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: 1639273
Sex: F
Age: 66
State:

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 08/27/2021
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: Back went into spasms; This spontaneous case was reported by a consumer and describes the occurrence of MUSCLE SPASMS (Back went into spasms) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 ml. On 03-Mar-2021, the patient experienced MUSCLE SPASMS (Back went into spasms). At the time of the report, MUSCLE SPASMS (Back went into spasms) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. patient stated that she has had back issues and its not related to vaccine. she also stated she had injections for it in November and December.

Other Meds:

Current Illness:

ID: 1639274
Sex: F
Age: 72
State: WV

Vax Date: 01/14/2021
Onset Date: 02/10/2021
Rec V Date: 08/27/2021
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: Sore Arm; Chills; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Sore Arm) and CHILLS (Chills) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039K20A and 010M20A) for COVID-19 vaccination. Concomitant products included LEVOTHYROXINE, LISINOPRIL and ATORVASTATIN for an unknown indication. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 10-Feb-2021, the patient experienced VACCINATION SITE PAIN (Sore Arm) and CHILLS (Chills). The patient was treated with NAPROXEN SODIUM (ALEVE) at a dose of 1 dosage form. On 12-Feb-2021, VACCINATION SITE PAIN (Sore Arm) and CHILLS (Chills) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. This case was linked to MOD-2021-223842 (Patient Link).

Other Meds: LEVOTHYROXINE; LISINOPRIL; ATORVASTATIN

Current Illness:

ID: 1639275
Sex: M
Age:
State: WA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 08/27/2021
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: Tongue is tingly; Cheeks feel a little puffy; Arm is mildly sore; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA ORAL (Tongue is tingly), SWELLING FACE (Cheeks feel a little puffy) and PAIN IN EXTREMITY (Arm is mildly sore) 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 16-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Mar-2021, the patient experienced PARAESTHESIA ORAL (Tongue is tingly), SWELLING FACE (Cheeks feel a little puffy) and PAIN IN EXTREMITY (Arm is mildly sore). At the time of the report, PARAESTHESIA ORAL (Tongue is tingly), SWELLING FACE (Cheeks feel a little puffy) and PAIN IN EXTREMITY (Arm is mildly sore) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment medications were not provided.

Other Meds:

Current Illness:

ID: 1639276
Sex: F
Age:
State: NJ

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 08/27/2021
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: feels really really nervous; HCP strongly thinks the vaccine was administered subcutaneously; soreness in the triceps area; This spontaneous case was reported by an other health care professional and describes the occurrence of NERVOUSNESS (feels really really nervous), INCORRECT DOSE ADMINISTERED (HCP strongly thinks the vaccine was administered subcutaneously) and VACCINATION SITE PAIN (soreness in the triceps area) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. No Medical History information was reported. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced NERVOUSNESS (feels really really nervous), INCORRECT DOSE ADMINISTERED (HCP strongly thinks the vaccine was administered subcutaneously) and VACCINATION SITE PAIN (soreness in the triceps area). On 15-Jan-2021, INCORRECT DOSE ADMINISTERED (HCP strongly thinks the vaccine was administered subcutaneously) had resolved. At the time of the report, NERVOUSNESS (feels really really nervous) and VACCINATION SITE PAIN (soreness in the triceps area) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639277
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
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: Swollen leg; Pain; Very sick; sore under arm; sore rib cage, cannot rock side to side; Pain in the same arm of injection; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen leg), PAIN (Pain), ILLNESS (Very sick), AXILLARY PAIN (sore under arm) and MUSCULOSKELETAL CHEST PAIN (sore rib cage, cannot rock side to side) 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 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 PERIPHERAL SWELLING (Swollen leg), PAIN (Pain), ILLNESS (Very sick), AXILLARY PAIN (sore under arm), MUSCULOSKELETAL CHEST PAIN (sore rib cage, cannot rock side to side) and VACCINATION SITE PAIN (Pain in the same arm of injection). At the time of the report, PERIPHERAL SWELLING (Swollen leg), PAIN (Pain), ILLNESS (Very sick), AXILLARY PAIN (sore under arm), MUSCULOSKELETAL CHEST PAIN (sore rib cage, cannot rock side to side) and VACCINATION SITE PAIN (Pain in the same arm of injection) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1639278
Sex: F
Age:
State: WV

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 08/27/2021
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: Fatigue; Headache; Muscle pain; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Fatigue), HEADACHE (Headache) and MYALGIA (Muscle pain) in a 95-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Mar-2021, the patient experienced FATIGUE (Fatigue), HEADACHE (Headache) and MYALGIA (Muscle pain). At the time of the report, FATIGUE (Fatigue), HEADACHE (Headache) and MYALGIA (Muscle pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication reported. No treatment information provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 30-Jun-2021: Follow up received and contains no new information

Other Meds:

Current Illness:

ID: 1639279
Sex: M
Age:
State: FL

Vax Date: 06/12/2021
Onset Date: 06/13/2021
Rec V Date: 08/27/2021
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: Weakness; Discomfort in Arm,under left Armpit; Slight pain in the body; Swelling in left armpit near lymph glands; Tiredness; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Weakness), DISCOMFORT (Discomfort in Arm, under left Armpit), PAIN (Slight pain in the body), LYMPHADENOPATHY (Swelling in left armpit near lymph glands) and FATIGUE (Tiredness) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Jun-2021, the patient experienced ASTHENIA (Weakness), DISCOMFORT (Discomfort in Arm, under left Armpit), PAIN (Slight pain in the body), LYMPHADENOPATHY (Swelling in left armpit near lymph glands) and FATIGUE (Tiredness). At the time of the report, ASTHENIA (Weakness), DISCOMFORT (Discomfort in Arm,under left Armpit), PAIN (Slight pain in the body) and FATIGUE (Tiredness) outcome was unknown and LYMPHADENOPATHY (Swelling in left armpit near lymph glands) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant information was provided. No treatment information was provided by the reporter.

Other Meds:

Current Illness:

ID: 1639280
Sex: F
Age:
State: CA

Vax Date: 01/10/2021
Onset Date: 02/08/2021
Rec V Date: 08/27/2021
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: Ringing in the ears; Cough; This spontaneous case was reported by a consumer and describes the occurrence of TINNITUS (Ringing in the ears) and COUGH (Cough) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013M20A and 011L20A) for COVID-19 vaccination. No Medical History information was reported. On 10-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Feb-2021, the patient experienced TINNITUS (Ringing in the ears) and COUGH (Cough). At the time of the report, TINNITUS (Ringing in the ears) and COUGH (Cough) outcome was unknown. Action taken with mRNA-1273 in response to the event was not applicable. No concomitant medications were reported. Treatment information was unknown.

Other Meds:

Current Illness:

ID: 1639281
Sex: M
Age: 83
State: IL

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 08/27/2021
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: sore arm at the injection site; This spontaneous case was reported by a non-health professional and describes the occurrence of INJECTION SITE PAIN (sore arm at the injection site) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031M20A) for COVID-19 vaccination. No medical history reported by reporter. Concomitant products included WARFARIN from 11-Feb-2021 to an unknown date for an unknown indication. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Feb-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced INJECTION SITE PAIN (sore arm at the injection site). At the time of the report, INJECTION SITE PAIN (sore arm at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment medication was provided.

Other Meds: WARFARIN

Current Illness:

ID: 1639282
Sex: F
Age:
State: CA

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 08/27/2021
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: Fatigue; Joint Pain; Fever; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Fatigue), ARTHRALGIA (Joint Pain) and PYREXIA (Fever) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011L20A and 013M20A) for COVID-19 vaccination. No Medical History information was reported. On 10-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Jan-2021, the patient experienced FATIGUE (Fatigue), ARTHRALGIA (Joint Pain) and PYREXIA (Fever). At the time of the report, FATIGUE (Fatigue), ARTHRALGIA (Joint Pain) and PYREXIA (Fever) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication details was reported. No treatment medication details was reported.

Other Meds:

Current Illness:

ID: 1639283
Sex: F
Age: 65
State: TX

Vax Date: 01/11/2021
Onset Date:
Rec V Date: 08/27/2021
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: Potential Missed Window for Vaccination; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Potential Missed Window for Vaccination) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L2OA) for COVID-19 vaccination. No Medical History information was reported. On 11-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 INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Potential Missed Window for Vaccination). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Potential Missed Window for Vaccination) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. The treatment information was not given.

Other Meds:

Current Illness:

ID: 1639284
Sex: F
Age: 73
State: MA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: Test Date: 20210223; Test Name: Heart beat; Result Unstructured Data: Fast heart beat

Allergies:

Symptom List: Rash, Urticaria

Symptoms: 2nd shot past due; palpitations; felt jittery inside of her chest; This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (palpitations), CHEST DISCOMFORT (felt jittery inside of her chest) and PRODUCT DOSE OMISSION ISSUE (2nd shot past due) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. o24m20a) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure abnormal. 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 CHEST DISCOMFORT (felt jittery inside of her chest). On 24-Feb-2021, the patient experienced PALPITATIONS (palpitations). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (2nd shot past due). At the time of the report, PALPITATIONS (palpitations), CHEST DISCOMFORT (felt jittery inside of her chest) and PRODUCT DOSE OMISSION ISSUE (2nd shot past due) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Feb-2021, Heart rate: abnormal (abnormal) Fast heart beat. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication included blood pressure meds. No treatment information provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 30-Jun-2021: Info regarding 2nd dose updated

Other Meds:

Current Illness:

ID: 1639285
Sex: F
Age: 65
State:

Vax Date: 01/11/2021
Onset Date:
Rec V Date: 08/27/2021
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: Potential missed window for vaccination; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Potential missed window for vaccination) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L2OA) for COVID-19 vaccination. No Medical History information was reported. On 11-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 INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Potential missed window for vaccination). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Potential missed window for vaccination) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No information about concomitant medication was provided. No information about treatment medication was provided.

Other Meds:

Current Illness:

ID: 1639286
Sex: F
Age: 83
State: NC

Vax Date: 02/01/2021
Onset Date: 02/08/2021
Rec V Date: 08/27/2021
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: itching on scalp; Vaginal itching; Itching on arm; Itching around injection site; This spontaneous case was reported by a consumer and describes the occurrence of VULVOVAGINAL PRURITUS (Vaginal itching), PRURITUS (Itching on arm and scalp) and INJECTION SITE PRURITUS (Itching around injection site) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. No Medical History information was reported. On 01-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, the patient experienced VULVOVAGINAL PRURITUS (Vaginal itching), PRURITUS (Itching on arm and scalp) and INJECTION SITE PRURITUS (Itching around injection site). At the time of the report, VULVOVAGINAL PRURITUS (Vaginal itching), PRURITUS (Itching on arm and scalp) and INJECTION SITE PRURITUS (Itching around injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications are not taking Treatment information includes non-itch cream OTC

Other Meds:

Current Illness:

ID: 1639287
Sex: F
Age: 76
State:

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 08/27/2021
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: Large blotchy area of redness; Swelling; General tenderness; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (Large blotchy area of redness), VACCINATION SITE SWELLING (Swelling) and VACCINATION SITE PAIN (General tenderness) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by reporter. No concomitant medication reported. 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 VACCINATION SITE ERYTHEMA (Large blotchy area of redness), VACCINATION SITE SWELLING (Swelling) and VACCINATION SITE PAIN (General tenderness). On 17-Jan-2021, VACCINATION SITE ERYTHEMA (Large blotchy area of redness), VACCINATION SITE SWELLING (Swelling) and VACCINATION SITE PAIN (General tenderness) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639288
Sex: F
Age:
State: LA

Vax Date: 03/15/2021
Onset Date:
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Received a dose that past 24 hs withdrawn from the vial; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received a dose that past 24 hs withdrawn from the vial) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. No Medical History information was reported. On 15-Mar-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received a dose that past 24 hs withdrawn from the vial). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Received a dose that past 24 hs withdrawn from the vial) 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. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639289
Sex: M
Age: 45
State: GA

Vax Date: 02/02/2021
Onset Date: 02/25/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: poison ivy on 25feb2021 and a rash developed. Patient reports the rash started on their right wrist and moved to the entire right arm, then traveled to his left arm, as well as a small patch on their should/neck area and around his belt line.; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of RASH (poison ivy on 25feb2021 and a rash developed. Patient reports the rash started on their right wrist and moved to the entire right arm, then traveled to his left arm, as well as a small patch on their should/neck area and around his belt line.) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Cough. Concomitant products included IBUPROFEN (ADVIL [IBUPROFEN]) for an unknown indication. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 25-Feb-2021, the patient experienced RASH (poison ivy on 25feb2021 and a rash developed. Patient reports the rash started on their right wrist and moved to the entire right arm, then traveled to his left arm, as well as a small patch on their should/neck area and around his belt line.). The patient was treated with METHYLPREDNISOLONE (MEDROL [METHYLPREDNISOLONE]) for Symptomatic treatment, at an unspecified dose and frequency and CLOBETASOL (topical) for Symptomatic treatment, at an unspecified dose and frequency. At the time of the report, RASH (poison ivy on 25feb2021 and a rash developed. Patient reports the rash started on their right wrist and moved to the entire right arm, then traveled to his left arm, as well as a small patch on their should/neck area and around his belt line.) had not resolved. Concomitant medications also included Cough drops as needed. Most recent FOLLOW-UP information incorporated above includes: On 07-Jul-2021: Follow-up information received on 07-JUL-2021 contains no new information.

Other Meds: ADVIL [IBUPROFEN]

Current Illness: Cough

ID: 1639290
Sex: F
Age: 65
State: VA

Vax Date: 01/19/2021
Onset Date:
Rec V Date: 08/27/2021
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: Hypersensitivity reaction; Local tching/pruritus; hives at injection site/broke out in a rash and hives at the injection site.; Local Redness/erythema; rash at injection site/broke out in a rash and hives at the injection site.; This spontaneous case was reported by a consumer and describes the occurrence of HYPERSENSITIVITY (Hypersensitivity reaction), VACCINATION SITE PRURITUS (Local tching/pruritus), VACCINATION SITE URTICARIA (hives at injection site/broke out in a rash and hives at the injection site.), VACCINATION SITE ERYTHEMA (Local Redness/erythema) and VACCINATION SITE RASH (rash at injection site/broke out in a rash and hives at the injection site.) in an elderly female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. Concurrent medical conditions included Allergy to antibiotic (Cefazolin - Asthma) since 2014, Sulfonamide allergy (Sulfa antibiotics - Rash), Allergy to intravenous contrast media (Iodine IV contrast - Asthma), Allergy to antibiotic (Gentamicin - Irritation), Allergy to vaccine, Osteoarthritis since 1984, Migraine headache since 1966 and Scoliosis. Concomitant products included AMLODIPINE from 2019 to an unknown date for Blood pressure management, TAMOXIFEN from 2014 to an unknown date for Chemoprophylaxis NOS, CICLOSPORIN (RESTASIS) for Dry eye, RANITIDINE from an unknown date to May 2021 for Esophageal reflux, MINOXIDIL for Hair loss, CIMETIDINE and TEMAZEPAM for an unknown indication. 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 HYPERSENSITIVITY (Hypersensitivity reaction), VACCINATION SITE PRURITUS (Local tching/pruritus) and VACCINATION SITE ERYTHEMA (Local Redness/erythema). an unknown date, the patient experienced VACCINATION SITE URTICARIA (hives at injection site/broke out in a rash and hives at the injection site.) and VACCINATION SITE RASH (rash at injection site/broke out in a rash and hives at the injection site.). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at a dose of 1 dosage form. At the time of the report, HYPERSENSITIVITY (Hypersensitivity reaction), VACCINATION SITE PRURITUS (Local tching/pruritus), VACCINATION SITE URTICARIA (hives at injection site/broke out in a rash and hives at the injection site.), VACCINATION SITE ERYTHEMA (Local Redness/erythema) and VACCINATION SITE RASH (rash at injection site/broke out in a rash and hives at the injection site.) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Most recent FOLLOW-UP information incorporated above includes: On 18-Jun-2021: No specific follow-up information recorded. On 28-Jun-2021: Follow-up information received on 28 Jun 2021 included no new information.

Other Meds: AMLODIPINE; CIMETIDINE; TEMAZEPAM; TAMOXIFEN; RANITIDINE; MINOXIDIL; RESTASIS

Current Illness: Allergy to antibiotic (Gentamicin - Irritation); Allergy to antibiotic (Cefazolin - Asthma); Allergy to intravenous contrast media (Iodine IV contrast - Asthma); Allergy to vaccine; Migraine headache; Osteoarthritis; Scoliosis; Sulfonamide allergy (Sulfa antibiotics - Rash)

ID: 1639291
Sex: F
Age: 76
State: AL

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 08/27/2021
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: Arm started hurting; bruise at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE BRUISING (bruise at the injection site) and PAIN IN EXTREMITY (Arm started hurting) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Asthma and Blood pressure high. Concomitant products included METFORMIN for an unknown indication. 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) (unknown route) 1 dosage form. On 26-Feb-2021, the patient experienced INJECTION SITE BRUISING (bruise at the injection site). On 02-Mar-2021, the patient experienced PAIN IN EXTREMITY (Arm started hurting). At the time of the report, INJECTION SITE BRUISING (bruise at the injection site) and PAIN IN EXTREMITY (Arm started hurting) had not resolved. Blood pressure and asthma medications are the other concomitant medications reported by investigator. Ointment is the treatment medication reported by reporter.

Other Meds: METFORMIN

Current Illness: Asthma; Blood pressure high

ID: 1639292
Sex: M
Age:
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 08/27/2021
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: Age not checked at time of vaccination; This spontaneous case was reported by a health care professional and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Age not checked at time of vaccination) in a 16-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016M20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021 at 9:30 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Feb-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Age not checked at time of vaccination). On 12-Feb-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Age not checked at time of vaccination) had 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 concomitant and treatment medication was reported Most recent FOLLOW-UP information incorporated above includes: On 17-Jun-2021: patient demographics, vaccine information such as batch number anatomical location was updated.

Other Meds:

Current Illness:

ID: 1639293
Sex: F
Age: 53
State: NJ

Vax Date: 03/04/2021
Onset Date: 03/13/2021
Rec V Date: 08/27/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of NASOPHARYNGITIS (head cold sore throat), OROPHARYNGEAL PAIN (head cold sore throat), RASH (rash on entire right arm) and VACCINATION SITE PRURITUS (site is itchy) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002A21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Mar-2021, the patient experienced NASOPHARYNGITIS (head cold sore throat), OROPHARYNGEAL PAIN (head cold sore throat), RASH (rash on entire right arm) and VACCINATION SITE PRURITUS (site is itchy). At the time of the report, NASOPHARYNGITIS (head cold sore throat), OROPHARYNGEAL PAIN (head cold sore throat), RASH (rash on entire right arm) and VACCINATION SITE PRURITUS (site is itchy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639294
Sex: F
Age: 66
State: IN

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 08/27/2021
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: exposed to COVID; inflammation in her body; fever; chills; a little bump at the injection site; right knee pain flared up/ intensified all her weaknesses/ attacking those "spots"; sore left arm; headache/sharp pain in her head; fatigued\extreme fatigue; ringing in the right ear; metallic taste in her mouth/experienced a taste in her mouth and throat of "Ether".; smelled ether/ smell of "ether"; cold hands; she laid down and fell asleep; extreme\ intense sciatic pain; feeling immobilized from the sciatic pain; she was "freezing" and "so cold" and she couldn't get warm; felt like she could cry; This spontaneous case was reported by a consumer and describes the occurrence of DYSGEUSIA (metallic taste in her mouth/experienced a taste in her mouth and throat of "Ether".), EXPOSURE TO SARS-COV-2 (exposed to COVID), PAROSMIA (smelled ether/ smell of "ether"), PERIPHERAL COLDNESS (cold hands) and SOMNOLENCE (she laid down and fell asleep) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 016M20A and 036A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Spinal stenosis, Knee arthritis (arthritis in right knee with pain), Bronchitis, Insulin resistant diabetes and Drug allergy. Concomitant products included VITAMINS NOS for an unknown indication. On 13-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 13-Apr-2021, the patient experienced DYSGEUSIA (metallic taste in her mouth/experienced a taste in her mouth and throat of "Ether".), PAROSMIA (smelled ether/ smell of "ether"), PERIPHERAL COLDNESS (cold hands), SOMNOLENCE (she laid down and fell asleep), BACK PAIN (extreme\ intense sciatic pain), MOBILITY DECREASED (feeling immobilized from the sciatic pain), FEELING COLD (she was "freezing" and "so cold" and she couldn't get warm), FEELING ABNORMAL (felt like she could cry), TINNITUS (ringing in the right ear), CHILLS (chills), VACCINATION SITE SWELLING (a little bump at the injection site), ARTHRALGIA (right knee pain flared up/ intensified all her weaknesses/ attacking those "spots"), MYALGIA (sore left arm), HEADACHE (headache/sharp pain in her head) and FATIGUE (fatigued\extreme fatigue). On 14-Apr-2021, the patient experienced PYREXIA (fever). On an unknown date, the patient experienced EXPOSURE TO SARS-COV-2 (exposed to COVID) and INFLAMMATION (inflammation in her body). The patient was treated with ASPIRIN [ACETYLSALICYLIC ACID] at a dose of 1 UNK. At the time of the report, DYSGEUSIA (metallic taste in her mouth/experienced a taste in her mouth and throat of "Ether".), EXPOSURE TO SARS-COV-2 (exposed to COVID), PAROSMIA (smelled ether/ smell of "ether"), PERIPHERAL COLDNESS (cold hands), SOMNOLENCE (she laid down and fell asleep), BACK PAIN (extreme\ intense sciatic pain), MOBILITY DECREASED (feeling immobilized from the sciatic pain), FEELING COLD (she was "freezing" and "so cold" and she couldn't get warm), FEELING ABNORMAL (felt like she could cry), INFLAMMATION (inflammation in her body), TINNITUS (ringing in the right ear), PYREXIA (fever), CHILLS (chills), VACCINATION SITE SWELLING (a little bump at the injection site), ARTHRALGIA (right knee pain flared up/ intensified all her weaknesses/ attacking those "spots"), MYALGIA (sore left arm), HEADACHE (headache/sharp pain in her head) and FATIGUE (fatigued\extreme fatigue) outcome was unknown. No concomitant medication was provided. Most recent FOLLOW-UP information incorporated above includes: On 16-Jun-2021: Upon follow-up received: Medical history: spinal stenosis, arthritis in right knee, bronchitis, insulin resistant were added. New events: she laid down and fell asleep, extreme\ intense sciatic pain, feeling immobilized from the sciatic pain, she was freezing" and so cold and she couldn't get warm, felt like she could cry, inflammation in her body, ringing in the right ear, sore left arm, a little bump at the injection site, Arthralgia and fever. On 16-Jun-2021: Follow up received (TCR) on 16 Jun 2021 included: details on reporter's mail ID and start dates of both doses of vaccine On 05-Aug-2021: Non-significant follow up appended

Other Meds: VITAMINS NOS

Current Illness: Bronchitis; Drug allergy; Insulin resistant diabetes; Knee arthritis (arthritis in right knee with pain); Spinal stenosis

ID: 1639295
Sex: F
Age: 31
State: TX

Vax Date: 01/27/2021
Onset Date:
Rec V Date: 08/27/2021
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: pregnant; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (pregnant) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 022M20A and 032L20A) for COVID-19 vaccination. No Medical History information was reported. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 2 dosage form. The patient's last menstrual period was on an unknown date and the estimated date of delivery was 22-Mar-2021. On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (pregnant). At the time of the report, EXPOSURE DURING PREGNANCY (pregnant) had resolved. No concomitant medications reported. Treatment information not reported.

Other Meds:

Current Illness:

ID: 1639296
Sex: F
Age: 54
State: TN

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 08/27/2021
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: ear pain above my ear on my head; This spontaneous case was reported by an other health care professional and describes the occurrence of EAR PAIN (ear pain above my ear on my head) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-Jan-2021, the patient experienced EAR PAIN (ear pain above my ear on my head). At the time of the report, EAR PAIN (ear pain above my ear on my head) 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 provided. No treatment medications provided.

Other Meds:

Current Illness:

ID: 1639297
Sex: M
Age:
State: OR

Vax Date: 06/08/2021
Onset Date:
Rec V Date: 08/27/2021
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: Sweats day after 2nd dose; Low grade fever; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (Sweats day after 2nd dose), PYREXIA (Low grade fever) and NAUSEA (Nausea) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 033c21a) for COVID-19 vaccination. No Medical History information was reported. On 08-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 HYPERHIDROSIS (Sweats day after 2nd dose), PYREXIA (Low grade fever) and NAUSEA (Nausea). At the time of the report, HYPERHIDROSIS (Sweats day after 2nd dose), PYREXIA (Low grade fever) and NAUSEA (Nausea) outcome was unknown. No concomitant medication were reported. No treatment information was reported The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) was not applicable.

Other Meds:

Current Illness:

ID: 1639298
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (very weak) and NAUSEA (nauseous) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by reporter. 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, 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 ASTHENIA (very weak) and NAUSEA (nauseous). At the time of the report, ASTHENIA (very weak) and NAUSEA (nauseous) outcome was unknown. No concomitant medications were reported. No laboratory details were provided. No treatment medications were reported. Action taken with mRNA-1273 in response to the events was not applicable.

Other Meds:

Current Illness:

ID: 1639299
Sex: F
Age:
State: SC

Vax Date: 05/02/2021
Onset Date: 05/02/2021
Rec V Date: 08/27/2021
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: 20210505; Test Name: Urine screen; Test Result: Positive ; Result Unstructured Data: Positive for fentanyl use

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 5 hrs after I developed severe reaction and could not stop vomiting for following 48 hrs; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of VOMITING (5 hrs after I developed severe reaction and could not stop vomiting for following 48 hrs) and NAUSEA (Nausea) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 003C21A and G41C21A) for COVID-19 vaccination. The patient's past medical history included Shoulder pain (Worsening due to neck and back injuries from vehicle accident.) on 15-Jun-2016, Back pain (Worsening due to neck and back injuries from vehicle accident.) on 15-Jun-2016, Neck pain (Vehicle accident.) on 15-Jul-2019, Back pain (Vehicle accident.) on 15-Jul-2019 and Illness from 02-May-2021 to 04-May-2021. Concurrent medical conditions included Migraine (Worsening due to neck and back injuries from vehicle accident .) since 01-Jan-1977. Concomitant products included DEXTROMETHORPHAN HYDROBROMIDE, PARACETAMOL, PHENYLEPHRINE HYDROCHLORIDE (DAYQUIL COLD & FLU) from 01-May-2021 to an unknown date for Allergy, CLONAZEPAM from 20-Feb-2020 to an unknown date for Anxiety, QUETIAPINE from 10-Oct-2020 to an unknown date for Bipolar depression, OXYCODONE HYDROCHLORIDE, PARACETAMOL (OXYCODONE AND ACETAMINOPHEN) from 18-Jun-2020 to an unknown date and CYCLOBENZAPRINE HCL from 20-Oct-2020 to an unknown date for Chronic pain. On 02-May-2021 at 5:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-May-2021 at 5:30 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 02-May-2021, the patient experienced VOMITING (5 hrs after I developed severe reaction and could not stop vomiting for following 48 hrs) and NAUSEA (Nausea). The patient was treated with DIMENHYDRINATE (DRAMAMINE) on 04-May-2021 at a dose of UNK dosage form. On 04-May-2021, VOMITING (5 hrs after I developed severe reaction and could not stop vomiting for following 48 hrs) and NAUSEA (Nausea) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-May-2021, Urine analysis: postive (Positive) Positive for fentanyl use. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient had taken pesto and OTC sleeping meds along with pain medicines to try to sleep. Most recent FOLLOW-UP information incorporated above includes: On 15-Jul-2021: Follow-up information received on 15 Jul 2021 contains significant information-Updated patient information, New events: Nausea. And updated event outcome: Recovered.

Other Meds: OXYCODONE AND ACETAMINOPHEN; CYCLOBENZAPRINE HCL; QUETIAPINE; CLONAZEPAM; DAYQUIL COLD & FLU

Current Illness: Illness; Migraine (Worsening due to neck and back injuries from vehicle accident .)

ID: 1639300
Sex: F
Age:
State: MI

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
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: she experienced severe stomach ache after receiving her first dose of Moderna Covid-19 vaccine.; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (she experienced severe stomach ache after receiving her first dose of Moderna Covid-19 vaccine.) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ABDOMINAL PAIN UPPER (she experienced severe stomach ache after receiving her first dose of Moderna Covid-19 vaccine.). At the time of the report, ABDOMINAL PAIN UPPER (she experienced severe stomach ache after receiving her first dose of Moderna Covid-19 vaccine.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications provided. No treatment drugs provided.

Other Meds:

Current Illness:

ID: 1639301
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: I had a bad side effect and have been advised not to take the second; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE REACTION (I had a bad side effect and have been advised not to take the second) 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 ADVERSE REACTION (I had a bad side effect and have been advised not to take the second). At the time of the report, ADVERSE REACTION (I had a bad side effect and have been advised not to take the second) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No laboratory details were provided. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1639302
Sex: M
Age:
State: FL

Vax Date: 06/11/2021
Onset Date: 06/14/2021
Rec V Date: 08/27/2021
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; aches and pains; fever; headache; throwing up; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (itching), PAIN (aches and pains), PYREXIA (fever), HEADACHE (headache) and VOMITING (throwing up) in a 30-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Hypertension. Concomitant products included AMFETAMINE ASPARTATE, AMFETAMINE SULFATE, DEXAMFETAMINE SACCHARATE, DEXAMFETAMINE SULFATE (ADDERALL) for an unknown indication. On 11-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Jun-2021, the patient experienced PRURITUS (itching), PAIN (aches and pains), PYREXIA (fever), HEADACHE (headache) and VOMITING (throwing up). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date at a dose of unknown. At the time of the report, PRURITUS (itching), PAIN (aches and pains), PYREXIA (fever), HEADACHE (headache) and VOMITING (throwing up) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: Significant Followup - events outcome has been updated.

Other Meds: ADDERALL

Current Illness: Hypertension

ID: 1639303
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
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: If a person tested positive for COVID and took the first Moderna vaccine before knowing they were positive. What should they do?; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (If a person tested positive for COVID and took the first Moderna vaccine before knowing they were positive. What should they do?) 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 COVID-19 (If a person tested positive for COVID and took the first Moderna vaccine before knowing they were positive. What should they do?). At the time of the report, COVID-19 (If a person tested positive for COVID and took the first Moderna vaccine before knowing they were positive. What should they do?) 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 medications were not provided. At the time of follow-up report, it was reported that the patient was fine. Treatment information not provided. Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: Updated outcome of the event.

Other Meds:

Current Illness:

ID: 1639304
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Still having headaches (second shot on 12th)) 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 HEADACHE (Still having headaches (second shot on 12th)). At the time of the report, HEADACHE (Still having headaches (second shot on 12th)) outcome was unknown. No concomitant medications were reported. No laboratory details were provided. No treatment medications were reported. Action taken with mRNA-1273 in response to the events was not applicable.

Other Meds:

Current Illness:

ID: 1639305
Sex: U
Age:
State: TX

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 08/27/2021
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: tested positive for COVID; This spontaneous case was reported by a patient and describes the occurrence of SARS-COV-2 TEST POSITIVE (tested positive for COVID) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 11-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Mar-2021, the patient experienced SARS-COV-2 TEST POSITIVE (tested positive for COVID). At the time of the report, SARS-COV-2 TEST POSITIVE (tested positive for COVID) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant was provided. Patient treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639306
Sex: F
Age: 19
State: VA

Vax Date: 06/13/2021
Onset Date: 06/13/2021
Rec V Date: 08/27/2021
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: shortness of breath; tension on back; sore arm at injection site immediately after the 1st shot; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (shortness of breath), BACK PAIN (tension on back) and VACCINATION SITE PAIN (sore arm at injection site immediately after the 1st shot) in a 19-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009b21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Jun-2021, the patient experienced DYSPNOEA (shortness of breath), BACK PAIN (tension on back) and VACCINATION SITE PAIN (sore arm at injection site immediately after the 1st shot). At the time of the report, DYSPNOEA (shortness of breath), BACK PAIN (tension on back) and VACCINATION SITE PAIN (sore arm at injection site immediately after the 1st shot) 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 was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639307
Sex: F
Age: 72
State: CA

Vax Date: 02/07/2021
Onset Date: 03/16/2021
Rec V Date: 08/27/2021
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: Difficult walking; right leg pain; Joint pain/ Right ankle pain/Knee pain/painful/Left shoulder extremely painful/Left knee pain/Left knee pain; This spontaneous case was reported by a consumer and describes the occurrence of GAIT DISTURBANCE (Difficult walking), PAIN IN EXTREMITY (right leg pain) and ARTHRALGIA (Joint pain/ Right ankle pain/Knee pain/painful/Left shoulder extremely painful/Left knee pain/Left knee pain) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025A21A and 016M20A) for COVID-19 vaccination. No Medical History information was reported. On 07-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-Mar-2021, the patient experienced GAIT DISTURBANCE (Difficult walking), PAIN IN EXTREMITY (right leg pain) and ARTHRALGIA (Joint pain/ Right ankle pain/Knee pain/painful/Left shoulder extremely painful/Left knee pain/Left knee pain). At the time of the report, GAIT DISTURBANCE (Difficult walking), PAIN IN EXTREMITY (right leg pain) and ARTHRALGIA (Joint pain/ Right ankle pain/Knee pain/painful/Left shoulder extremely painful/Left knee pain/Left knee pain) had not resolved. No relevant concomitant medications were reported No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639308
Sex: F
Age:
State: KS

Vax Date:
Onset Date: 06/09/2021
Rec V Date: 08/27/2021
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: right ear swollen inside; can't hear good with that ear; swollen index finger in right arm; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (swollen index finger in right arm), EAR SWELLING (right ear swollen inside) and HYPOACUSIS (can't hear good with that ear) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Jun-2021, the patient experienced PERIPHERAL SWELLING (swollen index finger in right arm). On 16-Jun-2021, the patient experienced EAR SWELLING (right ear swollen inside) and HYPOACUSIS (can't hear good with that ear). At the time of the report, PERIPHERAL SWELLING (swollen index finger in right arm), EAR SWELLING (right ear swollen inside) and HYPOACUSIS (can't hear good with that ear) 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. treatment information not provided. Concomitant medications were not provided.

Other Meds:

Current Illness:

ID: 1639309
Sex: F
Age:
State: OR

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Test Name: Body temperature; Result Unstructured Data: 99.9 degrees F

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Sweats day after 2nd dose; Weak after 2nd dose; Low grade fevers day after 2nd dose/she is run down and has a fever of 99.9 degrees F; Nausea day after 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (Sweats day after 2nd dose), ASTHENIA (Weak after 2nd dose), PYREXIA (Low grade fevers day after 2nd dose/she is run down and has a fever of 99.9 degrees F) and NAUSEA (Nausea day after 2nd 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. 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 HYPERHIDROSIS (Sweats day after 2nd dose), ASTHENIA (Weak after 2nd dose), PYREXIA (Low grade fevers day after 2nd dose/she is run down and has a fever of 99.9 degrees F) and NAUSEA (Nausea day after 2nd dose). At the time of the report, HYPERHIDROSIS (Sweats day after 2nd dose), ASTHENIA (Weak after 2nd dose), PYREXIA (Low grade fevers day after 2nd dose/she is run down and has a fever of 99.9 degrees F) and NAUSEA (Nausea day after 2nd dose) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 99.9 (High) 99.9 degrees F. Treatment information not provided. Concomitant medications were not provided.

Other Meds:

Current Illness:

ID: 1639310
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
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: son got sick after the vaccine; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (son got sick after the vaccine) 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) (unknown route) 1 dosage form. On an unknown date, the patient experienced ILLNESS (son got sick after the vaccine). At the time of the report, ILLNESS (son got sick after the vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medication was reported. Treatment information was not provided. This case was linked to MOD-2021-223973 (Patient Link).

Other Meds:

Current Illness:

ID: 1639311
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
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: feel absolutely horrible; didnt sleep at all last night; body is aching so nadly; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (feel absolutely horrible), INSOMNIA (didnt sleep at all last night) and PAIN (body is aching so nadly) 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, 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 FEELING ABNORMAL (feel absolutely horrible), INSOMNIA (didnt sleep at all last night) and PAIN (body is aching so nadly). At the time of the report, FEELING ABNORMAL (feel absolutely horrible), INSOMNIA (didnt sleep at all last night) and PAIN (body is aching so nadly) outcome was unknown. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639312
Sex: M
Age: 51
State: MA

Vax Date: 05/15/2021
Onset Date: 06/11/2021
Rec V Date: 08/27/2021
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: Shortness of breath; Fever; Chills; Headache; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Shortness of breath), PYREXIA (Fever), CHILLS (Chills) and HEADACHE (Headache) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. No Medical History information was reported. On 15-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 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 PYREXIA (Fever), CHILLS (Chills) and HEADACHE (Headache). On 12-Jun-2021, the patient experienced DYSPNOEA (Shortness of breath). On 13-Jun-2021, DYSPNOEA (Shortness of breath), PYREXIA (Fever), CHILLS (Chills) and HEADACHE (Headache) had resolved. Concomitant product use was not provided by the reporter. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not applicable. This case was linked to MOD-2021-223938 (Patient Link).

Other Meds:

Current Illness:

ID: 1639313
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
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: swollen lymph node; This spontaneous case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (swollen lymph node) 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 LYMPHADENOPATHY (swollen lymph node). At the time of the report, LYMPHADENOPATHY (swollen lymph node) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639314
Sex: F
Age: 39
State: NY

Vax Date: 03/24/2021
Onset Date:
Rec V Date: 08/27/2021
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: Second dose not given in allowed time window; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Second dose not given in allowed time window) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 018B21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Mar-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 (Second dose not given in allowed time window). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Second dose not given in allowed time window) 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 medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639315
Sex: U
Age:
State: NC

Vax Date: 06/16/2021
Onset Date: 06/16/2021
Rec V Date: 08/27/2021
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: Sore arm; Slight headache; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a physician and describes the occurrence of PAIN IN EXTREMITY (Sore arm) and HEADACHE (Slight 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 16-Jun-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Jun-2021, the patient experienced PAIN IN EXTREMITY (Sore arm) and HEADACHE (Slight headache). At the time of the report, PAIN IN EXTREMITY (Sore arm) and HEADACHE (Slight headache) 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. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639316
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/27/2021
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: Short of breath; Weak; Fever; 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 DYSPNEA (Short of breath), ASTHENIA (Weak) and PYREXIA (Fever) 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 DYSPNEA (Short of breath), ASTHENIA (Weak) and PYREXIA (Fever). At the time of the report, DYSPNEA (Short of breath), ASTHENIA (Weak) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639317
Sex: F
Age: 62
State: GA

Vax Date: 12/31/2020
Onset Date: 01/25/2021
Rec V Date: 08/27/2021
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: felt like she was kicked; chill that went from the back of neck to head/chills; aches in the muscle; second dose on day 25; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose on day 25), FEELING ABNORMAL (felt like she was kicked), CHILLS (chill that went from the back of neck to head/chills) and MYALGIA (aches in the muscle) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 004M20A and 0L6l20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included LOSARTAN, METOPROLOL and AMLODIPINE for Hypertension, ASCORBIC ACID (VITCEE), TOCOPHEROL (VITAMIN E [TOCOPHEROL]), VITAMIN D NOS, POTASSIUM and MAGNESIUM for an unknown indication. On 31-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Jan-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose on day 25). On 26-Jan-2021, the patient experienced FEELING ABNORMAL (felt like she was kicked), CHILLS (chill that went from the back of neck to head/chills) and MYALGIA (aches in the muscle). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 25-Jan-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose on day 25) had resolved. At the time of the report, FEELING ABNORMAL (felt like she was kicked), CHILLS (chill that went from the back of neck to head/chills) and MYALGIA (aches in the muscle) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment information was not provided.

Other Meds: LOSARTAN; METOPROLOL; AMLODIPINE; VITCEE; VITAMIN E [TOCOPHEROL]; VITAMIN D NOS; POTASSIUM; MAGNESIUM

Current Illness:

ID: 1639318
Sex: M
Age: 32
State: NY

Vax Date: 05/08/2021
Onset Date: 06/12/2021
Rec V Date: 08/27/2021
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: shortness of breath; sometimes a rapid heartbeat; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (shortness of breath) and HEART RATE INCREASED (sometimes a rapid heartbeat) in a 32-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023C21A) for COVID-19 vaccination. No Medical History information was reported. On 08-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 12-Jun-2021, the patient experienced DYSPNOEA (shortness of breath) and HEART RATE INCREASED (sometimes a rapid heartbeat). At the time of the report, DYSPNOEA (shortness of breath) and HEART RATE INCREASED (sometimes a rapid heartbeat) outcome was unknown. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639319
Sex: F
Age: 69
State: MO

Vax Date: 06/01/2021
Onset Date: 06/13/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: This spontaneous case was reported by a patient and describes the occurrence of SKIN DISCOLORATION (Black and blue discoloration of skin on back of her left knee) and ARTHRALGIA (Left knee pain) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037C21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included OLMESARTAN, BUPROPION and ACYCLOVIR [ACICLOVIR] for an unknown indication. On 01-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Jun-2021, the patient experienced ARTHRALGIA (Left knee pain). On 15-Jun-2021, the patient experienced SKIN DISCOLORATION (Black and blue discoloration of skin on back of her left knee). The patient was treated with ACETYLSALICYLIC ACID (BABY ASPIRIN) for Knee pain, at an unspecified dose and frequency. At the time of the report, SKIN DISCOLOURATION (Black and blue discoloration of skin on back of her left knee) and ARTHRALGIA (Left knee pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds: OLMESARTAN; BUPROPION; ACYCLOVIR [ACICLOVIR]

Current Illness:

ID: 1639320
Sex: M
Age:
State: MI

Vax Date: 01/18/2021
Onset Date: 05/06/2021
Rec V Date: 08/27/2021
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: Legs and arms broke out in a rash where the sun was in contact with them/Does the vaccine cause sensitivity to the sun; Arms and legs continue to blister and peal if I out in the sun; Arms and legs exposed to sun were extremely itchy; This spontaneous case was reported by a consumer and describes the occurrence of PHOTOSENSITIVITY REACTION (Legs and arms broke out in a rash where the sun was in contact with them/Does the vaccine cause sensitivity to the sun), BLISTER (Arms and legs continue to blister and peal if I out in the sun) and PRURITUS (Arms and legs exposed to sun were extremely itchy) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 015M20A and 011J20A) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy (Sulfa- Stomach pain) and Allergy to antibiotic (Amoxicillin- Hives). On 18-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 06-May-2021, the patient experienced PHOTOSENSITIVITY REACTION (Legs and arms broke out in a rash where the sun was in contact with them/Does the vaccine cause sensitivity to the sun), BLISTER (Arms and legs continue to blister and peal if I out in the sun) and PRURITUS (Arms and legs exposed to sun were extremely itchy). The patient was treated with HYDROCORTISONE on 06-May-2021 for Adverse event, at an unspecified dose and frequency. At the time of the report, PHOTOSENSITIVITY REACTION (Legs and arms broke out in a rash where the sun was in contact with them/Does the vaccine cause sensitivity to the sun), BLISTER (Arms and legs continue to blister and peal if I out in the sun) and PRURITUS (Arms and legs exposed to sun were extremely itchy) had not resolved. No relevant concomitant medication was reported. Patient experienced symptoms like redness. Most recent FOLLOW-UP information incorporated above includes: On 15-Jul-2021: Follow up received and reporter details, patient demography and medical history, dosage information, treatment and events were updated.

Other Meds:

Current Illness: Allergy to antibiotic (Amoxicillin- Hives); Drug allergy (Sulfa- Stomach pain)

ID: 1639321
Sex: F
Age: 14
State: GA

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 08/27/2021
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: 14 year old patient received first dose of Moderna vaccine; This spontaneous case was reported by a health care professional and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (14 year old patient received first dose of Moderna vaccine) in a 14-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 19-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-May-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (14 year old patient received first dose of Moderna vaccine). On 19-May-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (14 year old patient received first dose of Moderna vaccine) 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 concomitant medications information provided. Patient did not report any side effects after the vaccination.

Other Meds:

Current Illness:

ID: 1639322
Sex: F
Age: 78
State: NC

Vax Date: 02/11/2021
Onset Date:
Rec V Date: 08/27/2021
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: achiness; tingling; Loss of appetite; fatigue; fever; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (achiness), PARAESTHESIA (tingling), DECREASED APPETITE (Loss of appetite), FATIGUE (fatigue) and PYREXIA (fever) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 024M20A and 032M20A) 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) (unknown route) 1 dosage form. On 11-Mar-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 PAIN (achiness), PARAESTHESIA (tingling), DECREASED APPETITE (Loss of appetite), FATIGUE (fatigue) and PYREXIA (fever). The patient was treated with CALAMINE at a dose of UNK dosage form and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at a dose of UNK dosage form. At the time of the report, PAIN (achiness), PARAESTHESIA (tingling), DECREASED APPETITE (Loss of appetite), FATIGUE (fatigue) and PYREXIA (fever) outcome was unknown. No relevant concomitant medication was reported. This case was linked to MOD-2021-015832.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am