VAERS 2021 Database www.vaers.hhs.gov

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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: 1640424
Sex: F
Age: 61
State: CO

Vax Date: 06/16/2021
Onset Date: 06/17/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Test Date: 20210621; Test Name: COVID-19; Test Result: Positive ; Result Unstructured Data: positive

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: exhaustion; red at the injection site/injection site was red; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (exhaustion) and VACCINATION SITE ERYTHEMA (red at the injection site/injection site was red) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 030C21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in February 2021. On 16-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Jun-2021, the patient experienced FATIGUE (exhaustion) and VACCINATION SITE ERYTHEMA (red at the injection site/injection site was red). The patient was treated with Physical therapy for Vaccination site erythema. On 18-Jun-2021, VACCINATION SITE ERYTHEMA (red at the injection site/injection site was red) had resolved. At the time of the report, FATIGUE (exhaustion) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 21-Jun-2021, SARS-CoV-2 test: positive (Positive) positive. It was reported that her gynecologist scheduled her for exploratory surgery to check for possible cancer. No concomitant medications were reported. Treatment included taking a massage. Body temperature was taken on an unknown date and the results were 97.6 degrees F This case was linked to MOD-2021-231139 (Patient Link).

Other Meds:

Current Illness:

ID: 1640425
Sex: M
Age: 86
State: OH

Vax Date: 02/15/2021
Onset Date:
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: begun to feel dizzy and very light-headed/Dizziness; weak; had been falling a lot as well; Loss of balance; Can Barely Walk/Can't get around because it hurts so bad; Extreme Muscle Weakness; "Out of Sorts"; Delayed receiving second dose because he "bumped his elbow"; bursitis; bumped his elbow; This spontaneous case was reported by a patient family member or friend and describes the occurrence of DIZZINESS (begun to feel dizzy and very light-headed/Dizziness), ASTHENIA (weak), FALL (had been falling a lot as well), BALANCE DISORDER (Loss of balance) and GAIT DISTURBANCE (Can Barely Walk/Can't get around because it hurts so bad) in an 87-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. No Medical History information was reported. On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-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 DIZZINESS (begun to feel dizzy and very light-headed/Dizziness), ASTHENIA (weak), FALL (had been falling a lot as well), BALANCE DISORDER (Loss of balance), GAIT DISTURBANCE (Can Barely Walk/Can't get around because it hurts so bad), MUSCULAR WEAKNESS (Extreme Muscle Weakness), FEELING ABNORMAL ("Out of Sorts"), INTENTIONAL PRODUCT USE ISSUE (Delayed receiving second dose because he "bumped his elbow"), BURSITIS (bursitis) and JOINT INJURY (bumped his elbow). The patient was treated with PREDNISOLONE for Bursitis, at an unspecified dose and frequency. At the time of the report, DIZZINESS (begun to feel dizzy and very light-headed/Dizziness), ASTHENIA (weak), FALL (had been falling a lot as well), BALANCE DISORDER (Loss of balance), GAIT DISTURBANCE (Can Barely Walk/Can't get around because it hurts so bad), MUSCULAR WEAKNESS (Extreme Muscle Weakness), FEELING ABNORMAL ("Out of Sorts"), INTENTIONAL PRODUCT USE ISSUE (Delayed receiving second dose because he "bumped his elbow"), BURSITIS (bursitis) and JOINT INJURY (bumped his elbow) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment information was not provided. It was reported that caller is returning call from safety to provide email address. This case was linked to MOD-2021-231221 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 22-Jun-2021: Treatment medication are added and New events are added. On 16-Jul-2021: Follow up document received contains No significant information (NNI).

Other Meds:

Current Illness:

ID: 1640426
Sex: M
Age: 66
State: IL

Vax Date: 04/16/2021
Onset Date: 05/14/2021
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: lower back pain; body aches; Lowgrade fever of around 99-100 degrees; This spontaneous case was reported by a patient and describes the occurrence of BACK PAIN (lower back pain), PAIN (body aches) and PYREXIA (Lowgrade fever of around 99-100 degrees) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 042B212A and 040B27A) for COVID-19 vaccination. No Medical History information was reported. On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 14-May-2021, the patient experienced BACK PAIN (lower back pain), PAIN (body aches) and PYREXIA (Lowgrade fever of around 99-100 degrees). The patient was treated with PARACETAMOL (TYLENOL) for Fever, at a dose of 1 dosage form and IBUPROFEN (ADVIL [IBUPROFEN]) for Pain, at a dose of 1 dosage form. On 16-May-2021, PAIN (body aches) and PYREXIA (Lowgrade fever of around 99-100 degrees) had resolved. At the time of the report, BACK PAIN (lower back pain) had not resolved. Patient used arthritic cream for his back as corrective. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1640427
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: chest pain; Abdominal pain; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (chest pain) and ABDOMINAL PAIN (Abdominal pain) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced CHEST PAIN (chest pain) and ABDOMINAL PAIN (Abdominal pain). At the time of the report, CHEST PAIN (chest pain) and ABDOMINAL PAIN (Abdominal pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1640428
Sex: F
Age: 41
State: GA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: pain in the back/sore back/lower back pain; pain in the lower back, kidneys and lungs; hotness; dizziness; could not stand; Covid-19-like symptoms; drunk-likeness; nausea; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (pain in the back/sore back/lower back pain), PAIN (pain in the lower back, kidneys and lungs), FEELING HOT (hotness), DIZZINESS (dizziness) and DYSSTASIA (could not stand) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19. On 24-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-May-2021, the patient experienced BACK PAIN (pain in the back/sore back/lower back pain), PAIN (pain in the lower back, kidneys and lungs), FEELING HOT (hotness), DIZZINESS (dizziness), DYSSTASIA (could not stand), SUSPECTED COVID-19 (Covid-19-like symptoms), FEELING DRUNK (drunk-likeness) and NAUSEA (nausea). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. On 29-May-2021, FEELING HOT (hotness), DIZZINESS (dizziness), DYSSTASIA (could not stand), FEELING DRUNK (drunk-likeness) and NAUSEA (nausea) had resolved. On 08-Jun-2021, BACK PAIN (pain in the back/sore back/lower back pain), PAIN (pain in the lower back, kidneys and lungs) and SUSPECTED COVID-19 (Covid-19-like symptoms) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication were reported by the reporter

Other Meds:

Current Illness:

ID: 1640429
Sex: F
Age: 73
State: TX

Vax Date: 01/18/2021
Onset Date: 02/10/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: urinary tract infection; experiences vertigo "usually when I get up" / vertigo while sitting and throughout day; headache the day of receiving the vaccine; This spontaneous case was reported by a consumer and describes the occurrence of VERTIGO (experiences vertigo "usually when I get up" / vertigo while sitting and throughout day), URINARY TRACT INFECTION (urinary tract infection) and HEADACHE (headache the day of receiving the vaccine) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. Not provided and not provided) for COVID-19 vaccination. Concurrent medical conditions included Cancer. On 18-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Feb-2021, the patient experienced HEADACHE (headache the day of receiving the vaccine). On 13-Feb-2021, the patient experienced VERTIGO (experiences vertigo "usually when I get up" / vertigo while sitting and throughout day). On an unknown date, the patient experienced URINARY TRACT INFECTION (urinary tract infection). At the time of the report, VERTIGO (experiences vertigo "usually when I get up" / vertigo while sitting and throughout day), URINARY TRACT INFECTION (urinary tract infection) and HEADACHE (headache the day of receiving the vaccine) outcome was unknown. No Treatment information was reported

Other Meds:

Current Illness: Cancer

ID: 1640430
Sex: F
Age: 61
State: MN

Vax Date: 01/12/2021
Onset Date:
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: muscle spasm by the injection site, it's like a twitching sensation under the muscle; Feels like she has a bug on her legs, but she doesn't; had bumps at the injection site; Twitching is all over her body; Achiness in her joints especially her wrist; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of MUSCLE SPASMS (muscle spasm by the injection site, it's like a twitching sensation under the muscle), FEELING ABNORMAL (Feels like she has a bug on her legs, but she doesn't), VACCINATION SITE MASS (had bumps at the injection site), MUSCLE TWITCHING (Twitching is all over her body) and ARTHRALGIA (Achiness in her joints especially her wrist) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 032H20A and 030L20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced MUSCLE SPASMS (muscle spasm by the injection site, it's like a twitching sensation under the muscle), FEELING ABNORMAL (Feels like she has a bug on her legs, but she doesn't), VACCINATION SITE MASS (had bumps at the injection site), MUSCLE TWITCHING (Twitching is all over her body) and ARTHRALGIA (Achiness in her joints especially her wrist). At the time of the report, MUSCLE SPASMS (muscle spasm by the injection site, it's like a twitching sensation under the muscle), FEELING ABNORMAL (Feels like she has a bug on her legs, but she doesn't), VACCINATION SITE MASS (had bumps at the injection site), MUSCLE TWITCHING (Twitching is all over her body) and ARTHRALGIA (Achiness in her joints especially her wrist) outcome was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1640431
Sex: F
Age: 46
State: TX

Vax Date: 05/21/2021
Onset Date:
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: dose from vial that was opened on 6/18/21 was administered; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (dose from vial that was opened on 6/18/21 was administered) in a 46-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039B21A) for COVID-19 vaccination. No Medical History information was reported. 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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced EXPIRED PRODUCT ADMINISTERED (dose from vial that was opened on 6/18/21 was administered). At the time of the report, EXPIRED PRODUCT ADMINISTERED (dose from vial that was opened on 6/18/21 was administered) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication were provided. No treatment details were provided. Most recent FOLLOW-UP information incorporated above includes: On 22-Jun-2021: Follow up received on 22-JUN-2021 contains patient demographics and event information.

Other Meds:

Current Illness:

ID: 1640432
Sex: F
Age: 44
State: GA

Vax Date: 05/25/2021
Onset Date: 06/22/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The vaccine was expired/ expired dose; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (The vaccine was expired/ expired dose) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041C21A) for COVID-19 vaccination. No Medical History information was reported. On 25-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 22-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (The vaccine was expired/ expired dose). On 22-Jun-2021, EXPIRED PRODUCT ADMINISTERED (The vaccine was expired/ expired dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication reported by reporter. No treatment medication reported by reporter. Most recent FOLLOW-UP information incorporated above includes: On 23-Jun-2021: Received a new document, address of the reporter, patient initials, date of birth, the expiry date and patient route of administration of second dose was updated.

Other Meds:

Current Illness:

ID: 1640433
Sex: F
Age: 65
State: IL

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: sore arm/worse with touching it; headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm/worse with touching it) and HEADACHE (headache) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040B27A) for COVID-19 vaccination. No Medical History information was reported. On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Apr-2021, the patient experienced PAIN IN EXTREMITY (sore arm/worse with touching it) and HEADACHE (headache). On 16-Apr-2021, HEADACHE (headache) had resolved. On 20-Apr-2021, PAIN IN EXTREMITY (sore arm/worse with touching it) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. After the first dose of the vaccine, the patient experienced a headache for 2-3 hours and a sore arm for 3-4 days. The arm was worse with touching it. No treatment information was provided. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. This case was linked to MOD-2021-231296 (Patient Link).; 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:

Current Illness:

ID: 1640434
Sex: M
Age: 60
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: patient has been diagnosed with a medical problem; chills; mild fever, fever for a month after 1st dose; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (patient has been diagnosed with a medical problem), PYREXIA (mild fever, fever for a month after 1st dose) and CHILLS (chills) in a 60-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003C21A) for COVID-19 vaccination. The patient's past medical history included Colonoscopy. Concurrent medical conditions included Blood pressure. Concomitant products included LISINOPRIL for Blood pressure, ALENDRONATE SODIUM, CALCIUM, COLECALCIFEROL (ALOXIN) for an unknown indication. On 08-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Jun-2021, the patient experienced PYREXIA (mild fever, fever for a month after 1st dose). On an unknown date, the patient experienced VACCINATION COMPLICATION (patient has been diagnosed with a medical problem) and CHILLS (chills). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, VACCINATION COMPLICATION (patient has been diagnosed with a medical problem), PYREXIA (mild fever, fever for a month after 1st dose) and CHILLS (chills) outcome was unknown. 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. Patient had been diagnosed with a medical problem (denied sharing more information on this) that might had been causing the fever they reported before, so patient believes their reactions in not related to the vaccine and sees no point in filling the questioners, although they mention that if Safety still wants those filled, they will do it. This case was linked to MOD-2021-253098 (Dose 2) (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 23-Jul-2021: Additional event

Other Meds: LISINOPRIL; ALOXIN

Current Illness: Blood pressure

ID: 1640435
Sex: F
Age: 55
State: NC

Vax Date: 05/24/2021
Onset Date: 06/22/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Dizziness; Slurred speech; Some Vertigo; Almost like being drunk; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), DYSARTHRIA (Slurred speech), VERTIGO (Some Vertigo) and FEELING DRUNK (Almost like being drunk) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 24-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 22-Jun-2021, the patient experienced DIZZINESS (Dizziness), VERTIGO (Some Vertigo) and FEELING DRUNK (Almost like being drunk). 22-Jun-2021, the patient experienced DYSARTHRIA (Slurred speech). At the time of the report, DIZZINESS (Dizziness), DYSARTHRIA (Slurred speech), VERTIGO (Some Vertigo) and FEELING DRUNK (Almost like being drunk) outcome was unknown. No Concomitant medications were provided No treatment information provided.

Other Meds:

Current Illness:

ID: 1640436
Sex: M
Age: 52
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: Very Sleepy for two weeks; Chills; Fever; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (Very Sleepy for two weeks), CHILLS (Chills) and PYREXIA (Fever) in a 52-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 041C21A and 027C21A) for COVID-19 vaccination. No Medical History information was reported. On 05-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-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 SOMNOLENCE (Very Sleepy for two weeks), CHILLS (Chills) and PYREXIA (Fever). At the time of the report, SOMNOLENCE (Very Sleepy for two weeks), CHILLS (Chills) and PYREXIA (Fever) outcome was unknown. No concomitant medications were reported. No treatment medications were reported. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) was not applicable. For mRNA-1273 (Moderna COVID-19 Vaccine) ,the reporter did not provide any causality assessments. This case was linked to MOD-2021-231535 (Patient Link).

Other Meds:

Current Illness:

ID: 1640437
Sex: M
Age: 86
State: OH

Vax Date: 02/15/2021
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: Bursitis; Bumped Elbow; This spontaneous case was reported by a consumer and describes the occurrence of BURSITIS (Bursitis) and JOINT INJURY (Bumped Elbow) in an 87-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-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 BURSITIS (Bursitis) and JOINT INJURY (Bumped Elbow). The patient was treated with PREDNISONE for Bursitis, at a dose of 1 dosage form. At the time of the report, BURSITIS (Bursitis) and JOINT INJURY (Bumped Elbow) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication were reported by reporter. This case was linked to MOD-2021-231156 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 16-Jul-2021: Follow-up information received on contains non-significant information - added reporter's Email Address.

Other Meds:

Current Illness:

ID: 1640438
Sex: F
Age:
State: MI

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: really bad diarrhea which lasted for about 5 days; swelling at the site; a little bit of fever; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (really bad diarrhea which lasted for about 5 days), VACCINATION SITE SWELLING (swelling at the site) and PYREXIA (a little bit of fever) in a 27-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 00SC212) for COVID-19 vaccination. No Medical History information was reported. On 24-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-May-2021, the patient experienced DIARRHOEA (really bad diarrhea which lasted for about 5 days), VACCINATION SITE SWELLING (swelling at the site) and PYREXIA (a little bit of fever). At the time of the report, DIARRHOEA (really bad diarrhea which lasted for about 5 days), VACCINATION SITE SWELLING (swelling at the site) and PYREXIA (a little bit of fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 22-Jun-2021, Body temperature: 101 (Inconclusive) 101. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant products and treatment medication were reported. This case was linked to MOD-2021-231256 (Patient Link).

Other Meds:

Current Illness:

ID: 1640439
Sex: F
Age:
State: MI

Vax Date: 05/24/2021
Onset Date: 06/22/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data: Test Date: 20210621; Test Name: pyrexia; Result Unstructured Data: high fever (an hour ago patient'stemperature was 101).

Allergies:

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

Symptoms: pain all over her body,sore,muscle hurts,hurts to lift arm; high fever; arm is the size of a gulf ball; it is really hard and sore; weak,whole body is weak/ can barely walk,cant alone walk down stairs because it hurts to walk; not able to care for them now because she can't stand up long enough; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (arm is the size of a gulf ball), INDURATION (it is really hard and sore), ASTHENIA (weak,whole body is weak/ can barely walk,cant alone walk down stairs because it hurts to walk), DYSSTASIA (not able to care for them now because she can't stand up long enough ) and MYALGIA (pain all over her body,sore,muscle hurts,hurts to lift arm) in a 27-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 053C214 and 00SC212) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 24-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 22-Jun-2021, the patient experienced PERIPHERAL SWELLING (arm is the size of a gulf ball), INDURATION (it is really hard and sore), ASTHENIA (weak,whole body is weak/ can barely walk,cant alone walk down stairs because it hurts to walk) and PYREXIA (high fever). 22-Jun-2021, the patient experienced DYSSTASIA (not able to care for them now because she can't stand up long enough ). On an unknown date, the patient experienced MYALGIA (pain all over her body,sore,muscle hurts,hurts to lift arm). At the time of the report, PERIPHERAL SWELLING (arm is the size of a gulf ball), INDURATION (it is really hard and sore), ASTHENIA (weak,whole body is weak/ can barely walk,cant alone walk down stairs because it hurts to walk), DYSSTASIA (not able to care for them now because she can't stand up long enough ), MYALGIA (pain all over her body,sore,muscle hurts,hurts to lift arm) and PYREXIA (high fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 21-Jun-2021, Pyrexia: 101 (High) high fever (an hour ago patient'stemperature was 101).. No concomitant medication was provided. No treatment medication was given. Med info agent : Warm transfer with Moderna Customer Care Number 00176281 Caller wants to know how long patient's side effects will last because patient has 4 kids to take care of and patient is not able to care for them now because patient can't stand up long enough, let alone walk down the stairs because it hurts to walk, muscle hurts. Patient has not taken anything yet because patient is scared. Patient to 27- years on 11-may-2021.Patient received both vaccines at the health department. Patient states she is not on any medications and not aware of any health conditions. Consent for safety to follow-up was received. This case was linked to MOD-2021-231242 (Patient Link).

Other Meds:

Current Illness:

ID: 1640440
Sex: U
Age:
State:

Vax Date: 03/05/2021
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: I had 1st moderna vaccine on 05-MAR-2021. Is that ok if i get my second dose in the next few days.; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (I had 1st moderna vaccine on 05-MAR-2021. Is that ok if i get my second dose in the next few days.) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 05-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (I had 1st moderna vaccine on 05-MAR-2021. Is that ok if i get my second dose in the next few days.). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (I had 1st moderna vaccine on 05-MAR-2021. Is that ok if i get my second dose in the next few days.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication were not provided by the reporter. Treatment medication were not provided by the reporter.

Other Meds:

Current Illness:

ID: 1640441
Sex: F
Age: 68
State: CA

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 08/27/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: This spontaneous case reported by a healthcare professional, describes the occurrence of administered expired product (administration of one dose from the expired vial to a patient) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch# 037C21A) for COVID-19 immunization. No medical history reported. On Jun 22, 2021, patient received the second dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Jun 22, 2021, patient administered expired product (administration of one dose from the expired vial to a patient). On Jun 22, 2021, administered expired product (administration of one dose from the expired vial to a patient) resolved. The reporter did not provide any causality assessments, concomitant medication or treatment information.

Other Meds:

Current Illness:

ID: 1640442
Sex: U
Age:
State:

Vax Date: 06/16/2021
Onset Date:
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: The injection site is still red, welted; Itching; Injection site is welted.; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE ERYTHEMA (The injection site is still red, welted), VACCINATION SITE PRURITUS (Itching) and VACCINATION SITE URTICARIA (Injection site is welted.) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 16-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (The injection site is still red, welted), VACCINATION SITE PRURITUS (Itching) and VACCINATION SITE URTICARIA (Injection site is welted.). At the time of the report, VACCINATION SITE ERYTHEMA (The injection site is still red, welted), VACCINATION SITE PRURITUS (Itching) and VACCINATION SITE URTICARIA (Injection site is welted.) outcome was unknown.

Other Meds:

Current Illness:

ID: 1640443
Sex: F
Age:
State: KY

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

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

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

Symptoms: Urinary tract infection; This spontaneous case was reported by a consumer and describes the occurrence of URINARY TRACT INFECTION (Urinary tract infection) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history reported by reporter. Concomitant products included SULFAMETHOXAZOLE, TRIMETHOPRIM (BACTRIM) for Urinary tract infection. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced URINARY TRACT INFECTION (Urinary tract infection). At the time of the report, URINARY TRACT INFECTION (Urinary tract infection) outcome was unknown. The action taken with mRNA-1273 with the events was considered as not applicable. No treatment medication reported by reporter. Patient informed vaccine has something to do with her Urinary Tract Infection, and wants to know if she will continue the antibiotic.

Other Meds: BACTRIM

Current Illness:

ID: 1640444
Sex: M
Age: 56
State: CA

Vax Date: 04/07/2021
Onset Date:
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: pain in his left arm and even cannot lift a cup of tea; pain in his left arm and even cannot lift a cup of tea; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULAR WEAKNESS (pain in his left arm and even cannot lift a cup of tea) and MYALGIA (pain in his left arm and even cannot lift a cup of tea) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003B21A) for COVID-19 vaccination. Concurrent medical conditions included Asthma. Concomitant products included MONTELUKAST and LORATADINE for Asthma. On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced MUSCULAR WEAKNESS (pain in his left arm and even cannot lift a cup of tea) and MYALGIA (pain in his left arm and even cannot lift a cup of tea). At the time of the report, MUSCULAR WEAKNESS (pain in his left arm and even cannot lift a cup of tea) and MYALGIA (pain in his left arm and even cannot lift a cup of tea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided by the reporter. This case was linked to MOD-2021-231335 (Patient Link).

Other Meds: MONTELUKAST; LORATADINE

Current Illness: Asthma

ID: 1640445
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Back Pain; Urination issues.; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Back Pain) and MICTURITION DISORDER (Urination issues.) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced BACK PAIN (Back Pain) and MICTURITION DISORDER (Urination issues.). At the time of the report, BACK PAIN (Back Pain) and MICTURITION DISORDER (Urination issues.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. Treatment medication was not provided.

Other Meds:

Current Illness:

ID: 1640446
Sex: F
Age: 47
State: PA

Vax Date: 05/25/2021
Onset Date: 06/22/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: chest pain; got a little tired & took a short nap; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (chest pain) and FATIGUE (got a little tired & took a short nap) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 050C21A and 023C21A) for COVID-19 vaccination. No medical history was provided by reporter. Concomitant products included ESCITALOPRAM OXALATE (LEXAPRO), LAMOTRIGINE (LAMICTAL), ZIPRASIDONE HYDROCHLORIDE (GEODON [ZIPRASIDONE HYDROCHLORIDE]), TRAZODONE, DICYCLOMINE [DICYCLOVERINE], LACTOBACILLUS ACIDOPHILUS (ACIDOPHILUS [LACTOBACILLUS ACIDOPHILUS]), PROPRANOLOL, PRIMIDONE and LORAZEPAM (ATIVAN) for an unknown indication. On 25-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jun-2021 at 9:30 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 22-Jun-2021, the patient experienced CHEST PAIN (chest pain) and FATIGUE (got a little tired & took a short nap). At the time of the report, CHEST PAIN (chest pain) and FATIGUE (got a little tired & took a short nap) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Action taken with mRNA-1273 in response to the events was not Applicable. No treatment medications were provided.

Other Meds: LEXAPRO; LAMICTAL; GEODON [ZIPRASIDONE HYDROCHLORIDE]; TRAZODONE; DICYCLOMINE [DICYCLOVERINE]; ACIDOPHILUS [LACTOBACILLUS ACIDOPHILUS]; PROPRANOLOL; PRIMIDONE; ATIVAN

Current Illness:

ID: 1640447
Sex: U
Age:
State:

Vax Date: 06/22/2021
Onset Date: 06/22/2021
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: fever; fatigue; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 22-Jun-2021 and was forwarded to Moderna on 22-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever) and FATIGUE (fatigue) 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 22-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jun-2021, the patient experienced PYREXIA (fever) and FATIGUE (fatigue). At the time of the report, PYREXIA (fever) and FATIGUE (fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment and concomitant medications were provided.

Other Meds:

Current Illness:

ID: 1640448
Sex: F
Age: 63
State: CT

Vax Date: 03/09/2021
Onset Date: 04/08/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Broke out in hives 2 days later; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 22-Jun-2021 and was forwarded to Moderna on 22-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (Broke out in hives 2 days later) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025B21A and 030A21A) for COVID-19 vaccination. The patient's past medical history included Lymphoma (The patient has a past medical history of underlying condition of cancer (lymphoma). Patient reports she has a rare "B cell "lymphoma"). Concurrent medical conditions included Drug allergy (Patient is sensitive to certain medications(not specified).). Concomitant products included LORATADINE (CLARITIN [LORATADINE]) for Allergy NOS, LISINOPRIL DIHYDRATE (PRINIVIL) and SIMVASTATIN (ZOCOR) for Hypertension, CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000) for Nutritional supplement, DOCUSATE SODIUM (COLACE) for Stools loose, VITAMIN B6 for Vitamin supplementation, FAMOTIDINE. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 2 dosage form. On 08-Apr-2021, the patient experienced URTICARIA (Broke out in hives 2 days later). At the time of the report, URTICARIA (Broke out in hives 2 days later) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication also included fiber gummies 5g for daily supplement. The patient was prescribed with pre-medication with a loading dose of prednisone 80mg once by mouth and one 25 mg Benadryl by mouth an hour before taking the shot. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) in response to the events was not applicable. This case was linked to MOD-2021-039486 (Patient Link).

Other Meds: PRINIVIL; ZOCOR; VITAMIN D 2000; VITAMIN B6; COLACE; FAMOTIDINE; CLARITIN [LORATADINE]

Current Illness:

ID: 1640449
Sex: F
Age:
State: FL

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: not feeling well; Arm is very sore; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (not feeling well) and PAIN IN EXTREMITY (Arm is very sore) in a 46-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Anemia and Bradycardia. On 22-Jun-2021 at 11:15 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Jun-2021, the patient experienced MALAISE (not feeling well) and PAIN IN EXTREMITY (Arm is very sore). At the time of the report, MALAISE (not feeling well) and PAIN IN EXTREMITY (Arm is very sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications were not provided by reporter. Treatment information was not provided by reporter. Most recent FOLLOW-UP information incorporated above includes: On 22-Jun-2021: Consent for follow-up updated.

Other Meds:

Current Illness: Anemia; Bradycardia

ID: 1640450
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: missed second dose; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (missed second dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (missed second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (missed second dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant information was not reported. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1640451
Sex: M
Age: 56
State: CA

Vax Date: 04/07/2021
Onset Date:
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Day by day the left arm pain is getting worse; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Day by day the left arm pain is getting worse) in a 56-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003B21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included MONTELUKAST and LORATADINE for Asthma. On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced MYALGIA (Day by day the left arm pain is getting worse). At the time of the report, MYALGIA (Day by day the left arm pain is getting worse) had not resolved. The patient complained about pain in his left arm after first dose and later stated that after second dose the pain got worse, and day by day it is getting worse. No treatment medication were reported. This case was linked to MOD-2021-231275 (Patient Link).

Other Meds: MONTELUKAST; LORATADINE

Current Illness:

ID: 1640452
Sex: M
Age: 87
State: NJ

Vax Date: 06/17/2021
Onset Date: 06/18/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Weak after Second Shot; Itchy on the Injection Site after Second Shot; Tired after Second Shot; Headache after Second Shot; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Weak after Second Shot), VACCINATION SITE PRURITUS (Itchy on the Injection Site after Second Shot), FATIGUE (Tired after Second Shot) and HEADACHE (Headache after Second Shot) in an 86-year-old male 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) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Jun-2021, the patient experienced ASTHENIA (Weak after Second Shot), VACCINATION SITE PRURITUS (Itchy on the Injection Site after Second Shot), FATIGUE (Tired after Second Shot) and HEADACHE (Headache after Second Shot). On 21-Jun-2021, ASTHENIA (Weak after Second Shot) and VACCINATION SITE PRURITUS (Itchy on the Injection Site after Second Shot) had resolved. At the time of the report, FATIGUE (Tired after Second Shot) and HEADACHE (Headache after Second Shot) had not resolved. Concomitant product details was not reported. No treatment medication reported by the reporter This case was linked to MOD-2021-231441 (Patient Link).

Other Meds:

Current Illness:

ID: 1640453
Sex: F
Age: 47
State: AZ

Vax Date: 05/22/2021
Onset Date: 06/20/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came; red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came; red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came; COVID arm; nausea; chills; temperature of 101 after second ose; aches and pain in the legs and back; tingle in left hand/ figure tips; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (aches and pain in the legs and back), PARAESTHESIA (tingle in left hand/ figure tips), ERYTHEMA (red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came), SWELLING (red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came) and FEELING HOT (red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 035C21A and 011D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No specified medical history has been reported. Concomitant products included LISINOPRIL for an unknown indication. On 22-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 20-Jun-2021, the patient experienced PAIN IN EXTREMITY (aches and pain in the legs and back), PARAESTHESIA (tingle in left hand/ figure tips), MYALGIA (COVID arm), NAUSEA (nausea), CHILLS (chills) and PYREXIA (temperature of 101 after second ose). On 21-Jun-2021, the patient experienced ERYTHEMA (red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came), SWELLING (red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came) and FEELING HOT (red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL A) ongoing since an unknown date at an unspecified dose and frequency and PARACETAMOL (TYLENOL) ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (aches and pain in the legs and back), PARAESTHESIA (tingle in left hand/ figure tips), ERYTHEMA (red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came), SWELLING (red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came), FEELING HOT (red spot moved up arm to shoulder and is hot to the touch with white spots, then raised red bumps came), MYALGIA (COVID arm), NAUSEA (nausea), CHILLS (chills) and PYREXIA (temperature of 101 after second ose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient took ice compress on arm and back. Crosslink Case MOD21-104950 This case was linked to MOD-2021-193857 (Patient Link).

Other Meds: LISINOPRIL

Current Illness:

ID: 1640454
Sex: U
Age:
State: FL

Vax Date: 05/10/2021
Onset Date:
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: more than 35 days have passed between doses; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (more than 35 days have passed between doses) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 10-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (more than 35 days have passed between doses). At the time of the report, PRODUCT DOSE OMISSION ISSUE (more than 35 days have passed between doses) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1640455
Sex: F
Age: 49
State: OH

Vax Date: 06/19/2021
Onset Date: 06/19/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Feels off balance; Riningin in ears/Ringing in ears sounds muffled/Ringing in ears is painful; Not feeling well; Loss of appetite; Slept majority of the day; Diarrhea; Felt tired; Fever; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (Slept majority of the day), DIARRHOEA (Diarrhea), MALAISE (Not feeling well), DECREASED APPETITE (Loss of appetite) and TINNITUS (Riningin in ears/Ringing in ears sounds muffled/Ringing in ears is painful) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included DULAGLUTIDE (TRULICITY), COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]), VALSARTAN (VALSARTAN AL), CARVEDILOL (CARVEDILOL BP), TORSEMIDE and POTASSIUM for an unknown indication. On 19-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jun-2021, the patient experienced SOMNOLENCE (Slept majority of the day), DIARRHOEA (Diarrhea), DECREASED APPETITE (Loss of appetite), FATIGUE (Felt tired) and PYREXIA (Fever). On 20-Jun-2021, the patient experienced MALAISE (Not feeling well) and TINNITUS (Riningin in ears/Ringing in ears sounds muffled/Ringing in ears is painful). On an unknown date, the patient experienced BALANCE DISORDER (Feels off balance). On 22-Jun-2021, PYREXIA (Fever) had resolved. At the time of the report, SOMNOLENCE (Slept majority of the day), DIARRHOEA (Diarrhea), MALAISE (Not feeling well), DECREASED APPETITE (Loss of appetite), TINNITUS (Riningin in ears/Ringing in ears sounds muffled/Ringing in ears is painful), BALANCE DISORDER (Feels off balance) and FATIGUE (Felt tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Warm Transfer From Moderna Customer Care, Case # 00176354, on 22Jun2021.

Other Meds: TRULICITY; VITAMIN D [COLECALCIFEROL]; VALSARTAN AL; CARVEDILOL BP; TORSEMIDE; POTASSIUM

Current Illness:

ID: 1640456
Sex: U
Age:
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Medical assistant administered 2 Moderna vaccines were the vial was punctured for the last 7days out of refrigerator; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Medical assistant administered 2 Moderna vaccines were the vial was punctured for the last 7days out of refrigerator) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027b21a) 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 EXPIRED PRODUCT ADMINISTERED (Medical assistant administered 2 Moderna vaccines were the vial was punctured for the last 7days out of refrigerator). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Medical assistant administered 2 Moderna vaccines were the vial was punctured for the last 7days out of refrigerator) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications were not provided by reporter. Treatment information was not provided by reporter.

Other Meds:

Current Illness:

ID: 1640457
Sex: U
Age:
State:

Vax Date: 02/13/2021
Onset Date: 06/18/2021
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: sore-throat; runny-nose; ear-ache; loss of apatite; headache; possibly fever; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (sore-throat), RHINORRHOEA (runny-nose), EAR PAIN (ear-ache), DECREASED APPETITE (loss of apatite) and HEADACHE (headache) in a patient of an unknown age and gender 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 13-Feb-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Jun-2021, the patient experienced OROPHARYNGEAL PAIN (sore-throat), RHINORRHOEA (runny-nose), EAR PAIN (ear-ache), DECREASED APPETITE (loss of apatite), HEADACHE (headache) and PYREXIA (possibly fever). At the time of the report, OROPHARYNGEAL PAIN (sore-throat), RHINORRHOEA (runny-nose), EAR PAIN (ear-ache), DECREASED APPETITE (loss of apatite), HEADACHE (headache) and PYREXIA (possibly fever) outcome was unknown. Concomitant information was not reported. Treatment information was not reported. The action taken with mRNA-1273 with the event was considered as not applicable.

Other Meds:

Current Illness:

ID: 1640458
Sex: U
Age:
State:

Vax Date: 06/21/2021
Onset Date: 06/22/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: feel crummy; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 22-Jun-2021 and was forwarded to Moderna on 22-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (feel crummy) 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 21-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jun-2021, the patient experienced FEELING ABNORMAL (feel crummy). At the time of the report, FEELING ABNORMAL (feel crummy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Relevant concomitant medications was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1640459
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: Patient missed the appointment for the second shot; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Patient missed the appointment for the second shot) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Patient missed the appointment for the second shot). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Patient missed the appointment for the second shot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product details was not reported. Treatment details was not reported .

Other Meds:

Current Illness:

ID: 1640460
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: is depression/anxiety reported as a side effect post vaccine?; is depression/anxiety reported as a side effect post vaccine?; This spontaneous case was reported by a consumer and describes the occurrence of DEPRESSION (is depression/anxiety reported as a side effect post vaccine?) and ANXIETY (is depression/anxiety reported as a side effect post vaccine?) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced DEPRESSION (is depression/anxiety reported as a side effect post vaccine?) and ANXIETY (is depression/anxiety reported as a side effect post vaccine?). At the time of the report, DEPRESSION (is depression/anxiety reported as a side effect post vaccine?) and ANXIETY (is depression/anxiety reported as a side effect post vaccine?) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant and treatment medications were provided.

Other Meds:

Current Illness:

ID: 1640461
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Twitching; feel very weak; tired; sick to my stomach; mental health is bad right now; feel very off and not myself at all; Twitching and spasms in my legs; This spontaneous case was reported by a consumer and describes the occurrence of MUSCLE TWITCHING (Twitching), ASTHENIA (feel very weak), FATIGUE (tired), ABDOMINAL DISCOMFORT (sick to my stomach) and MENTAL DISORDER (mental health is bad right now) in a patient of an unknown age and gender 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced MUSCLE TWITCHING (Twitching), ASTHENIA (feel very weak), FATIGUE (tired), ABDOMINAL DISCOMFORT (sick to my stomach), MENTAL DISORDER (mental health is bad right now), MALAISE (feel very off and not myself at all) and MUSCLE SPASMS (Twitching and spasms in my legs). At the time of the report, MUSCLE TWITCHING (Twitching), ASTHENIA (feel very weak), FATIGUE (tired), ABDOMINAL DISCOMFORT (sick to my stomach), MENTAL DISORDER (mental health is bad right now), MALAISE (feel very off and not myself at all) and MUSCLE SPASMS (Twitching and spasms in my legs) outcome was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1640462
Sex: U
Age:
State: TX

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient given vaccine that was out over 12 hours; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient given vaccine that was out over 12 hours) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 033B21A) for COVID-19 vaccination. No Medical History information was reported. On 22-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient given vaccine that was out over 12 hours). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Patient given vaccine that was out over 12 hours) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was reported. No treatment medication was reported.

Other Meds:

Current Illness:

ID: 1640463
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: start feeling pain on the arm two months after 2nd shot; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (start feeling pain on the arm two months after 2nd shot) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced MYALGIA (start feeling pain on the arm two months after 2nd shot). At the time of the report, MYALGIA (start feeling pain on the arm two months after 2nd shot) outcome was unknown. Concomitant information was not reported. Treatment information was not reported. The action taken with mRNA-1273 with the event was considered as not applicable.

Other Meds:

Current Illness:

ID: 1640464
Sex: F
Age: 29
State: NM

Vax Date: 02/10/2021
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: Hives; Is there a body rash with second doze of vaccine, I currently have a rash and it's just getting worse; Hypersensitivity reaction; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HYPERSENSITIVITY (Hypersensitivity reaction), URTICARIA (Hives) and RASH (Is there a body rash with second doze of vaccine, I currently have a rash and it's just getting worse) in a 29-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 043L20A and 010M20A) for COVID-19 vaccination. The patient's past medical history included Anaphylaxis, Hypersensitivity reaction and Hives (Hives/Urticaria). Concurrent medical conditions included Bee sting hypersensitivity (Bee's hypersensitivity). On 10-Feb-2021 at 2:30 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Jun-2021 at 5:30 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Jun-2021 at 3:00 AM, the patient experienced HYPERSENSITIVITY (Hypersensitivity reaction). On an unknown date, the patient experienced URTICARIA (Hives) and RASH (Is there a body rash with second doze of vaccine, I currently have a rash and it's just getting worse). The patient was treated with LORATADINE (oral) ongoing from 19-Jun-2021 for Adverse event, at an unspecified dose and frequency and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) (oral) ongoing from 19-Jun-2021 for Adverse event, at an unspecified dose and frequency. At the time of the report, HYPERSENSITIVITY (Hypersensitivity reaction) and URTICARIA (Hives) had resolved with sequelae and RASH (Is there a body rash with second doze of vaccine, I currently have a rash and it's just getting worse) outcome was unknown. Treatment information were not provided by the reporter. Concomitant medications were not reported by reporter. Most recent FOLLOW-UP information incorporated above includes: On 11-Aug-2021: Additional information included patient's demographics (height, weight) ethnic group, race, date of birth patient's allergies, second dose details, treatment and newevents.

Other Meds:

Current Illness: Bee sting hypersensitivity (Bee's hypersensitivity)

ID: 1640465
Sex: U
Age:
State:

Vax Date: 06/21/2021
Onset Date: 06/22/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: fever; injection site is red; injection site swollen; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever), VACCINATION SITE ERYTHEMA (injection site is red) and VACCINATION SITE SWELLING (injection site swollen) 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 21-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 22-Jun-2021, the patient experienced PYREXIA (fever), VACCINATION SITE ERYTHEMA (injection site is red) and VACCINATION SITE SWELLING (injection site swollen). At the time of the report, PYREXIA (fever), VACCINATION SITE ERYTHEMA (injection site is red) and VACCINATION SITE SWELLING (injection site swollen) outcome was unknown. No Concomitant medications was provided by the reporter. No Treatment medications was provided by the reporter.

Other Meds:

Current Illness:

ID: 1640466
Sex: F
Age: 68
State: NY

Vax Date: 03/17/2021
Onset Date: 04/01/2021
Rec V Date: 08/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: It is a sensation of the skin being scalded by steam / skin with sensation area has been scaled as if when steamed or by sunburn; Head that was painful and hurt to touch even while brushing hair; Skin burning sensation/ it is rovering across my uper body which started from left of her face to earlobe/Like a fresh sunburn; Painful to touch / Pain is below skin level/extremely painful to touch or feel / very sharp pain along with skin sensation; This spontaneous case was reported by a consumer and describes the occurrence of SKIN BURNING SENSATION (Skin burning sensation/ it is rovering across my uper body which started from left of her face to earlobe/Like a fresh sunburn), PAIN (Painful to touch / Pain is below skin level/extremely painful to touch or feel / very sharp pain along with skin sensation), VACCINATION COMPLICATION (It is a sensation of the skin being scalded by steam / skin with sensation area has been scaled as if when steamed or by sunburn) and HYPERAESTHESIA (Head that was painful and hurt to touch even while brushing hair) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031A21B) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included ATORVASTATIN, METOPROLOL TARTRATE, HYDROCHLOROTHIAZIDE, LISINOPRIL (LISINOPRIL HCTZ), DESVENLAFAXINE SUCCINATE MONOHYDRATE (PRISTIQ) and SEMAGLUTIDE (OZEMPIC) for an unknown indication. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. In April 2021, the patient experienced SKIN BURNING SENSATION (Skin burning sensation/ it is rovering across my uper body which started from left of her face to earlobe/Like a fresh sunburn) and PAIN (Painful to touch / Pain is below skin level/extremely painful to touch or feel / very sharp pain along with skin sensation). On an unknown date, the patient experienced VACCINATION COMPLICATION (It is a sensation of the skin being scalded by steam / skin with sensation area has been scaled as if when steamed or by sunburn) and HYPERAESTHESIA (Head that was painful and hurt to touch even while brushing hair). At the time of the report, SKIN BURNING SENSATION (Skin burning sensation/ it is rovering across my uper body which started from left of her face to earlobe/Like a fresh sunburn), PAIN (Painful to touch / Pain is below skin level/extremely painful to touch or feel / very sharp pain along with skin sensation), VACCINATION COMPLICATION (It is a sensation of the skin being scalded by steam / skin with sensation area has been scaled as if when steamed or by sunburn) and HYPERAESTHESIA (Head that was painful and hurt to touch even while brushing hair) outcome was unknown. No treatment medication was reported by reporter. This case was linked to MOD-2021-232310 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 23-Jun-2021: Patient demographics added, Updated second dose details, added concomitant medications, added new event.

Other Meds: ATORVASTATIN; METOPROLOL TARTRATE; LISINOPRIL HCTZ; PRISTIQ; OZEMPIC

Current Illness:

ID: 1640467
Sex: M
Age: 72
State: AZ

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Mentally unclear; he hasn't gotten a decent night sleep and he can only sleep for 10-15 minutes; allergic reaction; his left and right ankles felt like it was breaking; Eshausted/ completely out/can hardly move; awakened with a burning pain in his right shoulder blade; had a couple of spots on shoulder blade similar to a poison ivy rash except it was not leaking/rash was raised/hurts really bad when you put any pressure on it/Caller got the Moderna Vaccine yesterday and experienced RASH; low-grade fever; sharp pain at the back of the head; had symptoms identical to his COVID symptoms 24 hours after the vaccine except no muscle cramps; stiffness (stiff as a board); lethargy; muscle and joint pain/awakened with a burning pain in his right shoulder blade,; This spontaneous case was reported by a consumer and describes the occurrence of SUSPECTED COVID-19 (had symptoms identical to his COVID symptoms 24 hours after the vaccine except no muscle cramps), MUSCULOSKELETAL STIFFNESS (stiffness (stiff as a board)), LETHARGY (lethargy), CONFUSIONAL STATE (Mentally unclear) and INSOMNIA (he hasn't gotten a decent night sleep and he can only sleep for 10-15 minutes) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047B21A) for an unknown indication. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19 (Patient having COVID back in January of 2021.) in January 2021. On 25-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-May-2021, the patient experienced SUSPECTED COVID-19 (had symptoms identical to his COVID symptoms 24 hours after the vaccine except no muscle cramps), MUSCULOSKELETAL STIFFNESS (stiffness (stiff as a board)), LETHARGY (lethargy), ARTHRALGIA (muscle and joint pain/awakened with a burning pain in his right shoulder blade,), HEADACHE (sharp pain at the back of the head) and PYREXIA (low-grade fever). On 12-Jun-2021, the patient experienced RASH (had a couple of spots on shoulder blade similar to a poison ivy rash except it was not leaking/rash was raised/hurts really bad when you put any pressure on it/Caller got the Moderna Vaccine yesterday and experienced RASH) and PAIN (awakened with a burning pain in his right shoulder blade). On an unknown date, the patient experienced CONFUSIONAL STATE (Mentally unclear), INSOMNIA (he hasn't gotten a decent night sleep and he can only sleep for 10-15 minutes), HYPERSENSITIVITY (allergic reaction), MUSCULOSKELETAL DISCOMFORT (his left and right ankles felt like it was breaking) and FATIGUE (Eshausted/ completely out/can hardly move). At the time of the report, SUSPECTED COVID-19 (had symptoms identical to his COVID symptoms 24 hours after the vaccine except no muscle cramps), MUSCULOSKELETAL STIFFNESS (stiffness (stiff as a board)), LETHARGY (lethargy), CONFUSIONAL STATE (Mentally unclear), INSOMNIA (he hasn't gotten a decent night sleep and he can only sleep for 10-15 minutes), HYPERSENSITIVITY (allergic reaction), MUSCULOSKELETAL DISCOMFORT (his left and right ankles felt like it was breaking), ARTHRALGIA (muscle and joint pain/awakened with a burning pain in his right shoulder blade,), RASH (had a couple of spots on shoulder blade similar to a poison ivy rash except it was not leaking/rash was raised/hurts really bad when you put any pressure on it/Caller got the Moderna Vaccine yesterday and experienced RASH), FATIGUE (Eshausted/ completely out/can hardly move), HEADACHE (sharp pain at the back of the head), PAIN (awakened with a burning pain in his right shoulder blade) and PYREXIA (low-grade fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not provided. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 08-Jul-2021: significant information Event Feeling Mentally Unclear was updated On 16-Jul-2021: TCR document was received contained No New Information On 21-Jul-2021: Non-significant follow-up received.

Other Meds:

Current Illness:

ID: 1640468
Sex: U
Age:
State:

Vax Date:
Onset Date: 06/21/2021
Rec V Date: 08/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: very bad migraine headache; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (very bad migraine 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 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 21-Jun-2021, the patient experienced MIGRAINE (very bad migraine headache). At the time of the report, MIGRAINE (very bad migraine headache) outcome was unknown. No Concomitant medications were reported. No treatment medications were reported. Action taken with mRNA-1273 in response to the events was not applicable. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1640469
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: dizziness lasts more than one month; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizziness lasts more than one month) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was 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 lasts more than one month). At the time of the report, DIZZINESS (dizziness lasts more than one month) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment information was provided. No relevant concomitant medications reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1640470
Sex: F
Age: 64
State: PA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
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: Felt stinging sensations in foot, felt like bee stings on the foot; Having eyesight/vision problems lost sight for a period of time and relying more on eye glasses; Feeling confused; Lightheadedness and dizziness; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Felt stinging sensations in foot, felt like bee stings on the foot), VISUAL IMPAIRMENT (Having eyesight/vision problems lost sight for a period of time and relying more on eye glasses), CONFUSIONAL STATE (Feeling confused) and DIZZINESS (Lightheadedness and dizziness) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included LEVETIRACETAM (KEPPRA XR) and OXCARBAZEPINE for an unknown indication. On 25-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-May-2021, the patient experienced PAIN (Felt stinging sensations in foot, felt like bee stings on the foot), VISUAL IMPAIRMENT (Having eyesight/vision problems lost sight for a period of time and relying more on eye glasses), CONFUSIONAL STATE (Feeling confused) and DIZZINESS (Lightheadedness and dizziness). On 26-May-2021, PAIN (Felt stinging sensations in foot, felt like bee stings on the foot), VISUAL IMPAIRMENT (Having eyesight/vision problems lost sight for a period of time and relying more on eye glasses), CONFUSIONAL STATE (Feeling confused) and DIZZINESS (Lightheadedness and dizziness) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment information was provided by the reporter.

Other Meds: KEPPRA XR; OXCARBAZEPINE

Current Illness:

ID: 1640471
Sex: M
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: very severe flu-like reaction; hot flash; sweat moments; Feverish; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (very severe flu-like reaction), HOT FLUSH (hot flash), HYPERHIDROSIS (sweat moments) and PYREXIA (Feverish) in an 18-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INFLUENZA LIKE ILLNESS (very severe flu-like reaction), HOT FLUSH (hot flash), HYPERHIDROSIS (sweat moments) and PYREXIA (Feverish). At the time of the report, INFLUENZA LIKE ILLNESS (very severe flu-like reaction), HOT FLUSH (hot flash), HYPERHIDROSIS (sweat moments) and PYREXIA (Feverish) outcome was unknown. Not Provided Concomitant information was not reported. Treatment information was not reported. The action taken with mRNA-1273 with the event was considered as not applicable.

Other Meds:

Current Illness:

ID: 1640472
Sex: F
Age: 26
State: NJ

Vax Date: 06/17/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Fever; Chills; Tiredness; Headache; This spontaneous case was reported by a patient family member or friend and describes the occurrence of PYREXIA (Fever), CHILLS (Chills), FATIGUE (Tiredness) and HEADACHE (Headache) in a 26-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) (Intramuscular) 1 dosage form. On 18-Jun-2021, the patient experienced PYREXIA (Fever), CHILLS (Chills), FATIGUE (Tiredness) and HEADACHE (Headache). On 18-Jun-2021, PYREXIA (Fever), CHILLS (Chills), FATIGUE (Tiredness) and HEADACHE (Headache) had resolved. No concomitant medications were reported. No treatment information was provided by the reporter. This case was linked to MOD-2021-231341 (Patient Link).

Other Meds:

Current Illness:

ID: 1640473
Sex: M
Age: 83
State: WV

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

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

Lab Data:

Allergies:

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

Symptoms: Sick to his stomach; Nauseated; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL DISCOMFORT (Sick to his stomach) and NAUSEA (Nauseated) in an 83-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 18-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced ABDOMINAL DISCOMFORT (Sick to his stomach) and NAUSEA (Nauseated). At the time of the report, ABDOMINAL DISCOMFORT (Sick to his stomach) and NAUSEA (Nauseated) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant medication reported. No treatment information was provided. This case was linked to MOD-2021-231478 (Patient Link).

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am