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: 1635605
Sex: F
Age:
State: MD

Vax Date: 01/01/2021
Onset Date:
Rec V Date: 08/26/2021
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: received her first dose of the Moderna Covid -19 and did not return for the second dose; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 16-Apr-2021 and was forwarded to Moderna on 11-Jun-2021. This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (received her first dose of the Moderna Covid -19 and did not return for the second dose) 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. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intra-articular) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (received her first dose of the Moderna Covid -19 and did not return for the second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (received her first dose of the Moderna Covid -19 and did not return for the second dose) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intra-articular) was unknown. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1635606
Sex: U
Age:
State: DC

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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 a temperature excursion recently where the temperature hit -12 C; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT TEMPERATURE EXCURSION ISSUE (Had a temperature excursion recently where the temperature hit -12 C) 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) at an unspecified dose. On an unknown date, the patient experienced PRODUCT TEMPERATURE EXCURSION ISSUE (Had a temperature excursion recently where the temperature hit -12 C). At the time of the report, PRODUCT TEMPERATURE EXCURSION ISSUE (Had a temperature excursion recently where the temperature hit -12 C) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments. The reporter stated that they had a temperature excursion recently where the temperature hit -12 C. They moved the vaccines to other location's freezer within 30 minutes in a cooler with some ice packs.

Other Meds:

Current Illness:

ID: 1635607
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: My arm is so sore after second shot, terribly sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (My arm is so sore after second shot, terribly 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) (unknown route) at an unspecified dose. On an unknown date, the patient experienced PAIN IN EXTREMITY (My arm is so sore after second shot, terribly sore). At the time of the report, PAIN IN EXTREMITY (My arm is so sore after second shot, terribly sore) outcome was unknown. No concomitant medications reported by investigator No treatment medications provided by the reporter.

Other Meds:

Current Illness:

ID: 1635608
Sex: F
Age: 45
State: CO

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 08/26/2021
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: Received the second dose outside of the recommended intervals; Did not receive the second dose >35; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Did not receive the second dose >35) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received the second dose outside of the recommended intervals) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. No Medical History information was reported. On 17-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Mar-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Did not receive the second dose >35). On 11-Jun-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received the second dose outside of the recommended intervals). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Did not receive the second dose >35) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received the second dose outside of the recommended intervals) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. Treatment information was not provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 11-Jun-2021: Added event was received the second dose outside of the recommended intervals.

Other Meds:

Current Illness:

ID: 1635609
Sex: U
Age:
State: FL

Vax Date: 06/10/2021
Onset Date: 06/11/2021
Rec V Date: 08/26/2021
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: Headache; Fever; Chills; 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 HEADACHE (Headache), PYREXIA (Fever) and CHILLS (Chills) 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 10-Jun-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 11-Jun-2021, the patient experienced HEADACHE (Headache), PYREXIA (Fever) and CHILLS (Chills). At the time of the report, HEADACHE (Headache), PYREXIA (Fever) and CHILLS (Chills) was resolving. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1635610
Sex: F
Age: 21
State: TX

Vax Date: 05/04/2021
Onset Date: 06/11/2021
Rec V Date: 08/26/2021
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: Feels very hungry; Nauseous; Headache that hurts when she turns her head side to side; This spontaneous case was reported by a consumer and describes the occurrence of HUNGER (Feels very hungry), NAUSEA (Nauseous) and HEADACHE (Headache that hurts when she turns her head side to side) in a 21-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 050C21A.) for COVID-19 vaccination. No medical history was provided by the reporter. On 04-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Jun-2021, the patient experienced HUNGER (Feels very hungry), NAUSEA (Nauseous) and HEADACHE (Headache that hurts when she turns her head side to side). At the time of the report, HUNGER (Feels very hungry), NAUSEA (Nauseous) and HEADACHE (Headache that hurts when she turns her head side to side) outcome was unknown.

Other Meds: MULTIVITAMIN & MINERAL

Current Illness:

ID: 1635611
Sex: F
Age: 26
State: WY

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 08/26/2021
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: 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 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) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication information was not reported. Treatment information as not reported.

Other Meds:

Current Illness:

ID: 1635612
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: Foggy head; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Foggy head) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Hashimoto's disease (Patient was diagnosed with Hashimotos 2 years ago). 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 FEELING ABNORMAL (Foggy head). At the time of the report, FEELING ABNORMAL (Foggy head) outcome was unknown. Not Provided The patient had been feeling foggy head which is the side effect of hashimoto's disease. Relevant concomitant medications were not reported. Treatment medication was not reported. Action taken with mRNA-1273 in response to the event was not applicable. Most recent FOLLOW-UP information incorporated above includes: On 14-Jun-2021: Additional information received on 14 JUN 2021 and does not contain any new information.

Other Meds:

Current Illness: Hashimoto's disease (Patient was diagnosed with Hashimotos 2 years ago)

ID: 1635613
Sex: U
Age:
State: PA

Vax Date: 04/05/2021
Onset Date:
Rec V Date: 08/26/2021
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: has been 10 weeks since first dose/ patient says they were not called to get their second dose; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (has been 10 weeks since first dose/ patient says they were not called to get their second dose) 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 05-Apr-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 INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (has been 10 weeks since first dose/ patient says they were not called to get their second dose). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (has been 10 weeks since first dose/ patient says they were not called to get their second dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. No information regarding corrective treatment was reported by the patient.; Sender's Comments: This report refers to a case of Inappropriate schedule of product administration (has been 10 weeks since first dose/ patient says they were not called to get their second dose) for mRNA-1273, lot # unknown is assessed as not applicable.

Other Meds:

Current Illness:

ID: 1635614
Sex: U
Age:
State: NJ

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: little red area; swelling; lump very hard; itch; lump very hard; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a non-health professional and describes the occurrence of ERYTHEMA (little red area), SWELLING (swelling), MASS (lump very hard), PRURITUS (itch) and INDURATION (lump very hard) 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 ERYTHEMA (little red area), SWELLING (swelling), MASS (lump very hard), PRURITUS (itch) and INDURATION (lump very hard). At the time of the report, ERYTHEMA (little red area), SWELLING (swelling), MASS (lump very hard), PRURITUS (itch) and INDURATION (lump very hard) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was included. No treatment drug details was provided.

Other Meds:

Current Illness:

ID: 1635615
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: what medication can I take after my 2nd covid shot to help with pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (what medication can I take after my 2nd covid shot to help with pain) 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 (what medication can I take after my 2nd covid shot to help with pain). At the time of the report, PAIN (what medication can I take after my 2nd covid shot to help with pain) outcome was unknown. No concomitant medications were reported. No information regarding corrective treatment was reported by the patient.

Other Meds:

Current Illness:

ID: 1635616
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: The 1st one no side effects besides sore arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (The 1st one no side effects besides sore arm) 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 PAIN IN EXTREMITY (The 1st one no side effects besides sore arm). At the time of the report, PAIN IN EXTREMITY (The 1st one no side effects besides sore arm) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. No concomitant medications were reported. Patient experienced no side effects besides sore arm after the first dose of vaccine Treatment information was not provided. This case was linked to MOD-2021-220986 (Patient Link).

Other Meds:

Current Illness:

ID: 1635617
Sex: U
Age:
State:

Vax Date: 06/13/2021
Onset Date:
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: Test Name: Body Temperature; Result Unstructured Data: 103 to 104

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: 103 to 104 fever/high fever; Severe headache; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (103 to 104 fever/high fever) and HEADACHE (Severe 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 13-Jun-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 PYREXIA (103 to 104 fever/high fever) and HEADACHE (Severe headache). At the time of the report, PYREXIA (103 to 104 fever/high fever) and HEADACHE (Severe headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 104 (High) 103 to 104. No relevant concomitant medications were reported. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1635618
Sex: U
Age:
State:

Vax Date:
Onset Date: 06/14/2021
Rec V Date: 08/26/2021
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: feel like I got hit by a bus/Still feeling awful, it feels like my skin; woke up at 5 this morning with all over muscle and joint aches and chills; woke up at 5 this morning with all over muscle and joint aches and chills; woke up at 5 this morning with all over muscle and joint aches and chills; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (feel like I got hit by a bus/Still feeling awful, it feels like my skin), MYALGIA (woke up at 5 this morning with all over muscle and joint aches and chills), ARTHRALGIA (woke up at 5 this morning with all over muscle and joint aches and chills) and CHILLS (woke up at 5 this morning with all over muscle and joint aches and chills) 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 14-Jun-2021, the patient experienced FEELING ABNORMAL (feel like I got hit by a bus/Still feeling awful, it feels like my skin), MYALGIA (woke up at 5 this morning with all over muscle and joint aches and chills), ARTHRALGIA (woke up at 5 this morning with all over muscle and joint aches and chills) and CHILLS (woke up at 5 this morning with all over muscle and joint aches and chills). At the time of the report, FEELING ABNORMAL (feel like I got hit by a bus/Still feeling awful, it feels like my skin), MYALGIA (woke up at 5 this morning with all over muscle and joint aches and chills), ARTHRALGIA (woke up at 5 this morning with all over muscle and joint aches and chills) and CHILLS (woke up at 5 this morning with all over muscle and joint aches and chills) outcome was unknown. No concomitant medications were reported. No information regarding corrective treatment was reported by the patient. This case was linked to MOD-2021-220983 (Patient Link).

Other Meds:

Current Illness:

ID: 1635619
Sex: F
Age: 51
State: LA

Vax Date: 05/13/2021
Onset Date: 06/11/2021
Rec V Date: 08/26/2021
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 Date: 20210611; Test Name: Body temperature; Result Unstructured Data: 39.2 degree Celsius

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: bulging of veins on her both feet, both hands and on right side of forehead and it is still there; soreness of left arm; Body ache; Fever; Chills; This spontaneous case was reported by a consumer and describes the occurrence of VEIN DISORDER (bulging of veins on her both feet, both hands and on right side of forehead and it is still there), PAIN IN EXTREMITY (soreness of left arm), MYALGIA (Body ache), PYREXIA (Fever) and CHILLS (Chills) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 034C21A and 002C21A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure since 01-May-2006. Concomitant products included AMLODIPINE for Blood pressure. On 13-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 11-Jun-2021, the patient experienced PAIN IN EXTREMITY (soreness of left arm), MYALGIA (Body ache), PYREXIA (Fever) and CHILLS (Chills). On 12-Jun-2021, the patient experienced VEIN DISORDER (bulging of veins on her both feet, both hands and on right side of forehead and it is still there). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of 500 mg. At the time of the report, VEIN DISORDER (bulging of veins on her both feet, both hands and on right side of forehead and it is still there) had not resolved and PAIN IN EXTREMITY (soreness of left arm), MYALGIA (Body ache), PYREXIA (Fever) and CHILLS (Chills) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 11-Jun-2021, Body temperature: 39.2 (abnormal) 39.2 degree Celsius. This case was linked to MOD-2021-221001 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 10-Aug-2021: Follow-up information received contains patient's race, height and weight, Lot number.

Other Meds: AMLODIPINE

Current Illness: Blood pressure

ID: 1635620
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: Inappropriate schedule of vaccine administration; 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 PRODUCT DOSE OMISSION ISSUE (Inappropriate schedule of vaccine administration) 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 PRODUCT DOSE OMISSION ISSUE (Inappropriate schedule of vaccine administration). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Inappropriate schedule of vaccine administration) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported by the reporter.

Other Meds:

Current Illness:

ID: 1635621
Sex: F
Age: 56
State: FL

Vax Date: 04/13/2021
Onset Date:
Rec V Date: 08/26/2021
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: 202104; Test Name: blood pressure; Result Unstructured Data: 68/40; Test Date: 20210526; Test Name: SARS-Cov-2 test; Test Result: Negative ; Result Unstructured Data: Nasopharyngeal sample- negative; Test Date: 20210530; Test Name: SARS-Cov-2 test; Test Result: Negative ; Result Unstructured Data: Nasopharyngeal sample- negative

Allergies:

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

Symptoms: felt like having COVID again after both doses; blood pressure is low and sometime plummets to about 70/40; nasal congestion; Muscle ache; headache; This spontaneous case was reported by a consumer and describes the occurrence of SUSPECTED COVID-19 (felt like having COVID again after both doses), HYPOTENSION (blood pressure is low and sometime plummets to about 70/40), NASAL CONGESTION (nasal congestion), MYALGIA (Muscle ache) and HEADACHE (headache) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 036B21A and 045B21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in October 2020 and Pneumonia in October 2020. Concurrent medical conditions included Hypertension. Concomitant products included LOSARTAN for Blood pressure management, ZOLPIDEM TARTRATE (AMBIEN) for Sleep disorder NOS. On 13-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-May-2021, 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 experienced SUSPECTED COVID-19 (felt like having COVID again after both doses), HYPOTENSION (blood pressure is low and sometime plummets to about 70/40), NASAL CONGESTION (nasal congestion), MYALGIA (Muscle ache) and HEADACHE (headache). The patient was treated with CAFFEINE for Hypotension, at an unspecified dose and frequency. At the time of the report, SUSPECTED COVID-19 (felt like having COVID again after both doses), HYPOTENSION (blood pressure is low and sometime plummets to about 70/40) and NASAL CONGESTION (nasal congestion) outcome was unknown and MYALGIA (Muscle ache) and HEADACHE (headache) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In April 2021, Blood pressure measurement: 68/40 (Low) 68/40. On 26-May-2021, SARS-CoV-2 test: negative (Negative) Nasopharyngeal sample- negative. On 30-May-2021, SARS-CoV-2 test: negative (Negative) Nasopharyngeal sample- negative. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patient also reported taking an unspecified pain medication and a muscle relaxer concomitantly. Patient stated that for SARS-CoV-2 infection got hospitalized on OCT 2. This case was linked to MOD-2021-220941 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 05-Jul-2021: Follow-up information contains historical lab test data updated and historical COVID-19 related symptoms updated. On 08-Jul-2021: Follow up received on 08-JUL-2021 and contains No Significant INformation

Other Meds: LOSARTAN; AMBIEN

Current Illness: Hypertension

ID: 1635622
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: report side effects; 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. 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 VACCINATION COMPLICATION (report side effects) 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 (report side effects). At the time of the report, VACCINATION COMPLICATION (report side effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitants were provided. No treatment medications were provided by the Reporter. Med Info Agent: Nensi pandya caller wants to report the side effects.

Other Meds:

Current Illness:

ID: 1635623
Sex: M
Age: 71
State: NJ

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: Test Date: 20210517; Test Name: nuclear stress test; Result Unstructured Data: Normal; Comments: Patient was put on a treadmill and was all wired to an ECG. They injected a liquid and he had a reaction to it, but he was fine after and the test was ok.; Test Date: 20210507; Test Name: cardioversion; Result Unstructured Data: heart and vascular system looked fine

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: his heart was racing, he was in atrial fibrillation; the injection site was swelled up; injection site was a little red; This spontaneous case was reported by a patient and describes the occurrence of ATRIAL FIBRILLATION (his heart was racing, he was in atrial fibrillation) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 021B21A and 004C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included APIXABAN (ELIQUIS) for an unknown indication. On 01-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 01-Apr-2021, the patient experienced VACCINATION SITE SWELLING (the injection site was swelled up) and VACCINATION SITE ERYTHEMA (injection site was a little red). On 02-Apr-2021, the patient experienced ATRIAL FIBRILLATION (his heart was racing, he was in atrial fibrillation) (seriousness criterion medically significant). The patient was treated with DILTIAZEM ongoing since an unknown date at a dose of 1 dosage form; FUROSEMIDE ongoing since an unknown date at a dose of 1 dosage form and AMIODARONE HYDROCHLORIDE (PACERONE) ongoing since an unknown date for Heartbeats irregular and Hypertension, at a dose of 200 mg three times a day. On 02-Apr-2021, VACCINATION SITE SWELLING (the injection site was swelled up) and VACCINATION SITE ERYTHEMA (injection site was a little red) had resolved. At the time of the report, ATRIAL FIBRILLATION (his heart was racing, he was in atrial fibrillation) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 07-May-2021, Cardioversion: normal (normal) heart and vascular system looked fine. On 17-May-2021, Cardiac stress test: normal (normal) Normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Company comment: Based on the current available information and temporal association between the use of the product, and the start date of the events, a causal relationship cannot be excluded. This case was linked to MOD-2021-221013 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 30-Jul-2021: Follow up received 0-JUL-2021. No significant information. Contact information updated; Sender's Comments: Based on the current available information and temporal association between the use of the product, and the start date of the events, a causal relationship cannot be excluded.

Other Meds: ELIQUIS

Current Illness:

ID: 1635624
Sex: M
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: It has been 57 days since a patient has received 1st dose; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (It has been 57 days since a patient has received 1st dose) 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 PRODUCT DOSE OMISSION ISSUE (It has been 57 days since a patient has received 1st dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (It has been 57 days since a patient has received 1st dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported by the reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1635625
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: running a fever; body aches; 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 PYREXIA (running a fever) and MYALGIA (body aches) 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 PYREXIA (running a fever) and MYALGIA (body aches). At the time of the report, PYREXIA (running a fever) and MYALGIA (body aches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No information regarding corrective treatment was reported by the patient.

Other Meds:

Current Illness:

ID: 1635626
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: Side effects; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Side effects) 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 VACCINATION COMPLICATION (Side effects). At the time of the report, VACCINATION COMPLICATION (Side effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1635627
Sex: F
Age:
State:

Vax Date:
Onset Date: 06/14/2021
Rec V Date: 08/26/2021
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: Test Date: 20210614; Test Name: Body temperature; Result Unstructured Data: 101

Allergies:

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

Symptoms: been on the couch; pains; Sick at my stomach; Fever running up down; Aches; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (been on the couch), ABDOMINAL PAIN UPPER (pains), ABDOMINAL DISCOMFORT (Sick at my stomach), PYREXIA (Fever running up down) and MYALGIA (Aches) 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 (Patient had Covid around March it was not too bad) in March 2021. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Jun-2021, the patient experienced ILLNESS (been on the couch), ABDOMINAL PAIN UPPER (pains), ABDOMINAL DISCOMFORT (Sick at my stomach), PYREXIA (Fever running up down) and MYALGIA (Aches). At the time of the report, ILLNESS (been on the couch), ABDOMINAL PAIN UPPER (pains), ABDOMINAL DISCOMFORT (Sick at my stomach), PYREXIA (Fever running up down) and MYALGIA (Aches) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Jun-2021, Body temperature: 101 (High) 101. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. no relevant concomitant product was reported. no treatment product was reported

Other Meds:

Current Illness:

ID: 1635628
Sex: F
Age: 51
State: LA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 08/26/2021
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 of arm; Light fever; Chills; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Soreness of arm), PYREXIA (Light fever) and CHILLS (Chills) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002C21A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high since 01-May-2006. Concomitant products included AMLODIPINE for Blood pressure high. On 13-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-May-2021 at 8:00 AM, the patient experienced VACCINATION SITE PAIN (Soreness of arm), PYREXIA (Light fever) and CHILLS (Chills). On 14-May-2021, VACCINATION SITE PAIN (Soreness of arm), PYREXIA (Light fever) and CHILLS (Chills) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment information were provided This case was linked to MOD-2021-220987 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 10-Aug-2021: Follow-up document was received.Secondary Reporter Information was updated. Patient's weight, height, race and ethnic group were added. Event outcome were updated from unknown to recovered, route of administration added, relevant medical history and causality as reported was updated. Event coding has been changed from Pain in arm to Vaccination site pain. It contains significant information.

Other Meds: AMLODIPINE

Current Illness: Blood pressure high

ID: 1635629
Sex: U
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: Pharmacist states that a needle separated while administering vaccine; Patient was given 0.2 ml of Moderna COVID-19 Vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of WRONG TECHNIQUE IN DEVICE USAGE PROCESS (Pharmacist states that a needle separated while administering vaccine) and UNDERDOSE (Patient was given 0.2 ml of Moderna COVID-19 Vaccine) 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 WRONG TECHNIQUE IN DEVICE USAGE PROCESS (Pharmacist states that a needle separated while administering vaccine) and UNDERDOSE (Patient was given 0.2 ml of Moderna COVID-19 Vaccine). At the time of the report, WRONG TECHNIQUE IN DEVICE USAGE PROCESS (Pharmacist states that a needle separated while administering vaccine) and UNDERDOSE (Patient was given 0.2 ml of 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. Concomitant medication was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1635630
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: 16 year old was accidentally given the Moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old was accidentally given the Moderna vaccine) 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 PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old was accidentally given the Moderna vaccine). At the time of the report, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old was accidentally given the Moderna vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication not provided. Treatment medication not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1635631
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: Im still not feeling well/When will I feel better; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (Im still not feeling well/When will I feel better) 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 MALAISE (Im still not feeling well/When will I feel better). At the time of the report, MALAISE (Im still not feeling well/When will I feel better) had not resolved. No treatment information was provided. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1635632
Sex: F
Age: 72
State: OH

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 08/26/2021
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: Felt a little weak; Experienced headache; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Felt a little weak) and HEADACHE (Experienced headache) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 005C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-May-2021, the patient experienced ASTHENIA (Felt a little weak) and HEADACHE (Experienced headache). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. On 14-May-2021, ASTHENIA (Felt a little weak) and HEADACHE (Experienced headache) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant products were reported. This case was linked to MOD-2021-221016 (Patient Link).

Other Meds:

Current Illness:

ID: 1635633
Sex: F
Age:
State: MN

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: magnetic objects sticking at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (magnetic objects sticking at the injection site) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE REACTION (magnetic objects sticking at the injection site). At the time of the report, VACCINATION SITE REACTION (magnetic objects sticking at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1635634
Sex: M
Age:
State: MA

Vax Date: 03/30/2021
Onset Date: 04/26/2021
Rec V Date: 08/26/2021
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: received the second dose after it underwent a potential temperature excursion; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT TEMPERATURE EXCURSION ISSUE (received the second dose after it underwent a potential temperature excursion) 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 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 26-Apr-2021, the patient experienced PRODUCT TEMPERATURE EXCURSION ISSUE (received the second dose after it underwent a potential temperature excursion). On 26-Apr-2021, PRODUCT TEMPERATURE EXCURSION ISSUE (received the second dose after it underwent a potential temperature excursion) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1635635
Sex: F
Age: 72
State: OH

Vax Date: 05/14/2021
Onset Date: 06/11/2021
Rec V Date: 08/26/2021
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: This spontaneous case was reported by a patient and describes the occurrence of DECREASED APPETITE (I couldn't eat anything/appetite is still not what it should be), ASTHENIA (Feeling dizzy and weak), DIZZINESS (Feeling dizzy and weak), HEADACHE (headache) and NAUSEA (Had nausea all day long) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 005C21A and 053C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 14-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Jun-2021, the patient experienced HEADACHE (headache). On 12-Jun-2021, the patient experienced DECREASED APPETITE (I couldn't eat anything/appetite is still not what it should be), ASTHENIA (Feeling dizzy and weak), DIZZINESS (Feeling dizzy and weak) and NAUSEA (Had nausea all day long). On 13-Jun-2021, the patient experienced FATIGUE (Still tired and weak). On 12-Jun-2021, DECREASED APPETITE (I couldn't eat anything/appetite is still not what it should be), ASTHENIA (Feeling dizzy and weak), DIZZINESS (Feeling dizzy and weak), HEADACHE (headache) and NAUSEA (Had nausea all day long) outcome was unknown. On 13-Jun-2021, FATIGUE (Still tired and weak) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments. No concomitant medication were reported No treatment medication were reported. The patient received both scheduled doses of mRNA-1273 prior to the event, therefore action taken with the drug in the event is not applicable. This case was linked to MOD-2021-221009 (Patient Link).

Other Meds:

Current Illness:

ID: 1635636
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: missed my vaccine scheduled/ it is about 3 months since I took the first dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (missed my vaccine scheduled/ it is about 3 months since I took the first dose) 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 PRODUCT DOSE OMISSION ISSUE (missed my vaccine scheduled/ it is about 3 months since I took the first dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (missed my vaccine scheduled/ it is about 3 months since I took the first dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported by the reporter.

Other Meds:

Current Illness:

ID: 1635637
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: My husband got a Maderna very bad reaction; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (My husband got a Maderna very bad reaction) 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 VACCINATION COMPLICATION (My husband got a Maderna very bad reaction). At the time of the report, VACCINATION COMPLICATION (My husband got a Maderna very bad reaction) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. Treatment medication was not provided.

Other Meds:

Current Illness:

ID: 1635638
Sex: M
Age:
State:

Vax Date: 03/01/2021
Onset Date:
Rec V Date: 08/26/2021
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: received a single dose of Moderna Covid vaccine in March, but was unable to receive the second; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (received a single dose of Moderna Covid vaccine in March, but was unable to receive the second) in a 29-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In March 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (received a single dose of Moderna Covid vaccine in March, but was unable to receive the second). At the time of the report, PRODUCT DOSE OMISSION ISSUE (received a single dose of Moderna Covid vaccine in March, but was unable to receive the second) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported by the reporter.

Other Meds:

Current Illness:

ID: 1635639
Sex: M
Age:
State: LA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 08/26/2021
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: increase of a liver enzyme, ALT, from eighteen to sixty-four; This spontaneous case was reported by a pharmacist and describes the occurrence of HEPATIC ENZYME INCREASED (increase of a liver enzyme, ALT, from eighteen to sixty-four) 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 (no medical history provided). On 20-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Jan-2021, the patient experienced HEPATIC ENZYME INCREASED (increase of a liver enzyme, ALT, from eighteen to sixty-four). At the time of the report, HEPATIC ENZYME INCREASED (increase of a liver enzyme, ALT, from eighteen to sixty-four) 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.

Other Meds:

Current Illness:

ID: 1635640
Sex: M
Age: 46
State: VA

Vax Date: 03/23/2021
Onset Date: 03/29/2021
Rec V Date: 08/26/2021
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: arm pain after carrying 5-10 pounds items; Joint pain/Left shoulder pain; Muscle pain/whole upper body hurting; Chest pain; Leg pain/arm pain/left arm pain; Headache; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of CHEST PAIN (Chest pain), PAIN IN EXTREMITY (Leg pain/arm pain/left arm pain), PAIN IN EXTREMITY (arm pain after carrying 5-10 pounds items), ARTHRALGIA (Joint pain/Left shoulder pain) and MYALGIA (Muscle pain/whole upper body hurting) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008B21) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included MULTIVITAMINS [VITAMINS NOS] for an unknown indication. On 23-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Mar-2021, the patient experienced PAIN IN EXTREMITY (Leg pain/arm pain/left arm pain) and HEADACHE (Headache). On 20-Apr-2021, the patient experienced CHEST PAIN (Chest pain), ARTHRALGIA (Joint pain/Left shoulder pain) and MYALGIA (Muscle pain/whole upper body hurting). On 14-Jun-2021, the patient experienced PAIN IN EXTREMITY (arm pain after carrying 5-10 pounds items). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) at an unspecified dose and frequency and METHYLPREDNISOLONE at an unspecified dose and frequency. At the time of the report, CHEST PAIN (Chest pain) and HEADACHE (Headache) outcome was unknown and PAIN IN EXTREMITY (Leg pain/arm pain/left arm pain), PAIN IN EXTREMITY (arm pain after carrying 5-10 pounds items), ARTHRALGIA (Joint pain/Left shoulder pain) and MYALGIA (Muscle pain/whole upper body hurting) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient has had multiple types of testing including blood, autoimmune and neurological testing. No concomitant medications were reported by the reporter. No treatment medications were reported by the reporter.

Other Meds: MULTIVITAMINS [VITAMINS NOS]

Current Illness:

ID: 1635641
Sex: U
Age:
State: MD

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 08/26/2021
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: utilized multiple vials for one dose; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of WRONG TECHNIQUE IN PRODUCT USAGE PROCESS (utilized multiple vials for one dose) 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. In June 2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) .5 milliliter. In June 2021, the patient experienced WRONG TECHNIQUE IN PRODUCT USAGE PROCESS (utilized multiple vials for one dose). At the time of the report, WRONG TECHNIQUE IN PRODUCT USAGE PROCESS (utilized multiple vials for one dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications reported. No treatment information was provided. It was reported that 11 unidentified patients were affected. These patients received a full 0.5 ml dose.

Other Meds:

Current Illness:

ID: 1635642
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: not to be able to smell; not to be able to taste; This spontaneous case was reported by a consumer and describes the occurrence of ANOSMIA (not to be able to smell) and AGEUSIA (not to be able to taste) 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, the patient experienced ANOSMIA (not to be able to smell) and AGEUSIA (not to be able to taste). At the time of the report, ANOSMIA (not to be able to smell) and AGEUSIA (not to be able to taste) outcome was unknown. No concomitant medication were reported. No treatment medication were given.

Other Meds:

Current Illness:

ID: 1635643
Sex: F
Age: 16
State: TX

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 08/26/2021
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: Pregnant patient; 16 years old patient; This spontaneous prospective pregnancy case was reported by a nurse and describes the occurrence of MATERNAL EXPOSURE DURING PREGNANCY (Pregnant patient) and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 years old patient) in a 16-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination. No Medical History information was reported. On 17-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on 26-Nov-2020 and the estimated date of delivery was 06-Sep-2021. On 17-May-2021, the patient experienced MATERNAL EXPOSURE DURING PREGNANCY (Pregnant patient) and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 years old patient). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the twenty-fourth week of the pregnancy. On 17-May-2021, MATERNAL EXPOSURE DURING PREGNANCY (Pregnant patient) and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 years old patient) 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 product use was not provided by the reporter. ? No treatment information was provided.

Other Meds:

Current Illness:

ID: 1635644
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: Miserable; Hurt all over my body; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Miserable) and MYALGIA (Hurt all over my body) 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, the patient experienced FEELING ABNORMAL (Miserable) and MYALGIA (Hurt all over my body). At the time of the report, FEELING ABNORMAL (Miserable) and MYALGIA (Hurt all over my body) outcome was unknown. No concomitant medications were reported by the reporter. No treatment medications were reported by the reporter.

Other Meds:

Current Illness:

ID: 1635645
Sex: F
Age: 60
State: MN

Vax Date: 03/29/2021
Onset Date:
Rec V Date: 08/26/2021
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: Metal in arm, magnetic objects sticking at the injection site and right clavicle; Loss of appetite; Metalic taste in mouth; hives on arm/neck; covid arm; Intense cold chills; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (Metal in arm, magnetic objects sticking at the injection site and right clavicle), DECREASED APPETITE (Loss of appetite), DYSGEUSIA (Metalic taste in mouth), URTICARIA (hives on arm/neck) and INJECTION SITE REACTION (covid arm) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 06A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medication history was reported. Concomitant products included AMLODIPINE and SIMVASTATIN for an unknown indication. On 29-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE REACTION (Metal in arm, magnetic objects sticking at the injection site and right clavicle), DECREASED APPETITE (Loss of appetite), DYSGEUSIA (Metalic taste in mouth), URTICARIA (hives on arm/neck), INJECTION SITE REACTION (covid arm) and CHILLS (Intense cold chills). At the time of the report, VACCINATION SITE REACTION (Metal in arm, magnetic objects sticking at the injection site and right clavicle), DECREASED APPETITE (Loss of appetite), DYSGEUSIA (Metalic taste in mouth), URTICARIA (hives on arm/neck), INJECTION SITE REACTION (covid arm) and CHILLS (Intense cold chills) outcome was unknown. No treatment medication was reported. Most recent FOLLOW-UP information incorporated above includes: On 14-Jun-2021: follow-up received on 14-JUN-2021. Contains non significant information On 16-Jun-2021: Added new event loss of appetite. Added start date of loss of appetite On 30-Jun-2021: Email: Video attached with email summarizing that her nail clipper and fork are sticking to her skin.

Other Meds: AMLODIPINE; SIMVASTATIN

Current Illness:

ID: 1635646
Sex: F
Age: 56
State: PA

Vax Date: 05/17/2021
Onset Date:
Rec V Date: 08/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: rash on eye, mouth, chin and leg; This spontaneous case was reported by a consumer and describes the occurrence of RASH (rash on eye, mouth, chin and leg) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 17-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced RASH (rash on eye, mouth, chin and leg). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Rash, at an unspecified dose and frequency. At the time of the report, RASH (rash on eye, mouth, chin and leg) outcome was unknown. No concomitant medications were reported by the reporter. Additional treatment medications included unspecified steroid and itch cream.

Other Meds:

Current Illness:

ID: 1635647
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: My neck feels stiff; I have awaken with a mighty headache; 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 MUSCULOSKELETAL STIFFNESS (My neck feels stiff) and HEADACHE (I have awaken with a mighty 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) (unknown route) 1 dosage form. On an unknown date, the patient experienced MUSCULOSKELETAL STIFFNESS (My neck feels stiff) and HEADACHE (I have awaken with a mighty headache). At the time of the report, MUSCULOSKELETAL STIFFNESS (My neck feels stiff) and HEADACHE (I have awaken with a mighty headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medication were reported. No treatment medication were reported.

Other Meds:

Current Illness:

ID: 1635648
Sex: M
Age:
State: NY

Vax Date: 06/12/2021
Onset Date:
Rec V Date: 08/26/2021
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: Could not sleep; Does not feel right; Received second dose 8 weeks after the first one; Headache; Slight fever; This spontaneous case was reported by a consumer and describes the occurrence of INSOMNIA (Could not sleep), MALAISE (Does not feel right), INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received second dose 8 weeks after the first one), HEADACHE (Headache) and PYREXIA (Slight fever) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-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 an unknown date, the patient experienced INSOMNIA (Could not sleep), MALAISE (Does not feel right), INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received second dose 8 weeks after the first one), HEADACHE (Headache) and PYREXIA (Slight fever). At the time of the report, INSOMNIA (Could not sleep), MALAISE (Does not feel right), HEADACHE (Headache) and PYREXIA (Slight fever) outcome was unknown and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received second dose 8 weeks after the first one) had resolved. No concomitant medications reported. Treatment information not reported.

Other Meds:

Current Illness:

ID: 1635649
Sex: M
Age: 51
State: NC

Vax Date: 05/27/2021
Onset Date: 06/14/2021
Rec V Date: 08/26/2021
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: Second Dose Administered 18 days after the First Shot; This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second Dose Administered 18 days after the First Shot) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009D21A) for COVID-19 vaccination. No Medical History information was reported. On 27-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 14-Jun-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second Dose Administered 18 days after the First Shot). On 14-Jun-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second Dose Administered 18 days after the First Shot) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported by the reporter. No treatment medications were reported by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 03-Jul-2021: Significant FU Correspondence mail - Patient stated no adverse reactions.

Other Meds:

Current Illness:

ID: 1635650
Sex: M
Age: 16
State: OH

Vax Date: 04/04/2021
Onset Date: 05/03/2021
Rec V Date: 08/26/2021
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: two 16 year old patients that received the Moderna covid vaccination; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (two 16 year old patients that received the Moderna covid vaccination) in a 16-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 043B21A and 02B21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-May-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (two 16 year old patients that received the Moderna covid vaccination). On 03-May-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (two 16 year old patients that received the Moderna covid vaccination) had resolved. 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. No treatment information was provided. This case was linked to MOD-2021-067524 (Patient Link).

Other Meds:

Current Illness:

ID: 1635651
Sex: F
Age: 20
State: PA

Vax Date: 01/27/2021
Onset Date:
Rec V Date: 08/26/2021
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: Test Name: SARS-CoV-2 test; Test Result: Negative ; Result Unstructured Data: Negative

Allergies:

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

Symptoms: swelling under the left eye; slight swelling of her upper eyelid; This spontaneous case was reported by an other health care professional and describes the occurrence of EYE SWELLING (swelling under the left eye) and SWELLING OF EYELID (slight swelling of her upper eyelid) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Long QT. Concurrent medical conditions included Allergy NOS (common allergies). Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID) for an unknown indication. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced EYE SWELLING (swelling under the left eye) and SWELLING OF EYELID (slight swelling of her upper eyelid). The patient was treated with LORATADINE (CLARITINE) for Swelling, at a dose of Claritin at night; FLUTICASONE PROPIONATE (FLONASE [FLUTICASONE PROPIONATE]) for Swelling, at a dose of Flonase in the morning, one spray in each nostril; CORTISONE for Swelling, at a dose of Cortisone cream and PARACETAMOL (TYLENOL) for Swelling, at a dose of 1 UNK. At the time of the report, EYE SWELLING (swelling under the left eye) and SWELLING OF EYELID (slight swelling of her upper eyelid) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) Negative. 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. Relevant concomitant medications also included natarol. Patient experienced swelling under the left eye which progressed to her left upper eyelid. 4-5 days later the right eyelid and under the right eye started to swell.She had seen a physician where they did a throat culture, covid test, blood work and immunology studies.

Other Meds: SYNTHROID

Current Illness: Allergy NOS (common allergies)

ID: 1635652
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: What are the typical side effects; 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 VACCINATION COMPLICATION (What are the typical side effects) 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 (What are the typical side effects). At the time of the report, VACCINATION COMPLICATION (What are the typical side effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information was not provided. No concomitant medications reported.

Other Meds:

Current Illness:

ID: 1635653
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/26/2021
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: Weird taste in my mouth and it starts in my sinuses after the 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of TASTE DISORDER (Weird taste in my mouth and it starts in my sinuses after the 2nd dose) 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 TASTE DISORDER (Weird taste in my mouth and it starts in my sinuses after the 2nd dose). At the time of the report, TASTE DISORDER (Weird taste in my mouth and it starts in my sinuses after the 2nd dose) outcome was unknown. No concomitant medications were provided. No treatment was reported for the events.

Other Meds:

Current Illness:

ID: 1635654
Sex: M
Age: 63
State: HI

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: Test Date: 20210413; Test Name: Blood pressure; Result Unstructured Data: High; Test Date: 20210413; Test Name: Body temperature; Result Unstructured Data: fever 100.7; Test Date: 20210413; Test Name: Heart rate; Result Unstructured Data: 155/ Min; Test Date: 20210413; Test Name: Oxygen saturation; Result Unstructured Data: Low

Allergies:

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

Symptoms: Shivering, shaking; Headache; Shivering, shaking; Fever; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (Shivering, shaking), HEADACHE (Headache), CHILLS (Shivering, shaking) and PYREXIA (Fever) in a 63-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032B21A) for COVID-19 vaccination. Concurrent medical conditions included COPD. On 13-Apr-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 13-Apr-2021, the patient experienced CHILLS (Shivering, shaking) and PYREXIA (Fever). On an unknown date, the patient experienced TREMOR (Shivering, shaking) and HEADACHE (Headache). At the time of the report, TREMOR (Shivering, shaking), HEADACHE (Headache) and CHILLS (Shivering, shaking) outcome was unknown and PYREXIA (Fever) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 13-Apr-2021, Blood pressure measurement: high (High) High. On 13-Apr-2021, Body temperature: 100.7 (High) fever 100.7. On 13-Apr-2021, Heart rate: 155 per minute (High) 155/ Min. On 13-Apr-2021, Oxygen saturation: low (Low) Low. Steroid inhaler was taken as concomitant medication. No treatment information was provided.

Other Meds:

Current Illness: COPD

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am