VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1627388
Sex: M
Age: 44
State: KS

Vax Date: 01/13/2021
Onset Date: 02/10/2021
Rec V Date: 08/24/2021
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: Heavy arm; Little lethargic; A little soreness on both sides below his earlobes; Pressure in ears, like a clogged ear, ears need to pop like being on an airplane; Puffiness (both sides under his ear/jawline area; Slight swelling (both sides under his ear/jawline area); A sore arm; This spontaneous case was reported by a consumer and describes the occurrence of LIMB DISCOMFORT (Heavy arm), LETHARGY (Little lethargic), EAR PAIN (A little soreness on both sides below his earlobes), EAR DISCOMFORT (Pressure in ears, like a clogged ear, ears need to pop like being on an airplane) and SWELLING FACE (Puffiness (both sides under his ear/jawline area) in a 45-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 042L20A and 025J20-2A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Drug allergy (Allergic to Demerol), Drug allergy (Allergic to Benadryl), Allergy to topical drugs (Allergic to topical iodine), Seasonal allergy and Complex regional pain syndrome Type II (CRPS Type II vagus (affects left arm)). Concomitant products included POTASSIUM, PROPRANOLOL, LISDEXAMFETAMINE MESILATE (VYVANSE), VITAMIN D NOS and MOMETASONE FUROATE (FLONASE [MOMETASONE FUROATE]) for an unknown indication. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 09-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to .5 milliliter. On 10-Feb-2021, the patient experienced LIMB DISCOMFORT (Heavy arm), LETHARGY (Little lethargic), EAR PAIN (A little soreness on both sides below his earlobes), EAR DISCOMFORT (Pressure in ears, like a clogged ear, ears need to pop like being on an airplane), SWELLING FACE (Puffiness (both sides under his ear/jawline area), SWELLING (Slight swelling (both sides under his ear/jawline area)) and PAIN IN EXTREMITY (A sore arm). At the time of the report, LIMB DISCOMFORT (Heavy arm), LETHARGY (Little lethargic), EAR PAIN (A little soreness on both sides below his earlobes), EAR DISCOMFORT (Pressure in ears, like a clogged ear, ears need to pop like being on an airplane), SWELLING FACE (Puffiness (both sides under his ear/jawline area), SWELLING (Slight swelling (both sides under his ear/jawline area)) and PAIN IN EXTREMITY (A sore arm) had not resolved. On 09-Feb-2021, the patient received their second dose and stated they had a heavy arm at the time of report and a sore arm and was a little lethargic post receiving the vaccine. The patient also mentioned that they were experiencing a little soreness on both sides below their earlobes and also experienced slight swelling and puffiness on both sides under their ear/jawline area. The patient also experienced pressure in their ears like a clogged ear and stated that it was like their ears need to pop like being on an airplane. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not applicable. This case was linked to MOD-2021-029277 (Patient Link).

Other Meds: POTASSIUM; PROPRANOLOL; VYVANSE; VITAMIN D NOS; FLONASE [MOMETASONE FUROATE]

Current Illness: Allergy to topical drugs (Allergic to topical iodine); Complex regional pain syndrome Type II (CRPS Type II vagus (affects left arm)); Drug allergy (Allergic to Demerol); Drug allergy (Allergic to Benadryl); Seasonal allergy

ID: 1627389
Sex: F
Age:
State: OH

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: had better breathing and perfect oxygen level after receiving the Moderna COVID-19 vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of THERAPEUTIC RESPONSE UNEXPECTED (had better breathing and perfect oxygen level after receiving the Moderna COVID-19 vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced THERAPEUTIC RESPONSE UNEXPECTED (had better breathing and perfect oxygen level after receiving the Moderna COVID-19 vaccine). At the time of the report, THERAPEUTIC RESPONSE UNEXPECTED (had better breathing and perfect oxygen level after receiving the Moderna COVID-19 vaccine) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was provided Treatment medication was not provided

Other Meds:

Current Illness:

ID: 1627390
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Its black and blue; A lot of itching on left arm where they gave me the injection; it's still sore; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOLORATION (Its black and blue), VACCINATION SITE PRURITUS (A lot of itching on left arm where they gave me the injection) and VACCINATION SITE PAIN (it's still sore) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE DISCOLORATION (Its black and blue), VACCINATION SITE PRURITUS (A lot of itching on left arm where they gave me the injection) and VACCINATION SITE PAIN (it's still sore). At the time of the report, VACCINATION SITE DISCOLORATION (Its black and blue) and VACCINATION SITE PRURITUS (A lot of itching on left arm where they gave me the injection) outcome was unknown and VACCINATION SITE PAIN (it's still sore) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medication was not provided by the reporter.

Other Meds:

Current Illness:

ID: 1627391
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I received my second dose an hour ago. Now I'm coughing; I received my second dose an hour ago. Now fluttery feeling in my chest; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (I received my second dose an hour ago. Now I'm coughing) and CHEST DISCOMFORT (I received my second dose an hour ago. Now fluttery feeling in my chest) in a patient of an unknown age and gender 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced COUGH (I received my second dose an hour ago. Now I'm coughing) and CHEST DISCOMFORT (I received my second dose an hour ago. Now fluttery feeling in my chest). At the time of the report, COUGH (I received my second dose an hour ago. Now I'm coughing) and CHEST DISCOMFORT (I received my second dose an hour ago. Now fluttery feeling in my chest) outcome was unknown. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was reported as not applicable.

Other Meds:

Current Illness:

ID: 1627392
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: lasting joint pain after the vaccinatiob; This spontaneous case was reported by a consumer and describes the occurrence of ARTHRALGIA (lasting joint pain after the vaccinatiob) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced ARTHRALGIA (lasting joint pain after the vaccinatiob). At the time of the report, ARTHRALGIA (lasting joint pain after the vaccinatiob) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medication were not provided by the reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1627393
Sex: M
Age:
State: WY

Vax Date:
Onset Date: 06/04/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient received expired Moderna Covid-19 vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine) in a 26-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028A21A) 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 04-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine). On 04-Jun-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine) 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.

Other Meds:

Current Illness:

ID: 1627394
Sex: M
Age: 39
State: NH

Vax Date: 04/29/2021
Onset Date:
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: Test Name: COVID-19 test; Test Result: Negative ; Result Unstructured Data: negative

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: running nose; A patient experienced chest pain; A patient experienced Dry cough/dry cough is so bad sometimes they cannot even speak with cough drops; A patient experienced Trouble breathing; asthma; t feels as if they have on a tight jacket allowing them not to breathe properly./ pressure in the chest; a hard time lifting,; have difficulty breathing/were breathing at 100% before the vaccination they are now breathing at 40%.; sore throat are due to the excessive coughing.; very tired,/fatigue; A patient experienced Fever; This spontaneous case was reported by a patient and describes the occurrence of NASOPHARYNGITIS (running nose), CHEST PAIN (A patient experienced chest pain), COUGH (A patient experienced Dry cough/dry cough is so bad sometimes they cannot even speak with cough drops), DYSPNOEA (A patient experienced Trouble breathing) and ASTHMA (asthma) in a 39-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 009C21A and 047C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 29-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-May-2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced NASOPHARYNGITIS (running nose), CHEST PAIN (A patient experienced chest pain), COUGH (A patient experienced Dry cough/dry cough is so bad sometimes they cannot even speak with cough drops), DYSPNOEA (A patient experienced Trouble breathing), ASTHMA (asthma), CHEST DISCOMFORT (t feels as if they have on a tight jacket allowing them not to breathe properly./ pressure in the chest), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (a hard time lifting,), DYSPNOEA (have difficulty breathing/were breathing at 100% before the vaccination they are now breathing at 40%.), OROPHARYNGEAL PAIN (sore throat are due to the excessive coughing.), FATIGUE (very tired,/fatigue) and PYREXIA (A patient experienced Fever). The patient was treated with AZITHROMYCIN at a dose of 500 mg; BENZONATATE at a dose of 100 mg and PREDNISONE at a dose of 20 mg. At the time of the report, NASOPHARYNGITIS (running nose), CHEST PAIN (A patient experienced chest pain), COUGH (A patient experienced Dry cough/dry cough is so bad sometimes they cannot even speak with cough drops), DYSPNOEA (A patient experienced Trouble breathing), ASTHMA (asthma), CHEST DISCOMFORT (t feels as if they have on a tight jacket allowing them not to breathe properly./ pressure in the chest), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (a hard time lifting,), DYSPNOEA (have difficulty breathing/were breathing at 100% before the vaccination they are now breathing at 40%.), OROPHARYNGEAL PAIN (sore throat are due to the excessive coughing.), FATIGUE (very tired,/fatigue) and PYREXIA (A patient experienced Fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test negative: negative (Negative) negative. The HCP stated the patient had asthma and allergies to pollen.This diagnoses confused the patient, the patient emphasized they are 39 years old and have never been allergic to anything nor have they every has .seasonal allergies Most recent FOLLOW-UP information incorporated above includes: On 11-Jun-2021: Follow up received on 11-JUNE-2021. updated on both dose details, new events were added, treatment medications were added patient demographics were updated, reporter information were updated.

Other Meds:

Current Illness:

ID: 1627395
Sex: F
Age: 55
State: OH

Vax Date: 03/25/2021
Onset Date: 04/22/2021
Rec V Date: 08/24/2021
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 better breathing and perfect oxygen level; This spontaneous case was reported by a consumer and describes the occurrence of THERAPEUTIC RESPONSE UNEXPECTED (she had better breathing and perfect oxygen level) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017B21A and 040B21A) for COVID-19 vaccination. Concurrent medical conditions included Diabetes, Diabetic neuropathy, Heart disease, unspecified, Allergy NOS and Long COVID since 15-Nov-2020. Concomitant products included LORATADINE, DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) and FAMOTIDINE for Allergy, INSULIN for Diabetes, GABAPENTIN for Diabetic neuropathy, ESOMEPRAZOLE SODIUM (NEXIUM [ESOMEPRAZOLE SODIUM]) for Gastrooesophageal reflux, VERAPAMIL, ISOSORBIDE and CARVEDILOL for Heart disease, unspecified, BUPROPION HYDROCHLORIDE (WELLBUTRIN) for Post-traumatic stress disorder. On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 22-Apr-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced THERAPEUTIC RESPONSE UNEXPECTED (she had better breathing and perfect oxygen level). At the time of the report, THERAPEUTIC RESPONSE UNEXPECTED (she had better breathing and perfect oxygen level) 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 treatment medication provided. No adverse events reported but therapeutic benefit was mentioned. Most recent FOLLOW-UP information incorporated above includes: On 18-Jun-2021: Follow up document was attached on 18-Jun-2021 which contains no new information.

Other Meds: INSULIN; VERAPAMIL; ISOSORBIDE; CARVEDILOL; GABAPENTIN; WELLBUTRIN; LORATADINE; BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]; FAMOTIDINE; NEXIUM [ESOMEPRAZOLE SODIUM]

Current Illness: Allergy NOS; Diabetes; Diabetic neuropathy; Heart disease, unspecified; Long COVID

ID: 1627396
Sex: F
Age: 34
State: WY

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient received expired Moderna Covid-19 vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028A21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1627397
Sex: M
Age: 50
State: NC

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 08/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Vaccine was administered to the patient after the beyond use date; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Vaccine was administered to the patient after the beyond use date) in a 50-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004C21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Jun-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 02-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Vaccine was administered to the patient after the beyond use date). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Vaccine was administered to the patient after the beyond use date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patient received both scheduled doses of mRNA-1273 prior to the events therefore, action taken with the drug in response to the events was not applicable. This case was linked to MOD-2021-218565, MOD-2021-218569.

Other Meds:

Current Illness:

ID: 1627398
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: Cough; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (Cough) and NAUSEA (Nausea) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced COUGH (Cough) and NAUSEA (Nausea). At the time of the report, COUGH (Cough) and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1627399
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: Coughing; Hives; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (Coughing) and URTICARIA (Hives) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced COUGH (Coughing) and URTICARIA (Hives). At the time of the report, COUGH (Coughing) and URTICARIA (Hives) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1627400
Sex: M
Age: 20
State: IN

Vax Date: 05/21/2021
Onset Date: 06/07/2021
Rec V Date: 08/24/2021
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: 2nd dose of Moderna vaccine administered <25 days; This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (2nd dose of Moderna vaccine administered <25 days) in a 20-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 21-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Jun-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (2nd dose of Moderna vaccine administered <25 days). On 07-Jun-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (2nd dose of Moderna vaccine administered <25 days) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant Medications were not provided by the reporter. Treatment Information was not provided by the reporter.

Other Meds:

Current Illness:

ID: 1627401
Sex: F
Age: 75
State: NJ

Vax Date: 01/22/2021
Onset Date:
Rec V Date: 08/24/2021
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: Lack of appetite; Mild chills; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of DECREASED APPETITE (Lack of appetite), CHILLS (Mild chills) and FATIGUE (Fatigue) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032L20A) for COVID-19 vaccination. No Medical History information was reported. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. 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 DECREASED APPETITE (Lack of appetite), CHILLS (Mild chills) and FATIGUE (Fatigue). At the time of the report, DECREASED APPETITE (Lack of appetite), CHILLS (Mild chills) and FATIGUE (Fatigue) had resolved. Treatment information was not provided. This case was linked to MOD-2021-027237 (Patient Link).

Other Meds:

Current Illness:

ID: 1627402
Sex: M
Age: 20
State: WY

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 08/24/2021
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: Patient received expired Moderna Covid-19 vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine) in a 34-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028A21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine). On 04-Jun-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine) 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. Treatment information was not provided. This case was linked to Crosslinked cases-MOD21-110132,MOD21-110133,MOD21-110134,MOD21-110135,MOD21-110137,MOD21-110141 (Patient Link).

Other Meds:

Current Illness:

ID: 1627403
Sex: M
Age: 46
State: OH

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 08/24/2021
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: Received a Johnson and Johnson vaccine and then received a dose of the Moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT ADMINISTRATION ERROR (Received a Johnson and Johnson vaccine and then received a dose of the Moderna vaccine) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. No concomitant medication was reported. On 03-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Jun-2021, the patient experienced PRODUCT ADMINISTRATION ERROR (Received a Johnson and Johnson vaccine and then received a dose of the Moderna vaccine). At the time of the report, PRODUCT ADMINISTRATION ERROR (Received a Johnson and Johnson vaccine and then received a dose of the Moderna vaccine) outcome was unknown. Treatment medication was not provided. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was not applicable. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1627404
Sex: F
Age:
State: FL

Vax Date: 06/03/2021
Onset Date: 06/01/2021
Rec V Date: 08/24/2021
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: Arm itchy; Swollen arm; Hard arm; Hot to touch; COVID arm; other pain; fatigue; chills; headache; muscle aches and pains; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Arm itchy), PERIPHERAL SWELLING (Swollen arm), INDURATION (Hard arm), FEELING HOT (Hot to touch) and VACCINATION SITE REACTION (COVID arm) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036C21H) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 03-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Jun-2021, the patient experienced PRURITUS (Arm itchy), PERIPHERAL SWELLING (Swollen arm), INDURATION (Hard arm) and FEELING HOT (Hot to touch). In June 2021, the patient experienced VACCINATION SITE REACTION (COVID arm), PAIN (other pain), FATIGUE (fatigue), CHILLS (chills), HEADACHE (headache) and MYALGIA (muscle aches and pains). At the time of the report, PRURITUS (Arm itchy), PERIPHERAL SWELLING (Swollen arm), INDURATION (Hard arm), FEELING HOT (Hot to touch), VACCINATION SITE REACTION (COVID arm), PAIN (other pain), FATIGUE (fatigue), CHILLS (chills), HEADACHE (headache) and MYALGIA (muscle aches and pains) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. Patient was not taking any treatment medications for events- itchy, swollen, hard and hot to touch.

Other Meds:

Current Illness:

ID: 1627405
Sex: F
Age:
State: FL

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Migraine; Body ache; Cough; Threw Up; On 3rd daytemperature 99 F; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (Migraine), PAIN (Body ache), COUGH (Cough), VOMITING (Threw Up) and PYREXIA (On 3rd daytemperature 99 F) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. UNK) for COVID-19 vaccination. No Medical History information was reported. 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 MIGRAINE (Migraine), COUGH (Cough), VOMITING (Threw Up) and PYREXIA (On 3rd daytemperature 99 F). an unknown date, the patient experienced PAIN (Body ache). At the time of the report, MIGRAINE (Migraine), VOMITING (Threw Up) and PYREXIA (On 3rd daytemperature 99 F) outcome was unknown and PAIN (Body ache) and COUGH (Cough) had resolved. Date: Unk, Body temperature: 99F No information regarding treatment medications was provided by the reporter. This case was linked to MOD-2021-019704 (Patient Link).

Other Meds:

Current Illness:

ID: 1627406
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pain in my brain; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Pain in my brain) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) Unknown. On an unknown date, the patient experienced HEADACHE (Pain in my brain). At the time of the report, HEADACHE (Pain in my brain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication provided. No treatment information provided.; Sender's Comments: Very limited information regarding this event has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1627407
Sex: F
Age:
State: OH

Vax Date: 02/27/2021
Onset Date: 03/27/2021
Rec V Date: 08/24/2021
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: Loss of long term memory; Feeling weakness.; Fell down twice on floor from standing position; Looks confused; Out of mind/feels likes somebody has raised hard disk; This spontaneous case was reported by a consumer and describes the occurrence of AMNESIA (Loss of long term memory), ASTHENIA (Feeling weakness.), FALL (Fell down twice on floor from standing position), CONFUSIONAL STATE (Looks confused) and FEELING ABNORMAL (Out of mind/feels likes somebody has raised hard disk) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 038A21A and 022M20A) for COVID-19 vaccination. No Medical History information was reported. On 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 27-Mar-2021, the patient experienced AMNESIA (Loss of long term memory), ASTHENIA (Feeling weakness.), FALL (Fell down twice on floor from standing position), CONFUSIONAL STATE (Looks confused) and FEELING ABNORMAL (Out of mind/feels likes somebody has raised hard disk). At the time of the report, AMNESIA (Loss of long term memory) had not resolved and ASTHENIA (Feeling weakness.), FALL (Fell down twice on floor from standing position), CONFUSIONAL STATE (Looks confused) and FEELING ABNORMAL (Out of mind/feels likes somebody has raised hard disk) outcome was unknown. The patient stated that she is not on concomitant medication. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1627408
Sex: F
Age:
State: WY

Vax Date:
Onset Date: 06/10/2021
Rec V Date: 08/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient received expired Moderna Covid-19 vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028A21A) 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 10-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine). On 10-Jun-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired Moderna Covid-19 vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1627409
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: This spontaneous case reported by a consumer, describes the occurrence of headache in a patient, of an unknown age and gender, who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. On an unknown date, patient received a dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On an unknown date, patient experienced headache. At the time of the report, headache outcome: unknown. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. No concomitant medication or treatment information reported. Reporter did not allow further contact.

Other Meds:

Current Illness:

ID: 1627410
Sex: F
Age:
State: OR

Vax Date:
Onset Date: 05/11/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: COVID like respiratory, hard to breath; Headache; achiness symptoms; got exposed to a person who got COVID positive; This spontaneous case was reported by a consumer and describes the occurrence of EXPOSURE TO SARS-COV-2 (got exposed to a person who got COVID positive), DYSPNOEA (COVID like respiratory, hard to breath), HEADACHE (Headache) and MYALGIA (achiness symptoms) 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 COVID-19 in March 2020. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-May-2021, the patient experienced EXPOSURE TO SARS-COV-2 (got exposed to a person who got COVID positive). On an unknown date, the patient experienced DYSPNOEA (COVID like respiratory, hard to breath), HEADACHE (Headache) and MYALGIA (achiness symptoms). At the time of the report, EXPOSURE TO SARS-COV-2 (got exposed to a person who got COVID positive), DYSPNOEA (COVID like respiratory, hard to breath), HEADACHE (Headache) and MYALGIA (achiness symptoms) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient had an appointment for second dose Moderna COVID-19 Vaccine on 21-May-2021. She got exposed to a person who got COVID positive on 11-May-2021. She was planning to go for COVID test. Concomitant medications were not provided. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1627411
Sex: M
Age:
State: FL

Vax Date: 05/26/2021
Onset Date: 06/02/2021
Rec V Date: 08/24/2021
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: fainted; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 11-Jun-2021 and was forwarded to Moderna on 11-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of SYNCOPE (fainted) in an 81-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Alzheimer's disease. On 26-May-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced SYNCOPE (fainted). At the time of the report, SYNCOPE (fainted) outcome was unknown. Concomitant medications were not provided. Treatment information was not reported. The patient received both doses and one was on 26 May 2021. The patient stated that between 7-10 days post vaccine he fainted 3 times in one day. He was concerned that this might happen to him again, but he doesn't know for sure when and this was causing him lot of frustrations. As a healthy man he doesn't think he should faint from getting a vaccine. He also stated that the pharmacist told him there was no reason for him to get side effects from the moderna vaccine since he was a health man. Very limited information regarding this event has been provided at this time. Further information has been requested. Patient medical condition may be of relevance regrading the event occurrence.; Sender's Comments: Very limited information regarding this event has been provided at this time. Further information has been requested. Patient medical condition may be of relevance regrading the event occurrence.

Other Meds:

Current Illness: Alzheimer's disease

ID: 1627412
Sex: F
Age:
State: TN

Vax Date: 05/02/2021
Onset Date: 06/07/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: Test Date: 20210607; Test Name: Body temp; Result Unstructured Data: Fever with 103 F

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Arm is swollen; Arm is itchy; Stomach pain; Diarrhea; Nausea; Shaking; Headache; Chills; Fever; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (Shaking), PERIPHERAL SWELLING (Arm is swollen), PRURITUS (Arm is itchy), ABDOMINAL PAIN UPPER (Stomach pain) and DIARRHOEA (Diarrhea) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 038C21A and 002C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 02-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 07-Jun-2021, the patient experienced PYREXIA (Fever). On 08-Jun-2021, the patient experienced TREMOR (Shaking), HEADACHE (Headache) and CHILLS (Chills). On an unknown date, the patient experienced PERIPHERAL SWELLING (Arm is swollen), PRURITUS (Arm is itchy), ABDOMINAL PAIN UPPER (Stomach pain), DIARRHOEA (Diarrhea) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. On 08-Jun-2021, PYREXIA (Fever) outcome was unknown. At the time of the report, TREMOR (Shaking), PERIPHERAL SWELLING (Arm is swollen), PRURITUS (Arm is itchy), HEADACHE (Headache) and CHILLS (Chills) outcome was unknown and ABDOMINAL PAIN UPPER (Stomach pain), DIARRHOEA (Diarrhea) and NAUSEA (Nausea) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 07-Jun-2021, Body temperature: 103 f (High) Fever with 103 F. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1627413
Sex: U
Age:
State:

Vax Date: 03/26/2021
Onset Date:
Rec V Date: 08/24/2021
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: My first shot was March 26; This spontaneous case was reported by a patient and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (My first shot was March 26) in a patient of an unknown age and gender 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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (My first shot was March 26). At the time of the report, PRODUCT DOSE OMISSION ISSUE (My first shot was March 26) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1627414
Sex: M
Age:
State: FL

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 08/24/2021
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: vaccine leakage (not administered a full dose); vaccine leakage (not administered a full dose)\syringe was not tightened and there was a leak. Pharmacist is not sure that the patient received the full dose; This spontaneous case was reported by a pharmacist and describes the occurrence of DEVICE CONNECTION ISSUE (vaccine leakage (not administered a full dose)) and UNDERDOSE (vaccine leakage (not administered a full dose)\syringe was not tightened and there was a leak. Pharmacist is not sure that the patient received the full dose) in a 40-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002DA1C) for COVID-19 vaccination. No Medical History information was reported. On 10-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Jun-2021, the patient experienced DEVICE CONNECTION ISSUE (vaccine leakage (not administered a full dose)) and UNDERDOSE (vaccine leakage (not administered a full dose)\syringe was not tightened and there was a leak. Pharmacist is not sure that the patient received the full dose). On 10-Jun-2021, DEVICE CONNECTION ISSUE (vaccine leakage (not administered a full dose)) and UNDERDOSE (vaccine leakage (not administered a full dose)\syringe was not tightened and there was a leak. Pharmacist is not sure that the patient received the full dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant and treatment information not provided. The first dose of the Moderna Covid-19 vaccine to a patient on 10Jun2021 but that the syringe was not tightened and there was a leak. Pharmacist is not sure that the patient received the full dose and asks for guidance in management

Other Meds:

Current Illness:

ID: 1627415
Sex: M
Age:
State: MO

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: running temperature of 100.4 then it went to 101.2; hurting at the injection site; This spontaneous case was reported by a patient and describes the occurrence of PYREXIA (running temperature of 100.4 then it went to 101.2) and VACCINATION SITE PAIN (hurting at the injection site) in a 19-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041B21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PYREXIA (running temperature of 100.4 then it went to 101.2) and VACCINATION SITE PAIN (hurting at the injection site). The patient was treated with ACETAMINOPHEN at an unspecified dose and frequency. At the time of the report, PYREXIA (running temperature of 100.4 then it went to 101.2) and VACCINATION SITE PAIN (hurting at the injection site) outcome was unknown. Not Provided Patient is taking two doses of acetaminophen.

Other Meds:

Current Illness:

ID: 1627416
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: I have now been diagnosed with an autoimmune disease; Numbness in extremities; Tingling in extremities; Fogginess; Swelling in extremities; joint pain; Headache; Bad Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of AUTOIMMUNE DISORDER (I have now been diagnosed with an autoimmune disease), HYPOAESTHESIA (Numbness in extremities), PARAESTHESIA (Tingling in extremities), FEELING ABNORMAL (Fogginess) and PERIPHERAL SWELLING (Swelling in extremities) in a patient of an unknown age and gender who received mRNA-1273 for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (unknown route) 1 dosage form. On an unknown date, the patient experienced AUTOIMMUNE DISORDER (I have now been diagnosed with an autoimmune disease), HYPOAESTHESIA (Numbness in extremities), PARAESTHESIA (Tingling in extremities), FEELING ABNORMAL (Fogginess), PERIPHERAL SWELLING (Swelling in extremities), ARTHRALGIA (joint pain), HEADACHE (Headache) and FATIGUE (Bad Fatigue). At the time of the report, AUTOIMMUNE DISORDER (I have now been diagnosed with an autoimmune disease), HYPOAESTHESIA (Numbness in extremities), PARAESTHESIA (Tingling in extremities), FEELING ABNORMAL (Fogginess), PERIPHERAL SWELLING (Swelling in extremities), ARTHRALGIA (joint pain), HEADACHE (Headache) and FATIGUE (Bad Fatigue) outcome was unknown. The action taken with mRNA-1273 (Unknown) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided. Very limited information regarding these events has been provided at this time. Further information has been requested. Patient previously undiagnosed medical condition may provide an alterative justification for the vents occurrence.; Sender's Comments: Very limited information regarding these events has been provided at this time. Further information has been requested. Patient previously undiagnosed medical condition may provide an alterative justification for the vents occurrence.

Other Meds:

Current Illness:

ID: 1627417
Sex: M
Age: 52
State: WY

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 08/24/2021
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: This spontaneous case reported by a pharmacist, describes the occurrence of administered expired product (patient received expired Moderna COVID-19 vaccine) in a 52-year-old male patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch# 028A21A) for COVID-19 immunization. No medical history reported. On Jun 10, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Jun 10, 2021, patient administered expired product (patient received expired Moderna COVID-19 vaccine). At the time of the report, administered expired product (patient received expired Moderna COVID-19 vaccine) outcome: unknown. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. The reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1627418
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: i had side effects with my 1st; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (i had side effects with my 1st) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (i had side effects with my 1st). At the time of the report, VACCINATION COMPLICATION (i had side effects with my 1st) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1627419
Sex: F
Age: 31
State: TX

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 08/24/2021
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: She is also currently pregnant; Sore L arm at site of injection; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (She is also currently pregnant) and INJECTION SITE PAIN (Sore L arm at site of injection) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017C21A) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy and Vitamin D deficiency. Concomitant products included MINERALS NOS, VITAMINS NOS (PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]) for Pregnancy, ASPIRIN [ACETYLSALICYLIC ACID] from 06-Jan-2021 to an unknown date for Prevention, VITAMIN C [ASCORBIC ACID] for Symptomatic treatment, COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) for Vitamin D deficiency. On 15-May-2021 at 2:15 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on 11-Feb-2021 and the estimated date of delivery was 15-Nov-2021. On 15-May-2021 at 3:15 PM, the patient experienced INJECTION SITE PAIN (Sore L arm at site of injection). On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (She is also currently pregnant). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the thirteenth week of the pregnancy. On 18-May-2021, INJECTION SITE PAIN (Sore L arm at site of injection) had resolved. At the time of the report, EXPOSURE DURING PREGNANCY (She is also currently pregnant) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 04-Jul-2021: Additional info appended

Other Meds: VITAMIN D [COLECALCIFEROL]; VITAMIN C [ASCORBIC ACID]; PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]; ASPIRIN [ACETYLSALICYLIC ACID]

Current Illness: Penicillin allergy; Vitamin D deficiency

ID: 1627420
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: Numb; Tingly; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (Numb) and PARAESTHESIA (Tingly) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced HYPOAESTHESIA (Numb) and PARAESTHESIA (Tingly). At the time of the report, HYPOAESTHESIA (Numb) and PARAESTHESIA (Tingly) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information not provided. No concomitant medication were provided.

Other Meds:

Current Illness:

ID: 1627421
Sex: U
Age:
State: WI

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: Adverse event; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE EVENT (Adverse event) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ADVERSE EVENT (Adverse event). At the time of the report, ADVERSE EVENT (Adverse event) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. It was reported that patient had an adverse event No concomitant medication was reported No treatment medication was reported

Other Meds:

Current Illness:

ID: 1627422
Sex: U
Age:
State:

Vax Date:
Onset Date: 06/11/2021
Rec V Date: 08/24/2021
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: low blood pressure; high pulse; This spontaneous case was reported by a consumer and describes the occurrence of HYPOTENSION (low blood pressure) and HEART RATE INCREASED (high pulse) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. UNKNOWN) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Jun-2021, the patient experienced HYPOTENSION (low blood pressure) and HEART RATE INCREASED (high pulse). At the time of the report, HYPOTENSION (low blood pressure) and HEART RATE INCREASED (high pulse) outcome was unknown. Action taken with mRNA-1273 in response to the event was not applicable. Treatment medicines were not reported.

Other Meds:

Current Illness:

ID: 1627423
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: lymph node pain in my armpit; This spontaneous case was reported by a consumer and describes the occurrence of LYMPH NODE PAIN (lymph node pain in my armpit) in a patient of an unknown age and gender 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced LYMPH NODE PAIN (lymph node pain in my armpit). At the time of the report, LYMPH NODE PAIN (lymph node pain in my armpit) outcome was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1627424
Sex: F
Age: 72
State: MO

Vax Date: 03/05/2021
Onset Date:
Rec V Date: 08/24/2021
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: Severe body aches in both shoulders across her back and down to her lower back that started one or two weeks after second shot and still continues; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Severe body aches in both shoulders across her back and down to her lower back that started one or two weeks after second shot and still continues) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 020B21A and 029A21A) for COVID-19 vaccination. Concurrent medical conditions included Thyroid disorder NOS. Concomitant products included LEVOTHYROXINE for Thyroid disorder NOS. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced MYALGIA (Severe body aches in both shoulders across her back and down to her lower back that started one or two weeks after second shot and still continues). The patient was treated with THERAWORX RELIEF for Myalgia, at an unspecified dose and frequency and HISTAMINE HYDROCHLORIDE (PAIN RELIEVING ARTHRITIS) (topical) for Myalgia, at an unspecified dose and frequency. At the time of the report, MYALGIA (Severe body aches in both shoulders across her back and down to her lower back that started one or two weeks after second shot and still continues) had not resolved.

Other Meds: LEVOTHYROXINE

Current Illness: Thyroid disorder NOS

ID: 1627425
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: feel tingles on your hands; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (feel tingles on your hands) in a patient of an unknown age and gender 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PARAESTHESIA (feel tingles on your hands). At the time of the report, PARAESTHESIA (feel tingles on your hands) outcome was unknown. No concomitant medication information provided. No treatment information given. Reporter gave consent for safety follow up.

Other Meds:

Current Illness:

ID: 1627426
Sex: M
Age:
State: FL

Vax Date: 06/04/2021
Onset Date:
Rec V Date: 08/24/2021
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: crying from the pain in his head; This spontaneous case was reported by a patient family member or friend and describes the occurrence of HEADACHE (crying from the pain in his head) 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 04-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced HEADACHE (crying from the pain in his head). At the time of the report, HEADACHE (crying from the pain in his head) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. No treatment was reported for the events. Most recent FOLLOW-UP information incorporated above includes: On 11-Jun-2021: No new information

Other Meds:

Current Illness:

ID: 1627427
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: Arm is so sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm is so sore) in a patient of an unknown age and gender 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Arm is so sore). At the time of the report, PAIN IN EXTREMITY (Arm is so sore) outcome was unknown. No concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1627428
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: head aches; feeling nausea; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (head aches) and NAUSEA (feeling nausea) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced HEADACHE (head aches) and NAUSEA (feeling nausea). At the time of the report, HEADACHE (head aches) and NAUSEA (feeling nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. No treatment was reported for the events.

Other Meds:

Current Illness:

ID: 1627429
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: Severe back pain; severe pain in the side; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Severe back pain) and PAIN (severe pain in the side) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced BACK PAIN (Severe back pain) and PAIN (severe pain in the side). At the time of the report, BACK PAIN (Severe back pain) and PAIN (severe pain in the side) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant products were not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1627430
Sex: F
Age: 54
State: AL

Vax Date: 05/26/2021
Onset Date:
Rec V Date: 08/24/2021
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: Redness on arm; Sleepy; swelling in that arm; hot to touch; hardly lift my left arm; Fatigue; Chills; fever; 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 ERYTHEMA (Redness on arm), SOMNOLENCE (Sleepy), SWELLING (swelling in that arm), SKIN WARM (hot to touch) and LIMB DISCOMFORT (hardly lift my left arm) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Previously administered products included for Product used for unknown indication: Flu vaccine (swelling in arm; redness at the site for about 3 weeks; 4 inch diameter; hot to touch) in 2008 and Flu vaccine (swelling in arm; redness at the site for about 2 weeks; 3 inch diameter; hot to touch) in 2020. Concurrent medical conditions included Wasp sting (stung on bottom of right foot and leg was swollen and red to the knee in 5 mins; required emergency room visit and follow-up care/rx) since 1985, Bee sting (stung on left forearm; arm swelled really quickly and was taken to doctor immediately; treated and rx) since 1984, Hypersensitivity reaction, Hay fever, Hives, Hypertension since 1994, High cholesterol since 2003 and Drug allergy (allergic reaction verified by doctor; rash/hives on stomach) since 2011. Concomitant products included SIMVASTATIN for High cholesterol, HYDROCHLOROTHIAZIDE, LOSARTAN POTASSIUM (LOSARTAN/HCTZ) and METOPROLOL TARTRATE for Hypertension. On 26-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 ERYTHEMA (Redness on arm), SOMNOLENCE (Sleepy), SWELLING (swelling in that arm), SKIN WARM (hot to touch), LIMB DISCOMFORT (hardly lift my left arm), FATIGUE (Fatigue), CHILLS (Chills) and PYREXIA (fever). On 13-Jun-2021, ERYTHEMA (Redness on arm) and FATIGUE (Fatigue) had resolved. At the time of the report, SOMNOLENCE (Sleepy), SWELLING (swelling in that arm), SKIN WARM (hot to touch), LIMB DISCOMFORT (hardly lift my left arm), CHILLS (Chills) and PYREXIA (fever) was resolving. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered ERYTHEMA (Redness on arm), SOMNOLENCE (Sleepy), SWELLING (swelling in that arm), SKIN WARM (hot to touch), LIMB DISCOMFORT (hardly lift my left arm), FATIGUE (Fatigue), CHILLS (Chills) and PYREXIA (fever) to be possibly related. As treatment medication, the patient started taking Benadryl (25 mg/8 hours) on April 28, 2021. The patient still continues to take Benadryl. Most recent FOLLOW-UP information incorporated above includes: On 13-Jun-2021: Nonsignificant FU Appended

Other Meds: LOSARTAN/HCTZ; METOPROLOL TARTRATE; SIMVASTATIN

Current Illness: Bee sting (stung on left forearm; arm swelled really quickly and was taken to doctor immediately; treated and rx); Drug allergy (allergic reaction verified by doctor; rash/hives on stomach); Hay fever; High cholesterol; Hives; Hypersensitivity reaction; Hypertension; Wasp sting (stung on bottom of right foot and leg was swollen and red to the knee in 5 mins; required emergency room visit and follow-up care/rx)

ID: 1627431
Sex: M
Age:
State: TX

Vax Date: 06/11/2021
Onset Date: 06/11/2021
Rec V Date: 08/24/2021
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: vaccination to a patient from a vial that was opened yesterday at 11 AM and refrigerated afterwards, then used again at 9 AM this morning to vaccinate another patient.; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 11-Jun-2021 and was forwarded to Moderna on 11-Jun-2021. This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT STORAGE ERROR (vaccination to a patient from a vial that was opened yesterday at 11 AM and refrigerated afterwards, then used again at 9 AM this morning to vaccinate another patient.) 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 11-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Jun-2021, the patient experienced PRODUCT STORAGE ERROR (vaccination to a patient from a vial that was opened yesterday at 11 AM and refrigerated afterwards, then used again at 9 AM this morning to vaccinate another patient.). At the time of the report, PRODUCT STORAGE ERROR (vaccination to a patient from a vial that was opened yesterday at 11 AM and refrigerated afterwards, then used again at 9 AM this morning to vaccinate another patient.) 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. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1627432
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: excruciating pain in my left thigh/pain has spread past down my knee; swelling in my left thigh; constant spasms; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (excruciating pain in my left thigh/pain has spread past down my knee), PERIPHERAL SWELLING (swelling in my left thigh) and MUSCLE SPASMS (constant spasms) in a patient of an unknown age and gender 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (excruciating pain in my left thigh/pain has spread past down my knee), PERIPHERAL SWELLING (swelling in my left thigh) and MUSCLE SPASMS (constant spasms). At the time of the report, PAIN IN EXTREMITY (excruciating pain in my left thigh/pain has spread past down my knee), PERIPHERAL SWELLING (swelling in my left thigh) and MUSCLE SPASMS (constant spasms) outcome was unknown. No concomitant medications were provided. No treatment was reported for the events.

Other Meds:

Current Illness:

ID: 1627433
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: Feeling sleepy and drowsy; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 14-Jun-2021 and was forwarded to Moderna on 14-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (Feeling sleepy and drowsy) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On an unknown date, the patient experienced SOMNOLENCE (Feeling sleepy and drowsy). At the time of the report, SOMNOLENCE (Feeling sleepy and drowsy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment information was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1627434
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: This spontaneous case reported by a consumer, describes the occurrence of back pain (very bad backache) and tremor (shaking) in a patient, of an unknown age and gender, 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), unknown route; 1 dosage form. On an unknown date, patient experienced back pain (very bad backache) and tremor (shaking). At the time of the report, back pain (very bad backache) and tremor (shaking) outcome: unknown. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. No concomitant medication or treatment information provided.

Other Meds:

Current Illness:

ID: 1627435
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/24/2021
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: Bloody nose; Mild headache; This spontaneous case was reported by a consumer and describes the occurrence of EPISTAXIS (Bloody nose) and HEADACHE (Mild headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, 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 EPISTAXIS (Bloody nose) and HEADACHE (Mild headache). At the time of the report, EPISTAXIS (Bloody nose) and HEADACHE (Mild headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. No treatment information was reported .

Other Meds:

Current Illness:

ID: 1627436
Sex: M
Age: 55
State: MI

Vax Date: 06/10/2021
Onset Date:
Rec V Date: 08/24/2021
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: Sore chest; Stiff neck; Sore arm / shoulder; This spontaneous case was reported by a pharmacist and describes the occurrence of CHEST PAIN (Sore chest), MUSCULOSKELETAL STIFFNESS (Stiff neck) and PAIN IN EXTREMITY (Sore arm / shoulder) in a 56-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049C21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included AMITRIPTYLINE for an unknown indication. On 10-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced CHEST PAIN (Sore chest), MUSCULOSKELETAL STIFFNESS (Stiff neck) and PAIN IN EXTREMITY (Sore arm / shoulder). At the time of the report, CHEST PAIN (Sore chest), MUSCULOSKELETAL STIFFNESS (Stiff neck) and PAIN IN EXTREMITY (Sore arm / shoulder) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment information was provided.

Other Meds: AMITRIPTYLINE

Current Illness:

ID: 1627437
Sex: M
Age: 31
State: FL

Vax Date: 06/04/2021
Onset Date:
Rec V Date: 08/24/2021
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: It feels like swollen; sore in the eyes; head is haunted; high blood pressure; severe head ache between the neck and the head; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 11-Jun-2021 and was forwarded to Moderna on 11-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of SWELLING (It feels like swollen), EYE PAIN (sore in the eyes), FEELING ABNORMAL (head is haunted), BLOOD PRESSURE INCREASED (high blood pressure) and HEADACHE (severe head ache between the neck and the head) in a 31-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 04-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced SWELLING (It feels like swollen), EYE PAIN (sore in the eyes), FEELING ABNORMAL (head is haunted), BLOOD PRESSURE INCREASED (high blood pressure) and HEADACHE (severe head ache between the neck and the head). The patient was treated with ASPIRIN [ACETYLSALICYLIC ACID] for Adverse event, at an unspecified dose and frequency. At the time of the report, SWELLING (It feels like swollen), EYE PAIN (sore in the eyes), FEELING ABNORMAL (head is haunted), BLOOD PRESSURE INCREASED (high blood pressure) and HEADACHE (severe head ache between the neck and the head) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided by reporter.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am