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: 1639974
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: had leg nervousness after taking the shot.; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 18-Jun-2021 and was forwarded to Moderna on 18-Jun-2021. Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of LIMB DISCOMFORT (had leg nervousness after taking 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 LIMB DISCOMFORT (had leg nervousness after taking the shot.). At the time of the report, LIMB DISCOMFORT (had leg nervousness after taking the shot.) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The Concomitant medication information were not provided. The Treatment medication information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639975
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Rash on the arm; Fever; This spontaneous case was reported by a non-health professional and describes the occurrence of RASH (Rash on the arm) and PYREXIA (Fever) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced RASH (Rash on the arm) and PYREXIA (Fever). At the time of the report, RASH (Rash on the arm) and PYREXIA (Fever) 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.; 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: 1639976
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Blurred vision; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 18-Jun-2021 and was forwarded to Moderna on 18-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of VISION BLURRED (Blurred vision) 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 VISION BLURRED (Blurred vision). At the time of the report, VISION BLURRED (Blurred vision) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication not reported Treatment information was not provided Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639977
Sex: F
Age: 68
State: NY

Vax Date: 05/21/2021
Onset Date: 04/23/2021
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: hypokinesia; coughing; walking difficulty; flu like symptoms; bone pain; swelling in her left arm; This spontaneous case was reported by a consumer and describes the occurrence of GAIT DISTURBANCE (walking difficulty), PERIPHERAL SWELLING (swelling in her left arm), INFLUENZA LIKE ILLNESS (flu like symptoms), BONE PAIN (bone pain) and HYPOKINESIA (hypokinesia) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Atopic dermatitis. Concomitant products included DUPILUMAB for Atopic dermatitis. On 21-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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 23-Apr-2021, the patient experienced PERIPHERAL SWELLING (swelling in her left arm). On 21-May-2021, the patient experienced GAIT DISTURBANCE (walking difficulty), INFLUENZA LIKE ILLNESS (flu like symptoms) and BONE PAIN (bone pain). On 22-May-2021, the patient experienced HYPOKINESIA (hypokinesia) and COUGH (coughing). On 26-May-2021, HYPOKINESIA (hypokinesia) and COUGH (coughing) had resolved. At the time of the report, GAIT DISTURBANCE (walking difficulty), PERIPHERAL SWELLING (swelling in her left arm), INFLUENZA LIKE ILLNESS (flu like symptoms) and BONE PAIN (bone pain) had resolved. Patient received injection in her arm, held dupilumab in 90 degree angle, Patient never felt the needle go in and all of a sudden there was medicine running down to her arm, felt like all the medicine leaked out instead going into her arm. Patient requested for replacement (300 mg 1 pen).

Other Meds: DUPILUMAB

Current Illness: Atopic dermatitis

ID: 1639978
Sex: M
Age: 41
State: WI

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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; random pains all over; lightheaded; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Sick), PAIN (random pains all over) and DIZZINESS (lightheaded) in a 41-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high. Concomitant products included HYDROCHLOROTHIAZIDE for Blood pressure high, VITAMINS NOS (DAILY MULTIVITAMIN) for an unknown indication. In April 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In April 2021, the patient experienced ILLNESS (Sick), PAIN (random pains all over) and DIZZINESS (lightheaded). At the time of the report, ILLNESS (Sick), PAIN (random pains all over) and DIZZINESS (lightheaded) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment information was not provided. The patient received his first dose April 2021 sometime around the 18th to 20th of the month. The patient's dose of hydrochlorothiazide had been changed at some point because his blood pressure numbers were getting low, stating he was usually around 132-140 for the top number. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds: DAILY MULTIVITAMIN; HYDROCHLOROTHIAZIDE

Current Illness: Blood pressure high

ID: 1639979
Sex: F
Age:
State: TN

Vax Date: 02/08/2021
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: patient received moderna vaccine on 8Feb2021 and would like to know if she can still receive the second dose; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (patient received moderna vaccine on 8Feb2021 and would like to know if she can still receive the second dose) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 08-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (patient received moderna vaccine on 8Feb2021 and would like to know if she can still receive the second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (patient received moderna vaccine on 8Feb2021 and would like to know if she can still receive the second dose) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. Treatment medications were not provided by the reporter.

Other Meds:

Current Illness:

ID: 1639980
Sex: M
Age: 19
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Vaccine had been punctured for 26 hours; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 18-Jun-2021 and was forwarded to Moderna on 18-Jun-2021. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Vaccine had been punctured for 26 hours) in a 19-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026D21A) for COVID-19 vaccination. No Medical History information was reported. On 17-Jun-2021, the patient received 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. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639981
Sex: F
Age: 30
State: MI

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: hard to lift arm; under the left arm started hurting; pain at injection site of left arm; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 18-Jun-2021 and was forwarded to Moderna on 18-Jun-2021. This spontaneous case was reported by a patient and describes the occurrence of MOBILITY DECREASED (hard to lift arm), VACCINATION SITE PAIN (pain at injection site of left arm) and MYALGIA (under the left arm started hurting) in a 30-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023C21A) for COVID-19 vaccination. No Medical History information was reported. On 15-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jun-2021, the patient experienced VACCINATION SITE PAIN (pain at injection site of left arm). On 17-Jun-2021, the patient experienced MOBILITY DECREASED (hard to lift arm) and MYALGIA (under the left arm started hurting). At the time of the report, MOBILITY DECREASED (hard to lift arm), VACCINATION SITE PAIN (pain at injection site of left arm) and MYALGIA (under the left arm started hurting) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided Treatment medications were not provided by reporter Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639982
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: Abdominal pain, Chills, Sleep disorder

Symptoms: I stopped experiencing this many weeks ago; This spontaneous case was reported by a consumer and describes the occurrence of THERAPEUTIC RESPONSE UNEXPECTED (I stopped experiencing this many weeks ago) 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 THERAPEUTIC RESPONSE UNEXPECTED (I stopped experiencing this many weeks ago). At the time of the report, THERAPEUTIC RESPONSE UNEXPECTED (I stopped experiencing this many weeks ago) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided. This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 18-Jun-2021 and was forwarded to Moderna on 18-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of THERAPEUTIC RESPONSE UNEXPECTED (I stopped experiencing this many weeks ago) 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 THERAPEUTIC RESPONSE UNEXPECTED (I stopped experiencing this many weeks ago). At the time of the report, THERAPEUTIC RESPONSE UNEXPECTED (I stopped experiencing this many weeks ago) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1639983
Sex: M
Age: 71
State: IL

Vax Date: 09/09/2020
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: Test Name: Blood pressure; Result Unstructured Data: High

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Depressed mood; scaly/ peeling all over (face, neck, chest, and ears); acne/have some pimples on face; itchy all over, (face, neck, chest, and ears); allergic reaction; rash all over his body; This spontaneous case was reported by a consumer and describes the occurrence of DEPRESSED MOOD (Depressed mood), SKIN EXFOLIATION (scaly/ peeling all over (face, neck, chest, and ears)), ACNE (acne/have some pimples on face), PRURITUS (itchy all over, (face, neck, chest, and ears)) and HYPERSENSITIVITY (allergic reaction) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Co-suspect product included non-company product VANDETANIB (CAPRELSA) for Malignant neoplasm of thyroid gland. Concurrent medical conditions included Malignant neoplasm of thyroid gland. Concomitant products included METOPROLOL for Blood pressure high, CLINDAMYCIN HYDROCHLORIDE, MIRTAZAPINUM and DEXAMETHASONE for an unknown indication. On 09-Sep-2020, the patient started VANDETANIB (CAPRELSA) (Oral) 200 mg once a day. 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 DEPRESSED MOOD (Depressed mood), SKIN EXFOLIATION (scaly/ peeling all over (face, neck, chest, and ears)), ACNE (acne/have some pimples on face), PRURITUS (itchy all over, (face, neck, chest, and ears)), HYPERSENSITIVITY (allergic reaction) and RASH (rash all over his body). At the time of the report, DEPRESSED MOOD (Depressed mood), SKIN EXFOLIATION (scaly/ peeling all over (face, neck, chest, and ears)), ACNE (acne/have some pimples on face), PRURITUS (itchy all over, (face, neck, chest, and ears)), HYPERSENSITIVITY (allergic reaction) and RASH (rash all over his body) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: high (High) High. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 21-Jun-2021 and was forwarded to Moderna on 21-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of DEPRESSED MOOD (Depressed mood), SKIN EXFOLIATION (scaly/ peeling all over (face, neck, chest, and ears)), ACNE (acne/have some pimples on face), PRURITUS (itchy all over, (face, neck, chest, and ears)) and HYPERSENSITIVITY (allergic reaction) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Co-suspect product included non-company product VANDETANIB (CAPRELSA) for Malignant neoplasm of thyroid gland. Concurrent medical conditions included Malignant neoplasm of thyroid gland. Concomitant products included METOPROLOL for Blood pressure high, CLINDAMYCIN HYDROCHLORIDE, MIRTAZAPINUM and DEXAMETHASONE for an unknown indication. On 09-Sep-2020, the patient started VANDETANIB (CAPRELSA) (Oral) 200 mg once a day. 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 DEPRESSED MOOD (Depressed mood), SKIN EXFOLIATION (scaly/ peeling all over (face, neck, chest, and ears)), ACNE (acne/have some pimples on face), PRURITUS (itchy all over, (face, neck, chest, and ears)), HYPERSENSITIVITY (allergic reaction) and RASH (rash all over his body). At the time of the report, DEPRESSED MOOD (Depressed mood), SKIN EXFOLIATION (scaly/ peeling all over (face, neck, chest, and ears)), ACNE (acne/have some pimples on face), PRURITUS (itchy all over, (face, neck, chest, and ears)), HYPERSENSITIVITY (allergic reaction) and RASH (rash all over his body) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: high (High) High. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided

Other Meds: CLINDAMYCIN HYDROCHLORIDE; MIRTAZAPINUM; METOPROLOL; DEXAMETHASONE

Current Illness: Malignant neoplasm of thyroid gland

ID: 1639984
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: I have flu symptoms; my arm is red and itchy; my arm is red and itchy; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (I have flu symptoms), PRURITUS (my arm is red and itchy) and ERYTHEMA (my arm is red and itchy) 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 INFLUENZA LIKE ILLNESS (I have flu symptoms), PRURITUS (my arm is red and itchy) and ERYTHEMA (my arm is red and itchy). At the time of the report, INFLUENZA LIKE ILLNESS (I have flu symptoms), PRURITUS (my arm is red and itchy) and ERYTHEMA (my arm is red and itchy) outcome was unknown. Not Provided Relevant concomitant medications were not reported. Treatment medication was not provided. Action taken with mRNA-1273 in response to the event was not applicable.

Other Meds:

Current Illness:

ID: 1639985
Sex: F
Age: 77
State: OH

Vax Date: 03/02/2021
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: Sick for couple of weeks from both the doses; Right arm hurts like deep into the bone; Pain making stomach feel upset; Right arm has hurt and moving up to shoulder; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 18-Jun-2021 and was forwarded to Moderna on 18-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Sick for couple of weeks from both the doses), PAIN IN EXTREMITY (Right arm hurts like deep into the bone), ABDOMINAL PAIN (Pain making stomach feel upset) and ARTHRALGIA (Right arm has hurt and moving up to shoulder) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030A21A and 017B21A) for COVID-19 vaccination. No patient history was reported by reporter. On 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ILLNESS (Sick for couple of weeks from both the doses), PAIN IN EXTREMITY (Right arm hurts like deep into the bone), ABDOMINAL PAIN (Pain making stomach feel upset) and ARTHRALGIA (Right arm has hurt and moving up to shoulder). The patient was treated with PARACETAMOL (TYLENOL) for Illness, Abdominal pain, Arthralgia and Pain in extremity, at an unspecified dose and frequency; MENTHOL (ASPERCREME HEAT PAIN RELIEVING) for Arthralgia, Pain in extremity, Illness and Abdominal pain, at an unspecified dose and frequency and LIDOCAINE for Pain in extremity, Arthralgia, Illness and Abdominal pain, at an unspecified dose and frequency. At the time of the report, ILLNESS (Sick for couple of weeks from both the doses), PAIN IN EXTREMITY (Right arm hurts like deep into the bone), ABDOMINAL PAIN (Pain making stomach feel upset) and ARTHRALGIA (Right arm has hurt and moving up to shoulder) outcome was unknown. Not Provided Concomitant medications were not reported. Reportedly, the patient used heating pad which made the pain more worse.

Other Meds:

Current Illness:

ID: 1639986
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Headache; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 18-Jun-2021 and was forwarded to Moderna on 18-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced HEADACHE (Headache). At the time of the report, HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatments were provided. Patient asked whether to take Excedrin?.

Other Meds:

Current Illness:

ID: 1639987
Sex: F
Age: 77
State: OH

Vax Date: 03/02/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Sick for couple of weeks from both the doses; Pain was making her stomach feel upset; right arm has hurt , Arm hurts like deep into the bone; arm has hurt and it is moving up to shoulder; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 18-Jun-2021 and was forwarded to Moderna on 18-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Sick for couple of weeks from both the doses), ABDOMINAL DISCOMFORT (Pain was making her stomach feel upset), MYALGIA (right arm has hurt , Arm hurts like deep into the bone) and ARTHRALGIA (arm has hurt and it is moving up to shoulder) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017B21A and 030A21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ILLNESS (Sick for couple of weeks from both the doses), ABDOMINAL DISCOMFORT (Pain was making her stomach feel upset), MYALGIA (right arm has hurt , Arm hurts like deep into the bone) and ARTHRALGIA (arm has hurt and it is moving up to shoulder). The patient was treated with PARACETAMOL (TYLENOL) for Illness, Abdominal pain, Arthralgia and Pain in extremity, at a dose of 1 dosage form; LIDOCAINE for Pain in extremity, Arthralgia, Abdominal pain and Illness, at a dose of 1 UNK and LIDOCAINE (ASPERCREME LIDOCAINE PATCH) for Pain in extremity and Arthralgia, at an unspecified dose and frequency. At the time of the report, ILLNESS (Sick for couple of weeks from both the doses), ABDOMINAL DISCOMFORT (Pain was making her stomach feel upset), MYALGIA (right arm has hurt , Arm hurts like deep into the bone) and ARTHRALGIA (arm has hurt and it is moving up to shoulder) outcome was unknown. Not Provided No concomitant medication was reported. Treatment also included heating pad which made the pain worse. This case was linked to MOD-2021-229279 (Patient Link).

Other Meds:

Current Illness:

ID: 1639988
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: after you first dose to have side effects; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (after you first dose to have side effects) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for an unknown indication. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (after you first dose to have side effects). At the time of the report, VACCINATION COMPLICATION (after you first dose to have side effects) outcome was unknown. Not Provided 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.

Other Meds:

Current Illness:

ID: 1639989
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: extreme joint pain & It's been over 6 weeks and I still have it & joint pain is getting unbearable; This spontaneous case was reported by a consumer and describes the occurrence of ARTHRALGIA (extreme joint pain & It's been over 6 weeks and I still have it & joint pain is getting unbearable) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ARTHRALGIA (extreme joint pain & It's been over 6 weeks and I still have it & joint pain is getting unbearable). At the time of the report, ARTHRALGIA (extreme joint pain & It's been over 6 weeks and I still have it & joint pain is getting unbearable) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication were reported. No treatment medication were reported.

Other Meds:

Current Illness:

ID: 1639990
Sex: M
Age: 29
State:

Vax Date: 04/29/2021
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: Fever; headache for 1 day; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever) and HEADACHE (headache for 1 day) in a 29-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 29-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PYREXIA (Fever) and HEADACHE (headache for 1 day). At the time of the report, PYREXIA (Fever) outcome was unknown and HEADACHE (headache for 1 day) had resolved. No relevant concomitant medications were reported. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not applicable. This case was linked to MOD-2021-057824 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639991
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: I have missed my second moderna shot, how late is too late to get the shot; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (I have missed my second moderna shot, how late is too late to get 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 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 (I have missed my second moderna shot, how late is too late to get the shot). At the time of the report, PRODUCT DOSE OMISSION ISSUE (I have missed my second moderna shot, how late is too late to get the shot) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided by the reporter Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1639992
Sex: F
Age: 22
State: VA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
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: right upper arm pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (right upper arm pain) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037C21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included FLUOXETINE HYDROCHLORIDE (PROZAC) for Depression. On 20-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-May-2021, the patient experienced PAIN IN EXTREMITY (right upper arm pain). On 23-May-2021, PAIN IN EXTREMITY (right upper arm pain) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No laboratory details were provided. No treatment medications were reported. This case was linked to MOD-2021-229303 (Patient Link).

Other Meds: PROZAC

Current Illness:

ID: 1639993
Sex: U
Age:
State:

Vax Date: 05/04/2021
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: Got my first vaccine of Moderna on the 4th of May and got the second shot on the 16th of June; This spontaneous case was reported by a patient and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Got my first vaccine of Moderna on the 4th of May and got the second shot on the 16th of June) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. Unknown and Unknown) for COVID-19 vaccination. No Medical History information was reported. On 04-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 an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Got my first vaccine of Moderna on the 4th of May and got the second shot on the 16th of June). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Got my first vaccine of Moderna on the 4th of May and got the second shot on the 16th of June) had resolved. No concomitant medication were reported by the reporter. Treatment medication was not reported by the reporter.

Other Meds:

Current Illness:

ID: 1639994
Sex: F
Age: 22
State: VA

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: 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: Arm hurting around injection site; Headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache) and VACCINATION SITE PAIN (Arm hurting around injection site) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026C2ZX and 037C21A) for COVID-19 vaccination. Concurrent medical conditions included Depression. Concomitant products included FLUOXETINE HYDROCHLORIDE (PROZAC) for Depression. On 20-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 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 17-Jun-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced HEADACHE (Headache). On 18-Jun-2021, the patient experienced VACCINATION SITE PAIN (Arm hurting around injection site). At the time of the report, HEADACHE (Headache) and VACCINATION SITE PAIN (Arm hurting around injection site) outcome was unknown. No treatment drugs were reported. This case was linked to MOD-2021-229301 (Patient Link).

Other Meds: PROZAC

Current Illness: Depression

ID: 1639995
Sex: F
Age: 60
State: MD

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

Allergies:

Symptom List: Unevaluable event

Symptoms: chest pain; fever; body aches; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (chest pain), PYREXIA (fever), MYALGIA (body aches) and NAUSEA (Nausea) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 17-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Jun-2021, the patient experienced CHEST PAIN (chest pain), PYREXIA (fever), MYALGIA (body aches) and NAUSEA (Nausea). At the time of the report, CHEST PAIN (chest pain), PYREXIA (fever), MYALGIA (body aches) and NAUSEA (Nausea) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Jun-2021, Body temperature: 101.9 (High) High. No concomitant medication were used. No treatment medication were used.

Other Meds:

Current Illness:

ID: 1639996
Sex: M
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: Test Name: G6PD; Result Unstructured Data: not G6PD deficient.

Allergies:

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

Symptoms: severe sweats; head aches; body aches; fever; chills; extremely tired; This spontaneous case was reported by an other and describes the occurrence of HYPERHIDROSIS (severe sweats), HEADACHE (head aches), MYALGIA (body aches), PYREXIA (fever) and CHILLS (chills) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History Information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced HYPERHIDROSIS (severe sweats), HEADACHE (head aches), MYALGIA (body aches), PYREXIA (fever), CHILLS (chills) and FATIGUE (extremely tired). At the time of the report, HYPERHIDROSIS (severe sweats), HEADACHE (head aches), MYALGIA (body aches), PYREXIA (fever), CHILLS (chills) and FATIGUE (extremely tired) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Glucose-6-phosphate dehydrogenase: normal (normal) not G6PD deficient.. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was reported by reporter. No treatment medication was reported by reporter. Most recent FOLLOW-UP information incorporated above includes: On 29-Jun-2021: Pfizer report : dose number changed to 2nd dose This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 21-Jun-2021 and was forwarded to Moderna on 21-Jun-2021. This spontaneous case was reported by an other and describes the occurrence of HYPERHIDROSIS (severe sweats), HEADACHE (head aches), MYALGIA (body aches), PYREXIA (fever) and CHILLS (chills) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History Information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced HYPERHIDROSIS (severe sweats), HEADACHE (head aches), MYALGIA (body aches), PYREXIA (fever), CHILLS (chills) and FATIGUE (extremely tired). At the time of the report, HYPERHIDROSIS (severe sweats), HEADACHE (head aches), MYALGIA (body aches), PYREXIA (fever), CHILLS (chills) and FATIGUE (extremely tired) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Glucose-6-phosphate dehydrogenase: normal (normal) not G6PD deficient.. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was reported by reporter. No treatment medication was reported by reporter. Most recent FOLLOW-UP information incorporated above includes: On 29-Jun-2021: Pfizer report : dose number changed to 2nd dose

Other Meds:

Current Illness:

ID: 1639997
Sex: F
Age: 65
State: IL

Vax Date: 01/26/2021
Onset Date: 03/02/2021
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: redness on arm; Covid-arm; Rash; Soreness on arm; Weird saliva reaction in her mouth; Stiffness in the shoulder/Stiffness in the neck/Stiffness in the spine; Ended up sleeping for 5 hours; This spontaneous case was reported by a consumer and describes the occurrence of SALIVA ALTERED (Weird saliva reaction in her mouth), MUSCULOSKELETAL STIFFNESS (Stiffness in the shoulder/Stiffness in the neck/Stiffness in the spine), SOMNOLENCE (Ended up sleeping for 5 hours), ERYTHEMA (redness on arm) and VACCINATION COMPLICATION (Covid-arm) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011A21A and 013L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Ulcerative colitis (Received remicade infusions every 6 weeks) in 1990. Concurrent medical conditions included Penicillin allergy. Concomitant products included INFLIXIMAB (REMICADE), AZATHIOPRINE (IMURAN [AZATHIOPRINE]), LISINOPRIL, FISH OIL (FISH OIL OMEGA 3), PANTOPRAZOLE and BUPROPION HYDROCHLORIDE (WELLBUTRIN) for an unknown indication, ATORVASTATIN CALCIUM (LIPITOR), HYDROCHLOROTHIAZIDE, TRIAMTERENE (TRIAMTERENE & HCTZ) and BUPROPION HCL. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 02-Mar-2021, the patient experienced SALIVA ALTERED (Weird saliva reaction in her mouth), MUSCULOSKELETAL STIFFNESS (Stiffness in the shoulder/Stiffness in the neck/Stiffness in the spine) and SOMNOLENCE (Ended up sleeping for 5 hours). On an unknown date, the patient experienced ERYTHEMA (redness on arm), VACCINATION COMPLICATION (Covid-arm), RASH (Rash) and MYALGIA (Soreness on arm). At the time of the report, SALIVA ALTERED (Weird saliva reaction in her mouth), MUSCULOSKELETAL STIFFNESS (Stiffness in the shoulder/Stiffness in the neck/Stiffness in the spine), SOMNOLENCE (Ended up sleeping for 5 hours), ERYTHEMA (redness on arm), VACCINATION COMPLICATION (Covid-arm), RASH (Rash) and MYALGIA (Soreness on arm) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment information was provided. This case was linked to MOD-2021-035860 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 24-Jun-2021: Added new reporter details, Allery (penicillin), concomitant medications (Lipitor, Triamterene-HCTZ, Bupropion HCL) and added new events.

Other Meds: REMICADE; IMURAN [AZATHIOPRINE]; LISINOPRIL; FISH OIL OMEGA 3; PANTOPRAZOLE; WELLBUTRIN; LIPITOR; TRIAMTERENE & HCTZ; BUPROPION HCL

Current Illness: Penicillin allergy

ID: 1639998
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: Dizziness; This spontaneous case was reported by a consumer and describes the occurrence of 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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced DIZZINESS (Dizziness). At the time of the report, DIZZINESS (Dizziness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant product use was provided by the reporter. No treatment medication was provided.

Other Meds:

Current Illness:

ID: 1639999
Sex: F
Age:
State: IL

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: adverse event; fatigue; loss of appetite; loss of taste; migraines; shortness of breath; chest pain; fever; muscle pain; joint pain; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 21-Jun-2021 and was forwarded to Moderna on 21-Jun-2021. This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 21-Jun-2021 and was forwarded to Moderna on 21-Jun-2021. This spontaneous case was reported by a physician and describes the occurrence of ADVERSE EVENT (adverse event) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product ADALIMUMAB (HUMIRA) for an unknown indication. 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 and ADALIMUMAB (HUMIRA) (Subcutaneous) 1 dosage form. On an unknown date, the patient experienced ADVERSE EVENT (adverse event). 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 adverse event name is provided by the reporter.No treatment information was provided by the reporter. Primary reporter refused to be contacted.

Other Meds:

Current Illness:

ID: 1640000
Sex: F
Age:
State: VA

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: Nausea, Pain in extremity, Pyrexia

Symptoms: have had GERD that I cannot get rid of, aggravated my GERD; have a hiatal hernia and do react to mediations that way; This spontaneous case was reported by a consumer and describes the occurrence of GASTROOESOPHAGEAL REFLUX DISEASE (have had GERD that I cannot get rid of, aggravated my GERD) and HIATUS HERNIA (have a hiatal hernia and do react to mediations that way) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included AMLODIPINE BESYLATE and GLUCOSAMINE HYDROCHLORIDE for an unknown indication. 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 GASTROOESOPHAGEAL REFLUX DISEASE (have had GERD that I cannot get rid of, aggravated my GERD) and HIATUS HERNIA (have a hiatal hernia and do react to mediations that way). At the time of the report, GASTROOESOPHAGEAL REFLUX DISEASE (have had GERD that I cannot get rid of, aggravated my GERD) had not resolved and HIATUS HERNIA (have a hiatal hernia and do react to mediations that way) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was not applicable No treatment medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 19-Jul-2021: A follow up received on 19-JUL-2021 which contained Patient's demographics, Concomitant medications.

Other Meds: AMLODIPINE BESYLATE; GLUCOSAMINE HYDROCHLORIDE

Current Illness:

ID: 1640001
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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Weakness; Fatigue; This spontaneous case was reported by a physician and describes the occurrence of ASTHENIA (Weakness) and FATIGUE (Fatigue) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History Information was reported. Concomitant products included ADALIMUMAB (HUMIRA) for Rheumatoid arthritis. 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 ASTHENIA (Weakness) and FATIGUE (Fatigue). At the time of the report, ASTHENIA (Weakness) and FATIGUE (Fatigue) 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 treatment information was provided by reporter. This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 21-Jun-2021 and was forwarded to Moderna on 21-Jun-2021. This spontaneous case was reported by a physician and describes the occurrence of ASTHENIA (Weakness) and FATIGUE (Fatigue) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History Information was reported. Concomitant products included ADALIMUMAB (HUMIRA) for Rheumatoid arthritis. 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 ASTHENIA (Weakness) and FATIGUE (Fatigue). At the time of the report, ASTHENIA (Weakness) and FATIGUE (Fatigue) 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 treatment information was provided by reporter.

Other Meds: HUMIRA

Current Illness:

ID: 1640002
Sex: F
Age: 60
State: IL

Vax Date: 05/01/2016
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: Test Date: 20210524; Test Name: Antibody test; Test Result: Negative ; Result Unstructured Data: Did not develop antibody for COVID-19

Allergies:

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

Symptoms: Injection site stinging; This spontaneous case was reported by a physician and describes the occurrence of INJECTION SITE PAIN (Injection site stinging) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 006B21A and 023M20A) for COVID-19 vaccination. Co-suspect product included non-company product ADALIMUMAB (HUMIRA) for Rheumatoid arthritis. Concurrent medical conditions included Depression, Hypothyroidism, Blood pressure high, Migraine, Non-smoker, Abstains from alcohol, Penicillin allergy (Hives), Allergy to antibiotic (Hives), Drug allergy (throat swelling, increased blood pressure, increased heart rate and felt like a heart attack), Allergy to antibiotic (Hives) and Rheumatoid arthritis. Concomitant products included MONTELUKAST SODIUM and LEVOCETIRIZINE DIHYDROCHLORIDE (XYZAL) for Allergy, LOSARTAN POTASSIUM for Blood pressure high, VENLAFAXINE for Depression, LEVOTHYROXINE SODIUM for Hypothyroidism, TOPIRAMATE for Migraine, DESMOPRESSIN ACETATE, ATORVASTATIN, METHOTREXATE, FOLIC ACID and TRAZODONE for an unknown indication. In May 2016, the patient ADALIMUMAB (HUMIRA) (Subcutaneous) dosage was changed to 40 mg every two weeks. On 22-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-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 started ADALIMUMAB (HUMIRA) (Subcutaneous) at an unspecified dose. On an unknown date, the patient experienced INJECTION SITE PAIN (Injection site stinging). At the time of the report, INJECTION SITE PAIN (Injection site stinging) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 24-May-2021, SARS-CoV-2 antibody test: negative (Negative) Did not develop antibody for COVID-19. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication desmopressin acetate indication was reported as "urine." No treatment medication was reported. The patient reported COVID-19 antibody test negative (10084495) SARS-CoV-2 antibody test negative (10084509); which was captured as a Lab data as per, not having MEASURABLE antibodies is neither an adverse event nor an evidence of therapeutic failure; as per there is no specific threshold considered protective for COVID-19 vaccines, there are multiple methods to measure antibodies (with different threshold sensitivity), antibodies measurement might be IgG, IgM, total, or anti-spike antibodies. The method of measuring antibodies is not explained in narrative and rapid methods are unreliable. Immunosuppressed patients often do not develop antibody response to vaccines and that is not considered AE of the vaccine. For the event, injection site pain, based on the current available information and temporal association between the use of the product, and the start date of the events, a causal relationship cannot be excluded.; Sender's Comments: For the event, injection site pain, based on the current available information and temporal association between the use of the product, and the start date of the events, a causal relationship cannot be excluded.

Other Meds: VENLAFAXINE; LEVOTHYROXINE SODIUM; LOSARTAN POTASSIUM; DESMOPRESSIN ACETATE; ATORVASTATIN; METHOTREXATE; FOLIC ACID; TRAZODONE; TOPIRAMATE; MONTELUKAST SODIUM; XYZAL

Current Illness: Abstains from alcohol; Allergy to antibiotic (Hives); Blood pressure high; Depression; Drug allergy (throat swelling, increased blood pressure, increased heart rate and felt like a heart attack); Hypothyroidism; Migraine; Non-smoker; Penicillin allergy (Hives); Rheumatoid arthritis

ID: 1640003
Sex: M
Age:
State: OH

Vax Date: 01/18/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Arm pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm pain) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 18-Jan-2021, the patient 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 received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Arm pain). At the time of the report, PAIN IN EXTREMITY (Arm pain) had resolved. No concomitant medication was reported. T he treatment information was unknown.

Other Meds:

Current Illness:

ID: 1640004
Sex: F
Age:
State: IL

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: Shaking; Sickness; Cold; Feeling bad; Tiredness; This spontaneous case was reported by a physician and describes the occurrence of TREMOR (Shaking), ILLNESS (Sickness), NASOPHARYNGITIS (Cold), FEELING ABNORMAL (Feeling bad) and FATIGUE (Tiredness) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product ADALIMUMAB (HUMIRA) for Rheumatoid arthritis. The patient's past medical history included Rheumatoid arthritis since an unknown date. 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. and ADALIMUMAB (HUMIRA) (Subcutaneous) at an unspecified dose. On an unknown date, the patient experienced TREMOR (Shaking), ILLNESS (Sickness), NASOPHARYNGITIS (Cold), FEELING ABNORMAL (Feeling bad) and FATIGUE (Tiredness). At the time of the report, TREMOR (Shaking), ILLNESS (Sickness), NASOPHARYNGITIS (Cold), FEELING ABNORMAL (Feeling bad) and FATIGUE (Tiredness) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment information was provided by the reporter. This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 21-Jun-2021 and was forwarded to Moderna on 21-Jun-2021. This spontaneous case was reported by a physician and describes the occurrence of TREMOR (Shaking), ILLNESS (Sickness), NASOPHARYNGITIS (Cold), FEELING ABNORMAL (Feeling bad) and FATIGUE (Tiredness) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product ADALIMUMAB (HUMIRA) for Rheumatoid arthritis. The patient's past medical history included Rheumatoid arthritis since an unknown date. 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. and ADALIMUMAB (HUMIRA) (Subcutaneous) at an unspecified dose. On an unknown date, the patient experienced TREMOR (Shaking), ILLNESS (Sickness), NASOPHARYNGITIS (Cold), FEELING ABNORMAL (Feeling bad) and FATIGUE (Tiredness). At the time of the report, TREMOR (Shaking), ILLNESS (Sickness), NASOPHARYNGITIS (Cold), FEELING ABNORMAL (Feeling bad) and FATIGUE (Tiredness) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment information was provided by the reporter.

Other Meds:

Current Illness: Rheumatoid arthritis

ID: 1640005
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: headache; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headache) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced HEADACHE (headache). At the time of the report, HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. No treatment medications were reported but patient wanted to know if they could take Tynol for their headache. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1640006
Sex: F
Age: 66
State: GA

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Dermatitis of scalp; Alopecia; Patient's head stared itching; Patient's head stared flaking; This spontaneous case was reported by a consumer and describes the occurrence of DERMATITIS (Dermatitis of scalp), PRURITUS (Patient's head stared itching), SKIN EXFOLIATION (Patient's head stared flaking) and ALOPECIA (Alopecia) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 027L20A and 028L20A) for COVID-19 vaccination. Concurrent medical conditions included CIDP. Concomitant products included AZATHIOPRINE (IMURAN [AZATHIOPRINE]) and TRIAMCINOLONE ACETONIDE (KENALOG 40) for CIDP. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Jan-2021, the patient experienced PRURITUS (Patient's head stared itching) and SKIN EXFOLIATION (Patient's head stared flaking). On 27-Jan-2021, the patient experienced ALOPECIA (Alopecia). On an unknown date, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced DERMATITIS (Dermatitis of scalp). The patient was treated with CLOBETASOL for Itching, at a dose of 1 dosage form. At the time of the report, DERMATITIS (Dermatitis of scalp) had not resolved and PRURITUS (Patient's head stared itching), SKIN EXFOLIATION (Patient's head stared flaking) and ALOPECIA (Alopecia) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. On 18 Jun 2021, the patient's hair started to fall out. On 27 Jun 2021, the patient was diagnosed with Alopecia. This case was linked to MOD-2021-229351 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 01-Jul-2021: Updated reporter's address, patient's age, DOB, medical history, concomitant medications, batch/lot number, start date of the suspect product,treatment medications and new events were added.

Other Meds: IMURAN [AZATHIOPRINE]; KENALOG 40

Current Illness: CIDP

ID: 1640007
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: Tremor

Symptoms: feel sluggish; tiredness/tired; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 20-Jun-2021 and was forwarded to Moderna on 21-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of SLUGGISHNESS (feel sluggish) and FATIGUE (tiredness/tired) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced SLUGGISHNESS (feel sluggish) and FATIGUE (tiredness/tired). At the time of the report, SLUGGISHNESS (feel sluggish) and FATIGUE (tiredness/tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1640008
Sex: F
Age: 66
State: GA

Vax Date: 01/15/2021
Onset Date: 01/18/2021
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: Alopecia; Patient's head stared itching; Patient's head stared flaking; Patient's hair started to fall out; This spontaneous case was reported by a physician and describes the occurrence of PRURITUS (Patient's head stared itching), SKIN EXFOLIATION (Patient's head stared flaking), DERMATITIS (Patient's hair started to fall out) and ALOPECIA (Alopecia) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 027L20A and 028L20A) for COVID-19 vaccination. Concurrent medical conditions included Alopecia since 27-Jun-2021 and CIDP. Concomitant products included AZATHIOPRINE (IMURAN [AZATHIOPRINE]) and TRIAMCINOLONE ACETONIDE (KENALOG [TRIAMCINOLONE ACETONIDE]) for an unknown indication. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Jan-2021, the patient experienced PRURITUS (Patient's head stared itching), SKIN EXFOLIATION (Patient's head stared flaking) and DERMATITIS (Patient's hair started to fall out). On 27-Jun-2021, the patient experienced ALOPECIA (Alopecia). The patient was treated with CLOBETASOL ongoing since an unknown date for Itchy scalp, at a dose of 1 dosage form. At the time of the report, PRURITUS (Patient's head stared itching) and SKIN EXFOLIATION (Patient's head stared flaking) had not resolved and DERMATITIS (Patient's hair started to fall out) and ALOPECIA (Alopecia) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. This case was linked to MOD-2021-229344. Most recent FOLLOW-UP information incorporated above includes: On 01-Jul-2021: Significant follow up received on 01-JUL-2021. Medical history, Concomitant products and treatment medication ,drug information and events were reported.

Other Meds: IMURAN [AZATHIOPRINE]; KENALOG [TRIAMCINOLONE ACETONIDE]

Current Illness: Alopecia; CIDP

ID: 1640009
Sex: U
Age:
State:

Vax Date:
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: dizzy; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 19-Jun-2021 and was forwarded to Moderna on 21-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizzy) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced DIZZINESS (dizzy). At the time of the report, DIZZINESS (dizzy) outcome was unknown. No concomitant medication details was reported. No treatment medication details was reported.

Other Meds:

Current Illness:

ID: 1640010
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: I have been tired; my heart races occasionally; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (I have been tired) and PALPITATIONS (my heart races occasionally) 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 FATIGUE (I have been tired) and PALPITATIONS (my heart races occasionally). At the time of the report, FATIGUE (I have been tired) and PALPITATIONS (my heart races occasionally) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1640011
Sex: F
Age:
State:

Vax Date: 04/17/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Swollen Lymph Nodes; This spontaneous case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (Swollen Lymph Nodes) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 19-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced LYMPHADENOPATHY (Swollen Lymph Nodes). At the time of the report, LYMPHADENOPATHY (Swollen Lymph Nodes) outcome was unknown. No concomitant medications were provided. No treatment medications were provided. Action taken in response to mRNA-1273 was considered to be not applicable.

Other Meds:

Current Illness:

ID: 1640012
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: Report a side effect; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Report a side effect) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Report a side effect). At the time of the report, VACCINATION COMPLICATION (Report a side effect) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1640013
Sex: M
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Name: Body temperature; Result Unstructured Data: 99; Test Name: Body temperature; Result Unstructured Data: 101

Allergies:

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

Symptoms: Thursday he had the chills; Fever of 99 then at night 101; bit more tired; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Thursday he had the chills), PYREXIA (Fever of 99 then at night 101) and FATIGUE (bit more tired) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received 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 CHILLS (Thursday he had the chills), PYREXIA (Fever of 99 then at night 101) and FATIGUE (bit more tired). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. At the time of the report, CHILLS (Thursday he had the chills) and PYREXIA (Fever of 99 then at night 101) had resolved and FATIGUE (bit more tired) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 99 (High) 99 and 101 (High) 101. Concomitant medication was not provided . Patient was in hospital for aneurysm procedure. Most recent FOLLOW-UP information incorporated above includes: On 21-Jul-2021: Significant follow up received on 21-JUL-2021. Patient details added. Treatment medications provided. New events added.

Other Meds:

Current Illness:

ID: 1640014
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Vomiting; This spontaneous case was reported by a consumer and describes the occurrence of VOMITING (Vomiting) 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 18-Jun-2021, the patient experienced VOMITING (Vomiting). At the time of the report, VOMITING (Vomiting) had not resolved. No concomitant medications were mentioned. No treatment details were reported.

Other Meds:

Current Illness:

ID: 1640015
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: excessive urination; This spontaneous case was reported by a consumer and describes the occurrence of POLLAKIURIA (excessive urination) 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 POLLAKIURIA (excessive urination). At the time of the report, POLLAKIURIA (excessive urination) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications details were not reported by the reporter. Treatment details was not reported by the reporter.

Other Meds:

Current Illness:

ID: 1640016
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: daughter has rsv and is due for her second shot Tuesday; This spontaneous case was reported by a consumer and describes the occurrence of RESPIRATORY SYNCYTIAL VIRUS INFECTION (daughter has rsv and is due for her second shot Tuesday) in an 18-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced RESPIRATORY SYNCYTIAL VIRUS INFECTION (daughter has rsv and is due for her second shot Tuesday). At the time of the report, RESPIRATORY SYNCYTIAL VIRUS INFECTION (daughter has rsv and is due for her second shot Tuesday) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product information, if any, was not provided by the reporter. Treatment information, if any, was not provided by the reporter

Other Meds:

Current Illness:

ID: 1640017
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: red blotches on left arm; This spontaneous case was reported by a consumer and describes the occurrence of RASH MACULAR (red blotches on left arm) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received 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 RASH MACULAR (red blotches on left arm). At the time of the report, RASH MACULAR (red blotches on left arm) outcome was unknown. Action taken with mRNA-1273 (Moderna COVID-19 Vaccine) for events was not applicable. No concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1640018
Sex: M
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Severe heart inflammation; This spontaneous case was reported by a consumer and describes the occurrence of MYOCARDITIS (Severe heart inflammation) in a 21-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced MYOCARDITIS (Severe heart inflammation) (seriousness criterion medically significant). At the time of the report, MYOCARDITIS (Severe heart inflammation) outcome was unknown. No relevant concomitant medications were reported. Very limited information regarding this event has been provided at this time, however, based on the available information, a causal relationship cannot be excluded. Further information is not expected Most recent FOLLOW-UP information incorporated above includes: On 21-Jun-2021: Upon internal review on 04-AUG-2021, this case was revised and initials, age, gender, events related to patient were updated. Reporter type was updated. Vaccine information updated.; Sender's Comments: Very limited information regarding this event has been provided at this time, however, based on the available information, a causal relationship cannot be excluded. Further information is not expected

Other Meds:

Current Illness:

ID: 1640019
Sex: F
Age: 66
State: MI

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

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: sore throat; Hives all over; stuffed up nose; on and off fever; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (sore throat), URTICARIA (Hives all over), NASAL CONGESTION (stuffed up nose) and PYREXIA (on and off fever) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 054C21A) for COVID-19 vaccination. Concurrent medical conditions included Aneurysm cerebral since 2005 and Blood pressure. On 13-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 13-Jun-2021, the patient experienced OROPHARYNGEAL PAIN (sore throat), URTICARIA (Hives all over), NASAL CONGESTION (stuffed up nose) and PYREXIA (on and off fever). The patient was treated with NAPROXEN SODIUM (ALEVE) at an unspecified dose and frequency and IBUPROFEN at an unspecified dose and frequency. At the time of the report, OROPHARYNGEAL PAIN (sore throat), URTICARIA (Hives all over), NASAL CONGESTION (stuffed up nose) and PYREXIA (on and off fever) outcome was unknown. Not Provided Concomitant medication information was provided as Blood pressure medication.

Other Meds:

Current Illness: Aneurysm cerebral; Blood pressure

ID: 1640020
Sex: U
Age:
State:

Vax Date: 06/19/2021
Onset Date: 06/19/2021
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: Redness/ redness has spread; Swelling on the inside about the size of an orange; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Redness/ redness has spread) and SWELLING (Swelling on the inside about the size of an orange) 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 19-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jun-2021, the patient experienced ERYTHEMA (Redness/ redness has spread) and SWELLING (Swelling on the inside about the size of an orange). At the time of the report, ERYTHEMA (Redness/ redness has spread) and SWELLING (Swelling on the inside about the size of an orange) outcome was unknown. No concomitant medications were provided. Treatment medications were unknown.

Other Meds:

Current Illness:

ID: 1640021
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: sore arm; feel weak; This spontaneous case was reported by a patient and describes the occurrence of PAIN IN EXTREMITY (sore arm) and ASTHENIA (feel weak) 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 PAIN IN EXTREMITY (sore arm) and ASTHENIA (feel weak). At the time of the report, PAIN IN EXTREMITY (sore arm) and ASTHENIA (feel weak) outcome was unknown. No concomitant medication details was reported. No treatment medication details was reported.

Other Meds:

Current Illness:

ID: 1640022
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: This spontaneous case reported by a consumer, describes the occurrence of macular rash (red blotchy rash) and erythematous rash (red blotchy rash) 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 first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On an unknown date, patient experienced macular rash (red blotchy rash) and erythematous rash (red blotchy rash). At the time of the report, macular rash (red blotchy rash) and erythematous rash (red blotchy rash) outcome: unknown. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. No concomitant medication or treatment information provided.

Other Meds:

Current Illness:

ID: 1640023
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: arm twitching after my vaccine; This spontaneous case was reported by a consumer and describes the occurrence of MUSCLE TWITCHING (arm twitching after my vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MUSCLE TWITCHING (arm twitching after my vaccine). At the time of the report, MUSCLE TWITCHING (arm twitching after my vaccine) 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:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am