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: 1639323
Sex: U
Age:
State:

Vax Date: 05/05/2021
Onset Date: 06/16/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (I ready got my vaccine on June 16) 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-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Jun-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (I ready got my vaccine on June 16). On 16-Jun-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (I ready got my vaccine on June 16) had resolved. No concomitant medications were reported. No treatment medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 05-Aug-2021: Moderna vaccine dose 2 details added and event 'Missed dose' was changed to 'Inappropriate schedule of drug administration.

Other Meds:

Current Illness:

ID: 1639324
Sex: M
Age: 64
State: LA

Vax Date: 04/06/2021
Onset Date:
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: Pharmacist states patient received 1st dose 6Apr2021; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Pharmacist states patient received 1st dose 6Apr2021) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 06-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) unknown. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Pharmacist states patient received 1st dose 6Apr2021). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Pharmacist states patient received 1st dose 6Apr2021) 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 provided. No treatment details were provided. Most recent FOLLOW-UP information incorporated above includes: On 05-Aug-2021: Fallow up received and contains no new information

Other Meds:

Current Illness:

ID: 1639325
Sex: M
Age:
State: NC

Vax Date: 03/05/2021
Onset Date: 04/01/2021
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: 2nd dose not received,Missed the 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (2nd dose not received,Missed the 2nd dose) in a 44-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Apr-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (2nd dose not received,Missed the 2nd dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (2nd dose not received,Missed the 2nd dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided by the reporter. No treatment medications were provided by the reporter. Patient was scheduled to 2nd dose on 1-APR-2021 however somehow missed it and wanted to know if patient could get 2nd shot or does need to start over again. Most recent FOLLOW-UP information incorporated above includes: On 16-Jun-2021: Follow up received on 16-06-2021 and additional non-significant information added as reporter address

Other Meds:

Current Illness:

ID: 1639326
Sex: F
Age: 48
State: MA

Vax Date: 05/15/2021
Onset Date: 06/11/2021
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: Fever; Chills; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever), CHILLS (Chills) and HEADACHE (Headache) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039K20A and 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 13-Jun-2021, PYREXIA (Fever), CHILLS (Chills) and HEADACHE (Headache) had resolved. No relevant concomitant medication was reported. Treatment information was not provided. This case was linked to MOD-2021-223907 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 12-Jul-2021: Follow up received contains no new information.

Other Meds:

Current Illness:

ID: 1639327
Sex: F
Age: 74
State: MI

Vax Date: 03/10/2021
Onset Date: 03/10/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Sick; Slept on and off all day; Nauseous; Arm was sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm was sore), ILLNESS (Sick), SOMNOLENCE (Slept on and off all day) and NAUSEA (Nauseous) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Mar-2021, the patient experienced PAIN IN EXTREMITY (Arm was sore). On 11-Mar-2021, the patient experienced ILLNESS (Sick), SOMNOLENCE (Slept on and off all day) and NAUSEA (Nauseous). In March 2021, SOMNOLENCE (Slept on and off all day) and NAUSEA (Nauseous) had resolved. At the time of the report, PAIN IN EXTREMITY (Arm was sore) and ILLNESS (Sick) had resolved. 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-2021-223978.

Other Meds:

Current Illness:

ID: 1639328
Sex: U
Age:
State:

Vax Date:
Onset Date:
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: Contracting COVID-19 after receiving the Moderna Covid-19 vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Contracting COVID-19 after receiving the 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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced COVID-19 (Contracting COVID-19 after receiving the Moderna Covid-19 vaccine). At the time of the report, COVID-19 (Contracting COVID-19 after receiving the Moderna Covid-19 vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatment details were provided.

Other Meds:

Current Illness:

ID: 1639329
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Arm is hot to touch; Arm is hard; Rash; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Arm is hot to touch), VACCINATION SITE INDURATION (Arm is hard) and VACCINATION SITE RASH (Rash) 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 SITE WARMTH (Arm is hot to touch), VACCINATION SITE INDURATION (Arm is hard) and VACCINATION SITE RASH (Rash). At the time of the report, VACCINATION SITE WARMTH (Arm is hot to touch), VACCINATION SITE INDURATION (Arm is hard) and VACCINATION SITE RASH (Rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639330
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: Pharyngeal swelling

Symptoms: The spot where I got the vaccine is now yellow and blueish; This spontaneous case was reported by a pharmacist and describes the occurrence of VACCINATION SITE DISCOLOURATION (The spot where I got the vaccine is now yellow and blueish) 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 SITE DISCOLOURATION (The spot where I got the vaccine is now yellow and blueish). At the time of the report, VACCINATION SITE DISCOLOURATION (The spot where I got the vaccine is now yellow and blueish) 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. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639331
Sex: M
Age: 17
State: SC

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Inappropriate age at vaccine administration; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Inappropriate age at vaccine administration) in a 17-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022C21A) for COVID-19 vaccination. No Medical History information was reported. On 16-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Jun-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Inappropriate age at vaccine administration). On 16-Jun-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Inappropriate age at vaccine administration) 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 medication reported. No treatment information reported.

Other Meds:

Current Illness:

ID: 1639332
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: been 10 weeks since my first vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (been 10 weeks since my first 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (been 10 weeks since my first vaccine). At the time of the report, PRODUCT DOSE OMISSION ISSUE (been 10 weeks since my first vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639333
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: I have all possible side effects; I believe I have got covid-19; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE REACTION (I have all possible side effects) and COVID-19 (I believe I have got covid-19) 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 ADVERSE REACTION (I have all possible side effects) and COVID-19 (I believe I have got covid-19). At the time of the report, ADVERSE REACTION (I have all possible side effects) and COVID-19 (I believe I have got covid-19) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information not provided. Concomitant medications were not provided. This case was linked to MOD-2021-223973 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639334
Sex: M
Age: 33
State: AL

Vax Date: 04/30/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: at the vaccination site it got itchy,it's like a bug bite or something; sore arm; red bump; inflammation; like a bug bite; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (at the vaccination site it got itchy,it's like a bug bite or something), PAIN IN EXTREMITY (sore arm), ERYTHEMA (red bump), INFLAMMATION (inflammation) and VACCINATION SITE REACTION (like a bug bite ) in a 33-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030B21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included CANNABIS SATIVA (CANNABIS) for an unknown indication. On 30-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 VACCINATION SITE PRURITUS (at the vaccination site it got itchy,it's like a bug bite or something), PAIN IN EXTREMITY (sore arm), ERYTHEMA (red bump), INFLAMMATION (inflammation) and VACCINATION SITE REACTION (like a bug bite ). At the time of the report, VACCINATION SITE PRURITUS (at the vaccination site it got itchy,it's like a bug bite or something), PAIN IN EXTREMITY (sore arm), ERYTHEMA (red bump), INFLAMMATION (inflammation) and VACCINATION SITE REACTION (like a bug bite ) 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 relevant concomitant medication was reported. Treatment information was not provided. This case was linked to MOD-2021-224027 (Patient Link).

Other Meds: CANNABIS

Current Illness:

ID: 1639335
Sex: U
Age:
State:

Vax Date: 05/28/2021
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: arm was still really sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm was still really 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 28-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (arm was still really sore). At the time of the report, PAIN IN EXTREMITY (arm was still really sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medication was reported. No treatment information provided by Reporter. Second dose scheduled on 29-JUN-2021. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639336
Sex: F
Age: 29
State: TX

Vax Date: 06/13/2021
Onset Date: 06/14/2021
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: Throat pain/ sore throat; Felt like throat was closing up; Pain in the left butt cheek; Got period with in 24 hours of getting the vaccine; This spontaneous case was reported by a consumer and describes the occurrence of MENSTRUATION IRREGULAR (Got period with in 24 hours of getting the vaccine), OROPHARYNGEAL PAIN (Throat pain/ sore throat), THROAT TIGHTNESS (Felt like throat was closing up) and MUSCULOSKELETAL PAIN (Pain in the left butt cheek) in a 29-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 02B21A) for COVID-19 vaccination. Concurrent medical conditions included Food allergy (Allergy to cinnamon) and Latex allergy. Concomitant products included COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) for an unknown indication. On 13-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Jun-2021, the patient experienced MENSTRUATION IRREGULAR (Got period with in 24 hours of getting the vaccine) and MUSCULOSKELETAL PAIN (Pain in the left butt cheek). On 15-Jun-2021, the patient experienced OROPHARYNGEAL PAIN (Throat pain/ sore throat) and THROAT TIGHTNESS (Felt like throat was closing up). The patient was treated with DEXTROMETHORPHAN HYDROBROMIDE, GUAIFENESIN, PARACETAMOL, PSEUDOEPHEDRINE (WALGREENS NON-DROWSY DAYTIME) for Throat pain, at an unspecified dose and frequency; DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency and PREDNISONE at an unspecified dose and frequency. At the time of the report, MENSTRUATION IRREGULAR (Got period with in 24 hours of getting the vaccine), OROPHARYNGEAL PAIN (Throat pain/ sore throat), THROAT TIGHTNESS (Felt like throat was closing up) and MUSCULOSKELETAL PAIN (Pain in the left butt cheek) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: VITAMIN D [COLECALCIFEROL]

Current Illness: Food allergy (Allergy to cinnamon); Latex allergy

ID: 1639337
Sex: F
Age: 44
State: NJ

Vax Date: 05/18/2021
Onset Date: 06/16/2021
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: Fever : 100.6 F; Joint pain that ?it is the worst thing she ever had?; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever : 100.6 F), ARTHRALGIA (Joint pain that ?it is the worst thing she ever had?) and HEADACHE (Headache) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003C21A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension (patient takes Blood pressure pills?.) and Heart disease, unspecified (patient takes?Heart Medicine?.). On 18-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Jun-2021, the patient experienced PYREXIA (Fever : 100.6 F), ARTHRALGIA (Joint pain that ?it is the worst thing she ever had?) and HEADACHE (Headache). The patient was treated with PARACETAMOL (TYLENOL) ongoing from 16-Jun-2021 at a dose of 2 tablets. At the time of the report, PYREXIA (Fever : 100.6 F), ARTHRALGIA (Joint pain that ?it is the worst thing she ever had?) and HEADACHE (Headache) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant drugs include pills for stomach, blood pressure, allergy and heart ache. No treatment medications were reported. Action taken with mRNA-1273 in response to the events was not applicable. Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: home address provided.

Other Meds:

Current Illness: Heart disease, unspecified (patient takes?Heart Medicine?.); Hypertension (patient takes Blood pressure pills?.)

ID: 1639338
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: allergic reaction; arm is still swollen; itched like a thousand mosquito bites; This spontaneous case was reported by a patient and describes the occurrence of ALLERGY TO VACCINE (allergic reaction), PERIPHERAL SWELLING (arm is still swollen) and PRURITUS (itched like a thousand mosquito bites) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (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 ALLERGY TO VACCINE (allergic reaction), PERIPHERAL SWELLING (arm is still swollen) and PRURITUS (itched like a thousand mosquito bites). At the time of the report, ALLERGY TO VACCINE (allergic reaction), PERIPHERAL SWELLING (arm is still swollen) and PRURITUS (itched like a thousand mosquito bites) outcome was unknown. Concomitant information were not provided by the reporter.

Other Meds:

Current Illness:

ID: 1639339
Sex: U
Age:
State:

Vax Date:
Onset Date:
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: I had severe stomach cramping; 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 ABDOMINAL PAIN UPPER (I had severe stomach cramping) 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 ABDOMINAL PAIN UPPER (I had severe stomach cramping). At the time of the report, ABDOMINAL PAIN UPPER (I had severe stomach cramping) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were mentioned. No treatment details were reported.

Other Meds:

Current Illness:

ID: 1639340
Sex: U
Age:
State:

Vax Date:
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: Grandson got sick after the vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Grandson got sick after the 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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ILLNESS (Grandson got sick after the vaccine). At the time of the report, ILLNESS (Grandson got sick after the vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medication was reported. No Treatment medication was reported. This case was linked to MOD-2021-223903, MOD-2021-223952 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639341
Sex: F
Age: 74
State: MI

Vax Date: 03/10/2021
Onset Date: 04/01/2021
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: all she wanted to do was sleep; arm was sore; tired; her arm turned bright pink all around the wound which lasted about a week; This spontaneous case was reported by a patient and describes the occurrence of SOMNOLENCE (all she wanted to do was sleep), PAIN IN EXTREMITY (arm was sore), FATIGUE (tired) and VACCINATION SITE RASH (her arm turned bright pink all around the wound which lasted about a week) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In April 2021, the patient experienced SOMNOLENCE (all she wanted to do was sleep), PAIN IN EXTREMITY (arm was sore), FATIGUE (tired) and VACCINATION SITE RASH (her arm turned bright pink all around the wound which lasted about a week). At the time of the report, SOMNOLENCE (all she wanted to do was sleep), PAIN IN EXTREMITY (arm was sore), FATIGUE (tired) and VACCINATION SITE RASH (her arm turned bright pink all around the wound which lasted about a week) had resolved. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639342
Sex: U
Age:
State:

Vax Date:
Onset Date:
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: had a headache after the shot; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (had a headache after the shot ) 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 HEADACHE (had a headache after the shot ). At the time of the report, HEADACHE (had a headache after the shot ) 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: 1639343
Sex: U
Age:
State:

Vax Date: 06/01/2021
Onset Date: 06/16/2021
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 VACCINATION SITE WARMTH (Hot Injection Site after Second vaccine) and VACCINATION SITE ERYTHEMA (Red Injection Site after Second 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. In June 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 16-Jun-2021, the patient experienced VACCINATION SITE WARMTH (Hot Injection Site after Second vaccine) and VACCINATION SITE ERYTHEMA (Red Injection Site after Second vaccine). At the time of the report, VACCINATION SITE WARMTH (Hot Injection Site after Second vaccine) and VACCINATION SITE ERYTHEMA (Red Injection Site after Second vaccine) outcome was unknown. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639344
Sex: F
Age:
State: FL

Vax Date: 03/10/2021
Onset Date: 03/24/2021
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: Test Date: 20210403; Test Name: kidney ultrasound; Test Result: Negative ; Result Unstructured Data: Negative

Allergies:

Symptom List: Unevaluable event

Symptoms: 16 hrs trying to sleep; Fever; extreme joint pain/Severe mucle/joint pains; extreme muscle pain/Severe mucle/joint pains; fatigue/Extreme fatigue lasting for apprx one wk.; Very bad/painful headache/Severe Headache; Slight Nausea; terrible chills/Severe chills/Shivering; Backache; Very severe reaction; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE REACTION (Very severe reaction), INSOMNIA (16 hrs trying to sleep), BACK PAIN (Backache), PYREXIA (Fever) and CHILLS (terrible chills/Severe chills/Shivering) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025A21A and 020B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Arthritis (changes in hip ,neck ,spine, hands) since 1990, Fibromyalgia, Penicillin allergy, Drug allergy (Allergic to Levaquin), Iodine allergy, Drug allergy (Allergic to prednisolone), Drug allergy (Allergic to aspirin), Drug allergy (Allergic to bystolic), Drug allergy (allergic to Norvasc), Drug allergy (Allergic to calcium tablets) and Drug allergy. Concomitant products included QUINAPRIL and CARVEDILOL for Blood pressure management, ROSUVASTATIN CALCIUM (CRESTOR) for Cholesterol, TRAZODONE, PARACETAMOL (TYLENOL), MULTIVITAMIN [VITAMINS NOS], KRILL OIL and CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000) for an unknown indication. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Mar-2021, the patient experienced ADVERSE REACTION (Very severe reaction), BACK PAIN (Backache), CHILLS (terrible chills/Severe chills/Shivering), MYALGIA (extreme muscle pain/Severe mucle/joint pains), FATIGUE (fatigue/Extreme fatigue lasting for apprx one wk.), HEADACHE (Very bad/painful headache/Severe Headache) and NAUSEA (Slight Nausea). On an unknown date, the patient experienced INSOMNIA (16 hrs trying to sleep), PYREXIA (Fever) and ARTHRALGIA (extreme joint pain/Severe mucle/joint pains). At the time of the report, ADVERSE REACTION (Very severe reaction), BACK PAIN (Backache), CHILLS (terrible chills/Severe chills/Shivering), MYALGIA (extreme muscle pain/Severe mucle/joint pains), FATIGUE (fatigue/Extreme fatigue lasting for apprx one wk.), HEADACHE (Very bad/painful headache/Severe Headache) and NAUSEA (Slight Nausea) had not resolved and INSOMNIA (16 hrs trying to sleep), PYREXIA (Fever) and ARTHRALGIA (extreme joint pain/Severe mucle/joint pains) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Apr-2021, Ultrasound kidney: negative (Negative) Negative. Concomitant medications include fenofibrilate and HCTZ and coq10-100mg one every other day No treatment medications were reported. This case was linked to MOD-2021-224013 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: Follow up received on 14-Jul-2021 contains added second dose information, patient demographics, concomitant medications, added new events and outcome of the events were updated.

Other Meds: TRAZODONE; TYLENOL; MULTIVITAMIN [VITAMINS NOS]; KRILL OIL; VITAMIN D 2000; QUINAPRIL; CARVEDILOL; CRESTOR

Current Illness: Arthritis (changes in hip ,neck ,spine, hands); Drug allergy (Allergic to prednisolone); Drug allergy (allergic to Norvasc); Drug allergy (Allergic to Levaquin); Drug allergy (Allergic to calcium tablets); Drug allergy (Allergic to bystolic); Drug allergy (Allergic to aspirin); Drug allergy; Fibromyalgia; Iodine allergy; Penicillin allergy

ID: 1639345
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: LA

Lab Data:

Allergies:

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

Symptoms: nose bleed; flu; 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 EPISTAXIS (nose bleed) and INFLUENZA (flu) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced EPISTAXIS (nose bleed) and INFLUENZA (flu). At the time of the report, EPISTAXIS (nose bleed) and INFLUENZA (flu) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. no concomitant medication was reported no treatment medication was reported

Other Meds:

Current Illness:

ID: 1639346
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Increased heart rate; Dizziness; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE INCREASED (Increased heart rate) and DIZZINESS (Dizziness) 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 HEART RATE INCREASED (Increased heart rate) and DIZZINESS (Dizziness). At the time of the report, HEART RATE INCREASED (Increased heart rate) and DIZZINESS (Dizziness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639347
Sex: M
Age: 46
State: FL

Vax Date: 02/02/2021
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: Patient hasn't received 2nd dose yet; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Patient hasn't received 2nd dose yet) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028L20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Patient hasn't received 2nd dose yet). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Patient hasn't received 2nd dose yet) 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. Treatment information was not provided. Action taken with mRNA-1273 (Moderna COVID-19 Vaccine) in response to the events was not applicable. Most recent FOLLOW-UP information incorporated above includes: On 16-Jun-2021: Non significant follow up information. No new information

Other Meds:

Current Illness:

ID: 1639348
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: dizzy still after 23 hours from second dose.; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizzy still after 23 hours from 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 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 DIZZINESS (dizzy still after 23 hours from second dose.). At the time of the report, DIZZINESS (dizzy still after 23 hours from second dose.) 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: 1639349
Sex: M
Age: 69
State: NC

Vax Date: 03/12/2021
Onset Date: 03/15/2021
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:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (had a sore left arm after receiving 1st dose on 3rd day/left arm has been hurting) and MOBILITY DECREASED (could barely lift his arm) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 044A21A) for COVID-19 vaccination. No medical history was provided by the reporter. On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Mar-2021, the patient experienced PAIN IN EXTREMITY (had a sore left arm after receiving 1st dose on 3rd day/left arm has ben hurting) and MOBILITY DECREASED (could barely lift his arm). At the time of the report, PAIN IN EXTREMITY (had a sore left arm after receiving 1st dose on 3rd day/left arm has ben hurting) and MOBILITY DECREASED (could barely lift his arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant products included Blood pressure medication, Anti-depressants and ANTIBIOTICS for an unknown indication. Treatment included Ice, heating pad and Muscle rub. This case was linked to MOD-2021-224267. Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: TCR was received patient address was updated.

Other Meds:

Current Illness:

ID: 1639350
Sex: F
Age: 35
State: FL

Vax Date: 12/23/2020
Onset Date: 12/23/2020
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: Vaccine exposure during pregnancy; Soreness at injection site; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy) and VACCINATION SITE PAIN (Soreness at injection site) in a 36-year-old female patient (gravida 3, para 2) who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 23-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on an unknown date and the estimated date of delivery was 06-Sep-2021. On 23-Dec-2020, the patient experienced EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy) and VACCINATION SITE PAIN (Soreness at injection site). On 23-Dec-2020, EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy) had resolved. At the time of the report, VACCINATION SITE PAIN (Soreness at injection site) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was withdrawn on an unknown date. Concomitant medication use was not provided. Patient reported date of last menstrual period was unknown but also reported it was in November 2020. No Treatment information was provided. This is a case of product exposure during pregnancy with an associated adverse event of vaccination site pain in the mother. Based on temporal association a causal relationship cannot be excluded. For the event transposition of the great vessels a case for the unborn fetus has been requested to be opened.; Sender's Comments: This is a case of product exposure during pregnancy with an associated adverse event of vaccination site pain in the mother. Based on temporal association a causal relationship cannot be excluded. For the event transposition of the great vessels a case for the unborn fetus has been requested to be opened.

Other Meds:

Current Illness:

ID: 1639351
Sex: M
Age: 75
State: VA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: itching; felt not his best/terrible and sick described as having no energy and could hardly move; headache suspected as migraine; sore arm muscle; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm muscle), PRURITUS (itching), FATIGUE (felt not his best/terrible and sick described as having no energy and could hardly move) and HEADACHE (headache suspected as migraine) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy and Drug allergy (benadryl). Concomitant products included FINASTERIDE and TAMSULOSIN for an unknown indication. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Feb-2021, the patient experienced PAIN IN EXTREMITY (sore arm muscle). On 27-Feb-2021, the patient experienced FATIGUE (felt not his best/terrible and sick described as having no energy and could hardly move) and HEADACHE (headache suspected as migraine). On 28-Feb-2021, the patient experienced PRURITUS (itching). The patient was treated with ISOPROPANOL (RUBBING ALCOHOL) for Adverse event, at an unspecified dose and frequency. On 28-Feb-2021, HEADACHE (headache suspected as migraine) had resolved. On 04-Mar-2021, FATIGUE (felt not his best/terrible and sick described as having no energy and could hardly move) had resolved. On 05-Mar-2021, PAIN IN EXTREMITY (sore arm muscle) and PRURITUS (itching) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications includes blood pressure medication.

Other Meds: FINASTERIDE; TAMSULOSIN

Current Illness: Drug allergy (benadryl); Penicillin allergy

ID: 1639352
Sex: F
Age: 67
State: FL

Vax Date: 02/05/2021
Onset Date: 02/13/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: had a delayed response; erythema/rectangular shape about 3.5 inches by 2 inches on the deltoid; tenseness underneath the skin; felt dense; looked like a bad rash after you take a band aid off; This spontaneous case was reported by a health care professional and describes the occurrence of VACCINATION COMPLICATION (had a delayed response), ERYTHEMA (erythema/rectangular shape about 3.5 inches by 2 inches on the deltoid), TENSION (tenseness underneath the skin), FEELING ABNORMAL (felt dense) and RASH (looked like a bad rash after you take a band aid off) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. Concurrent medical conditions included Allergy to antibiotic (sulfonamides). On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Feb-2021, the patient experienced VACCINATION COMPLICATION (had a delayed response), ERYTHEMA (erythema/rectangular shape about 3.5 inches by 2 inches on the deltoid), TENSION (tenseness underneath the skin), FEELING ABNORMAL (felt dense) and RASH (looked like a bad rash after you take a band aid off). At the time of the report, VACCINATION COMPLICATION (had a delayed response), ERYTHEMA (erythema/rectangular shape about 3.5 inches by 2 inches on the deltoid), TENSION (tenseness underneath the skin), FEELING ABNORMAL (felt dense) and RASH (looked like a bad rash after you take a band aid off) 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 Concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness: Allergy to antibiotic (sulfonamides)

ID: 1639353
Sex: F
Age:
State: KS

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: Vccaine given before 21 days after first dose; This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Vccaine given before 21 days after first dose) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unk) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (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 INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Vccaine given before 21 days after first dose). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Vccaine given before 21 days after first dose) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant and treatment information were not provided.

Other Meds:

Current Illness:

ID: 1639354
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: swelling at the inection sight; redness at the inection sight; This spontaneous case was reported by a patient and describes the occurrence of VACCINATION SITE SWELLING (swelling at the inection sight) and VACCINATION SITE ERYTHEMA (redness at the inection sight) 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 VACCINATION SITE SWELLING (swelling at the inection sight) and VACCINATION SITE ERYTHEMA (redness at the inection sight). At the time of the report, VACCINATION SITE SWELLING (swelling at the inection sight) and VACCINATION SITE ERYTHEMA (redness at the inection sight) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications were not provided. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639355
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: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Diarrhea; 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 DIARRHOEA (Diarrhea) 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 DIARRHOEA (Diarrhea). At the time of the report, DIARRHOEA (Diarrhea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information not provided. Concomitant medications were not provided.

Other Meds:

Current Illness:

ID: 1639356
Sex: M
Age: 59
State: CA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
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: hard time sleeping; pain limits the patient ability to walk; Shoulder pain; Pain spreading in muscle; Couldn't move his left hand/ raising the left arm to about 30 degrees the left arm falls/ pain limits the patient ability to do tasks; Finger was numb; Tingling hand; Neck pain/ neck pain happens when they turn their head to the left/ pain all the way up the neck; left hand and arm pain/tenderness; when they brush their teeth the sharp pain occurs in their left cheek bone/ left cheek bone pain; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE MOVEMENT IMPAIRMENT (Couldn't move his left hand/ raising the left arm to about 30 degrees the left arm falls/ pain limits the patient ability to do tasks), HYPOAESTHESIA (Finger was numb), PARAESTHESIA (Tingling hand), NECK PAIN (Neck pain/ neck pain happens when they turn their head to the left/ pain all the way up the neck) and PAIN IN EXTREMITY (left hand and arm pain/tenderness) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 31-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-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 MOVEMENT IMPAIRMENT (Couldn't move his left hand/ raising the left arm to about 30 degrees the left arm falls/ pain limits the patient ability to do tasks), HYPOAESTHESIA (Finger was numb), PARAESTHESIA (Tingling hand), NECK PAIN (Neck pain/ neck pain happens when they turn their head to the left/ pain all the way up the neck) and ARTHRALGIA (Shoulder pain). 01-Apr-2021, the patient experienced PAIN IN EXTREMITY (left hand and arm pain/tenderness), BONE PAIN (when they brush their teeth the sharp pain occurs in their left cheek bone/ left cheek bone pain) and MYALGIA (Pain spreading in muscle). On an unknown date, the patient experienced INSOMNIA (hard time sleeping) and GAIT DISTURBANCE (pain limits the patient ability to walk). The patient was treated with CORTISONE at an unspecified dose and frequency; HYDROCODONE BITARTRATE, PARACETAMOL (NORCO) for Pain, at an unspecified dose and frequency; BUPRENORPHINE HYDROCHLORIDE (BUPRENORPHIN) for Pain, at an unspecified dose and frequency and Physical therapy for Gait disturbance. At the time of the report, VACCINATION SITE MOVEMENT IMPAIRMENT (Couldn't move his left hand/ raising the left arm to about 30 degrees the left arm falls/ pain limits the patient ability to do tasks), NECK PAIN (Neck pain/ neck pain happens when they turn their head to the left/ pain all the way up the neck), PAIN IN EXTREMITY (left hand and arm pain/tenderness), BONE PAIN (when they brush their teeth the sharp pain occurs in their left cheek bone/ left cheek bone pain), INSOMNIA (hard time sleeping), GAIT DISTURBANCE (pain limits the patient ability to walk), ARTHRALGIA (Shoulder pain) and MYALGIA (Pain spreading in muscle) had not resolved and HYPOAESTHESIA (Finger was numb) and PARAESTHESIA (Tingling hand) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Action taken with mRNA-1273 in response to the event was not applicable. Concomitant medicines were not provided by the reporter. Lab data included as Magnetic resonance imaging on arm Most recent FOLLOW-UP information incorporated above includes: On 16-Jun-2021: Follow up received and report a potential AE, caller wanted to call in and verify that his symptoms reported started before he received his 2nd dose, as he originally reported they had started after. Outcome of event numbness was updated from unknown to recovered/resolved. Contact information was corrected. On 21-Jul-2021: Significant follow-up appended. Vaccine second dose date updated. Treatment medicines added. Events added and outcome of the events updated. Physical therapy included.

Other Meds:

Current Illness:

ID: 1639357
Sex: F
Age:
State: FL

Vax Date: 01/04/2021
Onset Date: 04/22/2021
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: second dose given outside vaccine window; This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose given outside vaccine window) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 001C21A and 025J202A) for COVID-19 vaccination. No Medical History information was reported. On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 22-Apr-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose given outside vaccine window). On 22-Apr-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose given outside vaccine window) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications were not provided. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1639358
Sex: F
Age:
State: FL

Vax Date: 03/10/2021
Onset Date: 04/07/2021
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: Test Date: 20210403; Test Name: kidney ultrasound; Test Result: Negative ; Result Unstructured Data: negative

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: every 3 wks or so I'm hit with another "wave" of the same side effects; Face itchy; eyes got puffy; again tongue burned; palate and tongue itchy; small bumps inside lips; nose (internally) had burning sensation; Allergic reaction to eating mangoes; Tongue felt burned/ again tongue burned/Nose (internally) had burning sensation; Tongue/palate itchy; Inside the lip had small bumps; Throat burned; fever; Joint pain/ muscle/joint pains; Slight nausea; fatigue/Extream fatigue lasting for apprx. one wk; muscle pain/muscle/joint pains; headache; Chills/ chills/Shivering; 16 hrs trying to sleep; Backache; This spontaneous case was reported by a consumer and describes the occurrence of INSOMNIA (16 hrs trying to sleep), BACK PAIN (Backache), FOOD ALLERGY (Allergic reaction to eating mangoes), BURNING SENSATION (Tongue felt burned/ again tongue burned/Nose (internally) had burning sensation) and TONGUE PRURITUS (Tongue/palate itchy) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 020B21A and 025A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Flu. Concurrent medical conditions included Fibromyalgia since 1980, Arthritis (changes in hip, neck, spine, hands) since 1990, Penicillin allergy (allergy to pcn), Drug allergy (allergy to levaquin), Iodine allergy, Drug allergy (allergy to prednisone), Drug allergy (allergy to aspirin), Drug allergy (allergy to Bystolic), Drug allergy (allergy to Norvasc), Drug allergy (allergy to calcium tablets) and Drug allergy (allergy to NSAIDS). Concomitant products included QUINAPRIL, HCTZ and CARVEDILOL for Blood pressure management, ROSUVASTATIN CALCIUM (CRESTOR) for Cholesterol high, FENOFIBRATE for Triglycerides abnormal, TRAZODONE, MULTIVITAMIN [VITAMINS NOS], KRILL OIL (KRILL OIL OMEGA 3), ERGOCALCIFEROL (VIT D [ERGOCALCIFEROL]), COLECALCIFEROL, UBIDECARENONE (COQ10 + D3) and PARACETAMOL (TYLENOL) for an unknown indication. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 07-Apr-2021, the patient experienced INSOMNIA (16 hrs trying to sleep), BACK PAIN (Backache), PYREXIA (fever), ARTHRALGIA (Joint pain/ muscle/joint pains), NAUSEA (Slight nausea), FATIGUE (fatigue/Extream fatigue lasting for apprx. one wk), MYALGIA (muscle pain/muscle/joint pains), HEADACHE (headache) and CHILLS (Chills/ chills/Shivering). In June 2021, the patient experienced FOOD ALLERGY (Allergic reaction to eating mangoes), BURNING SENSATION (Tongue felt burned/ again tongue burned/Nose (internally) had burning sensation), TONGUE PRURITUS (Tongue/palate itchy), LIP DISORDER (Inside the lip had small bumps) and THROAT IRRITATION (Throat burned). On 07-Jul-2021, the patient experienced PRURITUS (Face itchy), PERIORBITAL SWELLING (eyes got puffy), BURNING SENSATION (again tongue burned), TONGUE PRURITUS (palate and tongue itchy), LIP DISORDER (small bumps inside lips) and BURNING SENSATION (nose (internally) had burning sensation). On an unknown date, the patient experienced EXTRAPYRAMIDAL DISORDER (every 3 wks or so I'm hit with another "wave" of the same side effects). At the time of the report, INSOMNIA (16 hrs trying to sleep), EXTRAPYRAMIDAL DISORDER (every 3 wks or so I'm hit with another "wave" of the same side effects), PYREXIA (fever), ARTHRALGIA (Joint pain/ muscle/joint pains), FATIGUE (fatigue/Extream fatigue lasting for apprx. one wk), MYALGIA (muscle pain/muscle/joint pains), HEADACHE (headache) and CHILLS (Chills/ chills/Shivering) had not resolved, BACK PAIN (Backache), FOOD ALLERGY (Allergic reaction to eating mangoes), BURNING SENSATION (Tongue felt burned/ again tongue burned/Nose (internally) had burning sensation), TONGUE PRURITUS (Tongue/palate itchy), LIP DISORDER (Inside the lip had small bumps), THROAT IRRITATION (Throat burned) and NAUSEA (Slight nausea) had resolved and PRURITUS (Face itchy), PERIORBITAL SWELLING (eyes got puffy), BURNING SENSATION (again tongue burned), TONGUE PRURITUS (palate and tongue itchy), LIP DISORDER (small bumps inside lips) and BURNING SENSATION (nose (internally) had burning sensation) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Apr-2021, Ultrasound kidney: negative (Negative) negative. No treatment information was provided by the reporter. This case was linked to MOD-2021-223983 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: Follow up received including contains updated patient demographics , medical history , lab data , added concomitant medications, added new events and its outcome.

Other Meds: QUINAPRIL; HCTZ; CARVEDILOL; CRESTOR; FENOFIBRATE; TRAZODONE; MULTIVITAMIN [VITAMINS NOS]; KRILL OIL OMEGA 3; VIT D [ERGOCALCIFEROL]; COQ10 + D3; TYLENOL

Current Illness: Arthritis (changes in hip, neck, spine, hands); Drug allergy (allergy to prednisone); Drug allergy (allergy to NSAIDS); Drug allergy (allergy to Norvasc); Drug allergy (allergy to levaquin); Drug allergy (allergy to calcium tablets); Drug allergy (allergy to Bystolic); Drug allergy (allergy to aspirin); Fibromyalgia; Iodine allergy; Penicillin allergy (allergy to pcn)

ID: 1639359
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: 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: pregnancy registry; This spontaneous pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (pregnancy registry) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (pregnancy registry). At the time of the report, EXPOSURE DURING PREGNANCY (pregnancy registry) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not provided. Treatment medication was not provided.

Other Meds:

Current Illness:

ID: 1639360
Sex: U
Age:
State: NY

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: Missed the second appointment; 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 PRODUCT DOSE OMISSION ISSUE (Missed the second appointment) 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 DOSE OMISSION ISSUE (Missed the second appointment). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Missed the second appointment) 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 concomitant products were reported. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 14-Jul-2021: Followup received on 14-JUL-2021 contains no new significant information. updated primary reporter details On 14-Jul-2021: Follow up received included on 14-JUL-2021 contains no new significant information

Other Meds:

Current Illness:

ID: 1639361
Sex: M
Age: 35
State: TX

Vax Date: 04/09/2021
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: Patient did not receive the second vaccine dose yet and it is been more than 35 days since the first vaccine dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Patient did not receive the second vaccine dose yet and it is been more than 35 days since the first vaccine dose) in a 35-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037A21B) for COVID-19 vaccination. No Medical History information was reported. On 09-Apr-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 an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Patient did not receive the second vaccine dose yet and it is been more than 35 days since the first vaccine dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Patient did not receive the second vaccine dose yet and it is been more than 35 days since the first vaccine dose) had resolved. No Relevant concomitant medications was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639362
Sex: M
Age: 47
State: NC

Vax Date: 06/12/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: felt so bad; flu-like symptoms; chills; sweats; runny nose; weakness/ no energy/ only wanted to rest; chest pain; tight muscles; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (sweats), RHINORRHOEA (runny nose), ASTHENIA (weakness/ no energy/ only wanted to rest), CHEST PAIN (chest pain) and MUSCLE TIGHTNESS (tight muscles) in a 47-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 12-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 HYPERHIDROSIS (sweats), RHINORRHOEA (runny nose), ASTHENIA (weakness/ no energy/ only wanted to rest), CHEST PAIN (chest pain), MUSCLE TIGHTNESS (tight muscles) and CHILLS (chills). On 15-Jun-2021, the patient experienced FEELING ABNORMAL (felt so bad) and INFLUENZA LIKE ILLNESS (flu-like symptoms). At the time of the report, HYPERHIDROSIS (sweats), RHINORRHOEA (runny nose), ASTHENIA (weakness/ no energy/ only wanted to rest), CHEST PAIN (chest pain), MUSCLE TIGHTNESS (tight muscles), FEELING ABNORMAL (felt so bad), INFLUENZA LIKE ILLNESS (flu-like symptoms) and CHILLS (chills) 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 concomitant medication was reported. No treatment medication was reported .

Other Meds:

Current Illness:

ID: 1639363
Sex: M
Age: 33
State: AL

Vax Date: 04/30/2021
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: Pain in extremity

Symptoms: cold flu symptoms; severe reaction; cold flu symptoms; persistent sinus headache,it feels like a pressure behind the eyes and forehead, specially when patient coughs or stands up really fast; chills; muscle aches/body aches; got tired very easily; very bad headache/sharp pain in the head; This spontaneous case was reported by a consumer and describes the occurrence of NASOPHARYNGITIS (cold flu symptoms), VACCINATION COMPLICATION (severe reaction), INFLUENZA LIKE ILLNESS (cold flu symptoms), SINUS HEADACHE (persistent sinus headache,it feels like a pressure behind the eyes and forehead, specially when patient coughs or stands up really fast) and CHILLS (chills) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 016C21A and 030B21A) 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 CANNABIS SATIVA (CANNABIS) for an unknown indication. On 30-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Jun-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 NASOPHARYNGITIS (cold flu symptoms), VACCINATION COMPLICATION (severe reaction), INFLUENZA LIKE ILLNESS (cold flu symptoms), SINUS HEADACHE (persistent sinus headache,it feels like a pressure behind the eyes and forehead, specially when patient coughs or stands up really fast), CHILLS (chills), MYALGIA (muscle aches/body aches), FATIGUE (got tired very easily) and HEADACHE (very bad headache/sharp pain in the head). At the time of the report, NASOPHARYNGITIS (cold flu symptoms), VACCINATION COMPLICATION (severe reaction), INFLUENZA LIKE ILLNESS (cold flu symptoms), SINUS HEADACHE (persistent sinus headache,it feels like a pressure behind the eyes and forehead, specially when patient coughs or stands up really fast), CHILLS (chills), MYALGIA (muscle aches/body aches), FATIGUE (got tired very easily) and HEADACHE (very bad headache/sharp pain in the head) outcome was unknown. Treatment information not provided. This case was linked to MOD-2021-223956 (Patient Link).

Other Meds: CANNABIS

Current Illness:

ID: 1639364
Sex: F
Age: 40
State: CA

Vax Date: 04/25/2021
Onset Date: 06/16/2021
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: More than 42 days after First shot and she has not received the Second dose/More then 50 days after 1st shot; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 42 days after First shot and she has not received the Second dose/More then 50 days after 1st shot) in a 41-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 25-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Jun-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 42 days after First shot and she has not received the Second dose/More then 50 days after 1st shot). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 42 days after First shot and she has not received the Second dose/More then 50 days after 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 concomitant medications were reported. Treatment medications were not provided by the reporter. The patient reported it have been more than 50 days after first dose. Most recent FOLLOW-UP information incorporated above includes: On 16-Jun-2021: Follow-up information received on 16-JUN-2021: Event details added.

Other Meds:

Current Illness:

ID: 1639365
Sex: M
Age: 67
State:

Vax Date: 02/06/2021
Onset Date: 02/08/2021
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: This spontaneous case reported by a healthcare professional, describes the occurrence of pneumococcal immunisation (took pneumonia shot 2 days after the Moderna vaccine) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch# 013M20A) for COVID-19 immunization. No medical history reported. On Feb 6, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. On Feb 8, 2021, patient experienced pneumococcal immunisation (took pneumonia shot 2 days after the Moderna vaccine). At the time of the report, pneumococcal immunisation (took pneumonia shot 2 days after the Moderna vaccine): unknown. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. The reporter did not provide any causality assessments, concomitant product use or treatment information.

Other Meds:

Current Illness:

ID: 1639366
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: Couldn't sleep; Stomach popping; Stomach cramping and painful; Sharp pain for 8 hours in the stomach; 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 INSOMNIA (Couldn't sleep), GASTROINTESTINAL SOUNDS ABNORMAL (Stomach popping), ABDOMINAL PAIN UPPER (Stomach cramping and painful) and ABDOMINAL PAIN UPPER (Sharp pain for 8 hours in the stomach) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INSOMNIA (Couldn't sleep), GASTROINTESTINAL SOUNDS ABNORMAL (Stomach popping), ABDOMINAL PAIN UPPER (Stomach cramping and painful) and ABDOMINAL PAIN UPPER (Sharp pain for 8 hours in the stomach). At the time of the report, INSOMNIA (Couldn't sleep), GASTROINTESTINAL SOUNDS ABNORMAL (Stomach popping) and ABDOMINAL PAIN UPPER (Stomach cramping and painful) outcome was unknown and ABDOMINAL PAIN UPPER (Sharp pain for 8 hours in the stomach) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant products were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639367
Sex: U
Age:
State: FL

Vax Date: 06/12/2021
Onset Date: 06/12/2021
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: This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient was given a dose from vial that had been punctured more than 12 hours prior) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 050C21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Jun-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient was given a dose from vial that had been punctured more than 12 hours prior). On 12-Jun-2021, EXPIRED PRODUCT ADMINISTERED (Patient was given a dose from vial that had been punctured more than 12 hours prior) 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 product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639368
Sex: F
Age: 42
State:

Vax Date: 06/06/2021
Onset Date: 06/06/2021
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: it was red; (It was) very itchy & It has gotten worse; (It was) hot; Hard knot at the injection site & it was raised & It has gotten worse; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH ((It was) hot), VACCINATION SITE INDURATION (Hard knot at the injection site & it was raised & It has gotten worse), VACCINATION SITE PRURITUS ((It was) very itchy & It has gotten worse) and VACCINATION SITE ERYTHEMA (it was red) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 050C71A) for COVID-19 vaccination. No Medical History information was reported. On 06-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Jun-2021, the patient experienced VACCINATION SITE INDURATION (Hard knot at the injection site & it was raised & It has gotten worse). On 10-Jun-2021, the patient experienced VACCINATION SITE WARMTH ((It was) hot) and VACCINATION SITE PRURITUS ((It was) very itchy & It has gotten worse). On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (it was red). At the time of the report, VACCINATION SITE WARMTH ((It was) hot), VACCINATION SITE INDURATION (Hard knot at the injection site & it was raised & It has gotten worse), VACCINATION SITE PRURITUS ((It was) very itchy & It has gotten worse) and VACCINATION SITE ERYTHEMA (it was red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant medication were reported. Treatment medication was not provided.

Other Meds:

Current Illness:

ID: 1639369
Sex: F
Age: 58
State: MO

Vax Date: 03/10/2021
Onset Date: 03/11/2021
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 consumer and describes the occurrence of PAIN IN EXTREMITY (Arm Pain), MYALGIA (Body Aches) and NAUSEA (Nausea) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. Concomitant products included FLUTICASONE PROPIONATE (FLONASE [FLUTICASONE PROPIONATE]) for Allergy, LAMOTRIGINE for Antidepressant therapy, CLONAZEPAM for Anxiety, LISINOPRIL for Blood pressure abnormal, HYDROCHLOROTHIAZIDE for Blood pressure high, TIZANIDINE for Muscle relaxant. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) at an unspecified dose. On 11-Mar-2021, the patient experienced PAIN IN EXTREMITY (Arm Pain), MYALGIA (Body Aches) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL) for Symptomatic treatment, at an unspecified dose and frequency. On 12-Mar-2021, PAIN IN EXTREMITY (Arm Pain), MYALGIA (Body Aches) and NAUSEA (Nausea) 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.

Other Meds: LISINOPRIL; LAMOTRIGINE; CLONAZEPAM; TIZANIDINE; FLONASE [FLUTICASONE PROPIONATE]; HYDROCHLOROTHIAZIDE

Current Illness:

ID: 1639370
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Greater than 35 days from the first Moderna Covid-19 vaccine prior to receiving the second Moderna Covid-19 vaccine.; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Greater than 35 days from the first Moderna Covid-19 vaccine prior to receiving the second 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, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form(s). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Greater than 35 days from the first Moderna Covid-19 vaccine prior to receiving the second Moderna Covid-19 vaccine.). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Greater than 35 days from the first Moderna Covid-19 vaccine prior to receiving the second Moderna Covid-19 vaccine.) had resolved. 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: 1639371
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: RA

Lab Data:

Allergies:

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

Symptoms: vaccine was accidentally given to a 14 year old; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (vaccine was accidentally given to a 14 year old) in a 14-year-old patient of an unknown 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 (vaccine was accidentally given to a 14 year old). At the time of the report, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (vaccine was accidentally given to a 14 year old) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1639372
Sex: M
Age: 27
State: CO

Vax Date: 05/18/2021
Onset Date: 05/01/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Flu-like symptoms; Bruise at the injection site; Fever; Nausea; Muscle aches; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu-like symptoms), CONTUSION (Bruise at the injection site), PYREXIA (Fever), NAUSEA (Nausea) and MYALGIA (Muscle aches) in a 27-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 033C21A and 008C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 18-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In May 2021, the patient experienced INFLUENZA LIKE ILLNESS (Flu-like symptoms), CONTUSION (Bruise at the injection site), PYREXIA (Fever), NAUSEA (Nausea), MYALGIA (Muscle aches) and FATIGUE (Fatigue). At the time of the report, INFLUENZA LIKE ILLNESS (Flu-like symptoms), CONTUSION (Bruise at the injection site), PYREXIA (Fever), NAUSEA (Nausea), MYALGIA (Muscle aches) and FATIGUE (Fatigue) had resolved. No, Concomitant medication was provided. No, Treatment was provided. Patient had the first dose of the Moderna COVID-19 vaccine on 18May2021 (lot # 033C21A). Immediately after the shot, the patient felt flu-like symptoms, nausea, muscle aches, and fatigue. These got better after about 2 days. This case was linked to MOD-2021-224140 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 30-Jul-2021: Follow-up received on 30 Jul 2021, Updated the outcome for the events.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am