VAERS 2021 Database www.vaers.hhs.gov

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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: 1631417
Sex: M
Age: 67
State: MI

Vax Date: 02/09/2021
Onset Date: 02/12/2021
Rec V Date: 08/25/2021
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: a little sore arm; lightheadedness; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 17-Feb-2021 and was forwarded to Moderna on 17-Feb-2021. This spontaneous report from was received from a 67 year old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced lightheadedness and sore arm. The patient's concomitant medications included unspecified medication for blood pressure, cholesterol and acid reflux. On 09-Feb--2021 the patient received his dose of mRNA-1273 (Lot number: 015M20A) solution injection intramuscularly in his arm for prophylaxis of COVID-19 infection. On 12-feb-2021, the patient started experiencing this lightheadedness. Now it was mild but it was still there. The patient said that the vaccination was well executed. The patient had a little sore arm. Treatment information was not provided. Action taken with the suspect drug mRNA-1273 was unknown. The outcome of the event of lightheadedness was recovering and that of event of sore arm was not recovered /not resolved.

Other Meds:

Current Illness: Acid reflux (esophageal); Hypercholesteraemia; Hypertension

ID: 1631418
Sex: F
Age: 73
State: FL

Vax Date: 02/05/2021
Onset Date: 02/15/2021
Rec V Date: 08/25/2021
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: arm was blown up; sore; lumpy; swollen; hot; looked a little red; A spontaneous report was received from a Nurse concerning a 73-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced lumpy, swollen, hot and red reaction at injection site, arm was blown up and sore in arm. The patient's medical history was not provided. Concomitant medications reported were Calcium, Vitamin D, Vitamin B12, Zinc, Vitamin C, Metoprolol, Boniva for drug use for unknown indication. On 5 Feb 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot/batch: Unknown) intramuscularly in the left deltoid for prophylaxis of COVID-19 infection. On 15 Feb 2021, the patient experienced lumpy (vaccination site mass), swollen (vaccination site swelling), hot (vaccination site warmth) and it looked a little red (vaccination site erythema). On 16 Feb 2021, the arm was blown up (swelling arm) and was sore (pain). Treatment details included Ice pack. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events was unknown.

Other Meds: CALCIUM; VITAMIN D 2000; VITAMIN B 1-6-12; ZINC; VITAMIN C & ROSEHIP; METOPROLOL; BONIVA

Current Illness:

ID: 1631419
Sex: M
Age:
State: CA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 08/25/2021
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: low grade fever; A spontaneous report was received from a Healthcare Professional concerning a 65-years-old patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events low grade fever. The patient's medical history was not provided. No relevant concomitant medications were reported. On 15 Feb 2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot/batch: 011M20A) intramuscularly for prophylaxis of COVID-19 infection. On 15 Feb 2021, the patient experienced the events low grade fever. Treatment details included Tylenol Action taken with mRNA-1273 in response to the events was not reported. On an unknown date the outcome of events, low grade fever was not reported.

Other Meds:

Current Illness:

ID: 1631420
Sex: F
Age: 79
State: WI

Vax Date: 02/04/2021
Onset Date: 02/12/2021
Rec V Date: 08/25/2021
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: arm was itching below the injection site - left arm; rash where the shot was administered - left arm - It's about 6 inches long, 5 inched across; red rash - area has grown to 6 inches across the bottom of the arm past the top of the injection site; This spontaneous case was reported by a consumer and describes the occurrence of RASH ERYTHEMATOUS (red rash - area has grown to 6 inches across the bottom of the arm past the top of the injection site), VACCINATION SITE PRURITUS (arm was itching below the injection site - left arm) and VACCINATION SITE RASH (rash where the shot was administered - left arm - It's about 6 inches long, 5 inched across) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Feb-2021, the patient experienced RASH ERYTHEMATOUS (red rash - area has grown to 6 inches across the bottom of the arm past the top of the injection site) and VACCINATION SITE RASH (rash where the shot was administered - left arm - It's about 6 inches long, 5 inched across). On an unknown date, the patient experienced VACCINATION SITE PRURITUS (arm was itching below the injection site - left arm). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) ongoing since an unknown date for Itching, at an unspecified dose and frequency. At the time of the report, RASH ERYTHEMATOUS (red rash - area has grown to 6 inches across the bottom of the arm past the top of the injection site), VACCINATION SITE PRURITUS (arm was itching below the injection site - left arm) and VACCINATION SITE RASH (rash where the shot was administered - left arm - It's about 6 inches long, 5 inched across) 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 medication details were not reported by the reporter.

Other Meds:

Current Illness:

ID: 1631421
Sex: F
Age:
State: NY

Vax Date: 01/21/2021
Onset Date:
Rec V Date: 08/25/2021
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: red rash on arm; This spontaneous case was reported by a consumer and describes the occurrence of RASH (red rash on arm) 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 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced RASH (red rash on arm). At the time of the report, RASH (red rash on arm) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1631422
Sex: F
Age: 72
State: MI

Vax Date: 01/21/2021
Onset Date: 01/26/2021
Rec V Date: 08/25/2021
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: Rash - Near Injection Site; Redness - Near Injection Site; Arm Pain; Itchy Sensation - Near Injection Site; Swelling - Near Injection Site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (Rash - Near Injection Site), VACCINATION SITE ERYTHEMA (Redness - Near Injection Site), VACCINATION SITE PAIN (Arm Pain), VACCINATION SITE PRURITUS (Itchy Sensation - Near Injection Site) and VACCINATION SITE SWELLING (Swelling - Near Injection Site) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. No Medical History information was reported. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Jan-2021, the patient experienced VACCINATION SITE RASH (Rash - Near Injection Site), VACCINATION SITE ERYTHEMA (Redness - Near Injection Site), VACCINATION SITE PAIN (Arm Pain), VACCINATION SITE PRURITUS (Itchy Sensation - Near Injection Site) and VACCINATION SITE SWELLING (Swelling - Near Injection Site). At the time of the report, VACCINATION SITE RASH (Rash - Near Injection Site), VACCINATION SITE ERYTHEMA (Redness - Near Injection Site), VACCINATION SITE PAIN (Arm Pain), VACCINATION SITE PRURITUS (Itchy Sensation - Near Injection Site) and VACCINATION SITE SWELLING (Swelling - Near Injection Site) 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 relevant concomitant medications were reported. Treatment details included Benadryl (diphenhydramine HCL) - Advised by their HCP to try to alleviate the symptoms as well as Cortizone-10.

Other Meds:

Current Illness:

ID: 1631423
Sex: F
Age: 68
State: NJ

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 08/25/2021
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: Hives; rashes on her back of her neck,rash on arm and tights; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (Hives) and RASH (rashes on her back of her neck,rash on arm and tights) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. Concomitant products included ATORVASTATIN CALCIUM (LIPITOR), OLMESARTAN MEDOXOMIL (BENICAR), LEVOTHYROXINE SODIUM (SYNTHROID), OMEPRAZOLE (PRILOSEC [OMEPRAZOLE]), ACETYLSALICYLIC ACID (BABY ASPIRIN) and VITAMINS NOS for an unknown indication. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, the patient experienced URTICARIA (Hives) and RASH (rashes on her back of her neck,rash on arm and tights). At the time of the report, URTICARIA (Hives) and RASH (rashes on her back of her neck,rash on arm and tights) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment details included Benadryl and Zyrtec + concomitant.

Other Meds: LIPITOR; BENICAR; SYNTHROID; PRILOSEC [OMEPRAZOLE]; BABY ASPIRIN; VITAMINS NOS

Current Illness:

ID: 1631424
Sex: F
Age: 52
State: CA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/25/2021
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: headache; dizziness that is very bizzare; like having hypoglycemia; very tender and very painful; swollen; red, swollen, very tender and very painful; super sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (super sore), DIZZINESS (dizziness that is very bizzare), HYPOGLYCAEMIA (like having hypoglycemia), INJECTION SITE PAIN (very tender and very painful) and HEADACHE (headache) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse event. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Jan-2021, the patient experienced PAIN IN EXTREMITY (super sore). On 15-Jan-2021, the patient experienced INJECTION SITE PAIN (very tender and very painful), INJECTION SITE SWELLING (swollen) and INJECTION SITE ERYTHEMA (red, swollen, very tender and very painful). On 04-Feb-2021, the patient experienced DIZZINESS (dizziness that is very bizzare) and HYPOGLYCAEMIA (like having hypoglycemia). On an unknown date, the patient experienced HEADACHE (headache). At the time of the report, PAIN IN EXTREMITY (super sore), DIZZINESS (dizziness that is very bizzare), HYPOGLYCAEMIA (like having hypoglycemia), INJECTION SITE PAIN (very tender and very painful), HEADACHE (headache), INJECTION SITE SWELLING (swollen) and INJECTION SITE ERYTHEMA (red, swollen, very tender and very painful) 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 include Exedrin OTC. Treatment details include that the patient may have taken Naproxen 400mg and applied heat.

Other Meds:

Current Illness:

ID: 1631425
Sex: F
Age: 60
State: VA

Vax Date: 02/10/2021
Onset Date:
Rec V Date: 08/25/2021
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: lips and tongue got numb; lost taste; diarrhea; headache; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA ORAL (lips and tongue got numb), AGEUSIA (lost taste), DIARRHOEA (diarrhea) and HEADACHE (headache) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included CLOPIDOGREL BISULFATE (PLAVIX), CLONAZEPAM, CITALOPRAM, OMEPRAZOLE (PROTONIX [OMEPRAZOLE]), PREDNISONE and HYDROCORTISONE, NEOMYCIN SULFATE, POLYMYXIN B SULFATE (ANTIBIOTIC EAR) for an unknown indication. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced HYPOAESTHESIA ORAL (lips and tongue got numb), AGEUSIA (lost taste), DIARRHOEA (diarrhea) and HEADACHE (headache). At the time of the report, HYPOAESTHESIA ORAL (lips and tongue got numb), AGEUSIA (lost taste), DIARRHOEA (diarrhea) and HEADACHE (headache) 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 considered HYPOAESTHESIA ORAL (lips and tongue got numb), AGEUSIA (lost taste), DIARRHOEA (diarrhea) and HEADACHE (headache) to be possibly related. No treatment information was provided.

Other Meds: PLAVIX; CLONAZEPAM; CITALOPRAM; PROTONIX [OMEPRAZOLE]; PREDNISONE; ANTIBIOTIC EAR

Current Illness:

ID: 1631426
Sex: F
Age: 80
State:

Vax Date: 01/28/2021
Onset Date: 02/01/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Test Date: 20210201; Test Name: MRI; Result Unstructured Data: osteoarthritis, degenerative disc disease and discogenic marrow changes.; Test Date: 20210201; Test Name: X-Ray; Result Unstructured Data: no results provided

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: discogenic marrow changes; degenerative disc disease; osteoarthritis; chills; low grade fever; Severe backache/Severe low back pain that radiated to right hip; A spontaneous report was received from a consumer concerning a 80 year old, female patient who developed Severe backache/Severe low back pain that radiated to right hip, discogenic marrow changes, degenerative disc disease, osteoarthritis, fever, and chills. The patient's medical history included blood clots, hypertension and anxiety. Products known to have been used by the patient, within two weeks prior to the event, included clonazepam, apixaban, lisinopril, and oxycodone hydrochloride/oxycodone terephthalate. On 28-JAN-2021, approximately four days prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number: 012M20A) intramuscularly in the left deltoid for prophylaxis of COVID-19 infection. It was planned for patient to receive their second dose on 03 Mar 2021. On an unspecified date post vaccination, patient developed low grade fever and chills. On 01 Feb 2021, four days post vaccination, the patient developed severe backache described as severe low back pain that radiated to right hip. An ambulance was called and patient was transported to an emergency room (ER) where an X-ray was done. Patient was then sent home and told to follow-up with her primary care physician (PCP) who referred to a pain clinic. A magnetic resonance imaging (MRI) revealed osteoarthritis, degenerative disc disease and discogenic marrow changes. The patient is unable to have steroid injections because of her use of an anticoagulant. Treatment information was unknown. There was no change planned to the dosing schedule of mRNA-1273 in response to the event(s). The events Severe backache/Severe low back pain that radiated to right hip, discogenic marrow changes, degenerative disc disease, and osteoarthritis were considered not recovered/not resolved. The outcome of events fever and chills, was unknown.; Reporter's Comments: Very limited information regarding the events has been provided at this time. Further information has been requested.

Other Meds: KLONOPIN; ELIQUIS; LISINOPRIL; PERCOCET [OXYCODONE HYDROCHLORIDE;OXYCODONE TEREPHTHALATE;PARACETAMOL]

Current Illness:

ID: 1631427
Sex: F
Age:
State: FL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 08/25/2021
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: arm sore; diarrhea; cold and shaking could not warm up; headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm sore), HEADACHE (headache), DIARRHOEA (diarrhea) and FEELING COLD (cold and shaking could not warm up) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. O38K2OA) for COVID-19 vaccination. Concomitant products included centroid for an unknown indication. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced PAIN IN EXTREMITY (arm sore), HEADACHE (headache), DIARRHOEA (diarrhea) and FEELING COLD (cold and shaking could not warm up). On 05-Feb-2021, DIARRHOEA (diarrhea) had resolved. At the time of the report, PAIN IN EXTREMITY (arm sore) had not resolved and HEADACHE (headache) and FEELING COLD (cold and shaking could not warm up) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment details included : ginger ale, rice and soup, salting crackers, tea, banana and Tylenol

Other Meds: centroid

Current Illness:

ID: 1631428
Sex: F
Age:
State: NY

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 08/25/2021
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: Could barely stand; feels like she has the flu; feel really sick; body was fatigued; muscles were so achy, body aches; fever; Chills; headache; This spontaneous case was reported by an other health care professional and describes the occurrence of MALAISE (feel really sick), DYSSTASIA (Could barely stand), INFLUENZA LIKE ILLNESS (feels like she has the flu), FATIGUE (body was fatigued) and MYALGIA (muscles were so achy, body aches) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19 in April 2020. On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Jan-2021, the patient experienced MALAISE (feel really sick), DYSSTASIA (Could barely stand), INFLUENZA LIKE ILLNESS (feels like she has the flu), FATIGUE (body was fatigued), MYALGIA (muscles were so achy, body aches), PYREXIA (fever), CHILLS (Chills) and HEADACHE (headache). At the time of the report, MALAISE (feel really sick), DYSSTASIA (Could barely stand), INFLUENZA LIKE ILLNESS (feels like she has the flu), MYALGIA (muscles were so achy, body aches), PYREXIA (fever) and CHILLS (Chills) outcome was unknown and FATIGUE (body was fatigued) and HEADACHE (headache) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment information was provided. No concomitant medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 15-Apr-2021: Headache added, outcome of fatigue updated.

Other Meds:

Current Illness:

ID: 1631429
Sex: F
Age: 90
State: CA

Vax Date: 01/26/2021
Onset Date: 02/16/2021
Rec V Date: 08/25/2021
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: Arm was red; swollen; gum infection; injection site is very red; injection site is swollen; This spontaneous case was reported by a health care professional and describes the occurrence of ERYTHEMA (Arm was red), PERIPHERAL SWELLING (swollen), VACCINATION SITE ERYTHEMA (injection site is very red), VACCINATION SITE SWELLING (injection site is swollen) and GINGIVITIS (gum infection) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. Concomitant products included LEVOTHYROXINE and ATORVASTATIN CALCIUM (LIPITOR) for an unknown indication. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced VACCINATION SITE ERYTHEMA (injection site is very red) and VACCINATION SITE SWELLING (injection site is swollen). On an unknown date, the patient experienced ERYTHEMA (Arm was red), PERIPHERAL SWELLING (swollen) and GINGIVITIS (gum infection). The patient was treated with CLINDAMYCIN at an unspecified dose and frequency. At the time of the report, ERYTHEMA (Arm was red), PERIPHERAL SWELLING (swollen), VACCINATION SITE ERYTHEMA (injection site is very red), VACCINATION SITE SWELLING (injection site is swollen) and GINGIVITIS (gum infection) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.

Other Meds: LEVOTHYROXINE; LIPITOR

Current Illness:

ID: 1631430
Sex: F
Age:
State: FL

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 08/25/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: felt very thirsty; wasnt feeling great felt sick; chills, had a lot of chills; fatigue, felt very tired; unsure if she had a temperature it would be a low-grade fever; loss of appetite; This spontaneous case was reported by a consumer and describes the occurrence of POLYDIPSIA (felt very thirsty), MALAISE (wasnt feeling great felt sick), CHILLS (chills, had a lot of chills), FATIGUE (fatigue, felt very tired) and PYREXIA (unsure if she had a temperature it would be a low-grade fever) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Jan-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced POLYDIPSIA (felt very thirsty), MALAISE (wasnt feeling great felt sick), CHILLS (chills, had a lot of chills), FATIGUE (fatigue, felt very tired) and DECREASED APPETITE (loss of appetite). 27-Jan-2021, the patient experienced PYREXIA (unsure if she had a temperature it would be a low-grade fever). At the time of the report, POLYDIPSIA (felt very thirsty), MALAISE (wasnt feeling great felt sick), CHILLS (chills, had a lot of chills), FATIGUE (fatigue, felt very tired), PYREXIA (unsure if she had a temperature it would be a low-grade fever) and DECREASED APPETITE (loss of appetite) outcome 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 MOD-2021-035834 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 28-Feb-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1631431
Sex: M
Age: 55
State: AR

Vax Date: 02/04/2021
Onset Date: 02/08/2021
Rec V Date: 08/25/2021
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: tested positive for COVID-19 after vaccination; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (tested positive for COVID-19 after vaccination) in a 54-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, the patient experienced COVID-19 (tested positive for COVID-19 after vaccination). At the time of the report, COVID-19 (tested positive for COVID-19 after vaccination) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication were provided by reporter No treatment information was provided.

Other Meds:

Current Illness:

ID: 1631432
Sex: F
Age: 70
State: IL

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 08/25/2021
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: Itching at the injection site; Redness at the injection site; Blotches at the injection site; Swelling at the injection site; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of PRURITUS (Itching at the injection site), ERYTHEMA (Redness at the injection site), RASH MACULAR (Blotches at the injection site) and SWELLING (Swelling at the injection site) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, the patient experienced PRURITUS (Itching at the injection site), ERYTHEMA (Redness at the injection site), RASH MACULAR (Blotches at the injection site) and SWELLING (Swelling at the injection site). On 17-Feb-2021, PRURITUS (Itching at the injection site), ERYTHEMA (Redness at the injection site), RASH MACULAR (Blotches at the injection site) and SWELLING (Swelling at the injection site) 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. No relevant concomitant medications were reported. No treatment information was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1631433
Sex: F
Age:
State: GA

Vax Date: 01/19/2021
Onset Date:
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Test Date: 202101; Test Name: Covid; Test Result: Positive ; Result Unstructured Data: Diagnosed with covid19

Allergies:

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

Symptoms: diagnosed with covid19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (diagnosed with covid19) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced COVID-19 (diagnosed with covid19). At the time of the report, COVID-19 (diagnosed with covid19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In January 2021, SARS-CoV-2 test positive: Diagnosed with covid19. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported No treatment information was provided.

Other Meds:

Current Illness:

ID: 1631434
Sex: M
Age: 77
State: NJ

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/25/2021
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: injection site redness; injection site rash; sore arm again; Arm sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm sore), PAIN IN EXTREMITY (sore arm again), VACCINATION SITE ERYTHEMA (injection site redness) and VACCINATION SITE RASH (injection site rash) in a 77-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. Concurrent medical conditions included Cancer. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, the patient experienced PAIN IN EXTREMITY (Arm sore). On 13-Feb-2021, the patient experienced PAIN IN EXTREMITY (sore arm again) and VACCINATION SITE RASH (injection site rash). On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (injection site redness). At the time of the report, PAIN IN EXTREMITY (Arm sore), PAIN IN EXTREMITY (sore arm again) and VACCINATION SITE RASH (injection site rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant products information was not reported. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1631435
Sex: F
Age: 85
State: IA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 08/25/2021
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: headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headache) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031M20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Feb-2021, the patient experienced HEADACHE (headache). The patient was treated with DIPHENHYDRAMINE, PARACETAMOL (EXTRA STRENGTH TYLENOL PM) at a dose of 1 dosage form. On 12-Feb-2021, HEADACHE (headache) 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. No relevant concomitant medications reported. Most recent FOLLOW-UP information incorporated above includes: On 27-Apr-2021: NNI

Other Meds:

Current Illness:

ID: 1631436
Sex: F
Age: 66
State: WI

Vax Date: 01/31/2021
Onset Date: 02/02/2021
Rec V Date: 08/25/2021
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: arm started to itch again and was red again; small little red itchy spots; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (small little red itchy spots) and VACCINATION SITE ERYTHEMA (arm started to itch again and was red again) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. No Medical History information was reported. On 31-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Feb-2021, the patient experienced PRURITUS (small little red itchy spots). On 08-Feb-2021, the patient experienced VACCINATION SITE ERYTHEMA (arm started to itch again and was red again). At the time of the report, PRURITUS (small little red itchy spots) had resolved and VACCINATION SITE ERYTHEMA (arm started to itch again and was red again) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. Treatment Arthritis Strength Tylenol and prescription strength ibuprofen along with using an ice pack and cold compress

Other Meds:

Current Illness:

ID: 1631437
Sex: M
Age: 84
State: AZ

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 08/25/2021
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: flu like symptoms; aches and pains; fatigue; discomfort; injection arm hurt; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (flu like symptoms), PAIN (aches and pains), FATIGUE (fatigue), DISCOMFORT (discomfort) and INJECTION SITE PAIN (injection arm hurt) in an 84-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included TAMSULOSIN, LOSARTAN, AMLODIPINE and MULTIVITAMIN [VITAMINS NOS] for an unknown indication. On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Feb-2021, the patient experienced PAIN (aches and pains), FATIGUE (fatigue), DISCOMFORT (discomfort) and INJECTION SITE PAIN (injection arm hurt). On an unknown date, the patient experienced INFLUENZA LIKE ILLNESS (flu like symptoms). The patient was treated with ACETAMINOPHEN ongoing since an unknown date for Adverse event, at an unspecified dose and frequency. On 09-Feb-2021, INJECTION SITE PAIN (injection arm hurt) had resolved. At the time of the report, INFLUENZA LIKE ILLNESS (flu like symptoms), PAIN (aches and pains), FATIGUE (fatigue) and DISCOMFORT (discomfort) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Action taken with mRNA-1273 in response to the events was unknown. On 9 Feb 2021 the outcome of events, injection arm hurt was resolved. The outcome of events, flu-like symptoms, aches and pains, fatigue, discomfort was unknown.

Other Meds: TAMSULOSIN; LOSARTAN; AMLODIPINE; MULTIVITAMIN [VITAMINS NOS]

Current Illness:

ID: 1631438
Sex: F
Age:
State:

Vax Date: 01/26/2021
Onset Date:
Rec V Date: 08/25/2021
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: shortness of breath; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (shortness of breath) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Short-term memory loss. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DYSPNOEA (shortness of breath). At the time of the report, DYSPNOEA (shortness of breath) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. patient had a history of COL. patient was on Oxygen therapy for symptoms.

Other Meds:

Current Illness: Short-term memory loss

ID: 1631439
Sex: M
Age: 57
State: NJ

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 08/25/2021
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: He cant lift the arm because of the pain; Back is hurting; Can't use arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (He cant lift the arm because of the pain), BACK PAIN (Back is hurting) and LIMB DISCOMFORT (Can't use arm) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 316139 Wasn't sure) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 28-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Feb-2021, the patient experienced PAIN IN EXTREMITY (He cant lift the arm because of the pain), BACK PAIN (Back is hurting) and LIMB DISCOMFORT (Can't use arm). At the time of the report, PAIN IN EXTREMITY (He cant lift the arm because of the pain), BACK PAIN (Back is hurting) and LIMB DISCOMFORT (Can't use arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment information was included vitamins.

Other Meds:

Current Illness:

ID: 1631440
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/25/2021
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: soreness after first shot; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (soreness after first shot) 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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN (soreness after first shot). The patient was treated with IBUPROFEN at an unspecified dose and frequency. At the time of the report, PAIN (soreness after first shot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to MOD-2021-038612 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 27-Feb-2021: Additional information received

Other Meds:

Current Illness:

ID: 1631441
Sex: F
Age: 62
State: NC

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 08/25/2021
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: Experiencing an ice cold right hand with tingling fingertips; Tingling fingertips; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL COLDNESS (Experiencing an ice cold right hand with tingling fingertips) and PARAESTHESIA (Tingling fingertips) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Feb-2021, the patient experienced PERIPHERAL COLDNESS (Experiencing an ice cold right hand with tingling fingertips) and PARAESTHESIA (Tingling fingertips). At the time of the report, PERIPHERAL COLDNESS (Experiencing an ice cold right hand with tingling fingertips) and PARAESTHESIA (Tingling fingertips) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1631442
Sex: F
Age: 83
State: MD

Vax Date: 01/28/2021
Onset Date: 02/27/2021
Rec V Date: 08/25/2021
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: Vaccination site bruise; It is hard; Itchy; Large red spot; Covid arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (Covid arm), VACCINATION SITE BRUISING (Vaccination site bruise), INDURATION (It is hard), PRURITUS (Itchy) and ERYTHEMA (Large red spot) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 015M20A and 013L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included CITALOPRAM, VALPROATE SEMISODIUM (DIVALPROEX), PRAVASTATIN and METOPROLOL for an unknown indication. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Feb-2021, the patient experienced VACCINATION SITE REACTION (Covid arm), INDURATION (It is hard) and PRURITUS (Itchy). 27-Feb-2021, the patient experienced ERYTHEMA (Large red spot). On an unknown date, the patient experienced VACCINATION SITE BRUISING (Vaccination site bruise). At the time of the report, VACCINATION SITE REACTION (Covid arm), VACCINATION SITE BRUISING (Vaccination site bruise), INDURATION (It is hard), PRURITUS (Itchy) and ERYTHEMA (Large red spot) outcome was unknown.

Other Meds: CITALOPRAM; DIVALPROEX; PRAVASTATIN; METOPROLOL

Current Illness:

ID: 1631443
Sex: M
Age: 76
State: TX

Vax Date: 01/31/2021
Onset Date: 03/01/2021
Rec V Date: 08/25/2021
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: Vaccination side was swollen this morning; Seemed to be experiencing fatigue; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE SWELLING (Vaccination side was swollen this morning) and FATIGUE (Seemed to be experiencing fatigue) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012A21A and 042120A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension, Diabetes mellitus and Arthritis. On 31-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 01-Mar-2021, the patient experienced VACCINATION SITE SWELLING (Vaccination side was swollen this morning) and FATIGUE (Seemed to be experiencing fatigue). At the time of the report, VACCINATION SITE SWELLING (Vaccination side was swollen this morning) and FATIGUE (Seemed to be experiencing fatigue) had resolved.

Other Meds:

Current Illness: Arthritis; Diabetes mellitus; Hypertension

ID: 1631444
Sex: M
Age: 46
State:

Vax Date: 02/24/2021
Onset Date:
Rec V Date: 08/25/2021
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: Uncontrollable shaking; Couldn't lift up head; 103-106 fever; Chills; Nausea; Tired; Little rash with little bumps; Worse headache that he has ever had in his life; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (Uncontrollable shaking), HEAD DISCOMFORT (Couldn't lift up head), PYREXIA (103-106 fever), CHILLS (Chills) and NAUSEA (Nausea) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse reaction. On 24-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced TREMOR (Uncontrollable shaking), HEAD DISCOMFORT (Couldn't lift up head), PYREXIA (103-106 fever), CHILLS (Chills), NAUSEA (Nausea), FATIGUE (Tired), VACCINATION SITE RASH (Little rash with little bumps) and HEADACHE (Worse headache that he has ever had in his life). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, TREMOR (Uncontrollable shaking), HEAD DISCOMFORT (Couldn't lift up head), PYREXIA (103-106 fever), CHILLS (Chills), NAUSEA (Nausea), FATIGUE (Tired) and VACCINATION SITE RASH (Little rash with little bumps) had not resolved and HEADACHE (Worse headache that he has ever had in his life) had resolved. Wife of a patient reported that her husband received the 2nd dose on 24FEB2021 and on an unknown date reported 103-106 fever (lasted a few days), uncontrollable shaking, chills, nausea, tired, couldn't lift up head, worse headache that he has ever had in his life (ended), little rash with little bumps (ongoing). Patient said that she got her second vaccine shot and she still has side-effects Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: TCR received-Reaction outcome information provided.

Other Meds:

Current Illness:

ID: 1631445
Sex: F
Age: 88
State: GA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 08/25/2021
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: Itchy; Red spot moved toward the elbow; Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itchy), PAIN IN EXTREMITY (Sore arm) and ERYTHEMA (Red spot moved toward the elbow) in an 88-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002A21A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 24-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Feb-2021, the patient experienced PAIN IN EXTREMITY (Sore arm). On 26-Feb-2021, the patient experienced ERYTHEMA (Red spot moved toward the elbow). On 27-Feb-2021, the patient experienced PRURITUS (Itchy). At the time of the report, PRURITUS (Itchy), PAIN IN EXTREMITY (Sore arm) and ERYTHEMA (Red spot moved toward the elbow) was resolving.

Other Meds:

Current Illness:

ID: 1631446
Sex: F
Age: 79
State: IL

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 08/25/2021
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: Itching; Rash on both hands and knees; Diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea), PRURITUS (Itching) and RASH (Rash on both hands and knees) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 16-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced DIARRHOEA (Diarrhea). On 26-Feb-2021, the patient experienced PRURITUS (Itching) and RASH (Rash on both hands and knees). On 18-Feb-2021, DIARRHOEA (Diarrhea) had resolved. At the time of the report, PRURITUS (Itching) and RASH (Rash on both hands and knees) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1631447
Sex: F
Age: 34
State: TX

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 08/25/2021
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: Rash at injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (Rash at injection site) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022m20a) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 20-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Feb-2021, the patient experienced VACCINATION SITE RASH (Rash at injection site). At the time of the report, VACCINATION SITE RASH (Rash at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1631448
Sex: M
Age:
State: AZ

Vax Date:
Onset Date:
Rec V Date: 08/25/2021
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: Ringing in ears, has come and gone - in the right ear - has happened 2-3 days after the vaccine and has been persistent; Mild headache; This spontaneous case was reported by a consumer and describes the occurrence of TINNITUS (Ringing in ears, has come and gone - in the right ear - has happened 2-3 days after the vaccine and has been persistent) and HEADACHE (Mild headache) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025J202A) for COVID-19 vaccination. The patient's past medical history included No adverse event. 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 TINNITUS (Ringing in ears, has come and gone - in the right ear - has happened 2-3 days after the vaccine and has been persistent) and HEADACHE (Mild headache). At the time of the report, TINNITUS (Ringing in ears, has come and gone - in the right ear - has happened 2-3 days after the vaccine and has been persistent) had not resolved and HEADACHE (Mild headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient received his first dose of the Moderna vaccine a month ago, in his upper left arm. About 2-3 days later, he experienced ringing in his ears which has come and gone. The ringing was specifically in his right ear. He did mention that he had ringing in his ears in the past but stated that it has been persistent since he received the vaccine. He also experienced a mild headache.

Other Meds:

Current Illness:

ID: 1631449
Sex: F
Age:
State: NJ

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 08/25/2021
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: cold sensation on nose; tingling sensation on face and tongue; had a feeling on face like getting Novacaine, It did not stop me from doing my daily activities; This spontaneous case was reported by a consumer and describes the occurrence of FEELING COLD (cold sensation on nose), PARAESTHESIA (tingling sensation on face and tongue) and HYPOAESTHESIA (had a feeling on face like getting Novacaine, It did not stop me from doing my daily activities) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was reported. Concomitant products included IBUPROFEN (ADVIL [IBUPROFEN]) for an unknown indication. On 15-Feb-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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 15-Feb-2021, the patient experienced FEELING COLD (cold sensation on nose), PARAESTHESIA (tingling sensation on face and tongue) and HYPOAESTHESIA (had a feeling on face like getting Novacaine, It did not stop me from doing my daily activities). On 15-Feb-2021, FEELING COLD (cold sensation on nose), PARAESTHESIA (tingling sensation on face and tongue) and HYPOAESTHESIA (had a feeling on face like getting Novacaine, It did not stop me from doing my daily activities) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Patient stated that she got her 1st moderna dose on 15Feb2021 to right dominant hand via IM injection. Within minutes of getting shot I felt cold sensation on nose and tingling sensation on face and tongue it dissipated and resolved same day. she had a feeling on face like getting Novacaine. It did not stop her from doing her daily activities.

Other Meds: ADVIL [IBUPROFEN]

Current Illness:

ID: 1631450
Sex: M
Age: 73
State: NJ

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/25/2021
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: Heavy diarrhea; Bloating; Shooting gas pain from stomach; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Heavy diarrhea), ABDOMINAL DISTENSION (Bloating) and FLATULENCE (Shooting gas pain from stomach) in a 73-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007m20a) for COVID-19 vaccination. No medical history was reported. The patient's past medical history included No adverse event. Concomitant products included ATORVASTATIN, FINASTERIDE and TAMSULOSIN for an unknown indication. On 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, the patient experienced DIARRHOEA (Heavy diarrhea), ABDOMINAL DISTENSION (Bloating) and FLATULENCE (Shooting gas pain from stomach). At the time of the report, DIARRHOEA (Heavy diarrhea), ABDOMINAL DISTENSION (Bloating) and FLATULENCE (Shooting gas pain from stomach) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: ATORVASTATIN; FINASTERIDE; TAMSULOSIN

Current Illness:

ID: 1631451
Sex: F
Age:
State: MD

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 08/25/2021
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: Fever; Swelling; Redness; Pain; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever), VACCINATION SITE SWELLING (Swelling), VACCINATION SITE ERYTHEMA (Redness), VACCINATION SITE PAIN (Pain) and FATIGUE (Fatigue) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 23-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Feb-2021, the patient experienced PYREXIA (Fever), VACCINATION SITE SWELLING (Swelling), VACCINATION SITE ERYTHEMA (Redness), VACCINATION SITE PAIN (Pain) and FATIGUE (Fatigue). On 25-Feb-2021, PYREXIA (Fever) had resolved. At the time of the report, VACCINATION SITE SWELLING (Swelling), VACCINATION SITE ERYTHEMA (Redness), VACCINATION SITE PAIN (Pain) and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Caller states that she received the 1st dose of the moderna 23Feb2021. Fever the first 2 days.Swollen and red at first, it went down now. Had very little use of the right use, was given IM in the shoulder and had pain all the way down to the arm which subsided but its still too painful to move it. She is fatigued too.

Other Meds:

Current Illness:

ID: 1631452
Sex: F
Age:
State:

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 08/25/2021
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: Had blurry vision for 2 to 2.5 hours; This spontaneous case was reported by a consumer and describes the occurrence of VISION BLURRED (Had blurry vision for 2 to 2.5 hours) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 28-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Feb-2021, the patient experienced VISION BLURRED (Had blurry vision for 2 to 2.5 hours). On 28-Feb-2021, VISION BLURRED (Had blurry vision for 2 to 2.5 hours) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient stated that she got her first vaccine yesterday, had blurry vision for 2 to 2.5 hours, it had started right after the shot and it lasted the whole 2 hours. Patient said she's fine now.

Other Meds:

Current Illness:

ID: 1631453
Sex: M
Age: 50
State: NJ

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 08/25/2021
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: High fever of 103 degrees; Had the chills; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (High fever of 103 degrees) and CHILLS (Had the chills) in a 50-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, the patient experienced PYREXIA (High fever of 103 degrees) and CHILLS (Had the chills). At the time of the report, PYREXIA (High fever of 103 degrees) and CHILLS (Had the chills) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 04-Feb-2021, Pyrexia: 103 degree (plane angle) (High) 103 degrees. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient was vaccinated on 3Feb2021. On 4Feb2021 he had high fever of 103 degrees. Also he had chills.

Other Meds:

Current Illness:

ID: 1631454
Sex: F
Age:
State: CA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 08/25/2021
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: red mark around the vaccine site and it itches; red mark around the vaccine site and it itches; This spontaneous case was reported by a consumer and describes the occurrence of in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. No Medical History information was reported. On 28-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. patient called in stating she received her 2nd vaccine 28Feb2021 and had a red mark around the vaccine site and it itches

Other Meds:

Current Illness:

ID: 1631455
Sex: F
Age: 89
State: IA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 08/25/2021
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: lump; itching; swelling; bright red coloring; Incorrect route of product administration; This spontaneous case was reported by a consumer and describes the occurrence of INCORRECT ROUTE OF PRODUCT ADMINISTRATION (Incorrect route of product administration) in an 89-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Implant) 1 dosage form. On 12-Feb-2021, the patient experienced INCORRECT ROUTE OF PRODUCT ADMINISTRATION (Incorrect route of product administration). At the time of the report, INCORRECT ROUTE OF PRODUCT ADMINISTRATION (Incorrect route of product administration) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Implant) was unknown. Patient received the first dose of moderna vaccine on 12Feb201 and had a reaction. 4 days after the shot had itching on the arm of the injection. 6 or 7 days after noticed swelling and discovered the was a lump there, and bright red coloring. This symptoms were better,the swelling was better and itching was gone.

Other Meds:

Current Illness:

ID: 1631456
Sex: M
Age:
State: NY

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 08/25/2021
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: Fever; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 21-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Feb-2021, the patient experienced PYREXIA (Fever). At the time of the report, PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1631457
Sex: F
Age: 27
State: OH

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/25/2021
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: Diarrhea for over 72 hours; Lump near the injection site; Arm pain; Extreme fatigue; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea for over 72 hours), VACCINATION SITE MASS (Lump near the injection site), PAIN IN EXTREMITY (Arm pain) and FATIGUE (Extreme fatigue) in a 27-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012a21a) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, the patient experienced PAIN IN EXTREMITY (Arm pain) and FATIGUE (Extreme fatigue). On 01-Mar-2021, the patient experienced DIARRHOEA (Diarrhea for over 72 hours) and VACCINATION SITE MASS (Lump near the injection site). On 03-Mar-2021, DIARRHOEA (Diarrhea for over 72 hours) had resolved. At the time of the report, VACCINATION SITE MASS (Lump near the injection site), PAIN IN EXTREMITY (Arm pain) and FATIGUE (Extreme fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient received first Moderna vaccine on 2-27-2021. Patient stated she had arm pain, and extreme fatigue. Patient stated that it was odd that she still had lump near the injection site today.Patient stated she had diarrhea for over 72 hours

Other Meds:

Current Illness:

ID: 1631458
Sex: F
Age: 74
State: IL

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 08/25/2021
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: Limb discomfort; Vaccination site pain; Myalgia; This spontaneous case was reported by a consumer and describes the occurrence of LIMB DISCOMFORT (Limb discomfort), VACCINATION SITE PAIN (Vaccination site pain) and MYALGIA (Myalgia) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Nickel sensitivity and Drug allergy. Concomitant products included IBUPROFEN for an unknown indication. On 16-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, the patient experienced LIMB DISCOMFORT (Limb discomfort), VACCINATION SITE PAIN (Vaccination site pain) and MYALGIA (Myalgia). At the time of the report, LIMB DISCOMFORT (Limb discomfort), VACCINATION SITE PAIN (Vaccination site pain) and MYALGIA (Myalgia) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: IBUPROFEN

Current Illness: Drug allergy; Nickel sensitivity

ID: 1631459
Sex: F
Age:
State: OK

Vax Date:
Onset Date:
Rec V Date: 08/25/2021
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: Pain in her arm; Itchiness on the injection site; A spontaneous report was received from a consumer concerning a female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events pain in her arm and itchiness on the injection site. The patient's medical history was not provided. No relevant concomitant medications were reported. On unknown date, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: unknown) via unknown route for prophylaxis of COVID-19 infection. On unknown date, prior to the onset of the events the patient received second of two planned doses of mRNA-1273 (lot/batch: unknown) via unknown route for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the event(s) pain in her arm and itchiness on the injection site. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), pain in her arm and itchiness on the injection site was unknown.

Other Meds:

Current Illness:

ID: 1631460
Sex: M
Age:
State: NV

Vax Date: 02/25/2021
Onset Date:
Rec V Date: 08/25/2021
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: Swelling arm; Sharp pain; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swelling arm) and PAIN (Sharp pain) 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 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PERIPHERAL SWELLING (Swelling arm) and PAIN (Sharp pain). At the time of the report, PERIPHERAL SWELLING (Swelling arm) and PAIN (Sharp pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment related information has been reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1631461
Sex: M
Age: 71
State: CA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 08/25/2021
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: Headache; Muscle pain; Joint pain; Nausea; Chills; Fever; vomiting; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache), MYALGIA (Muscle pain), ARTHRALGIA (Joint pain), NAUSEA (Nausea) and CHILLS (Chills) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 113A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 26-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) (Intramuscular) 1 dosage form. On 27-Feb-2021, the patient experienced HEADACHE (Headache), MYALGIA (Muscle pain), ARTHRALGIA (Joint pain), NAUSEA (Nausea), CHILLS (Chills), PYREXIA (Fever) and VOMITING (vomiting). The patient was treated with NAPROXEN SODIUM (ALEVE) for Adverse reaction, at a dose of 4 Tab once a day. On 28-Feb-2021, HEADACHE (Headache), MYALGIA (Muscle pain), ARTHRALGIA (Joint pain), NAUSEA (Nausea), CHILLS (Chills), PYREXIA (Fever) and VOMITING (vomiting) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications reported.

Other Meds:

Current Illness:

ID: 1631462
Sex: F
Age: 78
State: CA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 08/25/2021
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: arm was sore at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (arm was sore at the injection site) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. No medical history was reported. No relevant concomitant medications were reported. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, the patient experienced INJECTION SITE PAIN (arm was sore at the injection site). At the time of the report, INJECTION SITE PAIN (arm was sore at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information provided.

Other Meds:

Current Illness:

ID: 1631463
Sex: F
Age: 64
State:

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 08/25/2021
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: Diarrhea; Tenderness if she pokes the injection site; Arm swollen; Inflammation hardness; Inflammation hardness; Allergic reaction; Felt a little tired and the arm was hurting a bit; Little tired; Forehead, nose and cheeks got really red and burning, Burning sensation in face, Burning sensation; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ALLERGY TO VACCINE (Allergic reaction), PAIN IN EXTREMITY (Felt a little tired and the arm was hurting a bit), FATIGUE (Little tired), ERYTHEMA (Forehead, nose and cheeks got really red and burning, Burning sensation in face, Burning sensation) and DIARRHOEA (Diarrhea) in a 67-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. Concurrent medical conditions included Allergy to animal (allergic to duck), Allergy to animals (allergic to turkey), Drug allergy (allergic to Cataprist,), Drug allergy (allergic to Januvia), Drug allergy (allergic to Keflex.), Diabetes mellitus, Hypertension and Hypercholesterolaemia. On 20-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Feb-2021, the patient experienced ALLERGY TO VACCINE (Allergic reaction), PAIN IN EXTREMITY (Felt a little tired and the arm was hurting a bit), FATIGUE (Little tired) and ERYTHEMA (Forehead, nose and cheeks got really red and burning, Burning sensation in face, Burning sensation). On an unknown date, the patient experienced DIARRHOEA (Diarrhea), VACCINATION SITE PAIN (Tenderness if she pokes the injection site), PERIPHERAL SWELLING (Arm swollen), INFLAMMATION (Inflammation hardness) and INDURATION (Inflammation hardness). At the time of the report, ALLERGY TO VACCINE (Allergic reaction), FATIGUE (Little tired), ERYTHEMA (Forehead, nose and cheeks got really red and burning, Burning sensation in face, Burning sensation), DIARRHOEA (Diarrhea), VACCINATION SITE PAIN (Tenderness if she pokes the injection site), PERIPHERAL SWELLING (Arm swollen), INFLAMMATION (Inflammation hardness) and INDURATION (Inflammation hardness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication were not provided.

Other Meds:

Current Illness: Diabetes mellitus; Hypertension

ID: 1631464
Sex: U
Age: 79
State:

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 08/25/2021
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: Fever of 100.6F; chills; fatigue; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever of 100.6F), CHILLS, FATIGUE (fatigue) and PAIN IN EXTREMITY (sore arm) in a 79-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038K20A) for COVID-19 vaccination. No medical history was provided by the reporter. On 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Mar-2021, the patient experienced PYREXIA (Fever of 100.6F), CHILLS, FATIGUE (fatigue) and PAIN IN EXTREMITY (sore arm). At the time of the report, PYREXIA (Fever of 100.6F), CHILLS, FATIGUE (fatigue) and PAIN IN EXTREMITY (sore arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. No treatment reported.

Other Meds:

Current Illness:

ID: 1631465
Sex: F
Age:
State: CA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Test Date: 20210226; Test Name: EKG; Result Unstructured Data: normal

Allergies:

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

Symptoms: chest pain; high blood pressure; soreness; terrible shoulder pain; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ARTHRALGIA (terrible shoulder pain), MYALGIA (soreness), CHEST PAIN (chest pain) and HYPERTENSION (high blood pressure) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 22-Jan-2021, the patient experienced ARTHRALGIA (terrible shoulder pain). On 19-Feb-2021, the patient experienced MYALGIA (soreness). On 22-Feb-2021, the patient experienced HYPERTENSION (high blood pressure). On 24-Feb-2021, the patient experienced CHEST PAIN (chest pain). On 23-Jan-2021, ARTHRALGIA (terrible shoulder pain) outcome was unknown. At the time of the report, MYALGIA (soreness), CHEST PAIN (chest pain) and HYPERTENSION (high blood pressure) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 26-Feb-2021, Electrocardiogram: normal. Upon internal review on 21-May-2021, the age was corrected to unknown. This case was linked to MOD21-041389 (Patient Link).

Other Meds:

Current Illness:

ID: 1631466
Sex: F
Age:
State:

Vax Date: 02/09/2021
Onset Date:
Rec V Date: 08/25/2021
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: pain/severe pain all the way on my left side; severe pain in my arm - left; severe pain moves to the neck - left side; severe pain moves to the ear - left side; I can barely move around; it's been very difficult; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (pain/severe pain all the way on my left side), PAIN IN EXTREMITY (severe pain in my arm - left), NECK PAIN (severe pain moves to the neck - left side), EAR PAIN (severe pain moves to the ear - left side) and MOVEMENT DISORDER (I can barely move around) in a female patient of an unknown age 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 was provided by the reporter. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN (pain/severe pain all the way on my left side), PAIN IN EXTREMITY (severe pain in my arm - left), NECK PAIN (severe pain moves to the neck - left side), EAR PAIN (severe pain moves to the ear - left side), MOVEMENT DISORDER (I can barely move around) and DISCOMFORT (it's been very difficult). At the time of the report, PAIN (pain/severe pain all the way on my left side), PAIN IN EXTREMITY (severe pain in my arm - left), NECK PAIN (severe pain moves to the neck - left side), EAR PAIN (severe pain moves to the ear - left side), MOVEMENT DISORDER (I can barely move around) and DISCOMFORT (it's been very difficult) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Reporter did not allow further contact

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am