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: 1639874
Sex: F
Age: 74
State: CA

Vax Date: 05/11/2021
Onset Date:
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: little pain in the arm after first dose; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (little pain in the arm after first dose) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006C21A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension. Concomitant products included LOSARTAN and LEVOTHYROXINE for an unknown indication. On 11-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 (little pain in the arm after first dose). At the time of the report, PAIN IN EXTREMITY (little pain in the arm after first dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication provided by the reporter No treatment information reported by the reporter This case was linked to MOD-2021-228288 (Patient Link).

Other Meds: LOSARTAN; LEVOTHYROXINE

Current Illness: Hypertension

ID: 1639875
Sex: F
Age: 45
State: PA

Vax Date: 02/12/2021
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: normal symptoms; This spontaneous case was reported by a nurse and describes the occurrence of ADVERSE REACTION (normal symptoms) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028l20a) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced ADVERSE REACTION (normal symptoms). At the time of the report, ADVERSE REACTION (normal symptoms) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication was not provided. Treatment medication was not provided. This case was linked to MOD-2021-075532 (Patient Link).

Other Meds:

Current Illness:

ID: 1639876
Sex: M
Age: 75
State: NY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: pain in my right hand subsides through out the day; clenched up into a fist/joint pain in my fingers and knuckles where I can't apply pressure with a fork, turn on the light switch or brushing my teeth; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in my right hand subsides through out the day) and ARTHRALGIA (clenched up into a fist/joint pain in my fingers and knuckles where I can't apply pressure with a fork, turn on the light switch or brushing my teeth) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. Concomitant products included LEVOTHYROXINE for Thyroid disorder, VITAMIN D NOS for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jan-2021, the patient experienced PAIN IN EXTREMITY (pain in my right hand subsides through out the day) and ARTHRALGIA (clenched up into a fist/joint pain in my fingers and knuckles where I can't apply pressure with a fork, turn on the light switch or brushing my teeth). The patient was treated with GABAPENTIN at a dose of 1 dosage form. At the time of the report, PAIN IN EXTREMITY (pain in my right hand subsides through out the day) had not resolved and ARTHRALGIA (clenched up into a fist/joint pain in my fingers and knuckles where I can't apply pressure with a fork, turn on the light switch or brushing my teeth) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient was prescribed medication for pain but it did not help.

Other Meds: LEVOTHYROXINE; VITAMIN D NOS

Current Illness:

ID: 1639877
Sex: F
Age: 43
State: AZ

Vax Date: 06/10/2021
Onset Date: 06/12/2021
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: Rash very itchy; Heat is felt when touching the area; On her back/all over her body/rash moving down her arm towards her hand/ the rash went from 2inches to 4inches in length; Noticed a rash at injection site; This spontaneous case was reported by an other caregiver and describes the occurrence of RASH PRURITIC (Rash very itchy), SKIN WARM (Heat is felt when touching the area), RASH (On her back/all over her body/rash moving down her arm towards her hand/ the rash went from 2inches to 4inches in length) and VACCINATION SITE RASH (Noticed a rash at injection site) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048C21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included LEVOTHYROXINE and PROGESTERONE for an unknown indication. On 10-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Jun-2021, the patient experienced RASH (On her back/all over her body/rash moving down her arm towards her hand/ the rash went from 2inches to 4inches in length) and VACCINATION SITE RASH (Noticed a rash at injection site). On an unknown date, the patient experienced RASH PRURITIC (Rash very itchy) and SKIN WARM (Heat is felt when touching the area). At the time of the report, RASH PRURITIC (Rash very itchy), SKIN WARM (Heat is felt when touching the area), RASH (On her back/all over her body/rash moving down her arm towards her hand/ the rash went from 2inches to 4inches in length) and VACCINATION SITE RASH (Noticed a rash at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication not provided. Treatment information not provided. This case was linked to MOD-2021-228293, MOD-2021-229879 (Patient Link).

Other Meds: LEVOTHYROXINE; PROGESTERONE

Current Illness:

ID: 1639878
Sex: M
Age: 63
State: FL

Vax Date: 05/05/2021
Onset Date: 05/05/2021
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: not gotten his second shot of Moderna; My shoulder still hurts, I can feel where I received the shot when I extend my arm out and is still in pain; Sore arm 2-3 hours receiving the vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (not gotten his second shot of Moderna), MYALGIA (Sore arm 2-3 hours receiving the vaccine) and ARTHRALGIA (My shoulder still hurts, I can feel where I received the shot when I extend my arm out and is still in pain) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. . Concomitant products included ZOLPIDEM TARTRATE (AMBIEN) for an unknown indication. On 05-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-May-2021, the patient experienced MYALGIA (Sore arm 2-3 hours receiving the vaccine). On 18-Jun-2021, the patient experienced ARTHRALGIA (My shoulder still hurts, I can feel where I received the shot when I extend my arm out and is still in pain). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (not gotten his second shot of Moderna). At the time of the report, PRODUCT DOSE OMISSION ISSUE (not gotten his second shot of Moderna) had resolved and MYALGIA (Sore arm 2-3 hours receiving the vaccine) and ARTHRALGIA (My shoulder still hurts, I can feel where I received the shot when I extend my arm out and is still in pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information not provided Most recent FOLLOW-UP information incorporated above includes: On 20-Jun-2021: Follow up document was received on 21-Jun-2021 which contain added event : Product dose omission issue. On 22-Jun-2021: Follow up document was attached on 22-Jun-2021 which contains Non-Significant information.

Other Meds: AMBIEN

Current Illness:

ID: 1639879
Sex: F
Age:
State:

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Shingles; This spontaneous case was reported by a consumer and describes the occurrence of HERPES ZOSTER (Shingles) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Mar-2021, the patient experienced HERPES ZOSTER (Shingles). At the time of the report, HERPES ZOSTER (Shingles) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The concomitant medications were not reported. The treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639880
Sex: F
Age: 74
State: CA

Vax Date: 05/11/2021
Onset Date: 06/09/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Blood pressure is fluctuating; Has not been feeling herself; Dizziness; She has no energy and spends a lot of time in bed/weakness; Tiredness; Body ache; Nausea; Headache; This spontaneous case was reported by a consumer and describes the occurrence of BLOOD PRESSURE FLUCTUATION (Blood pressure is fluctuating), FEELING ABNORMAL (Has not been feeling herself), DIZZINESS (Dizziness), ASTHENIA (She has no energy and spends a lot of time in bed/weakness) and FATIGUE (Tiredness) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 004C21A and 006C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Thyroid disorder NOS and Hypertension. Concomitant products included LOSARTAN and LEVOTHYROXINE for an unknown indication. On 11-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Jun-2021, the patient experienced BLOOD PRESSURE FLUCTUATION (Blood pressure is fluctuating), FEELING ABNORMAL (Has not been feeling herself), DIZZINESS (Dizziness), ASTHENIA (She has no energy and spends a lot of time in bed/weakness), FATIGUE (Tiredness), MYALGIA (Body ache), NAUSEA (Nausea) and HEADACHE (Headache). The patient was treated with ACETYLSALICYLIC ACID (ASPIRIN 81) at a dose of 81 mg. At the time of the report, BLOOD PRESSURE FLUCTUATION (Blood pressure is fluctuating), FEELING ABNORMAL (Has not been feeling herself), DIZZINESS (Dizziness), ASTHENIA (She has no energy and spends a lot of time in bed/weakness), FATIGUE (Tiredness), MYALGIA (Body ache), NAUSEA (Nausea) and HEADACHE (Headache) had not resolved. This case was linked to MOD-2021-228265 (Patient Link).

Other Meds: LOSARTAN; LEVOTHYROXINE

Current Illness: Hypertension; Thyroid disorder NOS

ID: 1639881
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Tingling under arm and breast; Discomfort under breast; It hurts; Discomfort under arm; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (Tingling under arm and breast), BREAST DISCOMFORT (Discomfort under breast), PAIN (It hurts) and DISCOMFORT (Discomfort under arm) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 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 PARAESTHESIA (Tingling under arm and breast), BREAST DISCOMFORT (Discomfort under breast), PAIN (It hurts) and DISCOMFORT (Discomfort under arm). At the time of the report, PARAESTHESIA (Tingling under arm and breast), BREAST DISCOMFORT (Discomfort under breast), PAIN (It hurts) and DISCOMFORT (Discomfort under arm) outcome was unknown. No concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639882
Sex: M
Age: 67
State: AZ

Vax Date: 05/06/2021
Onset Date: 05/06/2021
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: felt like someone slugged him in that area; soreness at injection site/ soreness built up gradually throughout out the day; injection site was slightly swollen; This spontaneous case was reported by a consumer and describes the occurrence of SLUGGISHNESS (felt like someone slugged him in that area), VACCINATION SITE PAIN (soreness at injection site/ soreness built up gradually throughout out the day) and VACCINATION SITE SWELLING (injection site was slightly swollen) in a 57-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026C21A) for COVID-19 vaccination. No medical history was provided by the reporter. . Concomitant products included TESTOSTERONE for an unknown indication. On 06-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-May-2021, the patient experienced SLUGGISHNESS (felt like someone slugged him in that area), VACCINATION SITE PAIN (soreness at injection site/ soreness built up gradually throughout out the day) and VACCINATION SITE SWELLING (injection site was slightly swollen). On 11-May-2021, SLUGGISHNESS (felt like someone slugged him in that area), VACCINATION SITE PAIN (soreness at injection site/ soreness built up gradually throughout out the day) and VACCINATION SITE SWELLING (injection site was slightly swollen) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medications reported. This case was linked to MOD-2021-229879 (Patient Link).

Other Meds: TESTOSTERONE

Current Illness:

ID: 1639883
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: Side effects; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Side effects) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Side effects). At the time of the report, VACCINATION COMPLICATION (Side effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The concomitant medications were not reported. The treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639884
Sex: F
Age: 120
State: UT

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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: Right arm hurt after 1st dose; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Right arm hurt after 1st dose) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 010M20A and 025A21A0) for COVID-19 vaccination. The patient's past medical history included Breast cancer. Previously administered products included for Shingles: Shingrix (The patient completed the vaccination series 3 years ago). Concurrent medical conditions included Heart failure, Lupus syndrome, Shingles and Vision loss (Lost vision in one eye). On 05-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 06-Feb-2021, the patient experienced PAIN IN EXTREMITY (Right arm hurt after 1st dose). On 07-Feb-2021, PAIN IN EXTREMITY (Right arm hurt after 1st dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patient takes unspecified concomitant medications for autoimmune conditions and mild pain. No treatment medication use was provided by the reporter. This case was linked to MOD-2021-228310 (Patient Link).

Other Meds:

Current Illness: Heart failure; Lupus syndrome; Shingles; Vision loss (Lost vision in one eye)

ID: 1639885
Sex: U
Age:
State:

Vax Date: 04/01/2021
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: Patient hasn't received 2nd dose yet; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Patient hasn't received 2nd dose yet) 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 April 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Patient hasn't received 2nd dose yet). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Patient hasn't received 2nd dose yet) outcome was unknown. No concomitant medication was reported. Treatment medication was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639886
Sex: F
Age: 67
State: PA

Vax Date: 06/03/2021
Onset Date: 06/12/2021
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: 20210612; Test Name: Blood pressure; Result Unstructured Data: Low; Test Date: 20210612; Test Name: Blood pressure; Result Unstructured Data: High

Allergies:

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

Symptoms: Coughing; Sharp pains in the right side of the head; Blood pressure high; This spontaneous case was reported by a nurse and describes the occurrence of HYPERTENSION (Blood pressure high), COUGH (Coughing) and HEADACHE (Sharp pains in the right side of the head) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022C21A) for COVID-19 vaccination. Concurrent medical conditions included Chronic bronchitis. On 03-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Jun-2021, the patient experienced HYPERTENSION (Blood pressure high). On an unknown date, the patient experienced COUGH (Coughing) and HEADACHE (Sharp pains in the right side of the head). At the time of the report, HYPERTENSION (Blood pressure high), COUGH (Coughing) and HEADACHE (Sharp pains in the right side of the head) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Jun-2021, Blood pressure measurement: then it went down (Low) Low and 280/90 (High) High. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications were not reported. The patient did not take any treatment medications for the symptoms. The patient experienced sharp pain which was like a stab. The patient went to emergency room (ER) on 12 Jun 2021, and studies were conducted. The patient's blood samples were collected and everything showed normal. The patient mentioned that the cough was more now and more frequent, specially at night.

Other Meds:

Current Illness: Chronic bronchitis

ID: 1639887
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: This spontaneous case reported by a consumer, describes the occurrence of chest discomfort (chest tightness), aphonia (losing my voice), headache and pyrexia (fever) in a patient, of an unknown age and gender, who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. On an unknown date, patient received the second dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On an unknown date, received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On an unknown date, patient experienced chest discomfort (chest tightness), aphonia (losing my voice), headache and pyrexia (fever). At the time of the report, chest discomfort (chest tightness), aphonia (losing my voice), headache and pyrexia (fever) outcome: unknown. Concomitant medication and treatment information not provided.

Other Meds:

Current Illness:

ID: 1639888
Sex: M
Age: 41
State: TX

Vax Date: 03/03/2021
Onset Date: 04/29/2021
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: Sweats; Night sweats; Something in lymph nodes; 57 days between first and second dose; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (Sweats), NIGHT SWEATS (Night sweats), LYMPH NODE PAIN (Something in lymph nodes) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (57 days between first and second dose) in a 41-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 048B21A and 029A21A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high. Concomitant products included VALPROATE SEMISODIUM (DEPAKOTE), METFORMIN and GLIPIZIDE for an unknown indication. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 29-Apr-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (57 days between first and second dose). On an unknown date, the patient experienced HYPERHIDROSIS (Sweats), NIGHT SWEATS (Night sweats) and LYMPH NODE PAIN (Something in lymph nodes). At the time of the report, HYPERHIDROSIS (Sweats), NIGHT SWEATS (Night sweats), LYMPH NODE PAIN (Something in lymph nodes) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (57 days between first and second dose) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment medication included unspecified antibiotics and pain medication. Patient received both doses of Moderna COVID Vaccine, first dose on 3Mar2021 and second dose on 29Apr2021. First dose was administered on left non-dominant arm and second dose on right dominant arm. Patient said of being a little worried and alarmed. Patient went to see doctor last week because has something in lymph nodes. Patient also had sweats and night sweats and these symptoms started approximately a week and a half ago. Concomitant medication included Avipiline, lazole and medications for psychiatric disorders, blood pressure and diabetes.

Other Meds: DEPAKOTE; METFORMIN; GLIPIZIDE

Current Illness: Blood pressure high

ID: 1639889
Sex: F
Age: 61
State: PA

Vax Date: 05/15/2021
Onset Date: 05/22/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Painful; Itchy rash; Hard at night; Bad rash on her back/ Bad rash on her stomach/ Bad rash up to her neck; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Painful), RASH PRURITIC (Itchy rash), SOMNOLENCE (Hard at night) and RASH (Bad rash on her back/ Bad rash on her stomach/ Bad rash up to her neck) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. O35C21A) for COVID-19 vaccination. No medical history was provided by the reporter. On 15-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-May-2021, the patient experienced PAIN (Painful), RASH PRURITIC (Itchy rash), SOMNOLENCE (Hard at night) and RASH (Bad rash on her back/ Bad rash on her stomach/ Bad rash up to her neck). At the time of the report, PAIN (Painful), RASH PRURITIC (Itchy rash), SOMNOLENCE (Hard at night) and RASH (Bad rash on her back/ Bad rash on her stomach/ Bad rash up to her neck) outcome was unknown. Concomitant medications included vitamins (unspecified). No treatment medications was provided by the reporter. This case was linked to MOD-2021-228459 (Patient Link).

Other Meds:

Current Illness:

ID: 1639890
Sex: F
Age: 69
State: CA

Vax Date: 02/10/2021
Onset Date: 03/25/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Bilateral arms ache; Ache from low back to back of both thighs, to the knees; Ache from low back to back of both thighs, to the knees; Muscles are weak; Hard time going up or down the stairs; Ache from low back to back of both thighs, to the knees; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Ache from low back to back of both thighs, to the knees), MUSCULAR WEAKNESS (Muscles are weak), MOBILITY DECREASED (Hard time going up or down the stairs), PAIN IN EXTREMITY (Ache from low back to back of both thighs, to the knees) and MYALGIA (Bilateral arms ache) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Mar-2021, the patient experienced BACK PAIN (Ache from low back to back of both thighs, to the knees), MUSCULAR WEAKNESS (Muscles are weak), MOBILITY DECREASED (Hard time going up or down the stairs), PAIN IN EXTREMITY (Ache from low back to back of both thighs, to the knees) and ARTHRALGIA (Ache from low back to back of both thighs, to the knees). On an unknown date, the patient experienced MYALGIA (Bilateral arms ache). At the time of the report, BACK PAIN (Ache from low back to back of both thighs, to the knees), MUSCULAR WEAKNESS (Muscles are weak), MOBILITY DECREASED (Hard time going up or down the stairs), PAIN IN EXTREMITY (Ache from low back to back of both thighs, to the knees), MYALGIA (Bilateral arms ache) and ARTHRALGIA (Ache from low back to back of both thighs, to the knees) outcome was unknown. No concomitant medications reported. After 3 months, the symptoms are not better, and now the patient also had bilateral achy arms. The patient had visited her HCP once about this and was given an order for physical therapy.

Other Meds:

Current Illness:

ID: 1639891
Sex: M
Age: 22
State: CA

Vax Date: 05/19/2021
Onset Date: 06/19/2021
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: Pfizer given accidentally as second dose.; This spontaneous case was reported by a pharmacist and describes the occurrence of WRONG PRODUCT ADMINISTERED (Pfizer given accidentally as second dose.) in a 22-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) for COVID-19 vaccination. No Medical History information was reported. On 19-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jun-2021, the patient started TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 19-Jun-2021, the patient experienced WRONG PRODUCT ADMINISTERED (Pfizer given accidentally as second dose.). On 19-Jun-2021, WRONG PRODUCT ADMINISTERED (Pfizer given accidentally as second dose.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The concomitant medications were not reported. The treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639892
Sex: U
Age:
State:

Vax Date:
Onset Date:
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: This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Soreness) 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 MYALGIA (Soreness). At the time of the report, MYALGIA (Soreness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639893
Sex: F
Age:
State:

Vax Date: 12/29/2020
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: Test Date: 20210123; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: Missed 2nd dose of M; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION IN ERROR (Missed 2nd dose of M) 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 29-Dec-2020, 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 IN ERROR (Missed 2nd dose of M). At the time of the report, PRODUCT DOSE OMISSION IN ERROR (Missed 2nd dose of M) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Jan-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639894
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: 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: My first vaccine was in April is it too late to get the second shot now?; This spontaneous case was reported by a patient and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (My first vaccine was in April is it too late to get the second shot now?) 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 (My first vaccine was in April is it too late to get the second shot now?). At the time of the report, PRODUCT DOSE OMISSION ISSUE (My first vaccine was in April is it too late to get the second shot now?) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The concomitant medications were not reported. The treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639895
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: Unevaluable event

Symptoms: I feel really tired; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (I feel really tired) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced FATIGUE (I feel really tired). At the time of the report, FATIGUE (I feel really tired) had not resolved. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639896
Sex: F
Age: 63
State: NC

Vax Date: 05/20/2021
Onset Date: 06/18/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Test Date: 20210618; Test Name: Blood pressure; Test Result: 180 {DF}; Result Unstructured Data: High systolic pressure.; Comments: Diastolic pressure was not reported.; Test Date: 20210618; Test Name: Body temperature; Result Unstructured Data: Slightly increased

Allergies:

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

Symptoms: Panic Attack; Short of Breath; Headache; Sore Injection Site; Hard to the touch Injected Muscle; Temperature 99.3F; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of PANIC ATTACK (Panic Attack), DYSPNOEA (Short of Breath), HEADACHE (Headache), VACCINATION SITE PAIN (Sore Injection Site) and MYALGIA (Hard to the touch Injected Muscle) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 024C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 20-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Jun-2021, the patient experienced PANIC ATTACK (Panic Attack), DYSPNOEA (Short of Breath), HEADACHE (Headache), VACCINATION SITE PAIN (Sore Injection Site), MYALGIA (Hard to the touch Injected Muscle), PYREXIA (Temperature 99.3F) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL EXTRA STRENGTH) for Headache, at a dose of 1 dosage form. At the time of the report, PANIC ATTACK (Panic Attack), DYSPNOEA (Short of Breath), HEADACHE (Headache), VACCINATION SITE PAIN (Sore Injection Site), MYALGIA (Hard to the touch Injected Muscle), PYREXIA (Temperature 99.3F) and NAUSEA (Nausea) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Jun-2021, Blood pressure measurement: 180 mmHg (High) High systolic pressure.. On 18-Jun-2021, Body temperature: 99.3 farenheit (High) Slightly increased. The action taken with mRNA-1273 in response to the event is not applicable. It is reported that the patient had went to emergency room and the health professionals have planned to test the patient for COVID-19. This case was linked to MOD-2021-186788 (Patient Link).

Other Meds:

Current Illness:

ID: 1639897
Sex: F
Age: 19
State: CA

Vax Date: 05/28/2021
Onset Date: 06/18/2021
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: developed headache 3 weeks later of the second shot; developed fever 3 weeks later of the second shot; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (developed headache 3 weeks later of the second shot) and PYREXIA (developed fever 3 weeks later of the second shot) in a 19-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 043B21A) for COVID-19 vaccination. No Medical History information was reported. On 28-May-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 18-Jun-2021, the patient experienced HEADACHE (developed headache 3 weeks later of the second shot) and PYREXIA (developed fever 3 weeks later of the second shot). At the time of the report, HEADACHE (developed headache 3 weeks later of the second shot) and PYREXIA (developed fever 3 weeks later of the second shot) outcome was unknown. No concomitant medication was reported. Treatment medication was not provided.

Other Meds:

Current Illness:

ID: 1639898
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: acne; This spontaneous case was reported by a consumer and describes the occurrence of ACNE (acne) 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 ACNE (acne). At the time of the report, ACNE (acne) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No laboratory details were provided. No treatment medications were reported.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1639899
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Sore arm after 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Sore arm after 2nd dose) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MYALGIA (Sore arm after 2nd dose). At the time of the report, MYALGIA (Sore arm after 2nd dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1639900
Sex: F
Age: 54
State: CA

Vax Date: 05/20/2021
Onset Date: 06/17/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Test Date: 20210617; Test Name: Body temperature; Result Unstructured Data: High

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Backache; Fever of 100.4; Headache; Joint pain; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Backache), PYREXIA (Fever of 100.4), HEADACHE (Headache), ARTHRALGIA (Joint pain) and NAUSEA (Nausea) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The medical history was not provided by the reporter. Concurrent medical conditions included Blood pressure. Concomitant products included LISINOPRIL and METOPROLOL SUCCINATE for an unknown indication. On 20-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Jun-2021, the patient experienced BACK PAIN (Backache), PYREXIA (Fever of 100.4), HEADACHE (Headache), ARTHRALGIA (Joint pain) and NAUSEA (Nausea). The patient was treated with ACETAMINOPHEN on 17-Jun-2021 at a dose of 1 UNK. At the time of the report, BACK PAIN (Backache), PYREXIA (Fever of 100.4), HEADACHE (Headache) and ARTHRALGIA (Joint pain) outcome was unknown and NAUSEA (Nausea) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Jun-2021, Body temperature: 100.4 (High) High. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Action taken with mRNA-1273 in response to the events was not applicable.

Other Meds: LISINOPRIL; METOPROLOL SUCCINATE

Current Illness:

ID: 1639901
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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: it's a bit warm; rash; This spontaneous case was reported by a consumer and describes the occurrence of SKIN WARM (it's a bit warm) and 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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) UNK dosage form. On an unknown date, the patient experienced SKIN WARM (it's a bit warm) and RASH (rash). At the time of the report, SKIN WARM (it's a bit warm) and RASH (rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medications were provided by the reporter. No Treatment medications were provided by the reporter.

Other Meds:

Current Illness:

ID: 1639902
Sex: F
Age:
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Is not getting her menstrual cycle; This spontaneous case was reported by a consumer and describes the occurrence of MENSTRUATION DELAYED (Is not getting her menstrual cycle) in a 38-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included IBUPROFEN (ADVIL [IBUPROFEN]), VITAMINS NOS and VITAMIN C [ASCORBIC ACID] for an unknown indication. 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 MENSTRUATION DELAYED (Is not getting her menstrual cycle). At the time of the report, MENSTRUATION DELAYED (Is not getting her menstrual cycle) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication also included OTC Heartburn medication and Anti Anxiety medication. Patient stated that her menstrual cycle was pretty regular normally. No treatment information provided.

Other Meds: ADVIL [IBUPROFEN]; VITAMINS NOS; VITAMIN C [ASCORBIC ACID]

Current Illness:

ID: 1639903
Sex: U
Age:
State: WA

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: Nausea

Symptoms: "two other patients couldn't even stand"; 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 DYSSTASIA ("two other patients couldn't even stand") 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 DYSSTASIA ("two other patients couldn't even stand"). At the time of the report, DYSSTASIA ("two other patients couldn't even stand") 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: 1639904
Sex: F
Age: 78
State: MA

Vax Date: 02/12/2021
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: Hard a hard time sitting in a chair and using the bathroom/ Can't lift her arms; Stuffy, runny nose; Severe stiffness in her elbows and knees; Did not experience pain like this before; Pain in the joints everywhere in her body/Side pain and wrist pain last week; This spontaneous case was reported by a consumer and describes the occurrence of MOBILITY DECREASED (Hard a hard time sitting in a chair and using the bathroom/ Can't lift her arms), RHINORRHOEA (Stuffy, runny nose), JOINT STIFFNESS (Severe stiffness in her elbows and knees), PAIN (Did not experience pain like this before) and ARTHRALGIA (Pain in the joints everywhere in her body/Side pain and wrist pain last week) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 015M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included APIXABAN (ELIQUIS) for an unknown indication. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced MOBILITY DECREASED (Hard a hard time sitting in a chair and using the bathroom/ Can't lift her arms), RHINORRHOEA (Stuffy, runny nose), JOINT STIFFNESS (Severe stiffness in her elbows and knees), PAIN (Did not experience pain like this before) and ARTHRALGIA (Pain in the joints everywhere in her body/Side pain and wrist pain last week). At the time of the report, MOBILITY DECREASED (Hard a hard time sitting in a chair and using the bathroom/ Can't lift her arms), RHINORRHOEA (Stuffy, runny nose), JOINT STIFFNESS (Severe stiffness in her elbows and knees), PAIN (Did not experience pain like this before) and ARTHRALGIA (Pain in the joints everywhere in her body/Side pain and wrist pain last week) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medication was reported by reporter. This case was linked to MOD-2021-228387 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 28-Jul-2021: follow-up was received and contains no significant information

Other Meds: ELIQUIS

Current Illness:

ID: 1639905
Sex: F
Age: 38
State: TX

Vax Date: 06/17/2021
Onset Date: 06/17/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: she is struggling to get up; she feels like she has the flu.; body aches, her whole body hurts, pain; This spontaneous case was reported by a patient and describes the occurrence of DYSSTASIA (she is struggling to get up), INFLUENZA (she feels like she has the flu.) and MYALGIA (body aches, her whole body hurts, pain) in a 38-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053C21A) for COVID-19 vaccination. Concomitant products included IBUPROFEN (ADVIL [IBUPROFEN]), VITAMINS NOS and VITAMIN C [ASCORBIC ACID] for an unknown indication. On 17-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Jun-2021, the patient experienced DYSSTASIA (she is struggling to get up), INFLUENZA (she feels like she has the flu.) and MYALGIA (body aches, her whole body hurts, pain). At the time of the report, DYSSTASIA (she is struggling to get up), INFLUENZA (she feels like she has the flu.) and MYALGIA (body aches, her whole body hurts, pain) outcome was unknown. Concomitant medication unspecified OTC Heartburn medication and unspecified Anti Anxiety medication. Treatment information were not Advil provided.

Other Meds: ADVIL [IBUPROFEN]; VITAMINS NOS; VITAMIN C [ASCORBIC ACID.]

Current Illness:

ID: 1639906
Sex: U
Age: 81
State: OH

Vax Date: 06/04/2021
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: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: I had an adverse reaction; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (I had an adverse reaction) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027C21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (I had an adverse reaction). At the time of the report, VACCINATION COMPLICATION (I had an adverse reaction) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant medications were provided No Treatment information provided

Other Meds:

Current Illness:

ID: 1639907
Sex: U
Age:
State: MD

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: Tremor

Symptoms: Patient had a transplant after getting both doses; 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 TRANSPLANT (Patient had a transplant after getting both doses) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced TRANSPLANT (Patient had a transplant after getting both doses). At the time of the report, TRANSPLANT (Patient had a transplant after getting both doses) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered TRANSPLANT (Patient had a transplant after getting both doses) to be not related. The patient recently underwent a transplant and the doctor was recommending that the patient get a 3rd dose because the antirejection medication might have rejected the vaccine. The pharmacist confirmed that the transplant was not related to any possible side effects the patient might have had after getting the Moderna COVID-19 vaccine.

Other Meds:

Current Illness:

ID: 1639908
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: Erythema, Pruritus

Symptoms: Dull pain in left thight and hand.; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Dull pain in left thight and hand.) 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 PAIN (Dull pain in left thight and hand.). At the time of the report, PAIN (Dull pain in left thight and hand.) outcome was unknown. No concomitant medications were reported. No laboratory details were provided. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1639909
Sex: U
Age:
State:

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

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Diarrhoea; 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 (Diarrhoea) 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 23-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced DIARRHOEA (Diarrhoea). At the time of the report, DIARRHOEA (Diarrhoea) outcome was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639910
Sex: U
Age:
State:

Vax Date: 06/18/2021
Onset Date: 06/19/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Myalgia; Feeling a little tired; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Myalgia) and FATIGUE (Feeling a little tired) 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 18-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jun-2021, the patient experienced MYALGIA (Myalgia) and FATIGUE (Feeling a little tired). At the time of the report, MYALGIA (Myalgia) and FATIGUE (Feeling a little tired) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The concomitant medications were not reported. The treatment information was not reported.

Other Meds:

Current Illness:

ID: 1639911
Sex: F
Age:
State: FL

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: i experienced a sore arm; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (i experienced a sore arm) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 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 MYALGIA (i experienced a sore arm). At the time of the report, MYALGIA (i experienced a sore arm) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1639912
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: experiencing a rash on my shins; This spontaneous case was reported by a consumer and describes the occurrence of RASH (experiencing a rash on my shins) 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) unknown. On an unknown date, the patient experienced RASH (experiencing a rash on my shins). At the time of the report, RASH (experiencing a rash on my shins) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication were provided. No treatment details were provided. Most recent FOLLOW-UP information incorporated above includes: On 28-Jul-2021: Fallow up received and contains no new information.

Other Meds:

Current Illness:

ID: 1639913
Sex: F
Age: 73
State: WA

Vax Date: 01/30/2021
Onset Date: 01/31/2021
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: sore arm; pain in arm; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (sore arm) and PAIN IN EXTREMITY (pain in arm) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included AMLODIPINE and OLMESARTAN for Blood pressure management. On 30-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 31-Jan-2021, the patient experienced MYALGIA (sore arm) and PAIN IN EXTREMITY (pain in arm). On 02-Feb-2021, MYALGIA (sore arm) and PAIN IN EXTREMITY (pain in arm) 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. Mexican yan harmone supplement pills were taken as concomitant medication along with others, as specified by the reporter. Treatment with Advil was taken pertained to the symptoms experienced.

Other Meds: AMLODIPINE; OLMESARTAN

Current Illness:

ID: 1639914
Sex: F
Age: 78
State: MA

Vax Date: 02/12/2021
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: Stiffness joints; Mobility decreased; runny nose; pain; wrist pain; This spontaneous case was reported by a consumer and describes the occurrence of JOINT STIFFNESS (Stiffness joints), MOBILITY DECREASED (Mobility decreased), RHINORRHOEA (runny nose), PAIN (pain) and ARTHRALGIA (wrist pain) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 015M20A and 003A21!,) for COVID-19 vaccination. No medical history was reported by the reporter. Concomitant products included APIXABAN (ELIQUIS) for an unknown indication. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced JOINT STIFFNESS (Stiffness joints), MOBILITY DECREASED (Mobility decreased), RHINORRHOEA (runny nose), PAIN (pain) and ARTHRALGIA (wrist pain). At the time of the report, JOINT STIFFNESS (Stiffness joints), MOBILITY DECREASED (Mobility decreased), RHINORRHOEA (runny nose), PAIN (pain) and ARTHRALGIA (wrist pain) had resolved. No treatment medications were reported by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 28-Jul-2021: Follow up received on 28-Jul-2021 and contains no new information.

Other Meds: ELIQUIS

Current Illness:

ID: 1639915
Sex: F
Age: 70
State: IA

Vax Date: 02/18/2021
Onset Date: 02/01/2021
Rec V Date: 08/27/2021
Hospital: Y

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

Lab Data: Test Date: 202011; Test Name: COVID_19 virus test; Test Result: Positive ; Result Unstructured Data: Positive

Allergies:

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

Symptoms: Chills after first and second vaccine and about 5 weeks after second shot; Ache; Extreme Fatigue after first and second vaccine and about 5 weeks after second shot; Confusion after first and second vaccine and about 5 weeks after second shot; Fever after first and second vaccine and about 5 weeks after second shot; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of CHILLS (Chills after first and second vaccine and about 5 weeks after second shot), FATIGUE (Extreme Fatigue after first and second vaccine and about 5 weeks after second shot) and PAIN (Ache) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013M20A and 031A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported. Concomitant products included METFORMIN, SIMVASTATIN and DIVALPROEX SODIUM for an unknown indication. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In February 2021, the patient experienced FATIGUE (Extreme Fatigue after first and second vaccine and about 5 weeks after second shot) (seriousness criterion hospitalization). On 19-Feb-2021, the patient experienced CHILLS (Chills after first and second vaccine and about 5 weeks after second shot) (seriousness criterion hospitalization), PAIN (Ache) (seriousness criterion hospitalization), CONFUSIONAL STATE (Confusion after first and second vaccine and about 5 weeks after second shot) and PYREXIA (Fever after first and second vaccine and about 5 weeks after second shot). On 24-Feb-2021, CHILLS (Chills after first and second vaccine and about 5 weeks after second shot), PAIN (Ache) and PYREXIA (Fever after first and second vaccine and about 5 weeks after second shot) had resolved. At the time of the report, FATIGUE (Extreme Fatigue after first and second vaccine and about 5 weeks after second shot) and CONFUSIONAL STATE (Confusion after first and second vaccine and about 5 weeks after second shot) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In November 2020, SARS-CoV-2 test: positive (Positive) Positive. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment information was provided. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. This case was linked to US-MODERNATX, INC.-MOD-2021-226199, US-MODERNATX, INC.-MOD-2021-226361, US-MODERNATX, INC.-MOD-2021-226399 (E2B Linked Report). Most recent FOLLOW-UP information incorporated above includes: On 03-Aug-2021: Follow-up information received contain significant information that include Patient demographic, Lab data ,Concomitant medication, event update to serious.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. US-MODERNATX, INC.-MOD-2021-226199:Dose 2 case US-MODERNATX, INC.-MOD-2021-226361:Same reporter US-MODERNATX, INC.-MOD-2021-226399:Same reporter

Other Meds: METFORMIN; SIMVASTATIN; DIVALPROEX SODIUM

Current Illness:

ID: 1639916
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: swollen arm after second shot; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (swollen arm after second 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 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 PERIPHERAL SWELLING (swollen arm after second shot). At the time of the report, PERIPHERAL SWELLING (swollen arm after second shot) outcome was unknown. No concomitant medications were reported. No treatment medication was reported.

Other Meds:

Current Illness:

ID: 1639917
Sex: F
Age: 73
State: WA

Vax Date: 01/30/2021
Onset Date: 01/31/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: couldn't walk for two days; All I could do was stand and that was hard; It felt like nerve pain; Was so frightened; pain in legs/"the pain was down my legs"/"the pain was ridiculous"; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in legs/"the pain was down my legs"/"the pain was ridiculous"), GAIT INABILITY (couldn't walk for two days), DYSSTASIA (All I could do was stand and that was hard), NEURALGIA (It felt like nerve pain) and FEAR (Was so frightened) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included AMLODIPINE and OLMESARTAN for Blood pressure management. On 30-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 31-Jan-2021, the patient experienced PAIN IN EXTREMITY (pain in legs/"the pain was down my legs"/"the pain was ridiculous"). On 28-Feb-2021, the patient experienced GAIT INABILITY (couldn't walk for two days), DYSSTASIA (All I could do was stand and that was hard), NEURALGIA (It felt like nerve pain) and FEAR (Was so frightened). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) at an unspecified dose and frequency. On 02-Feb-2021, PAIN IN EXTREMITY (pain in legs/"the pain was down my legs"/"the pain was ridiculous") had resolved. On 02-Mar-2021, GAIT INABILITY (couldn't walk for two days), DYSSTASIA (All I could do was stand and that was hard), NEURALGIA (It felt like nerve pain) and FEAR (Was so frightened) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant products included Mexican yam hormone supplement pills The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was not applicable.

Other Meds: AMLODIPINE; OLMESARTAN

Current Illness:

ID: 1639918
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Swelling and redness at the vaccination site; Swelling and redness at the vaccination site.; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE SWELLING (Swelling and redness at the vaccination site) and VACCINATION SITE ERYTHEMA (Swelling and redness at the vaccination site.) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE SWELLING (Swelling and redness at the vaccination site) and VACCINATION SITE ERYTHEMA (Swelling and redness at the vaccination site.). At the time of the report, VACCINATION SITE SWELLING (Swelling and redness at the vaccination site) and VACCINATION SITE ERYTHEMA (Swelling and redness at the vaccination site.) outcome was unknown. No concomitant medication were reported. No treatment information was reported The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) was not applicable.; Sender's Comments: Very limited information regarding this event/s has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1639919
Sex: M
Age:
State: NY

Vax Date:
Onset Date: 06/18/2021
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: My brother's arm hurt for a day; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (My brother's arm hurt for a day) in a male patient of an unknown age 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 18-Jun-2021, the patient experienced PAIN IN EXTREMITY (My brother's arm hurt for a day). At the time of the report, PAIN IN EXTREMITY (My brother's arm hurt for a day) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1639920
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Developed a baseball sized lump in both sides of underarm area; This spontaneous case was reported by a consumer and describes the occurrence of AXILLARY MASS (Developed a baseball sized lump in both sides of underarm area) 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 AXILLARY MASS (Developed a baseball sized lump in both sides of underarm area). At the time of the report, AXILLARY MASS (Developed a baseball sized lump in both sides of underarm area) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. No relevant concomitant medication were provided. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639921
Sex: F
Age:
State: MI

Vax Date: 06/10/2021
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: Lump; Itchy thigh; Red ring around itchy thigh; Diarrhea; Severe headache; This spontaneous case was reported by a consumer and describes the occurrence of MASS (Lump), PRURITUS (Itchy thigh), ERYTHEMA (Red ring around itchy thigh), DIARRHOEA (Diarrhea) and HEADACHE (Severe headache) 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 10-Jun-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 MASS (Lump), PRURITUS (Itchy thigh), ERYTHEMA (Red ring around itchy thigh), DIARRHOEA (Diarrhea) and HEADACHE (Severe headache). At the time of the report, MASS (Lump), PRURITUS (Itchy thigh), ERYTHEMA (Red ring around itchy thigh), DIARRHOEA (Diarrhea) and HEADACHE (Severe headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1639922
Sex: M
Age: 83
State: CA

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine had been punctured for 26 hours; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Vaccine had been punctured for 26 hours) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026D21A) for COVID-19 vaccination. No medical history was provided by the reporter. On 17-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Vaccine had been punctured for 26 hours). On 17-Jun-2021, EXPIRED PRODUCT ADMINISTERED (Vaccine had been punctured for 26 hours) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1639923
Sex: F
Age:
State: CA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Terrible rash/ very painful rash; This spontaneous case was reported by a consumer and describes the occurrence of RASH (Terrible rash/ very painful rash) in an elderly female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included NORTRIPTYLINE for an unknown indication. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-Feb-2021, the patient experienced RASH (Terrible rash/ very painful rash). The patient was treated with CLOBETASOL for Rash, at an unspecified dose and frequency. At the time of the report, RASH (Terrible rash/ very painful rash) outcome was unknown. The patients symptoms remained for approximately 3 weeks. This case was linked to MOD-2021-228443 (Patient Link).

Other Meds: NORTRIPTYLINE

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am