNATX, INC MOD-2021-080482. Sender's Comments: US-MODERNATX, INC MOD-2021-080482: 1st dose of vaccine.

Other Meds:

Current Illness: Vision abnormal

ID: 1590137
Sex: F
Age:
State: CA

Vax Date:
Onset Date: 04/18/2021
Rec V Date: 08/20/2021
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: She had lower leg pain in both legs; a red painful rash developed where she had the pain for both legs; a red painful rash developed where she had the pain for both legs; erythema nodusum; Immune reaction; This spontaneous case was reported by a physician and describes the occurrence of PAIN IN EXTREMITY (lower leg pain in both legs), ERYTHEMA, RASH, ERYTHEMA NODOSUM, and VACCINATION COMPLICATION (Immune reaction) in an 18-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Apr-2021, the patient experienced ERYTHEMA, RASH, ERYTHEMA NODOSUM, and VACCINATION COMPLICATION. On an unknown date, the patient experienced PAIN IN EXTREMITY. At the time of the report, PAIN IN EXTREMITY, ERYTHEMA, RASH, ERYTHEMA NODOSUM, and VACCINATION COMPLICATION (Immune reaction) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1590578
Sex: F
Age: 35
State: NY

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies: No allergies known, gluten intolerance

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Right lower leg pain, swelling, warmth, vein varicosities, chest pain, shortness of breath continuing over days

Other Meds: Multivitamin, Fish Oil

Current Illness: None

ID: 1590579
Sex: M
Age: 69
State: CA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 08/20/2021
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: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: After 2nd shot on 2/22, pt reported onset of muscle pain, joint pain, stiffness, fatigue, decreased mobility, back pain, slight chills, that persisted for months. Initially tried OTC NSAIDS (Aleve, Ibuprofen) without relief. After inflammation seen on lab testing & MRI of spine in May, started on Prednisone x 6 wks (15 mg initially, then tapered). Symptoms significantly improved.

Other Meds: Lisinopril, Metformin, Sildenafil, Latanoprost, Magnesium, multivitamin, Diclofenac gel

Current Illness: no known

ID: 1590621
Sex: F
Age:
State: PR

Vax Date: 03/10/2021
Onset Date: 03/01/2021
Rec V Date: 08/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: left side of my neck and face swelled; left side of my neck and face swelled; my glottis closed 85%; GFR was less than 60; blood pressure 87/57; This is a spontaneous report from a contactable consumer (patient). A 63-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in Arm Left on 10Mar2021 14:00 (Batch/Lot Number: EN6206; Expiration Date: Jun2021) as DOSE 1, SINGLE for covid-19 immunisation. Medical history included asthma, allergic bronchitis. There were no concomitant medications. Patient was not pregnant. The patient previously took iodo and experienced drug hypersensitivity. It was reported "When I got home, the left side of my neck and face swelled, my glottis closed 85%. To act quickly. I live alone. I ran and looked for Benadril. Two weeks later my GFR was less than 60. And during the hour of 4:30 am in several days, I woke up and when I took my blood pressure, I had for example 87/57. I had no one to take me to the Emergency Room. I tried to get the cardiologist to see me, but the office told me that there were no appointments available and I had to wait for my regular appointment. At that time my blood pressure was normal". Patient had COVID SARS-COVID-2 Antigen on 09Apr2021 with negative result. Outcome of events was recovered with sequel. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1590622
Sex: F
Age:
State: PR

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 08/20/2021
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: dizziness (vertigo), felt the mattress moved, elevated as if it was going to turn to the right and had slight sweating.; dizziness (vertigo), felt the mattress moved, elevated as if it was going to turn to the right and had slight sweating.; my eyes went crossed-eyes momentarily; lump between my buttocks.; Had mild sinus.; mild throat and nose congestion pressure; Could taste medication in the mouth; soar left arm.; This is a spontaneous report from a contactable consumer, the patient. A 61-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the arm left on 29Mar2021 at 10:45(at the age of 61-year-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient did not take any concomitant medication. The patient had no known allergies to medications, food or other products. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 29Mar2021 at 11:00 the patient experienced mild throat and nose congestion pressure, could taste medication in the mouth and sore left arm. On 30Mar2021 at 08:00 the patient experienced lump between her buttocks and had mild sinus. On 30Mar2021 at 22:30 the patient experienced her eyes went crossed-eyes momentarily. On 31Mar2021 at 08:45 the patient experienced dizziness (vertigo), felt the mattress moved, elevated as if it was going to turn to the right and had slight sweating. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. The patient did not receive any treatment for the reported event. The clinical outcome of the event mild throat and nose congestion pressure, Could taste medication in the mouth, sore left arm, lump between my buttocks, mild sinus, eyes went crossed-eyes momentarily, dizziness (vertigo), slight sweating was recovered with sequelae. No follow-up attempts are required; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1590881
Sex: F
Age: 62
State: SC

Vax Date: 05/15/2021
Onset Date: 05/17/2021
Rec V Date: 08/20/2021
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: severe diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (severe diarrhea) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. codine shellfish. Concurrent medical conditions included Drug allergy (codine) and Shellfish allergy. On 15-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-May-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced DIARRHOEA (severe diarrhea). On 23-May-2021, DIARRHOEA (severe diarrhea) had 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. No concomitant and treatment information was provided.

Other Meds:

Current Illness: Drug allergy (codine); Shellfish allergy

ID: 1590882
Sex: F
Age: 31
State:

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 08/20/2021
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: Numbness and tingling in both arms and hands; Numbness and tingling in both arms and hands; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (Numbness and tingling in both arms and hands) and PARAESTHESIA (Numbness and tingling in both arms and hands) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041CZ1A) for COVID-19 vaccination. No Medical History information was reported. On 24-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-May-2021, the patient experienced HYPOAESTHESIA (Numbness and tingling in both arms and hands) and PARAESTHESIA (Numbness and tingling in both arms and hands). At the time of the report, HYPOAESTHESIA (Numbness and tingling in both arms and hands) and PARAESTHESIA (Numbness and tingling in both arms and hands) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported by the reporter. No treatment medications provided by the reporter.

Other Meds:

Current Illness:

ID: 1590883
Sex: F
Age: 50
State: TX

Vax Date: 05/24/2021
Onset Date:
Rec V Date: 08/20/2021
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: Pain in the back of my leg; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain in the back of my leg) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 24-May-2021, 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 (Pain in the back of my leg). At the time of the report, PAIN IN EXTREMITY (Pain in the back of my leg) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication list was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1590884
Sex: F
Age: 47
State: SC

Vax Date: 05/24/2021
Onset Date: 05/27/2021
Rec V Date: 08/20/2021
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: Dizziness; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 045b21a) for COVID-19 vaccination. No Medical History information was reported. On 24-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form once. On 27-May-2021, the patient experienced DIZZINESS (Dizziness). At the time of the report, DIZZINESS (Dizziness) had not resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. Concomitant medications were not provided. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1590885
Sex: F
Age: 44
State: MN

Vax Date: 05/27/2021
Onset Date:
Rec V Date: 08/20/2021
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: Lymph node in arm pit swollen; This spontaneous case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (Lymph node in arm pit swollen) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 27-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced LYMPHADENOPATHY (Lymph node in arm pit swollen). At the time of the report, LYMPHADENOPATHY (Lymph node in arm pit swollen) outcome was unknown. Concomitant medications were not provided. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1590886
Sex: F
Age: 41
State: PR

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/20/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: No

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Left tympanic pain, tinnitus both ears, sound in ears. Headache, menstrual problems.

Other Meds: Synthroid, Gemfibrozil

Current Illness:

ID: 1590887
Sex: F
Age: 48
State: FL

Vax Date: 07/27/2021
Onset Date: 07/29/2021
Rec V Date: 08/20/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Soft tissue swelling in hands, lips, orbital area and tongue along with recurrent times over the last three weeks starting 2 days after vaccine, treated with Benadryl , cortisone cream and a metrology dose pack, this am half of my tongue is swollen with difficulty swallowing but not an emergent life threatening . My symptoms have not yet resolved and have been recurring

Other Meds: Losarten 25 mg gabepentin 200 mg

Current Illness: None

ID: 1590888
Sex: F
Age: 51
State: FL

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 08/20/2021
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: Nausea vomiting headache chills fever and pain; Nausea vomiting headache chills fever and pain; Nausea vomiting headache chills fever and pain; Nausea vomiting headache chills fever and pain; headache; body ache rated as 7 out of 10, 10 being the highest; fever.; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Nausea vomiting headache chills fever and pain), HEADACHE (headache), MYALGIA (body ache rated as 7 out of 10, 10 being the highest), PYREXIA (fever.) and VOMITING (Nausea vomiting headache chills fever and pain) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Immunosuppression (Sofa clindamycin codeine Supressed immune system) since an unknown date. Concomitant products included CLINDAMYCIN for Immunosuppression, DULOXETINE HYDROCHLORIDE (CYMBALTA), CILNIDIPINE and Garvapetine for an unknown indication. On 26-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-May-2021, the patient experienced HEADACHE (headache), MYALGIA (body ache rated as 7 out of 10, 10 being the highest) and PYREXIA (fever.). On an unknown date, the patient experienced PAIN (Nausea vomiting headache chills fever and pain), VOMITING (Nausea vomiting headache chills fever and pain), NAUSEA (Nausea vomiting headache chills fever and pain) and CHILLS (Nausea vomiting headache chills fever and pain). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date at a dose of 1 dosage form. At the time of the report, PAIN (Nausea vomiting headache chills fever and pain), HEADACHE (headache), PYREXIA (fever.), VOMITING (Nausea vomiting headache chills fever and pain), NAUSEA (Nausea vomiting headache chills fever and pain) and CHILLS (Nausea vomiting headache chills fever and pain) had not resolved and MYALGIA (body ache rated as 7 out of 10, 10 being the highest) 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. Most recent FOLLOW-UP information incorporated above includes: On 29-May-2021: No specific follow-up information recorded.

Other Meds: CYMBALTA; CILNIDIPINE; Garvapetine; CLINDAMYCIN

Current Illness: Immunosuppression (Sofa clindamycin codeine Supressed immune system)

ID: 1590889
Sex: F
Age: 18
State: PR

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/20/2021
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: No

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

Symptoms: Menstrual problem ,headache, tinitus , dizziness

Other Meds: No

Current Illness: No

ID: 1590890
Sex: F
Age: 30
State: MI

Vax Date: 08/19/2021
Onset Date: 08/19/2021
Rec V Date: 08/20/2021
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: At night had chills and headache. Chills resolved after 6hrs but headache continued Arm is sore

Other Meds: Qvar 80mcg 1 puff daily

Current Illness:

ID: 1590891
Sex: F
Age: 31
State: PA

Vax Date: 08/19/2021
Onset Date: 08/19/2021
Rec V Date: 08/20/2021
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: None

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

Symptoms: Pounding headache which started after being given vaccine. 6:39am on Friday 8/20 head still pounding barely got sleep. Blurred vision started about an hour after injection every so often, comes and goes. Nausea about an hour after being given vaccine on 8/19.

Other Meds: None

Current Illness: Blurred vision, nausea

ID: 1590892
Sex: F
Age: 44
State: NY

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 08/20/2021
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: Fever, chills, nausea , in ability to go about daily activities

Other Meds:

Current Illness:

ID: 1590893
Sex: F
Age: 42
State: IL

Vax Date: 07/23/2021
Onset Date: 08/13/2021
Rec V Date: 08/20/2021
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: Site: Pain at Injection Site-Medium.

Other Meds:

Current Illness:

ID: 1590894
Sex: F
Age: 18
State: CA

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 08/20/2021
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: Systemic: Dizziness / Lightheadness-Severe, Systemic: Weakness-Severe, Additional Details: Patient felt weak and faniting. She drank water and rest for 30 minutes and was fine. Asked her if she needs us to call 911 she said no she gets like this all the time whenever she gets vaccine/shot

Other Meds:

Current Illness:

ID: 1590895
Sex: M
Age: 31
State: CA

Vax Date: 08/17/2021
Onset Date: 08/19/2021
Rec V Date: 08/20/2021
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: Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Seizure-Severe, Systemic: Shakiness-Severe

Other Meds:

Current Illness:

ID: 1590896
Sex: F
Age:
State:

Vax Date:
Onset Date: 05/25/2021
Rec V Date: 08/20/2021
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: My underpit is swollen and hurts; My underpit is swollen and hurts; This spontaneous case was reported by a consumer and describes the occurrence of AXILLARY MASS (My underpit is swollen and hurts) and AXILLARY PAIN (My underpit is swollen and hurts) in a 46-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-May-2021, the patient experienced AXILLARY MASS (My underpit is swollen and hurts) and AXILLARY PAIN (My underpit is swollen and hurts). At the time of the report, AXILLARY MASS (My underpit is swollen and hurts) and AXILLARY PAIN (My underpit is swollen and hurts) had not resolved. Concomitant medications were not provided. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1590897
Sex: F
Age: 41
State: TX

Vax Date: 05/24/2021
Onset Date: 05/28/2021
Rec V Date: 08/20/2021
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: Injection site warmth; sore down to hands; Redness at injection site; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE WARMTH (Injection site warmth), PAIN IN EXTREMITY (sore down to hands) and INJECTION SITE ERYTHEMA (Redness at injection site) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Seasonal allergy. On 24-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-May-2021, the patient experienced INJECTION SITE WARMTH (Injection site warmth), PAIN IN EXTREMITY (sore down to hands) and INJECTION SITE ERYTHEMA (Redness at injection site). At the time of the report, INJECTION SITE WARMTH (Injection site warmth), PAIN IN EXTREMITY (sore down to hands) and INJECTION SITE ERYTHEMA (Redness at injection site) had not resolved. No concomitant medications reported by investigator No treatment medications provided by the reporter.

Other Meds:

Current Illness: Seasonal allergy

ID: 1590898
Sex: F
Age: 42
State: FL

Vax Date: 05/25/2021
Onset Date: 05/28/2021
Rec V Date: 08/20/2021
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: Severe headache for days since vaccination; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Severe headache for days since vaccination) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. None. On 25-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Subcutaneous) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-May-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced HEADACHE (Severe headache for days since vaccination). On 30-May-2021, HEADACHE (Severe headache for days since vaccination) had not resolved. On 25may2021, post vaccination, the patient reported that she experienced symptoms of severe headache. No treatment information was provided No conmed information was provided

Other Meds:

Current Illness:

ID: 1590899
Sex: F
Age: 55
State:

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 08/20/2021
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: Heavy metallic taste; Heavy sweating at night; very swollen lymph nodes on right side base of neck and arm pit tender to touch; very swollen lymph nodes on right side base of neck and arm pit, sore to touch; very swollen lymph nodes on right side base of neck and arm pit; Body aches; This spontaneous case was reported by a consumer and describes the occurrence of DYSGEUSIA (Heavy metallic taste), NIGHT SWEATS (Heavy sweating at night), TENDERNESS (very swollen lymph nodes on right side base of neck and arm pit tender to touch), PAIN (very swollen lymph nodes on right side base of neck and arm pit, sore to touch) and LYMPHADENOPATHY (very swollen lymph nodes on right side base of neck and arm pit) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 28-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-May-2021, the patient experienced DYSGEUSIA (Heavy metallic taste), NIGHT SWEATS (Heavy sweating at night), TENDERNESS (very swollen lymph nodes on right side base of neck and arm pit tender to touch), PAIN (very swollen lymph nodes on right side base of neck and arm pit, sore to touch), LYMPHADENOPATHY (very swollen lymph nodes on right side base of neck and arm pit) and MYALGIA (Body aches). At the time of the report, DYSGEUSIA (Heavy metallic taste), NIGHT SWEATS (Heavy sweating at night), TENDERNESS (very swollen lymph nodes on right side base of neck and arm pit tender to touch), PAIN (very swollen lymph nodes on right side base of neck and arm pit, sore to touch), LYMPHADENOPATHY (very swollen lymph nodes on right side base of neck and arm pit) and MYALGIA (Body aches) had not resolved. Treatment information was not provided. Concomitant product use was not provided. Lab data was not provided.

Other Meds:

Current Illness:

ID: 1590900
Sex: F
Age: 40
State: OK

Vax Date: 05/18/2021
Onset Date: 05/31/2021
Rec V Date: 08/20/2021
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: injection site redness and swelling 2 weeks after injection.; injection site redness and swelling 2 weeks after injection.; injection site started itching; I looked at it 3 hrs later and the site is red and welted; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE ERYTHEMA (injection site redness and swelling 2 weeks after injection.), INJECTION SITE SWELLING (injection site redness and swelling 2 weeks after injection.), INJECTION SITE PRURITUS (injection site started itching) and INJECTION SITE URTICARIA (I looked at it 3 hrs later and the site is red and welted) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. no allergies. on medication for diabetes - metforman and glipizide. on anxiety meds - zoloft. Concurrent medical conditions included Diabetes and Anxiety. Concomitant products included SERTRALINE HYDROCHLORIDE (ZOLOFT) for Anxiety, GLIPIZIDE, METFORMIN HYDROCHLORIDE (METFORMIN HYDROCHLORIDE AND GLIPIZIDE) for Diabetes. On 18-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1. On 31-May-2021, the patient experienced INJECTION SITE ERYTHEMA (injection site redness and swelling 2 weeks after injection.), INJECTION SITE SWELLING (injection site redness and swelling 2 weeks after injection.), INJECTION SITE PRURITUS (injection site started itching) and INJECTION SITE URTICARIA (I looked at it 3 hrs later and the site is red and welted). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Symptomatic treatment, at an unspecified dose and frequency. At the time of the report, INJECTION SITE ERYTHEMA (injection site redness and swelling 2 weeks after injection.), INJECTION SITE SWELLING (injection site redness and swelling 2 weeks after injection.), INJECTION SITE PRURITUS (injection site started itching) and INJECTION SITE URTICARIA (I looked at it 3 hrs later and the site is red and welted) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information were not provided.

Other Meds: METFORMIN HYDROCHLORIDE AND GLIPIZIDE; ZOLOFT

Current Illness: Anxiety; Diabetes

ID: 1590901
Sex: F
Age: 71
State: TX

Vax Date: 04/01/2021
Onset Date: 04/14/2021
Rec V Date: 08/20/2021
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: Hand cramps; Persistent, muscle weakness in injection arm; Numbness in injection arm; Occasional, heart palpatations; Severe, persistent leg and muscle pain in left leg( side of injection).; This spontaneous case was reported by a physician and describes the occurrence of MUSCLE SPASMS (Hand cramps), MUSCULAR WEAKNESS (Persistent, muscle weakness in injection arm), HYPOAESTHESIA (Numbness in injection arm), PALPITATIONS (Occasional, heart palpatations) and MYALGIA (Severe, persistent leg and muscle pain in left leg( side of injection).) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Hypertension and Diabetes. On 01-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form once. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Apr-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced MYALGIA (Severe, persistent leg and muscle pain in left leg( side of injection).). On an unknown date, the patient experienced MUSCLE SPASMS (Hand cramps), MUSCULAR WEAKNESS (Persistent, muscle weakness in injection arm), HYPOAESTHESIA (Numbness in injection arm) and PALPITATIONS (Occasional, heart palpatations). At the time of the report, MUSCLE SPASMS (Hand cramps), MUSCULAR WEAKNESS (Persistent, muscle weakness in injection arm), HYPOAESTHESIA (Numbness in injection arm), PALPITATIONS (Occasional, heart palpatations) and MYALGIA (Severe, persistent leg and muscle pain in left leg( side of injection).) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment product was reported Concomitant product included for the maintenance for Diabetes and Hypertension

Other Meds:

Current Illness: Diabetes; Hypertension

ID: 1590902
Sex: F
Age: 45
State: IN

Vax Date: 04/01/2021
Onset Date:
Rec V Date: 08/20/2021
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: SIRVA; injection site pain; This case was initially received via an unknown source (no reference has been entered for a health authority or license partner) on 03-Jun-2021. The most recent information was received on 03-Jun-2021 and was forwarded to Moderna on 03-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of SHOULDER INJURY RELATED TO VACCINE ADMINISTRATION (SIRVA) and INJECTION SITE PAIN (injection site pain) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028A21A) for COVID-19 vaccination. Ehlers Danlos Syndrome, Arthritis medly. The patient's past medical history included Ehlers-Danlos syndrome and Arthritis. On 01-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter once. On an unknown date, the patient experienced SHOULDER INJURY RELATED TO VACCINE ADMINISTRATION (SIRVA) and INJECTION SITE PAIN (injection site pain). At the time of the report, SHOULDER INJURY RELATED TO VACCINE ADMINISTRATION (SIRVA) outcome was unknown and INJECTION SITE PAIN (injection site pain) had not resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant medication were reported No treatment medication were reported. Most recent FOLLOW-UP information incorporated above includes: On 03-Jun-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1590903
Sex: F
Age: 67
State: CA

Vax Date: 02/19/2021
Onset Date: 02/23/2021
Rec V Date: 08/20/2021
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: Tinnitus; clogged ears; This spontaneous case was reported by a consumer and describes the occurrence of TINNITUS (Tinnitus) and EAR DISCOMFORT (clogged ears) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. No concomitant medications reported. Concurrent medical conditions included Sulfonamide allergy (allergy to sulfa drugs). On 19-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Feb-2021, the patient experienced TINNITUS (Tinnitus) and EAR DISCOMFORT (clogged ears). The patient was treated with PREDNISONE for Ear feels clogged, at a dose of 1 dosage form and GINKGO BILOBA (GINGKO BILOBA) at a dose of 1 dosage form. At the time of the report, TINNITUS (Tinnitus) and EAR DISCOMFORT (clogged ears) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported.Treatment for the events included sound therapy.Action taken with mRNA-1273 in response to the events was not applicable.

Other Meds:

Current Illness: Sulfonamide allergy (allergy to sulfa drugs)

ID: 1590904
Sex: F
Age:
State: MI

Vax Date: 04/12/2021
Onset Date: 06/01/2021
Rec V Date: 08/20/2021
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: Shingles; This spontaneous case was reported by a consumer and describes the occurrence of HERPES ZOSTER (Shingles) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Multiple sclerosis, PCOS, hypothyroidism, hypertension. Concurrent medical conditions included Multiple sclerosis, Polycystic ovary, Hypothyroidism and Hypertension. On 12-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Jun-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced HERPES ZOSTER (Shingles). At the time of the report, HERPES ZOSTER (Shingles) had not resolved. No concomitant medications were provided by the reporter. The patient is taking an antiviral medication for treatment of Shingles. The treatment is ongoing.

Other Meds:

Current Illness:

ID: 1590905
Sex: F
Age:
State: CA

Vax Date:
Onset Date: 06/12/2021
Rec V Date: 08/20/2021
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: Sore throat dry; Loss of appetite; Fatigue; Feverish; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 13-Jun-2021 and was forwarded to Moderna on 13-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (Sore throat dry), DECREASED APPETITE (Loss of appetite), FATIGUE (Fatigue) and PYREXIA (Feverish) in a 32-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Jun-2021, the patient experienced OROPHARYNGEAL PAIN (Sore throat dry), DECREASED APPETITE (Loss of appetite), FATIGUE (Fatigue) and PYREXIA (Feverish). At the time of the report, OROPHARYNGEAL PAIN (Sore throat dry), DECREASED APPETITE (Loss of appetite) and PYREXIA (Feverish) was resolving and FATIGUE (Fatigue) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitants were not reported. No treatment information was reported. Most recent FOLLOW-UP information incorporated above includes: On 14-Jun-2021: Follow up received on 14-06-2021 included reporter information and updated state.

Other Meds:

Current Illness: Drug allergy

ID: 1590906
Sex: F
Age: 52
State: AR

Vax Date: 06/09/2021
Onset Date: 06/15/2021
Rec V Date: 08/20/2021
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: Covid arm; arm swelling; stiff arm; warm to touch; Rash red; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Covid arm), PERIPHERAL SWELLING (arm swelling), MUSCULOSKELETAL STIFFNESS (stiff arm), SKIN WARM (warm to touch) and RASH ERYTHEMATOUS (Rash red) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049c21a) for COVID-19 vaccination. Has had copd, sleep apnea, diabetes type 2 and stage 4 congestive heart failure. Allergic to ace inhibitors and codeine. Concurrent medical conditions included Specific allergy (drug) (Allergic to Ace inhibitor), Specific allergy (drug) (Allergy to Codeine), COPD, Sleep apnea, Diabetes and Congestive heart failure (stage 4 congestive heart failure). On 09-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Cutaneous) 1 dosage form. On 15-Jun-2021, the patient experienced PAIN IN EXTREMITY (Covid arm), PERIPHERAL SWELLING (arm swelling), MUSCULOSKELETAL STIFFNESS (stiff arm), SKIN WARM (warm to touch) and RASH ERYTHEMATOUS (Rash red). At the time of the report, PAIN IN EXTREMITY (Covid arm) and PERIPHERAL SWELLING (arm swelling) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Cutaneous) was unknown. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness: Congestive heart failure (stage 4 congestive heart failure); COPD; Diabetes; Sleep apnea; Specific allergy (drug) (Allergy to Codeine); Specific allergy (drug) (Allergic to Ace inhibitor)

ID: 1590907
Sex: F
Age: 51
State: AZ

Vax Date: 04/05/2021
Onset Date: 05/23/2021
Rec V Date: 08/20/2021
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: made pain worse; Sleeping is painful; Walking is painful; I felt a slight sort of twinge/fluttering from the shot location across my back/ neck but it didn't hurt at the time; Stiff neck on opposite side from injected arm/Pers. neck pain opp side; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULOSKELETAL STIFFNESS (Stiff neck on opposite side from injected arm/Pers. neck pain opp side), PAIN (made pain worse), INSOMNIA (Sleeping is painful), GAIT DISTURBANCE (Walking is painful) and VACCINATION SITE PAIN (I felt a slight sort of twinge/fluttering from the shot location across my back/ neck but it didn't hurt at the time) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 034C21A and D26B21A) for COVID-19 vaccination. The patient's past medical history included Accident automobile (Over 30 years ago) and Trauma. Concurrent medical conditions included Drug allergy, Allergy to antibiotic, Allergy to antibiotic, Asthma, Depression and Anxiety. Concomitant products included LORATADINE, PSEUDOEPHEDRINE SULFATE (CLARITIN D 12 HOUR) for Allergy, ALBUTEROL SULFATE for Asthma, VORTIOXETINE HYDROBROMIDE (TRINTELLIX) for Depression and Anxiety. On 05-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 23-May-2021, the patient experienced MUSCULOSKELETAL STIFFNESS (Stiff neck on opposite side from injected arm/Pers. neck pain opp side). On an unknown date, the patient experienced PAIN (made pain worse), INSOMNIA (Sleeping is painful), GAIT DISTURBANCE (Walking is painful) and VACCINATION SITE PAIN (I felt a slight sort of twinge/fluttering from the shot location across my back/ neck but it didn't hurt at the time). The patient was treated with IBUPROFEN ongoing since an unknown date for Adverse event, at a dose of 1 dosage form and MENTHOL (BIOFREEZE PAIN RELIEVING) ongoing since an unknown date for Adverse event, at a dose of 1 dosage form. On 17-Jun-2021, MUSCULOSKELETAL STIFFNESS (Stiff neck on opposite side from injected arm/Pers. neck pain opp side) had not resolved. At the time of the report, PAIN (made pain worse), INSOMNIA (Sleeping is painful), GAIT DISTURBANCE (Walking is painful) and VACCINATION SITE PAIN (I felt a slight sort of twinge/fluttering from the shot location across my back/ neck but it didn't hurt at the time) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered MUSCULOSKELETAL STIFFNESS (Stiff neck on opposite side from injected arm/Pers. neck pain opp side) to be possibly related. No further causality assessments were provided for PAIN (made pain worse), INSOMNIA (Sleeping is painful), GAIT DISTURBANCE (Walking is painful) and VACCINATION SITE PAIN (I felt a slight sort of twinge/fluttering from the shot location across my back/ neck but it didn't hurt at the time). Patient reported pain beginning with second vaccine dose. Pain was not relieved by treatment medications, by icing, or by massaging. Most recent FOLLOW-UP information incorporated above includes: On 07-Aug-2021: Additional information received included reporter, new events of vaccination site pain, pain, sleep difficult and walking difficulty were added and vaccine details updated.

Other Meds: CLARITIN D 12 HOUR; ALBUTEROL SULFATE; TRINTELLIX

Current Illness: Allergy to antibiotic; Anxiety; Asthma; Depression; Drug allergy

ID: 1590908
Sex: M
Age: 70
State: ID

Vax Date: 05/07/2021
Onset Date: 06/05/2021
Rec V Date: 08/20/2021
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: Skin reaction and blood clots; in back side rashes and blood clots on skin; in back side rashes and blood clots on skin; This spontaneous case was reported by a consumer and describes the occurrence of SKIN REACTION (Skin reaction and blood clots), CONTUSION (in back side rashes and blood clots on skin) and RASH (in back side rashes and blood clots on skin) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 035C21A and 025C21A) for COVID-19 vaccination. Concurrent medical conditions included Diabetes. On 07-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Parenteral) dosage was changed to 1 dosage form. On 05-Jun-2021, the patient experienced SKIN REACTION (Skin reaction and blood clots), CONTUSION (in back side rashes and blood clots on skin) and RASH (in back side rashes and blood clots on skin). At the time of the report, SKIN REACTION (Skin reaction and blood clots), CONTUSION (in back side rashes and blood clots on skin) and RASH (in back side rashes and blood clots on skin) was resolving. No concomitant medications were reported. The reporter described the event as "in back side rashes and blood clots on skin." No treatment information was reported.

Other Meds:

Current Illness: Diabetes

ID: 1590909
Sex: F
Age: 56
State: AR

Vax Date: 06/17/2021
Onset Date:
Rec V Date: 08/20/2021
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: Fever,swelling,pain, flu symptoms; Fever,swelling,pain, flu symptoms; Injection site is feverish and really red; Fever,swelling,pain, flu symptoms; report a side effect; Injection site is feverish and really red; Fever,swelling,pain, flu symptoms; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING (Fever,swelling,pain, flu symptoms), INFLUENZA (Fever,swelling,pain, flu symptoms), INJECTION SITE WARMTH (Injection site is feverish and really red), PAIN (Fever,swelling,pain, flu symptoms) and VACCINATION COMPLICATION (report a side effect) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Multiple sclerosis, Fibrillation and Congestive heart failure. Concurrent medical conditions included Penicillin allergy, Tetanus, Contrast media allergy (IVP Dye) and Allergy to antibiotic. On 17-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced SWELLING (Fever,swelling,pain, flu symptoms), INFLUENZA (Fever,swelling,pain, flu symptoms), INJECTION SITE WARMTH (Injection site is feverish and really red), PAIN (Fever,swelling,pain, flu symptoms), VACCINATION COMPLICATION (report a side effect), INJECTION SITE ERYTHEMA (Injection site is feverish and really red) and PYREXIA (Fever,swelling,pain, flu symptoms). At the time of the report, SWELLING (Fever,swelling,pain, flu symptoms), INFLUENZA (Fever,swelling,pain, flu symptoms), PAIN (Fever,swelling,pain, flu symptoms) and PYREXIA (Fever,swelling,pain, flu symptoms) had not resolved and INJECTION SITE WARMTH (Injection site is feverish and really red), VACCINATION COMPLICATION (report a side effect) and INJECTION SITE ERYTHEMA (Injection site is feverish and really red) outcome was unknown. No Concomitant medications were provided. No Treatment medications were provided Most recent FOLLOW-UP information incorporated above includes: On 19-Jun-2021: Additional information received on 21/Jun/2021: Contains no new information.

Other Meds:

Current Illness: Allergy to antibiotic; Contrast media allergy (IVP Dye); Penicillin allergy; Tetanus

ID: 1590910
Sex: F
Age: 25
State: KY

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 08/20/2021
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: Rash all over body; This spontaneous case was reported by a consumer and describes the occurrence of RASH (Rash all over body) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 26-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Mar-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced RASH (Rash all over body). At the time of the report, RASH (Rash all over body) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment and concomitant information was provided by the reporter.

Other Meds:

Current Illness:

ID: 1590911
Sex: F
Age: 43
State: WA

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 08/20/2021
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: Headache; body aches; lymphatic swelling in armpit; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache), MYALGIA (body aches) and LYMPHADENOPATHY (lymphatic swelling in armpit) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 033b21a) for COVID-19 vaccination. born with MRKH, only 1 kidney, allergic to cotton wood trees. Concurrent medical conditions included Mullerian agenesis (only 1 kidney) and Allergy NOS. On 18-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Jun-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced LYMPHADENOPATHY (lymphatic swelling in armpit). On 19-Jun-2021, the patient experienced HEADACHE (Headache) and MYALGIA (body aches). The patient was treated with ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) ongoing since an unknown date for Myalgia, at an unspecified dose and frequency. On 19-Jun-2021, MYALGIA (body aches) had resolved. On 20-Jun-2021, HEADACHE (Headache) had resolved. At the time of the report, LYMPHADENOPATHY (lymphatic swelling in armpit) had not resolved. No concomitant medication information was provided by the reporter.

Other Meds:

Current Illness:

ID: 1590912
Sex: M
Age:
State: UT

Vax Date:
Onset Date:
Rec V Date: 08/20/2021
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: On going head aches; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (On going head aches) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Not known.) for COVID-19 vaccination. Skin cancer. The patient's past medical history included Skin cancer. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced HEADACHE (On going head aches). At the time of the report, HEADACHE (On going head aches) had not resolved. No Concomitant medications were reported. No Treatment information was reported.

Other Meds:

Current Illness:

ID: 1590913
Sex: F
Age: 45
State:

Vax Date: 04/18/2021
Onset Date: 06/20/2021
Rec V Date: 08/20/2021
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: pain in the right arm then moved to the right side of back; pain in the right arm, right shoulder and upper right side of my back; pain in the right arm, right shoulder and upper right side of my back; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in the right arm then moved to the right side of back), BACK PAIN (pain in the right arm, right shoulder and upper right side of my back) and ARTHRALGIA (pain in the right arm, right shoulder and upper right side of my back) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 18-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form once. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Jun-2021, the patient experienced PAIN IN EXTREMITY (pain in the right arm then moved to the right side of back), BACK PAIN (pain in the right arm, right shoulder and upper right side of my back) and ARTHRALGIA (pain in the right arm, right shoulder and upper right side of my back). At the time of the report, PAIN IN EXTREMITY (pain in the right arm then moved to the right side of back), BACK PAIN (pain in the right arm, right shoulder and upper right side of my back) and ARTHRALGIA (pain in the right arm, right shoulder and upper right side of my back) had not resolved. Concurrent condition of the patient was unknown. Concomitant medications were not reported. It was unknown if the patient was treated for the events. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1590914
Sex: U
Age: 40
State: VA

Vax Date: 06/01/2021
Onset Date: 06/02/2021
Rec V Date: 08/20/2021
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: ahead to toe hives, throat swelling; ahead to toe hives, throat swelling; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (ahead to toe hives, throat swelling) and PHARYNGEAL SWELLING (ahead to toe hives, throat swelling) in a 40-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 054c21a) for COVID-19 vaccination. No Medical History information was reported. In June 2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intravenous) .05 milligram once. On 02-Jun-2021, the patient experienced URTICARIA (ahead to toe hives, throat swelling) and PHARYNGEAL SWELLING (ahead to toe hives, throat swelling). On 02-Jun-2021, URTICARIA (ahead to toe hives, throat swelling) and PHARYNGEAL SWELLING (ahead to toe hives, throat swelling) was resolving. mRNA-1273 (Moderna COVID-19 Vaccine) (Intravenous) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intravenous), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1590915
Sex: M
Age: 67
State: VA

Vax Date: 01/13/2021
Onset Date: 02/01/2021
Rec V Date: 08/20/2021
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: itchy rash; intermittent migrating urticaria/Every day an itchy rash appears on several areas of body (mostly arms and legs, but sometimes on torso and even head and neck) at various times throughout the day; itching/pruritus; This spontaneous case was reported by a pharmacist and describes the occurrence of URTICARIA (intermittent migrating urticaria/Every day an itchy rash appears on several areas of body (mostly arms and legs, but sometimes on torso and even head and neck) at various times throughout the day), PRURITUS (itching/pruritus) and RASH PRURITIC (itchy rash) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013L20A and 025J20A) for COVID-19 vaccination. No known allergies. Type 2 Diabetes, well controlled on diet, exercise and oral medication. Concurrent medical conditions included Type 2 diabetes mellitus (Type 2 Diabetes, well controlled on diet, exercise and oral medication) since 2005. Concomitant products included METFORMIN HYDROCHLORIDE, SITAGLIPTIN PHOSPHATE MONOHYDRATE (JANUMET) for Diabetes, ASA for Primary prevention. On 13-Jan-2021 at 8:20 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021 at 8:15 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 10-Feb-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced URTICARIA (intermittent migrating urticaria/Every day an itchy rash appears on several areas of body (mostly arms and legs, but sometimes on torso and even head and neck) at various times throughout the day). In February 2021, the patient experienced PRURITUS (itching/pruritus). On an unknown date, the patient experienced RASH PRURITIC (itchy rash). The patient was treated with DIPHENHYDRAMINE (oral) ongoing from February 2021 for Rash, at a dose of 50 milligram as required and HYDROCORTISONE (topical) ongoing from February 2021 for Hives, at a dose of 1 % as required. At the time of the report, URTICARIA (intermittent migrating urticaria/Every day an itchy rash appears on several areas of body (mostly arms and legs, but sometimes on torso and even head and neck) at various times throughout the day), PRURITUS (itching/pruritus) and RASH PRURITIC (itchy rash) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. It was reported that rash usually recedes after 30 minutes, or so, but may reappear later in the day in the same area or a different area. Most recent FOLLOW-UP information incorporated above includes: On 28-Jul-2021: Significant FU Appended - narrative updated

Other Meds: JANUMET; ASA

Current Illness: Type 2 diabetes mellitus (Type 2 Diabetes, well controlled on diet, exercise and oral medication)

ID: 1590916
Sex: F
Age: 63
State: CA

Vax Date: 06/17/2021
Onset Date: 06/24/2021
Rec V Date: 08/20/2021
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: I've been more tired since I had the vaccine; I got a nosebleed and an old cut on my arm started bleeding.; I got a nosebleed and an old cut on my arm started bleeding.; This spontaneous case was reported by a consumer and describes the occurrence of EPISTAXIS (I got a nosebleed and an old cut on my arm started bleeding.), WOUND HAEMORRHAGE (I got a nosebleed and an old cut on my arm started bleeding.) and FATIGUE (I've been more tired since I had the vaccine) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 050C21A) for COVID-19 vaccination. No Medical History information was reported. On 17-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Jun-2021, the patient experienced EPISTAXIS (I got a nosebleed and an old cut on my arm started bleeding.) and WOUND HAEMORRHAGE (I got a nosebleed and an old cut on my arm started bleeding.). On an unknown date, the patient experienced FATIGUE (I've been more tired since I had the vaccine). On 24-Jun-2021, EPISTAXIS (I got a nosebleed and an old cut on my arm started bleeding.) and WOUND HAEMORRHAGE (I got a nosebleed and an old cut on my arm started bleeding.) had resolved. At the time of the report, FATIGUE (I've been more tired since I had the vaccine) outcome was unknown. Treatment information was not provided by reporter. Action taken with mRNA-1273 in response to the event was reported as not applicable.

Other Meds:

Current Illness:

ID: 1590917
Sex: F
Age: 42
State: NJ

Vax Date: 03/26/2021
Onset Date: 04/23/2021
Rec V Date: 08/20/2021
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: chest and masalas pain; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of CHEST PAIN (chest and masalas pain) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048B21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 23-Apr-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced CHEST PAIN (chest and masalas pain). At the time of the report, CHEST PAIN (chest and masalas pain) had not resolved. No concomitant medications were reported. Patient reported that she had done her chest mammogram and chest X-ray recommended by my primary care doctor on an unknown date. Furthermore, the radiologists request to return for additional mammographic imaging with an ultrasound to complete the evaluation. No treatment information was provided by reporter. Upon in internal review on 04-Aug-2021, the age was corrected to 43 years

Other Meds:

Current Illness:

ID: 1590918
Sex: F
Age: 33
State:

Vax Date: 04/16/2021
Onset Date: 06/24/2021
Rec V Date: 08/20/2021
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: Period starting and stopping blood clots; Period starting and stopping blood clots; This spontaneous case was reported by a consumer and describes the occurrence of MENSTRUATION IRREGULAR (Period starting and stopping blood clots) and BLOOD DISORDER (Period starting and stopping blood clots) in a 32-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 425) for COVID-19 vaccination. Medical history include Latex amatryptelin. On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form once. On 24-Jun-2021, the patient experienced MENSTRUATION IRREGULAR (Period starting and stopping blood clots) and BLOOD DISORDER (Period starting and stopping blood clots). At the time of the report, MENSTRUATION IRREGULAR (Period starting and stopping blood clots) and BLOOD DISORDER (Period starting and stopping blood clots) had not resolved. No Concomitant medications were received by the reporter. Treatment medication for these events were not reported by the reporter.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm