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: 1643592
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: I had severe muscle cramping in my legs last night; This spontaneous case was reported by a patient and describes the occurrence of MUSCLE SPASMS (I had severe muscle cramping in my legs last night) 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 MUSCLE SPASMS (I had severe muscle cramping in my legs last night). At the time of the report, MUSCLE SPASMS (I had severe muscle cramping in my legs last night) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1643593
Sex: F
Age: 49
State: IN

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 08/28/2021
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: extreme soreness; minor swelling; stiffness; It's debilitating my ability to earn money and pay bills; Bilateral pain in arms; Numbness in both arms; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (extreme soreness), SWELLING (minor swelling), MUSCULOSKELETAL STIFFNESS (stiffness), ASTHENIA (It's debilitating my ability to earn money and pay bills) and PAIN IN EXTREMITY (Bilateral pain in arms) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included MULTIVITAMIN [VITAMINS NOS] for an unknown indication. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, the patient experienced PAIN IN EXTREMITY (Bilateral pain in arms) and HYPOAESTHESIA (Numbness in both arms). On an unknown date, the patient experienced PAIN (extreme soreness), SWELLING (minor swelling), MUSCULOSKELETAL STIFFNESS (stiffness) and ASTHENIA (It's debilitating my ability to earn money and pay bills). At the time of the report, PAIN (extreme soreness), SWELLING (minor swelling), MUSCULOSKELETAL STIFFNESS (stiffness), PAIN IN EXTREMITY (Bilateral pain in arms) and HYPOAESTHESIA (Numbness in both arms) had not resolved and ASTHENIA (It's debilitating my ability to earn money and pay bills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication also included other vitamins. No treatment medications were reported. She was having an electrogram and nerve procedure done this week. Patient saw physician in April for severe pain and numbness. This case was linked to MOD-2021-237947 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 06-Aug-2021: Significant follow up received on 06-AUG-2021. added Containing Event added (Debility, pain in arms and Numbness of upper arms)

Other Meds: MULTIVITAMIN [VITAMINS NOS]

Current Illness:

ID: 1643594
Sex: M
Age: 76
State: TX

Vax Date: 03/15/2021
Onset Date: 04/16/2021
Rec V Date: 08/28/2021
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: (Sharp muscle) pain down the inner & outer part of left thigh & calf. It comes & goes.; Sharp muscle pain down the inner & outer part of left thigh & calf. It comes & goes.; Felt like he had a pair of pliers in his back pocket, Dr said it was bursitis? pain wakes him out of his sleep; Both arms broke out in rash, insides of arms had red spots with red bumps, backs of arms had white spots, like tiny blisters, "but they weren't real blisters"; This spontaneous case was reported by a consumer and describes the occurrence of RASH MACULO-PAPULAR (Both arms broke out in rash, insides of arms had red spots with red bumps, backs of arms had white spots, like tiny blisters, "but they weren't real blisters"), BURSITIS (Felt like he had a pair of pliers in his back pocket, Dr said it was bursitis? pain wakes him out of his sleep), PAIN IN EXTREMITY ((Sharp muscle) pain down the inner & outer part of left thigh & calf. It comes & goes.) and MYALGIA (Sharp muscle pain down the inner & outer part of left thigh & calf. It comes & goes.) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027B21A) for COVID-19 vaccination. No Medical History information was reported. On 15-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-Apr-2021, the patient experienced RASH MACULO-PAPULAR (Both arms broke out in rash, insides of arms had red spots with red bumps, backs of arms had white spots, like tiny blisters, "but they weren't real blisters"). In May 2021, the patient experienced BURSITIS (Felt like he had a pair of pliers in his back pocket, Dr said it was bursitis? pain wakes him out of his sleep). On 25-Jun-2021, the patient experienced PAIN IN EXTREMITY ((Sharp muscle) pain down the inner & outer part of left thigh & calf. It comes & goes.) and MYALGIA (Sharp muscle pain down the inner & outer part of left thigh & calf. It comes & goes.). The patient was treated with LIDOCAINE (topical) for Bursitis, at an unspecified dose and frequency. At the time of the report, RASH MACULO-PAPULAR (Both arms broke out in rash, insides of arms had red spots with red bumps, backs of arms had white spots, like tiny blisters, "but they weren't real blisters"), PAIN IN EXTREMITY ((Sharp muscle) pain down the inner & outer part of left thigh & calf. It comes & goes.) and MYALGIA (Sharp muscle pain down the inner & outer part of left thigh & calf. It comes & goes.) outcome was unknown and BURSITIS (Felt like he had a pair of pliers in his back pocket, Dr said it was bursitis? pain wakes him out of his sleep) had not resolved. Concomitant product information was not provided. Consumer stated the rash had come and gone several times. The rash lasted two weeks the first time it developed, and subsequent occurrences had been less in frequency, duration & intensity. Treatment for bursitis included cold packs. The consumer consulted his doctor via secure messaging. An injection to treat the symptoms of bursitis was recommended, but the consumer declined.

Other Meds:

Current Illness:

ID: 1643595
Sex: F
Age: 49
State: IN

Vax Date: 02/02/2021
Onset Date:
Rec V Date: 08/28/2021
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: limited mobility and difficulty when she is bathing by not able to wash her shoulder or wash her hair/ not able to move; tingling and numbness that is going from her elbow to tip of her fingers sometime under armpit / tingling and numbness is like going from collarbone to her neck; numbness is like going from collarbone to her neck/ tingling and numbness that is going from her elbow to tip of her fingers sometime under armpit; Shoulder Free or Frozen Shoulder; she feels weak/ lack of strength; extreme soreness on both arm; fatigue; This spontaneous case was reported by a consumer and describes the occurrence of MOBILITY DECREASED (limited mobility and difficulty when she is bathing by not able to wash her shoulder or wash her hair/ not able to move), PARAESTHESIA (tingling and numbness that is going from her elbow to tip of her fingers sometime under armpit / tingling and numbness is like going from collarbone to her neck), HYPOAESTHESIA (numbness is like going from collarbone to her neck/ tingling and numbness that is going from her elbow to tip of her fingers sometime under armpit), PERIARTHRITIS (Shoulder Free or Frozen Shoulder) and ASTHENIA (she feels weak/ lack of strength) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012A21A and 007M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included MULTIVITAMIN [VITAMINS NOS] for an unknown indication. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-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 MOBILITY DECREASED (limited mobility and difficulty when she is bathing by not able to wash her shoulder or wash her hair/ not able to move), PARAESTHESIA (tingling and numbness that is going from her elbow to tip of her fingers sometime under armpit / tingling and numbness is like going from collarbone to her neck), HYPOAESTHESIA (numbness is like going from collarbone to her neck/ tingling and numbness that is going from her elbow to tip of her fingers sometime under armpit), PERIARTHRITIS (Shoulder Free or Frozen Shoulder), ASTHENIA (she feels weak/ lack of strength), MYALGIA (extreme soreness on both arm) and FATIGUE (fatigue). The patient was treated with NAPROXEN SODIUM (ALEVE) for Adverse event, at a dose of 1 dosage form; IBUPROFEN (ADVIL [IBUPROFEN]) for Adverse event, at a dose of 1 dosage form and Physical therapy (HCP recommended physical therapy for Frozen shoulder.) for Periarthritis. At the time of the report, MOBILITY DECREASED (limited mobility and difficulty when she is bathing by not able to wash her shoulder or wash her hair/ not able to move), PARAESTHESIA (tingling and numbness that is going from her elbow to tip of her fingers sometime under armpit / tingling and numbness is like going from collarbone to her neck), HYPOAESTHESIA (numbness is like going from collarbone to her neck/ tingling and numbness that is going from her elbow to tip of her fingers sometime under armpit), PERIARTHRITIS (Shoulder Free or Frozen Shoulder), ASTHENIA (she feels weak/ lack of strength), MYALGIA (extreme soreness on both arm) and FATIGUE (fatigue) had not resolved. Patient went to the healthcare professional on 29 Mar 2021. Treatment for the events included heat compression, muscle massage and hot tub. 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-2021-237865 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 02-Aug-2021: NNI; 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: MULTIVITAMIN [VITAMINS NOS]

Current Illness:

ID: 1643596
Sex: M
Age: 54
State: NV

Vax Date: 01/28/2019
Onset Date:
Rec V Date: 08/28/2021
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: little stomach upset; buzzing on his legs when he is walking characterized by feeling like his; dental issues; had an outpatient surgery on his right foot to repair a torn plantar plates; had hammer toe; non weight bearing on his right foot for three (3) weeks; left sciatic nerve was inflamed and this is related to stress from having; left sciatic nerve was inflamed and this is related to stress; has been experiencing immense problems with his left side, the sciatic nerve, it wakes him up at around 2 am every night/could not; had been going to physical therapy in mar-2021 to realign his back; every time he stands, it bothers him and he of stabilizes himself first; could not remember the name; had a feeling in the back of his head as if an ice pick was in the back of his head; This spontaneous case was reported by a patient and describes the occurrence of ABDOMINAL DISCOMFORT (little stomach upset), SENSORY DISTURBANCE (buzzing on his legs when he is walking characterized by feeling like his), TOOTH DISORDER (dental issues), LIGAMENT RUPTURE (had an outpatient surgery on his right foot to repair a torn plantar plates) and FOOT DEFORMITY (had hammer toe) in a 54-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Co-suspect product included non-company product TERIFLUNOMIDE for Multiple sclerosis. No Medical History were provided by reporter. On 28-Jan-2019, the patient started TERIFLUNOMIDE (Oral) 7 milligram once a day. On 02-Dec-2019, TERIFLUNOMIDE (Oral) dosage was changed to 14 milligram once a day. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ABDOMINAL DISCOMFORT (little stomach upset), SENSORY DISTURBANCE (buzzing on his legs when he is walking characterized by feeling like his), TOOTH DISORDER (dental issues), LIGAMENT RUPTURE (had an outpatient surgery on his right foot to repair a torn plantar plates), FOOT DEFORMITY (had hammer toe), WEIGHT BEARING DIFFICULTY (non weight bearing on his right foot for three (3) weeks), SCIATICA (left sciatic nerve was inflamed and this is related to stress from having), STRESS (left sciatic nerve was inflamed and this is related to stress), SLEEP DISORDER (has been experiencing immense problems with his left side, the sciatic nerve, it wakes him up at around 2 am every night/could not), SPINAL DEFORMITY (had been going to physical therapy in mar-2021 to realign his back), DYSSTASIA (every time he stands, it bothers him and he of stabilizes himself first), MEMORY IMPAIRMENT (could not remember the name) and ILL-DEFINED DISORDER (had a feeling in the back of his head as if an ice pick was in the back of his head). The patient was treated with TRAMADOL ongoing since an unknown date for Nerve pain, at an unspecified dose and frequency; OXYCODONE ongoing since an unknown date for Nerve pain, at an unspecified dose and frequency and AMOXICILLIN ongoing since an unknown date for Adverse event, at an unspecified dose and frequency. In 2020, ABDOMINAL DISCOMFORT (little stomach upset) and ILL-DEFINED DISORDER (had a feeling in the back of his head as if an ice pick was in the back of his head) had resolved. At the time of the report, SENSORY DISTURBANCE (buzzing on his legs when he is walking characterized by feeling like his), TOOTH DISORDER (dental issues), FOOT DEFORMITY (had hammer toe), WEIGHT BEARING DIFFICULTY (non weight bearing on his right foot for three (3) weeks), SCIATICA (left sciatic nerve was inflamed and this is related to stress from having) and DYSSTASIA (every time he stands, it bothers him and he of stabilizes himself first) had not resolved, LIGAMENT RUPTURE (had an outpatient surgery on his right foot to repair a torn plantar plates) and SLEEP DISORDER (has been experiencing immense problems with his left side, the sciatic nerve, it wakes him up at around 2 am every night/could not) was resolving and STRESS (left sciatic nerve was inflamed and this is related to stress), SPINAL DEFORMITY (had been going to physical therapy in mar-2021 to realign his back) and MEMORY IMPAIRMENT (could not remember the name) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication were not provided. treatment include steroids for ill defined disorder. Treatment included reconstructive surgery on his right foot and occasional rehab and going to physical therapy and being given some steroids by his doctor for Sciatica; physical therapy for Spinal deformity.

Other Meds:

Current Illness:

ID: 1643597
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: Swelling at collar bone; lymph node symptoms near collar bone; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING (Swelling at collar bone) and LYMPHADENOPATHY (lymph node symptoms near collar bone) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced SWELLING (Swelling at collar bone) and LYMPHADENOPATHY (lymph node symptoms near collar bone). At the time of the report, SWELLING (Swelling at collar bone) and LYMPHADENOPATHY (lymph node symptoms near collar bone) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information not provided. List of concomitant medication were not given. This case was linked to MOD-2021-074208, MOD-2021-074228 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1643598
Sex: M
Age: 80
State: GA

Vax Date: 01/12/2021
Onset Date: 02/11/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Test Date: 202103; Test Name: Spike protein antibody; Test Result: Negative ; Result Unstructured Data: Spike protein antibody test was negative on Mar-2021.; Test Date: 202106; Test Name: Spike protein antibody; Test Result: Negative ; Result Unstructured Data: Spike protein antibody test was negative on Jun-2021.

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 3rd dose of the COVID-19 vaccine on 13APR2021 and the 4th dose on 10MAY2021; mildly sore arm; This spontaneous case was reported by a consumer and describes the occurrence of EXTRA DOSE ADMINISTERED (3rd dose of the COVID-19 vaccine on 13APR2021 and the 4th dose on 10MAY2021) and MYALGIA (mildly sore arm) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030M20A and 011L20A) for COVID-19 vaccination. Concurrent medical conditions included Autoimmune disorder NOS (Blood condition). Concomitant products included ATORVASTATIN, MAGNESIUM OXIDE, FISH OIL, MINERALS NOS, VITAMINS NOS (CENTRUM JR [MINERALS NOS;VITAMINS NOS]), PANTOPRAZOLE, FINASTERIDE, TAMSULOSIN, AMLODIPINE, FERROUS SULFATE and ACETYLSALICYLIC ACID (BABY ASPIRIN) for an unknown indication. 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 11-Feb-2021, the patient experienced MYALGIA (mildly sore arm). On an unknown date, the patient experienced EXTRA DOSE ADMINISTERED (3rd dose of the COVID-19 vaccine on 13APR2021 and the 4th dose on 10MAY2021). On 12-Feb-2021, MYALGIA (mildly sore arm) had resolved. At the time of the report, EXTRA DOSE ADMINISTERED (3rd dose of the COVID-19 vaccine on 13APR2021 and the 4th dose on 10MAY2021) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In March 2021, Antibody test: negative (Negative) Spike protein antibody test was negative on Mar-2021.. In June 2021, Antibody test: negative (Negative) Spike protein antibody test was negative on Jun-2021.. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment details were provided. This case was linked to MOD-2021-237330, MOD-2021-238101 (Patient Link).

Other Meds: ATORVASTATIN; MAGNESIUM OXIDE; FISH OIL; CENTRUM JR [MINERALS NOS;VITAMINS NOS]; PANTOPRAZOLE; FINASTERIDE; TAMSULOSIN; AMLODIPINE; FERROUS SULFATE; BABY ASPIRIN

Current Illness: Autoimmune disorder NOS (Blood condition)

ID: 1643599
Sex: M
Age: 80
State: GA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Test Date: 202103; Test Name: Spike protien test; Test Result: Negative ; Result Unstructured Data: negative; Test Date: 202106; Test Name: Spike protien test; Test Result: Negative ; Result Unstructured Data: negative

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: mildly sore left arm; mildly sore left arm; received 4 shots of the Moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of EXTRA DOSE ADMINISTERED (received 4 shots of the Moderna vaccine), the first episode of PAIN IN EXTREMITY (mildly sore left arm) and the second episode of PAIN IN EXTREMITY (mildly sore left arm) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 048B21A, 036B21A, 030M20A and 011L20A) for COVID-19 vaccination. Concurrent medical conditions included Autoimmune disorder (Autoimmune Blood Disorder). Concomitant products included ATORVASTATIN, MAGNESIUM OXIDE, FISH OIL, CENTRUM VITAMINTS, PANTOPRAZOLE, FINASTERIDE, TAMSULOSIN, AMLODIPINE, FERROUS SULFATE and ACETYLSALICYLIC ACID (BABY ASPIRIN) for an unknown indication. 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 2 dosage form. On 13-Apr-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 3 dosage form. On 10-May-2021, received fourth dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 4 dosage form. On 12-Jan-2021, the patient experienced EXTRA DOSE ADMINISTERED (received 4 shots of the Moderna vaccine). On 15-Apr-2021, the patient experienced the first episode of PAIN IN EXTREMITY (mildly sore left arm). On 12-May-2021, the patient experienced the second episode of PAIN IN EXTREMITY (mildly sore left arm). On 10-May-2021, EXTRA DOSE ADMINISTERED (received 4 shots of the Moderna vaccine) outcome was unknown. On 13-May-2021, last episode of PAIN IN EXTREMITY (mildly sore left arm) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In March 2021, SARS-CoV-2 antibody test: others (Negative) negative. In June 2021, SARS-CoV-2 antibody test: others (Negative) negative. This case was linked to MOD-2021-237330, MOD-2021-238058 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 29-Jul-2021: Alternative contact number updated and patient demographics added.

Other Meds: ATORVASTATIN; MAGNESIUM OXIDE; FISH OIL; CENTRUM VITAMINTS; PANTOPRAZOLE; FINASTERIDE; TAMSULOSIN; AMLODIPINE; FERROUS SULFATE; BABY ASPIRIN

Current Illness:

ID: 1643600
Sex: F
Age: 68
State: SC

Vax Date: 03/18/2021
Onset Date: 04/15/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Test Name: Body temperature; Result Unstructured Data: 12 hours after the second shot she ran a Fever 101.4 Fahrenheit.

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: after the second shot she ran a Fever 101.4 Fahrenheit.; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (after the second shot she ran a Fever 101.4 Fahrenheit.) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025B21A and 026A21A) for COVID-19 vaccination. No Medical History information was reported. On 18-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Apr-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PYREXIA (after the second shot she ran a Fever 101.4 Fahrenheit.). On 16-Apr-2021, PYREXIA (after the second shot she ran a Fever 101.4 Fahrenheit.) had resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 101.4 (High) 12 hours after the second shot she ran a Fever 101.4 Fahrenheit.. No concomitant medication was reported. No treatment was reported. This case was linked to MOD-2021-059782 (Patient Link).

Other Meds:

Current Illness:

ID: 1643601
Sex: F
Age: 70
State: PA

Vax Date: 01/13/2021
Onset Date:
Rec V Date: 08/28/2021
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: mild injection site discomfort; mild fatigue; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOMFORT (mild injection site discomfort) and FATIGUE (mild fatigue) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE DISCOMFORT (mild injection site discomfort) and FATIGUE (mild fatigue). At the time of the report, VACCINATION SITE DISCOMFORT (mild injection site discomfort) and FATIGUE (mild fatigue) outcome was unknown. No Concomitant medications were reported No Treatment information was reported. This case was linked to MOD-2021-008700 (Patient Link).

Other Meds:

Current Illness:

ID: 1643602
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: This spontaneous case reported by a consumer, describes the occurrence of erythema (red arm), pyrexia and myalgia (sore arms) in a female patient, of an unknown age, who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. On an unknown date, patient received a dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. On an unknown date, patient experienced erythema (red arm), pyrexia and myalgia (sore arms). At the time of the report, erythema (red arm), pyrexia and myalgia (sore arms) outcome: unknown. Concomitant medication include blood pressure and pain medication for unknown indication. No treatment medication reported. This case linked to MOD-2021-046513 (patient link).

Other Meds:

Current Illness:

ID: 1643603
Sex: F
Age:
State:

Vax Date: 04/16/2021
Onset Date:
Rec V Date: 08/28/2021
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: bad reaction; bumps all over; bad reaction with rashes; This spontaneous case was reported by a patient family member or friend and describes the occurrence of INJECTION SITE REACTION (bad reaction), URTICARIA (bumps all over) and RASH (bad reaction with rashes) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. no medical history was reported by reporter. 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) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced INJECTION SITE REACTION (bad reaction), URTICARIA (bumps all over) and RASH (bad reaction with rashes). At the time of the report, INJECTION SITE REACTION (bad reaction), URTICARIA (bumps all over) and RASH (bad reaction with rashes) outcome was unknown. no concomitant and treatment medications are provided.

Other Meds:

Current Illness:

ID: 1643604
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: sickness; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (sickness) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. The patient's past medical history included Kidney transplant and Cancer. Concomitant products included TACROLIMUS for an unknown indication. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ILLNESS (sickness). At the time of the report, ILLNESS (sickness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment information not provided.

Other Meds: TACROLIMUS

Current Illness:

ID: 1643605
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: Vaccine exposure during pregnancy; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Kidney transplant. Concurrent medical conditions included Cancer. Concomitant products included TACROLIMUS for an unknown indication. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy). At the time of the report, EXPOSURE DURING PREGNANCY (Vaccine exposure during pregnancy) outcome was unknown. No concomitant medication history were reported No treatment medication information were reported

Other Meds: TACROLIMUS

Current Illness: Cancer

ID: 1643606
Sex: F
Age:
State: AZ

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: Sore Throat; Body aches; Headache; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (Sore Throat), PAIN (Body aches) and HEADACHE (Headache) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. Concomitant products included APIXABAN (ELIQUIS), ASCORBIC ACID, BETACAROTENE, CUPRIC OXIDE, TOCOPHERYL ACETATE, ZINC OXIDE (PRESERVISION), PARACETAMOL (TYLENOL), POTASSIUM CHLORIDE (KLOR-CON), TRAMADOL, CITALOPRAM, FUROSEMIDE, GABAPENTIN, LISINOPRIL and LORAZEPAM for an unknown indication. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In 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 OROPHARYNGEAL PAIN (Sore Throat), PAIN (Body aches) and HEADACHE (Headache). At the time of the report, OROPHARYNGEAL PAIN (Sore Throat), PAIN (Body aches) and HEADACHE (Headache) had resolved. No treatment information was reported.

Other Meds: ELIQUIS; PRESERVISION; TYLENOL; KLOR-CON; TRAMADOL; CITALOPRAM; FUROSEMIDE; GABAPENTIN; LISINOPRIL; LORAZEPAM

Current Illness:

ID: 1643607
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Got hit the 2nd day; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Got hit the 2nd day) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Got hit the 2nd day). At the time of the report, VACCINATION COMPLICATION (Got hit the 2nd day) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications were not provided by the reporter. Treatment information was not provided. This case was linked to MOD-2021-238346 (Patient Link).

Other Meds:

Current Illness:

ID: 1643608
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: Rash; This spontaneous case was reported by a consumer and describes the occurrence of RASH (Rash) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced RASH (Rash). At the time of the report, RASH (Rash) outcome was unknown. No Concomitant medication was provided. The patient reported that after the second vaccine dose she developed a rash that was on the same arm but on the opposite side of the injection site. The rash was very hot and approximately 5 by 3.5 inches large. The patient has applied a cold compress, which has helped. The patient reported that after her first vaccine dose she had experienced a slight headache for approximately 10 hours.

Other Meds:

Current Illness:

ID: 1643609
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: gave vaccine way below deltoid; This spontaneous case was reported by a consumer and describes the occurrence of INCORRECT ROUTE OF PRODUCT ADMINISTRATION (gave vaccine way below deltoid) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced INCORRECT ROUTE OF PRODUCT ADMINISTRATION (gave vaccine way below deltoid). At the time of the report, INCORRECT ROUTE OF PRODUCT ADMINISTRATION (gave vaccine way below deltoid) outcome was unknown. Concomitant medication not provided by reporter. Treatment information not provided by reporter

Other Meds:

Current Illness:

ID: 1643610
Sex: F
Age: 50
State: CT

Vax Date: 05/05/2021
Onset Date: 05/21/2021
Rec V Date: 08/28/2021
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: She presented with a firm nodule along her right peroorbital rim; Having a reaction; This spontaneous case was reported by a physician and describes the occurrence of INJECTION SITE REACTION (Having a reaction) and NODULE (She presented with a firm nodule along her right peroorbital rim) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product BOTULINUM TOXIN TYPE A HAEMAGGLUTININ COMPLEX (DYSPORT) injection for an unknown indication. No Medical History information was reported. On 05-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 10-May-2021, the patient started BOTULINUM TOXIN TYPE A HAEMAGGLUTININ COMPLEX (DYSPORT) (unknown route) 150 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-May-2021, the patient experienced INJECTION SITE REACTION (Having a reaction). On an unknown date, the patient experienced NODULE (She presented with a firm nodule along her right peroorbital rim). The patient was treated with VORHYALURONIDASE ALFA (HYLENEX) for Adverse event, at a dose of UNK dosage form. At the time of the report, INJECTION SITE REACTION (Having a reaction) and NODULE (She presented with a firm nodule along her right peroorbital rim) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was provided. It was reported that patient had Dysport injected in her glabella, forehead, and crow's feet. The Dysport was reconstituted with 1.25 ml of bacteriostatic normal saline, was stored in a temperature controlled refrigerator before and after injection, and was used within one hour of dilution. The patient was not pre-medicated prior to the injection. Patient wanted to see the doctor. Patient had a nodule on the area where she had previously had filler. On an unknown date in Nov 2020, patient had Restylane Lyft, a full syringe, injected in the left temple. Restylane 0.2 cc was also injected in tear troughs on both sides in Nov 2020. In Oct 2020, patient had Versa 1.2 cc injected superficially via cannula in each temple. In Jan 2021, an unknown filler was injected in lower face by another provider, as reported to HCP by patient. HCP viewed it as a delayed inflammatory nodule, injected treatment and advised her to massage it. On 21 May 2021, HCP gave her a touch up of Dysport as well, as she needed a little touch up in her crow's feet and forehead.

Other Meds: Dysport

Current Illness:

ID: 1643611
Sex: F
Age:
State: AZ

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Test Name: covid antibody; Test Result: Negative ; Result Unstructured Data: negative

Allergies:

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

Symptoms: antibody screening test findings zero antibodies; This spontaneous case was reported by a consumer and describes the occurrence of ANTIBODY TEST NEGATIVE (antibody screening test findings zero antibodies) 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 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 ANTIBODY TEST NEGATIVE (antibody screening test findings zero antibodies). At the time of the report, ANTIBODY TEST NEGATIVE (antibody screening test findings zero antibodies) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 antibody test negative: negative negative (Negative) negative. Action taken with mRNA-1273 in response to the events was not applicable. Concomitant medication was not provided. Treatment medication was not provided.

Other Meds:

Current Illness:

ID: 1643612
Sex: F
Age: 53
State: ME

Vax Date: 04/05/2021
Onset Date: 05/03/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Arm started to hurt; Chills; High temperature; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm started to hurt), CHILLS (Chills) and PYREXIA (High temperature) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 003C21A and 032B21A) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy (Allergy: PCN), Sulfonamide allergy (Allergy: Sulfa), Drug allergy (Allergy: Aleve) and Crohn's disease since 31-May-1999. Concomitant products included ADALIMUMAB (HUMIRA) for Crohn's disease. On 05-Apr-2021 at 1:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-May-2021 at 8:30 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-May-2021, the patient experienced PAIN IN EXTREMITY (Arm started to hurt), CHILLS (Chills) and PYREXIA (High temperature). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 06-May-2021, PAIN IN EXTREMITY (Arm started to hurt) and CHILLS (Chills) had resolved. At the time of the report, PYREXIA (High temperature) had resolved. The action taken with mRNA-1273 was not applicable. This case was linked to MOD-2021-068520 (Patient Link).

Other Meds: HUMIRA

Current Illness: Crohn's disease; Drug allergy (Allergy: Aleve); Penicillin allergy (Allergy: PCN); Sulfonamide allergy (Allergy: Sulfa)

ID: 1643613
Sex: M
Age:
State: IL

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: cyst; leg pain; pain in arm; fever; pain ankle; chills; This spontaneous case was reported by an other and describes the occurrence of CYST (cyst), PAIN IN EXTREMITY (leg pain), PAIN IN EXTREMITY (pain in arm), PYREXIA (fever) and ARTHRALGIA (pain ankle) in a 45-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Co-suspect product included non-company product ADALIMUMAB (HUMIRA) solution for injection for Ulcerative colitis and Crohn's disease. 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 and ADALIMUMAB (HUMIRA) (Subcutaneous) 1 UNK. On an unknown date, the patient experienced CYST (cyst), PAIN IN EXTREMITY (leg pain), PAIN IN EXTREMITY (pain in arm), PYREXIA (fever), ARTHRALGIA (pain ankle) and CHILLS (chills). At the time of the report, CYST (cyst), PAIN IN EXTREMITY (leg pain) and ARTHRALGIA (pain ankle) had not resolved and PAIN IN EXTREMITY (pain in arm), PYREXIA (fever) and CHILLS (chills) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. An ultrasound was done on an unknown date. Treatment was not reported.

Other Meds: HUMIRA

Current Illness:

ID: 1643614
Sex: F
Age:
State: NY

Vax Date: 03/18/2021
Onset Date:
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Test Name: Haemoglobin; Result Unstructured Data: Decreased

Allergies:

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

Symptoms: Sick; dizziness; Decay; Anemia; Got the first dose of the Moderna vaccine on 18Mar2021 and has not received the second dose yet; Have a blocked vein; low haemoglobin; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Sick), DIZZINESS (dizziness), GENERAL PHYSICAL HEALTH DETERIORATION (Decay), ANAEMIA (Anemia) and PRODUCT DOSE OMISSION ISSUE (Got the first dose of the Moderna vaccine on 18Mar2021 and has not received the second dose yet) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Pacemaker insertion (cardiac). Concurrent medical conditions included Diabetes, Arthritis, Osteoporosis and Cholesterol. Concomitant products included VITAMIN B COMPLEX and MULTIVITAMINS [VITAMINS NOS] for an unknown indication. On 18-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 ILLNESS (Sick), DIZZINESS (dizziness), GENERAL PHYSICAL HEALTH DETERIORATION (Decay), ANAEMIA (Anemia), PRODUCT DOSE OMISSION ISSUE (Got the first dose of the Moderna vaccine on 18Mar2021 and has not received the second dose yet), VENOUS OCCLUSION (Have a blocked vein) and HAEMOGLOBIN DECREASED (low haemoglobin). The patient was treated with IRON for Hemoglobin low, at a dose of 1 dosage form. At the time of the report, ILLNESS (Sick), DIZZINESS (dizziness), GENERAL PHYSICAL HEALTH DETERIORATION (Decay), ANAEMIA (Anemia), PRODUCT DOSE OMISSION ISSUE (Got the first dose of the Moderna vaccine on 18Mar2021 and has not received the second dose yet), VENOUS OCCLUSION (Have a blocked vein) and HAEMOGLOBIN DECREASED (low haemoglobin) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Haemoglobin: decreased (Low) Decreased. 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. For diabetes, arthritis, osteoporosis, cholesterol, patient took several medicines .After having a pacemaker, and a blocked vein, patient took several medicines. Most recent FOLLOW-UP information incorporated above includes: On 25-Jul-2021: Significant follow up: Outcomes Changed from not recovered to recovered for all events. Denied further FU.

Other Meds: VITAMIN B COMPLEX; MULTIVITAMINS [VITAMINS NOS]

Current Illness: Arthritis; Cholesterol; Diabetes; Osteoporosis

ID: 1643615
Sex: M
Age:
State:

Vax Date: 04/01/2021
Onset Date: 06/01/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Test Date: 202106; Test Name: Body temperature; Result Unstructured Data: High

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: lack of appetite; headaches; extreme fatigue; low-grade fever (99.5-99.9 degrees); This spontaneous case was reported by a consumer and describes the occurrence of DECREASED APPETITE (lack of appetite), HEADACHE (headaches), FATIGUE (extreme fatigue) and PYREXIA (low-grade fever (99.5-99.9 degrees)) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In April 2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In June 2021, the patient experienced DECREASED APPETITE (lack of appetite), HEADACHE (headaches), FATIGUE (extreme fatigue) and PYREXIA (low-grade fever (99.5-99.9 degrees)). At the time of the report, DECREASED APPETITE (lack of appetite), HEADACHE (headaches), FATIGUE (extreme fatigue) and PYREXIA (low-grade fever (99.5-99.9 degrees)) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In June 2021, Body temperature (97.7-99.5): 99.5 - 99.9 degrees fahrenheit (High) High. No concomitant medications were reported. No treatment information was provided by the reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1643616
Sex: M
Age: 64
State: TX

Vax Date: 04/12/2021
Onset Date:
Rec V Date: 08/28/2021
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: Arthritis in both hands, joints, arms, elbows, shoulders, wrists; This spontaneous case was reported by a consumer and describes the occurrence of ARTHRITIS (Arthritis in both hands, joints, arms, elbows, shoulders, wrists) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 018B21A) for COVID-19 vaccination. The patient's past medical history included Amputation. On 12-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ARTHRITIS (Arthritis in both hands, joints, arms, elbows, shoulders, wrists). At the time of the report, ARTHRITIS (Arthritis in both hands, joints, arms, elbows, shoulders, wrists) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The patient reported that he was on pain management medications. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1643617
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: mixed doses Pfizer and Moderna/My first vaccine was Pfizer, my second was Moderna; chills; fever 103.2; This spontaneous case was reported by a consumer and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (mixed doses Pfizer and Moderna/My first vaccine was Pfizer, my second was Moderna), CHILLS (chills) and PYREXIA (fever 103.2) 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 INTERCHANGE OF VACCINE PRODUCTS (mixed doses Pfizer and Moderna/My first vaccine was Pfizer, my second was Moderna), CHILLS (chills) and PYREXIA (fever 103.2). At the time of the report, INTERCHANGE OF VACCINE PRODUCTS (mixed doses Pfizer and Moderna/My first vaccine was Pfizer, my second was Moderna), CHILLS (chills) and PYREXIA (fever 103.2) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1643618
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: huge red circle on my arm where I got the shot; swollen; hot to touch; hurts; This spontaneous case was reported by a nurse and describes the occurrence of VACCINATION SITE ERYTHEMA (huge red circle on my arm where I got the shot), VACCINATION SITE SWELLING (swollen), VACCINATION SITE WARMTH (hot to touch) and VACCINATION SITE PAIN (hurts) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (huge red circle on my arm where I got the shot), VACCINATION SITE SWELLING (swollen), VACCINATION SITE WARMTH (hot to touch) and VACCINATION SITE PAIN (hurts). At the time of the report, VACCINATION SITE ERYTHEMA (huge red circle on my arm where I got the shot), VACCINATION SITE SWELLING (swollen), VACCINATION SITE WARMTH (hot to touch) and VACCINATION SITE PAIN (hurts) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1643619
Sex: U
Age:
State:

Vax Date: 05/11/2021
Onset Date:
Rec V Date: 08/28/2021
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: I had my first vaccine taken on may 11/If I missed my second dose and passed the 6 weeks do i have to restart my vaccines; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (I had my first vaccine taken on may 11/If I missed my second dose and passed the 6 weeks do i have to restart my vaccines) 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 11-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (I had my first vaccine taken on may 11/If I missed my second dose and passed the 6 weeks do i have to restart my vaccines). At the time of the report, PRODUCT DOSE OMISSION ISSUE (I had my first vaccine taken on may 11/If I missed my second dose and passed the 6 weeks do i have to restart my vaccines) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1643620
Sex: M
Age:
State:

Vax Date: 06/21/2021
Onset Date:
Rec V Date: 08/28/2021
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: Arm is sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm is sore) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 21-Jun-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Arm is sore). At the time of the report, PAIN IN EXTREMITY (Arm is sore) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1643621
Sex: F
Age:
State: OH

Vax Date: 05/23/2021
Onset Date:
Rec V Date: 08/28/2021
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: Hands and feet are tingling; Burning; Kind of red underneath/face is kind of red; Whole back broke out last night; Rash; Itching on the palms of hands and feet/Itching on her back; Kind of like Dermatitis; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Itching on the palms of hands and feet/Itching on her back), PARAESTHESIA (Hands and feet are tingling), BURNING SENSATION (Burning), ERYTHEMA (Kind of red underneath/face is kind of red) and MUSCULOSKELETAL DISCOMFORT (Whole back broke out last night) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 009D21A and 049C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Dermatitis (Did not have a flare up In years- probably 3 years ago was the last one.). On 23-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Jun-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 PRURITUS (Itching on the palms of hands and feet/Itching on her back), PARAESTHESIA (Hands and feet are tingling), BURNING SENSATION (Burning), ERYTHEMA (Kind of red underneath/face is kind of red), MUSCULOSKELETAL DISCOMFORT (Whole back broke out last night), DERMATITIS (Kind of like Dermatitis) and RASH (Rash). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL) at a dose of 1 dosage form. At the time of the report, PRURITUS (Itching on the palms of hands and feet/Itching on her back), PARAESTHESIA (Hands and feet are tingling), BURNING SENSATION (Burning), ERYTHEMA (Kind of red underneath/face is kind of red), MUSCULOSKELETAL DISCOMFORT (Whole back broke out last night), DERMATITIS (Kind of like Dermatitis) and RASH (Rash) outcome was unknown. No relevant concomitant medications were reported. This case was linked to MOD-2021-238686 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 28-Jun-2021: Additional document received: Updated patient demographics, Added new event rash, back discomfort, redness, burning sensation, tingling feet/ hands

Other Meds:

Current Illness:

ID: 1643622
Sex: M
Age: 60
State:

Vax Date: 12/30/2020
Onset Date: 01/27/2021
Rec V Date: 08/28/2021
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: Feeling pain at the injection site, hurting worse than the needle, if he moves his arm it hurts; Chronic fatigue; Had a little bit of an adverse reaction after the second vaccine; Chronic fatigue; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Had a little bit of an adverse reaction after the second vaccine), VACCINATION SITE PAIN (Feeling pain at the injection site, hurting worse than the needle, if he moves his arm it hurts), the first episode of FATIGUE (Chronic fatigue) and the second episode of FATIGUE (Chronic fatigue) in a 60-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 30-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 27-Jan-2021, the patient experienced VACCINATION COMPLICATION (Had a little bit of an adverse reaction after the second vaccine) and the first episode of FATIGUE (Chronic fatigue). In April 2021, the patient experienced the second episode of FATIGUE (Chronic fatigue). On 24-Jun-2021, the patient experienced VACCINATION SITE PAIN (Feeling pain at the injection site, hurting worse than the needle, if he moves his arm it hurts). At the time of the report, VACCINATION COMPLICATION (Had a little bit of an adverse reaction after the second vaccine) outcome was unknown and VACCINATION SITE PAIN (Feeling pain at the injection site, hurting worse than the needle, if he moves his arm it hurts) and the last episode of FATIGUE (Chronic fatigue) had not resolved. Concomitant product information was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1643623
Sex: F
Age: 52
State: CA

Vax Date: 06/16/2021
Onset Date: 06/26/2021
Rec V Date: 08/28/2021
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: Extreme Itchy; Extremely painful/ Can't used because it hurt; Can't used because it hurt; Burning; Inflammation; Arm swell up/Arm is big; COVID arm; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Arm swell up/Arm is big), VACCINATION COMPLICATION (COVID arm), BURNING SENSATION (Burning), INFLAMMATION (Inflammation) and PRURITUS (Extreme Itchy) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included CLARITHROMYCIN (CLARITIN [CLARITHROMYCIN]) for an unknown indication. On 16-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Jun-2021, the patient experienced PERIPHERAL SWELLING (Arm swell up/Arm is big) and VACCINATION COMPLICATION (COVID arm). On 27-Jun-2021, the patient experienced BURNING SENSATION (Burning), INFLAMMATION (Inflammation) and MOBILITY DECREASED (Can't used because it hurt). On 28-Jun-2021, the patient experienced PRURITUS (Extreme Itchy) and MYALGIA (Extremely painful/ Can't used because it hurt). The patient was treated with IBUPROFEN at an unspecified dose and frequency and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency. At the time of the report, PERIPHERAL SWELLING (Arm swell up/Arm is big), VACCINATION COMPLICATION (COVID arm), BURNING SENSATION (Burning), INFLAMMATION (Inflammation), PRURITUS (Extreme Itchy), MOBILITY DECREASED (Can't used because it hurt) and MYALGIA (Extremely painful/ Can't used because it hurt) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds: CLARITIN [CLARITHROMYCIN]

Current Illness:

ID: 1643624
Sex: U
Age:
State: NE

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: This spontaneous case reported by a consumer, describes the occurrence of adverse event (taking IV-antibiotics daily) in a patient, of an unknown age and gender, who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. On an unknown date, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On an unknown date, patient experienced adverse event (taking IV-antibiotics daily). At the time of the report, adverse event (taking IV-antibiotics daily) outcome: unknown. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. No concomitant medication or treatment information reported.

Other Meds:

Current Illness:

ID: 1643625
Sex: M
Age:
State: IA

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

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Patient who was administered an expired dose; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient who was administered an expired dose) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002C21A) for COVID-19 vaccination. No Medical History information was reported. On 28-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 28-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient who was administered an expired dose). On 28-Jun-2021, EXPIRED PRODUCT ADMINISTERED (Patient who was administered an expired dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1643626
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: my arm and neck are sore; my arm and neck are sore; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULOSKELETAL STIFFNESS (my arm and neck are sore) and MYALGIA (my arm and neck are sore) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 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 MUSCULOSKELETAL STIFFNESS (my arm and neck are sore) and MYALGIA (my arm and neck are sore). At the time of the report, MUSCULOSKELETAL STIFFNESS (my arm and neck are sore) and MYALGIA (my arm and neck are sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication information was not reported. Treatment information as not reported.

Other Meds:

Current Illness:

ID: 1643627
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: constipation; had a headache; This spontaneous case was reported by a consumer and describes the occurrence of CONSTIPATION (constipation) and HEADACHE (had a headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced CONSTIPATION (constipation) and HEADACHE (had a headache). At the time of the report, CONSTIPATION (constipation) had not resolved and HEADACHE (had a headache) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1643628
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: Shortness of breathe; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Shortness of breathe) 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 DYSPNOEA (Shortness of breathe). At the time of the report, DYSPNOEA (Shortness of breathe) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The concomitant medication was not reported. The treatment information was not provided.

Other Meds:

Current Illness:

ID: 1643629
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: More than 35 days since first shot.He has had the first shot already in april; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days since first shot.He has had the first shot already in april) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days since first shot.He has had the first shot already in april). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days since first shot.He has had the first shot already in april) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1643630
Sex: F
Age: 54
State: TX

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 08/28/2021
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 felt like her body had been invaded and did not feel good; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Patient felt like her body had been invaded and did not feel good) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced FEELING ABNORMAL (Patient felt like her body had been invaded and did not feel good). On 10-Mar-2021, FEELING ABNORMAL (Patient felt like her body had been invaded and did not feel good) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant medications were provided by the reporter. No treatment medications were provided by the reporter. This case was linked to MOD-2021-238556 (Patient Link).

Other Meds:

Current Illness:

ID: 1643631
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: headache is bad that i can even bend my head; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headache is bad that i can even bend my head) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced HEADACHE (headache is bad that i can even bend my head). At the time of the report, HEADACHE (headache is bad that i can even bend my head) outcome was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1643632
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: Getting COVID After the Vaccine; fever; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Getting COVID After the Vaccine) and PYREXIA (fever) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced COVID-19 (Getting COVID After the Vaccine) and PYREXIA (fever). At the time of the report, COVID-19 (Getting COVID After the Vaccine) and PYREXIA (fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1643633
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: chest is tight; Fever; Headache; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of CHEST DISCOMFORT (chest is tight), PYREXIA (Fever) 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 patient's past medical history included No adverse event. 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 CHEST DISCOMFORT (chest is tight), PYREXIA (Fever) and HEADACHE (Headache). At the time of the report, CHEST DISCOMFORT (chest is tight), PYREXIA (Fever) and HEADACHE (Headache) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1643634
Sex: F
Age: 53
State: NM

Vax Date: 04/20/2021
Onset Date: 06/04/2021
Rec V Date: 08/28/2021
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: Had heavy bleeding/ she started with heavy menstrual bleeding again/started a menstrual period with spotting again; This spontaneous case was reported by a consumer and describes the occurrence of POSTMENOPAUSAL HAEMORRHAGE (Had heavy bleeding/ she started with heavy menstrual bleeding again/started a menstrual period with spotting again) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017C21A) for COVID-19 vaccination. No Medical History information was reported. On 20-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-Jun-2021, the patient experienced POSTMENOPAUSAL HAEMORRHAGE (Had heavy bleeding/ she started with heavy menstrual bleeding again/started a menstrual period with spotting again). At the time of the report, POSTMENOPAUSAL HAEMORRHAGE (Had heavy bleeding/ she started with heavy menstrual bleeding again/started a menstrual period with spotting again) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The concomitant medications were not reported. The treatment information was not provided. Post second dose patient had spotting from 04-JUN-2021 which then started to heavy bleeding on 15-JUN-2021 until 21-jun-2021.Again heavy bleeding started on 26-JUN-2021.The patient had an appointment with gynecologist on 22-jul-2021. The action taken with mRNA 1273 with the events was considered as not applicable. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. This case was linked to MOD-2021-238523 (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 event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1643635
Sex: F
Age: 54
State: TX

Vax Date: 03/09/2021
Onset Date: 04/08/2021
Rec V Date: 08/28/2021
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: Flu-like symptoms; Itching on her left collar bone; 2 swollen lymph nodes on my left collar bone/all lymph nodes on the side of the injection were swollen; Feel like my joint and shoulder is almost dislocating/left shoulder feels popped; Felt sick for 2-3 days/something's not right; Headache; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (Felt sick for 2-3 days/something's not right), JOINT DISLOCATION (Feel like my joint and shoulder is almost dislocating/left shoulder feels popped), INFLUENZA LIKE ILLNESS (Flu-like symptoms), PRURITUS (Itching on her left collar bone) and LYMPHADENOPATHY (2 swollen lymph nodes on my left collar bone/all lymph nodes on the side of the injection were swollen) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Apr-2021, the patient experienced MALAISE (Felt sick for 2-3 days/something's not right) and HEADACHE (Headache). On 11-Apr-2021, the patient experienced JOINT DISLOCATION (Feel like my joint and shoulder is almost dislocating/left shoulder feels popped) and LYMPHADENOPATHY (2 swollen lymph nodes on my left collar bone/all lymph nodes on the side of the injection were swollen). On an unknown date, the patient experienced INFLUENZA LIKE ILLNESS (Flu-like symptoms) and PRURITUS (Itching on her left collar bone). On 11-Apr-2021, MALAISE (Felt sick for 2-3 days/something's not right) and HEADACHE (Headache) had resolved. At the time of the report, JOINT DISLOCATION (Feel like my joint and shoulder is almost dislocating/left shoulder feels popped), INFLUENZA LIKE ILLNESS (Flu-like symptoms), PRURITUS (Itching on her left collar bone) and LYMPHADENOPATHY (2 swollen lymph nodes on my left collar bone/all lymph nodes on the side of the injection were swollen) outcome was unknown. No concomitant medications were reported. Treatment information was not provided by the reporter. This case was linked to MOD-2021-238518 (Patient Link).

Other Meds:

Current Illness:

ID: 1643636
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN (pain). At the time of the report, PAIN (pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1643637
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: Swelling of the legs and feet; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swelling of the legs and feet) 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 PERIPHERAL SWELLING (Swelling of the legs and feet). At the time of the report, PERIPHERAL SWELLING (Swelling of the legs and feet) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. Treatment information was not provided by the reporter.

Other Meds:

Current Illness:

ID: 1643638
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: i got thr vaccine today first dose ,have Side Effects; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (i got thr vaccine today first dose ,have Side Effects) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (i got thr vaccine today first dose ,have Side Effects). At the time of the report, VACCINATION COMPLICATION (i got thr vaccine today first dose ,have Side Effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1643639
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: Missed 2nd vaccine dose; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Missed 2nd vaccine 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 INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Missed 2nd vaccine dose). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Missed 2nd vaccine dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1643640
Sex: M
Age: 75
State: TX

Vax Date: 06/22/2021
Onset Date: 06/23/2021
Rec V Date: 08/28/2021
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: It has spread ever since but has not quite reached the elbow; Warm to the touch; That was developing some redness where shot was injected. It has spread ever since but has not quite reached the elbow; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (It has spread ever since but has not quite reached the elbow), FEELING HOT (Warm to the touch) and VACCINATION SITE ERYTHEMA (That was developing some redness where shot was injected. It has spread ever since but has not quite reached the elbow) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053C21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 on 26-Feb-2021. Concurrent medical conditions included Lymphoma. Concomitant products included IBRUTINIB (IMBRUVICA), FUROSEMIDE, WARFARIN, VITAMIN D3 and VITAMIN B COMPLEX (B COMPLEX [VITAMIN B COMPLEX]) for an unknown indication. On 22-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Jun-2021, the patient experienced ERYTHEMA (It has spread ever since but has not quite reached the elbow), FEELING HOT (Warm to the touch) and VACCINATION SITE ERYTHEMA (That was developing some redness where shot was injected. It has spread ever since but has not quite reached the elbow). At the time of the report, ERYTHEMA (It has spread ever since but has not quite reached the elbow) and VACCINATION SITE ERYTHEMA (That was developing some redness where shot was injected. It has spread ever since but has not quite reached the elbow) had resolved and FEELING HOT (Warm to the touch) 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 medications also included two heart medications. Patient received antibodies on 27-FEB-2021 No treatment medications were taken by the patient. Most recent FOLLOW-UP information incorporated above includes: On 25-Jul-2021: Follow up information received, included event (Redness recovered in 7-8 days) outcome was updated to recovered.

Other Meds: IMBRUVICA; FUROSEMIDE; WARFARIN; VITAMIN D3; B COMPLEX [VITAMIN B COMPLEX]

Current Illness: Lymphoma

ID: 1643641
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
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: "Slight tightness in my chest when I take deep breaths"; Aching joints; Aching muscles; Slight hearttburn; This spontaneous case was reported by a patient and describes the occurrence of CHEST DISCOMFORT ("Slight tightness in my chest when I take deep breaths"), DYSPEPSIA (Slight hearttburn), ARTHRALGIA (Aching joints) and MYALGIA (Aching muscles) 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 CHEST DISCOMFORT ("Slight tightness in my chest when I take deep breaths"), DYSPEPSIA (Slight hearttburn), ARTHRALGIA (Aching joints) and MYALGIA (Aching muscles). At the time of the report, CHEST DISCOMFORT ("Slight tightness in my chest when I take deep breaths"), DYSPEPSIA (Slight hearttburn), ARTHRALGIA (Aching joints) and MYALGIA (Aching muscles) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported. Reporter did not allow further contact

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am