VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1643642
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: Shortness of breath; fatigue; had reaction to vaccine; decided not to get the second vaccination; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Shortness of breath), FATIGUE (fatigue), VACCINATION COMPLICATION (had reaction to vaccine) and INTENTIONAL PRODUCT USE ISSUE (decided not to get the second vaccination) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included COPD and Heart murmur. 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 breath), FATIGUE (fatigue), VACCINATION COMPLICATION (had reaction to vaccine) and INTENTIONAL PRODUCT USE ISSUE (decided not to get the second vaccination). At the time of the report, DYSPNOEA (Shortness of breath), FATIGUE (fatigue), VACCINATION COMPLICATION (had reaction to vaccine) and INTENTIONAL PRODUCT USE ISSUE (decided not to get the second vaccination) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. No treatment information was provided.

Other Meds:

Current Illness: COPD; Heart murmur

ID: 1643643
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: having chills; feeling warm; sore in her arms; Moderna as the 2nd vaccine after having Pfizer as the first vaccine; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (having chills), FEELING HOT (feeling warm), MYALGIA (sore in her arms) and OFF LABEL USE (Moderna as the 2nd vaccine after having Pfizer as the first vaccine) 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, the patient experienced CHILLS (having chills), FEELING HOT (feeling warm), MYALGIA (sore in her arms) and OFF LABEL USE (Moderna as the 2nd vaccine after having Pfizer as the first vaccine). At the time of the report, CHILLS (having chills), FEELING HOT (feeling warm), MYALGIA (sore in her arms) and OFF LABEL USE (Moderna as the 2nd vaccine after having Pfizer as the first vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1643644
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: stomach issues/diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (stomach issues/diarrhea) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced DIARRHOEA (stomach issues/diarrhea). At the time of the report, DIARRHOEA (stomach issues/diarrhea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1643645
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Consumer answered "Yes" when the ChatBot asked if they had received the Moderna COVID-19 Vaccine and experienced a side effect.; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Consumer answered "Yes" when the ChatBot asked if they had received the Moderna COVID-19 Vaccine and experienced a side effect.) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Consumer answered "Yes" when the ChatBot asked if they had received the Moderna COVID-19 Vaccine and experienced a side effect). At the time of the report, VACCINATION COMPLICATION (Consumer answered "Yes" when the ChatBot asked if they had received the Moderna COVID-19 Vaccine and experienced a side effect.) outcome was unknown. Description of Event or Problem: AE submitted via Chatbot: "What are common side effects the after you get the" "Second shot. day after"

Other Meds:

Current Illness:

ID: 1643646
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Severe itching all over; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 28-Jun-2021 and was forwarded to Moderna on 28-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Severe itching all over) 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 PRURITUS (Severe itching all over). At the time of the report, PRURITUS (Severe itching all over) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1643647
Sex: F
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: Test Name: Fever; Result Unstructured Data: 102.8-103.6; Comments: for 10 days

Allergies:

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

Symptoms: severe vertigo; arm hurts so badly; fever of 102.8 - 103.6 for 10 days; Fatigue; nausea; This spontaneous case was reported by a consumer and describes the occurrence of VERTIGO (severe vertigo), MYALGIA (arm hurts so badly), PYREXIA (fever of 102.8 - 103.6 for 10 days), FATIGUE (Fatigue) and NAUSEA (nausea) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VERTIGO (severe vertigo), MYALGIA (arm hurts so badly), PYREXIA (fever of 102.8 - 103.6 for 10 days), FATIGUE (Fatigue) and NAUSEA (nausea). The patient was treated with MECLIZINE [MECLOZINE] for Vertigo, at a dose of 25 milligram three times a day. At the time of the report, VERTIGO (severe vertigo), MYALGIA (arm hurts so badly), PYREXIA (fever of 102.8 - 103.6 for 10 days), FATIGUE (Fatigue) and NAUSEA (nausea) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 102.8-103.6 (High) 102.8-103.6. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient declined to take second dose. No concomitant medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 27-Jul-2021: Follow up received and added lab data, treatment medication and new events. Updated event outcome of myalgia to Recovered/Resolved.

Other Meds:

Current Illness:

ID: 1643648
Sex: F
Age:
State: MA

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: Pyrexia, White blood cell count decreased

Symptoms: This spontaneous case reported by a consumer, describes the occurrence of myalgia (her second injection was in March and she experienced some pain in right arm) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch# 012M20A) for COVID-19 immunization. No medical history reported. On Feb 4, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. In March 2021, patient received the second dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. On an unknown date, patient experienced myalgia (her second injection was in March and she experienced some pain in right arm). At the time of the report, myalgia (her second injection was in March and she experienced some pain in right arm) resolved. No concomitant medication or treatment information provided. This case linked to MOD-2021-015032 (patient link).

Other Meds:

Current Illness:

ID: 1643649
Sex: U
Age:
State:

Vax Date: 03/12/2021
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: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: I did not go back for my second shot.; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (I did not go back for my second shot.) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-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 PRODUCT DOSE OMISSION ISSUE (I did not go back for my second shot.). At the time of the report, PRODUCT DOSE OMISSION ISSUE (I did not go back for my second shot.) 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: 1643650
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: Abdominal pain, Chills, Sleep disorder

Symptoms: "I feel sick"; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS ("I feel sick") 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 ILLNESS ("I feel sick"). At the time of the report, ILLNESS ("I feel sick") outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1643651
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: vaccine site be hot to touch; redness big like a baseball size; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 27-Jun-2021 and was forwarded to Moderna on 28-Jun-2021. This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (vaccine site be hot to touch) and VACCINATION SITE ERYTHEMA (redness big like a baseball size) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE WARMTH (vaccine site be hot to touch) and VACCINATION SITE ERYTHEMA (redness big like a baseball size). At the time of the report, VACCINATION SITE WARMTH (vaccine site be hot to touch) and VACCINATION SITE ERYTHEMA (redness big like a baseball size) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication not reported. Treatment medication not reported.

Other Meds:

Current Illness:

ID: 1643652
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: first dose of Covid Vicine on March 8 can I still take the second dose; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (fist dose of Covid Vicine on March 8 can I still take the second dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (fist dose of Covid Vicine on March 8 can I still take the second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (fist dose of Covid Vicine on March 8 can I still take the second dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1643653
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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: long term side effect vomiting mucus; This spontaneous case was reported by a consumer and describes the occurrence of VOMITING (long term side effect vomiting mucus) 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 VOMITING (long term side effect vomiting mucus). At the time of the report, VOMITING (long term side effect vomiting mucus) 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. This spontaneous case was reported by a consumer and describes the occurrence of VOMITING (long term side effect vomiting mucus) 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 VOMITING (long term side effect vomiting mucus). At the time of the report, VOMITING (long term side effect vomiting mucus) 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: 1643654
Sex: F
Age:
State: NY

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: This spontaneous case reported by a pharmacist, describes the occurrence of inappropriate schedule of product administration (received the second dose of vaccine when it is outside of recommended timeframe) in a 62-year-old female patient 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 inappropriate schedule of product administration (received the second dose of vaccine when it is outside of recommended timeframe). At the time of the report, inappropriate schedule of product administration (received the second dose of vaccine when it is outside of recommended timeframe) resolved. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. The reporter did not provide any causality assessments, concomitant medications or treatment information.

Other Meds:

Current Illness:

ID: 1643655
Sex: F
Age: 50
State: GA

Vax Date: 01/12/2021
Onset Date: 01/13/2021
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: 2nd dose not given at day 36; shingles on her face; This spontaneous case was reported by a pharmacist and describes the occurrence of HERPES ZOSTER (shingles on her face) and PRODUCT DOSE OMISSION ISSUE (2nd dose not given at day 36) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Jan-2021, the patient experienced HERPES ZOSTER (shingles on her face). On 28-Jun-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (2nd dose not given at day 36). On 28-Jun-2021, PRODUCT DOSE OMISSION ISSUE (2nd dose not given at day 36) had resolved. At the time of the report, HERPES ZOSTER (shingles on her face) 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. Patient missed her second dose because she still had shingles on her face.

Other Meds:

Current Illness:

ID: 1643656
Sex: M
Age: 49
State:

Vax Date: 04/30/2021
Onset Date: 06/27/2021
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:

Allergies:

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

Symptoms: the 2nd dose of Moderna vaccine was given beyond the scheduled appointment; This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (the 2nd dose of Moderna vaccine was given beyond the scheduled appointment) in a 49-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037B21A and 047C21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Jun-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (the 2nd dose of Moderna vaccine was given beyond the scheduled appointment). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (the 2nd dose of Moderna vaccine was given beyond the scheduled appointment) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. Treatment information was not provided. No adverse reactions were noted at the time of reporting.

Other Meds:

Current Illness:

ID: 1643657
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: Test Name: WBC; Result Unstructured Data: Elevated

Allergies:

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

Symptoms: slightly elevated wbc; This spontaneous case was reported by a consumer and describes the occurrence of WHITE BLOOD CELL COUNT INCREASED (slightly elevated wbc) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced WHITE BLOOD CELL COUNT INCREASED (slightly elevated wbc). At the time of the report, WHITE BLOOD CELL COUNT INCREASED (slightly elevated wbc) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, White blood cell count: elevated (abnormal) Elevated. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1643658
Sex: U
Age:
State: FL

Vax Date: 05/14/2021
Onset Date: 06/19/2021
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: more than 35 days since got the first dose/ not gotten the second one (was scheduled to get it on 11Jun2021).; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (more than 35 days since got the first dose/ not gotten the second one (was scheduled to get it on 11Jun2021).) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Jun-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (more than 35 days since got the first dose/ not gotten the second one (was scheduled to get it on 11Jun2021).). At the time of the report, PRODUCT DOSE OMISSION ISSUE (more than 35 days since got the first dose/ not gotten the second one (was scheduled to get it on 11Jun2021).) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatment medications were provided.

Other Meds:

Current Illness:

ID: 1643659
Sex: F
Age:
State: OH

Vax Date: 05/23/2021
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: flu like symptoms; her hand was heavy; hands and feet are tingling; burning; kind of red underneath/face is kind of red; whole back broke out last night; rash; kind of like dermatitis; been having issues with hands and feet; itching on her back; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (flu like symptoms), LIMB DISCOMFORT (her hand was heavy), PARAESTHESIA (hands and feet are tingling), BURNING SENSATION (burning) and ERYTHEMA (kind of red underneath/face is kind of red) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049C21A and 009D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included No adverse reaction. 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) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced INFLUENZA LIKE ILLNESS (flu like symptoms), LIMB DISCOMFORT (her hand was heavy), PARAESTHESIA (hands and feet are tingling), BURNING SENSATION (burning), ERYTHEMA (kind of red underneath/face is kind of red), SKIN EXFOLIATION (whole back broke out last night), RASH (rash), DERMATITIS (kind of like dermatitis), SKIN EXFOLIATION (been having issues with hands and feet) and PRURITUS (itching on her back). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency. At the time of the report, INFLUENZA LIKE ILLNESS (flu like symptoms), LIMB DISCOMFORT (her hand was heavy), PARAESTHESIA (hands and feet are tingling), BURNING SENSATION (burning), ERYTHEMA (kind of red underneath/face is kind of red), SKIN EXFOLIATION (whole back broke out last night), RASH (rash), DERMATITIS (kind of like dermatitis), SKIN EXFOLIATION (been having issues with hands and feet) and PRURITUS (itching on her back) outcome was unknown. Not Provided The patient received both scheduled doses of mRNA-1273 prior to the event, therefore action taken with the drug in the event is not applicable Caller wants to know if Benadryl is fine to continue taking No concomitant medication were reported This case was linked to MOD-2021-238461 (Patient Link).

Other Meds:

Current Illness:

ID: 1643660
Sex: U
Age:
State:

Vax Date:
Onset Date: 06/25/2021
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: had my second shot 3 days ago and my headache is just getting worse; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (had my second shot 3 days ago and my headache is just getting worse) 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 25-Jun-2021, the patient experienced HEADACHE (had my second shot 3 days ago and my headache is just getting worse). At the time of the report, HEADACHE (had my second shot 3 days ago and my headache is just getting worse) outcome was unknown. No concomitant medications were provided. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1643661
Sex: U
Age:
State:

Vax Date: 06/26/2021
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:

Allergies:

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

Symptoms: very tired; headache; This spontaneous case was reported by an other health care professional and describes the occurrence of FATIGUE (very tired) and HEADACHE (headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 26-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced FATIGUE (very tired) and HEADACHE (headache). At the time of the report, FATIGUE (very tired) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. Treatment information was unknown. This spontaneous case was reported by an other health care professional and describes the occurrence of FATIGUE (very tired) and HEADACHE (headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 26-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced FATIGUE (very tired) and HEADACHE (headache). At the time of the report, FATIGUE (very tired) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. Treatment information was unknown.

Other Meds:

Current Illness:

ID: 1643662
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: 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: can't get rid of this deep cough; wheezing; can't taste; can't taste or smell anything; sinus cold; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (can't get rid of this deep cough), WHEEZING (wheezing), AGEUSIA (can't taste), ANOSMIA (can't taste or smell anything) and NASOPHARYNGITIS (sinus cold) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced COUGH (can't get rid of this deep cough), WHEEZING (wheezing), AGEUSIA (can't taste), ANOSMIA (can't taste or smell anything) and NASOPHARYNGITIS (sinus cold). At the time of the report, COUGH (can't get rid of this deep cough), WHEEZING (wheezing), AGEUSIA (can't taste), ANOSMIA (can't taste or smell anything) and NASOPHARYNGITIS (sinus cold) outcome was unknown. No concomitant medication information was reported. Treatment medication was not provided.

Other Meds:

Current Illness:

ID: 1643663
Sex: F
Age:
State: CT

Vax Date: 03/25/2021
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: LA

Lab Data: Test Name: CAT scan; Test Result: Inconclusive ; Result Unstructured Data: Unknown

Allergies:

Symptom List: Unevaluable event

Symptoms: lower left groin pain on the side of shot (left side)/ a little bit of soreness in her lower left groin; swollen lymph nodes in her neck; swollen lymph nodes in the armpit (underarm); This spontaneous case was reported by a patient and describes the occurrence of GROIN PAIN (lower left groin pain on the side of shot (left side)/ a little bit of soreness in her lower left groin), LYMPHADENOPATHY (swollen lymph nodes in her neck) and LYMPHADENOPATHY (swollen lymph nodes in the armpit (underarm)) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 045B21A and 047A21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced GROIN PAIN (lower left groin pain on the side of shot (left side)/ a little bit of soreness in her lower left groin) and LYMPHADENOPATHY (swollen lymph nodes in the armpit (underarm)). an unknown date, the patient experienced LYMPHADENOPATHY (swollen lymph nodes in her neck). At the time of the report, GROIN PAIN (lower left groin pain on the side of shot (left side)/ a little bit of soreness in her lower left groin) outcome was unknown and LYMPHADENOPATHY (swollen lymph nodes in her neck) and LYMPHADENOPATHY (swollen lymph nodes in the armpit (underarm)) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Computerised tomogram: unknown (Inconclusive) Unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication details were not provided. No treatment details were provided. Patient experienced the lower left groin pain on the side of the shot after around 8 weeks of shot. Doctor thought that it was hernia, She had to go again to check it's not ovarian related as she still experiencing soreness. This case was linked to MOD-2021-065389 (Patient Link).

Other Meds:

Current Illness:

ID: 1643664
Sex: F
Age: 80
State: TN

Vax Date: 02/04/2021
Onset Date: 03/05/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Face started swelling at the place she had fillers and hurting; Face started swelling at the place she had fillers and hurting; Dissolved all the fillers in her face; Thought all her teeth were abscessed; Every joint in her body is aching; Persistent cough; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (Persistent cough), SWELLING FACE (Face started swelling at the place she had fillers and hurting), FACIAL PAIN (Face started swelling at the place she had fillers and hurting), DEVICE MALFUNCTION (Dissolved all the fillers in her face) and TOOTH ABSCESS (Thought all her teeth were abscessed) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 029A21A and 011M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Skin cosmetic procedure (fillers) in January 2020 and Skin cosmetic procedure (fillers) in November 2019. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 05-Mar-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced COUGH (Persistent cough). On an unknown date, the patient experienced SWELLING FACE (Face started swelling at the place she had fillers and hurting), FACIAL PAIN (Face started swelling at the place she had fillers and hurting), DEVICE MALFUNCTION (Dissolved all the fillers in her face), TOOTH ABSCESS (Thought all her teeth were abscessed) and ARTHRALGIA (Every joint in her body is aching). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. At the time of the report, COUGH (Persistent cough), SWELLING FACE (Face started swelling at the place she had fillers and hurting), FACIAL PAIN (Face started swelling at the place she had fillers and hurting), DEVICE MALFUNCTION (Dissolved all the fillers in her face), TOOTH ABSCESS (Thought all her teeth were abscessed) and ARTHRALGIA (Every joint in her body is aching) outcome was unknown. No relevant concomitant medications were reported. Patient also took steroid medications (unspecified) for treatment. This case was linked to MOD-2021-100618 (Patient Link).

Other Meds:

Current Illness:

ID: 1643665
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Woman realized shortly after receiving the vaccine that she was pregnant.; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 28-Jun-2021 and was forwarded to Moderna on 28-Jun-2021. This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (Woman realized shortly after receiving the vaccine that she was pregnant.) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (Woman realized shortly after receiving the vaccine that she was pregnant.). At the time of the report, EXPOSURE DURING PREGNANCY (Woman realized shortly after receiving the vaccine that she was pregnant.) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were provided. The patient realized shortly after receiving the vaccine that she was 3weeks pregnant. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1643666
Sex: U
Age:
State:

Vax Date:
Onset Date: 06/28/2021
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: Body is Shivering; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Body is Shivering) 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 28-Jun-2021, the patient experienced CHILLS (Body is Shivering). At the time of the report, CHILLS (Body is Shivering) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. Treatment medications were unknown. As per client, MI error in DOB capture as --1-JAN-1900

Other Meds:

Current Illness:

ID: 1643667
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: Still feel horrible; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Still feel horrible) 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 FEELING ABNORMAL (Still feel horrible). At the time of the report, FEELING ABNORMAL (Still feel horrible) had not resolved. 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: 1643668
Sex: F
Age: 41
State: FL

Vax Date: 06/22/2021
Onset Date: 06/23/2021
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: Liver enzymes; Result Unstructured Data: Her liver enzymes are extremely high on the results of her blood tests.

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: extreme abdominal pain; nausea; vomiting; migraine; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (migraine), ABDOMINAL PAIN (extreme abdominal pain), NAUSEA (nausea) and VOMITING (vomiting) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 22-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Jun-2021, the patient experienced MIGRAINE (migraine), NAUSEA (nausea) and VOMITING (vomiting). On 25-Jun-2021, the patient experienced ABDOMINAL PAIN (extreme abdominal pain). The patient was treated with ACETAMINOPHEN ongoing from 23-Jun-2021 at an unspecified dose and frequency and INVERT SUGAR, PHOSPHORIC ACID (EMETROL FISONS) ongoing from 23-Jun-2021 at an unspecified dose and frequency. At the time of the report, MIGRAINE (migraine), ABDOMINAL PAIN (extreme abdominal pain), NAUSEA (nausea) and VOMITING (vomiting) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Hepatic enzyme increased: extremely high (High) Her liver enzymes are extremely high on the results of her blood tests.. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The action taken with mRNA-1273(Moderna COVID-19 vaccine) was not applicable. No concomitant medication was mentioned.

Other Meds:

Current Illness:

ID: 1643669
Sex: F
Age:
State: CA

Vax Date:
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: Red spots on the entire both legs for almost 3 weeks; This spontaneous case was reported by a consumer and describes the occurrence of RASH MACULAR (Red spots on the entire both legs for almost 3 weeks) in a 26-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced RASH MACULAR (Red spots on the entire both legs for almost 3 weeks). At the time of the report, RASH MACULAR (Red spots on the entire both legs for almost 3 weeks) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment was reported. No concomitant medication was reported. Action taken with mRNA-1273 (Moderna COVID-19 Vaccine) was not applicable. This case was linked to MOD-2021-238755 (Patient Link).

Other Meds:

Current Illness:

ID: 1643670
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: Test Name: Blood Pressure; Result Unstructured Data: blood pressure is normal.

Allergies:

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

Symptoms: Is it normal for my body temperature to drop; This spontaneous case was reported by a consumer and describes the occurrence of BODY TEMPERATURE DECREASED (Is it normal for my body temperature to drop) 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 BODY TEMPERATURE DECREASED (Is it normal for my body temperature to drop). At the time of the report, BODY TEMPERATURE DECREASED (Is it normal for my body temperature to drop) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: normal (normal) blood pressure is normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant Concomitant Medications were reported. No Treatment Information Provided.

Other Meds:

Current Illness:

ID: 1643671
Sex: F
Age: 73
State: FL

Vax Date: 06/10/2021
Onset Date: 06/13/2021
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: Test Date: 20210613; Test Name: Blood pressure; Result Unstructured Data: BP was 173/103.

Allergies:

Symptom List: Nausea

Symptoms: Red color; Very itchy; Rash in arm; Bump on arm; Heart was beating very fast like Tachycardia; Felt so bad; This spontaneous case was reported by a consumer and describes the occurrence of TACHYCARDIA (Heart was beating very fast like Tachycardia), FEELING ABNORMAL (Felt so bad), PERIPHERAL SWELLING (Bump on arm), ERYTHEMA (Red color) and PRURITUS (Very itchy) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Allergic reaction to antibiotics. On 10-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Jun-2021, the patient experienced TACHYCARDIA (Heart was beating very fast like Tachycardia) and FEELING ABNORMAL (Felt so bad). On 14-Jun-2021, the patient experienced PERIPHERAL SWELLING (Bump on arm). On an unknown date, the patient experienced ERYTHEMA (Red color), PRURITUS (Very itchy) and RASH (Rash in arm). At the time of the report, TACHYCARDIA (Heart was beating very fast like Tachycardia), FEELING ABNORMAL (Felt so bad), PERIPHERAL SWELLING (Bump on arm), ERYTHEMA (Red color), PRURITUS (Very itchy) and RASH (Rash in arm) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 13-Jun-2021, Blood pressure measurement: 173/103 (High) BP was 173/103.. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant product use was provided by the reporter. No treatment medication was provided. On 13-Jun-2021, at 5AM the patient got up to go to bathroom and her heart was beating very fast like Tachycardia and called 911. Her BP was 173/103 and she felt so bad but was not transported to hospital. The following day she had rash in arm with big bump, the red color lasted a week and it was very itchy.

Other Meds:

Current Illness: Allergic reaction to antibiotics

ID: 1643672
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Why can't I smell; Why cant i taste; can't get rid of this cough; can't get rid of this wheezing; 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 ANOSMIA (Why can't I smell), AGEUSIA (Why cant i taste), COUGH (can't get rid of this cough) and WHEEZING (can't get rid of this wheezing) 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 ANOSMIA (Why can't I smell), AGEUSIA (Why cant i taste), COUGH (can't get rid of this cough) and WHEEZING (can't get rid of this wheezing). At the time of the report, ANOSMIA (Why can't I smell), AGEUSIA (Why cant i taste), COUGH (can't get rid of this cough) and WHEEZING (can't get rid of this wheezing) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1643673
Sex: F
Age:
State: CA

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

Symptoms: Bald spot appeared towards the back of her head after the first vaccine; This spontaneous case was reported by a patient and describes the occurrence of ALOPECIA (Bald spot appeared towards the back of her head after the first vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ALOPECIA (Bald spot appeared towards the back of her head after the first vaccine). At the time of the report, ALOPECIA (Bald spot appeared towards the back of her head after the first vaccine) 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. This case was linked to MOD-2021-238746 (Patient Link).

Other Meds:

Current Illness:

ID: 1643674
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: RA

Lab Data:

Allergies:

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

Symptoms: twitching arm spasms in the same are; severe headache; This spontaneous case was reported by a consumer and describes the occurrence of MUSCLE TWITCHING (twitching arm spasms in the same are) and HEADACHE (severe headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (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 MUSCLE TWITCHING (twitching arm spasms in the same are) and HEADACHE (severe headache). At the time of the report, MUSCLE TWITCHING (twitching arm spasms in the same are) and HEADACHE (severe headache) outcome was unknown. Concomitant medication information were not provided. Patient had severe headache off and on every day. No treatment information were given. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was not applicable.

Other Meds:

Current Illness:

ID: 1643675
Sex: U
Age:
State:

Vax Date: 06/18/2021
Onset Date: 06/19/2021
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: fatigued; headaches; Voice still strained; Losing voice; Chills; Body ache; Fever; This spontaneous case was reported by a consumer and describes the occurrence of DYSPHONIA (Voice still strained), APHONIA (Losing voice), FATIGUE (fatigued), HEADACHE (headaches) and CHILLS (Chills) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 18-Jun-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Jun-2021, the patient experienced CHILLS (Chills), MYALGIA (Body ache) and PYREXIA (Fever). On 20-Jun-2021, the patient experienced DYSPHONIA (Voice still strained) and APHONIA (Losing voice). On an unknown date, the patient experienced FATIGUE (fatigued) and HEADACHE (headaches). On 20-Jun-2021, CHILLS (Chills), MYALGIA (Body ache) and PYREXIA (Fever) had resolved. At the time of the report, DYSPHONIA (Voice still strained), FATIGUE (fatigued) and HEADACHE (headaches) had not resolved and APHONIA (Losing voice) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication were reported. No treatment information was reported

Other Meds:

Current Illness:

ID: 1643676
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: Side effects to first 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 VACCINATION COMPLICATION (Side effects to first 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 VACCINATION COMPLICATION (Side effects to first dose). At the time of the report, VACCINATION COMPLICATION (Side effects to first dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were mentioned. No treatment details were reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1643677
Sex: M
Age:
State:

Vax Date: 06/21/2021
Onset Date: 06/24/2021
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: A hot spot; It has progressed to an from my shoulder down to elbow with swelling; I noticed redness in the shot area; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (A hot spot), PERIPHERAL SWELLING (It has progressed to an from my shoulder down to elbow with swelling) and VACCINATION SITE ERYTHEMA (I noticed redness in the shot area) 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) (Intramuscular) 1 dosage form. On 24-Jun-2021, the patient experienced FEELING HOT (A hot spot), PERIPHERAL SWELLING (It has progressed to an from my shoulder down to elbow with swelling) and VACCINATION SITE ERYTHEMA (I noticed redness in the shot area). At the time of the report, FEELING HOT (A hot spot), PERIPHERAL SWELLING (It has progressed to an from my shoulder down to elbow with swelling) and VACCINATION SITE ERYTHEMA (I noticed redness in the shot area) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment information not reported. Most recent FOLLOW-UP information incorporated above includes: On 23-Jul-2021: No specific follow-up information recorded.

Other Meds:

Current Illness:

ID: 1643678
Sex: M
Age: 15
State: WA

Vax Date: 06/25/2021
Onset Date: 06/25/2021
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:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: 15 year old male had just received his first dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (15 year old male had just received his first dose) in a 15-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 20210625) for COVID-19 vaccination. No Medical History information was reported. On 25-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Jun-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (15 year old male had just received his first dose). At the time of the report, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (15 year old male had just received his first dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1643679
Sex: U
Age:
State: CA

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: a facility administered this expired vaccine to up to 70 patients; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (a facility administered this expired vaccine to up to 70 patients) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029A21A) 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 EXPIRED PRODUCT ADMINISTERED (a facility administered this expired vaccine to up to 70 patients). At the time of the report, EXPIRED PRODUCT ADMINISTERED (a facility administered this expired vaccine to up to 70 patients) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment information or concomitant medications were provided. Nurse stated that a facility administered this expired vaccine to up to 70 patients. Most recent FOLLOW-UP information incorporated above includes: On 28-Jun-2021: Followup received on 28-June-2021 and reporter details has been updated

Other Meds:

Current Illness:

ID: 1643680
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Still have itching where I got my shot; Still have redness where I got my shot; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Still have itching where I got my shot) and VACCINATION SITE ERYTHEMA (Still have redness where I got my shot) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE PRURITUS (Still have itching where I got my shot) and VACCINATION SITE ERYTHEMA (Still have redness where I got my shot). At the time of the report, VACCINATION SITE PRURITUS (Still have itching where I got my shot) and VACCINATION SITE ERYTHEMA (Still have redness where I got my shot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported by the reporter. Treatment medication was not provided by the reporter.

Other Meds:

Current Illness:

ID: 1643681
Sex: F
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: pain in my upper arm; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (pain in my upper arm) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MYALGIA (pain in my upper arm). At the time of the report, MYALGIA (pain in my upper arm) outcome was unknown. No concomitant medications was reported. No treatment drug details was reported.

Other Meds:

Current Illness:

ID: 1643682
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: like the blood isn't flowing properly or something; left leg has been hurting all day; Feeling kind of sore/ muscle pain; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (like the blood isn't flowing properly or something), PAIN IN EXTREMITY (left leg has been hurting all day) and MYALGIA (Feeling kind of sore/ muscle pain) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MALAISE (like the blood isn't flowing properly or something), PAIN IN EXTREMITY (left leg has been hurting all day) and MYALGIA (Feeling kind of sore/ muscle pain). At the time of the report, MALAISE (like the blood isn't flowing properly or something), PAIN IN EXTREMITY (left leg has been hurting all day) and MYALGIA (Feeling kind of sore/ muscle pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. No concomitant medications were reported. No treatment details were reported.

Other Meds:

Current Illness:

ID: 1643683
Sex: M
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: About 10 weeks post vax my PHN got bad; This spontaneous case was reported by a consumer and describes the occurrence of POST HERPETIC NEURALGIA (About 10 weeks post vax my PHN got bad) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Post herpetic neuralgia and Stenosis. 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 POST HERPETIC NEURALGIA (About 10 weeks post vax my PHN got bad). At the time of the report, POST HERPETIC NEURALGIA (About 10 weeks post vax my PHN got bad) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product were not provided/unknown. Treatment medication were not reported/unknown. Company Comment: Very limited information regarding the second vaccination dose has been provided at this time and insufficient to assess the temporal association. A causal relationship cannot be excluded. Additional information has been requested. Most recent FOLLOW-UP information incorporated above includes: On 05-Aug-2021: Significant Follow-up received on 06-aug-2021. patient details are updated; Sender's Comments: Very limited information regarding the second vaccination dose has been provided at this time and insufficient to assess the temporal association. A causal relationship cannot be excluded. Additional information has been requested.

Other Meds:

Current Illness:

ID: 1643684
Sex: M
Age:
State:

Vax Date: 06/25/2021
Onset Date: 06/26/2021
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: Burning in his feet ascending up his legs; severe pain; This spontaneous case was reported by a consumer and describes the occurrence of BURNING SENSATION (Burning in his feet ascending up his legs) and MYALGIA (severe pain) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 25-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Jun-2021, the patient experienced BURNING SENSATION (Burning in his feet ascending up his legs) and MYALGIA (severe pain). At the time of the report, BURNING SENSATION (Burning in his feet ascending up his legs) and MYALGIA (severe pain) outcome was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1643685
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Swollen lymph node on armpit; This spontaneous case was reported by a consumer and describes the occurrence of LYMPHADENOPATHY (Swollen lymph node on armpit) 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 LYMPHADENOPATHY (Swollen lymph node on armpit). At the time of the report, LYMPHADENOPATHY (Swollen lymph node on armpit) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication were reported. No treatment information was reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1643686
Sex: F
Age: 33
State: IL

Vax Date: 03/19/2021
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: Wife delayed the second dose because of early pregnancy/decided not to take 2nd covid vaccine after 28days; later she got conceived; This spontaneous pregnancy case was reported by a non-health professional and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Wife delayed the second dose because of early pregnancy/decided not to take 2nd covid vaccine after 28days) and PREGNANCY (later she got conceived) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) for COVID-19 vaccination. Concomitant products included LEVOTHYROXINE for an unknown indication. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on an unknown date and the estimated date of delivery was 17-Dec-2021. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Wife delayed the second dose because of early pregnancy/decided not to take 2nd covid vaccine after 28days) and PREGNANCY (later she got conceived). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Wife delayed the second dose because of early pregnancy/decided not to take 2nd covid vaccine after 28days) and PREGNANCY (later she got conceived) 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. Patient took her 1st COVID moderna vaccine on may 16th 2021 and later she got conceived and decided not to take 2nd covid vaccine after 28days.. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 28-Jun-2021: significant live follow up on 28-06-2021 was added.Email added was added.The date of first dose was changed which Is given as 16-05-2021.Events are added.

Other Meds: LEVOTHYROXINE

Current Illness:

ID: 1643687
Sex: F
Age: 39
State: CA

Vax Date: 05/25/2021
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: bruises in arm of vaccination; This spontaneous case was reported by a consumer and describes the occurrence of CONTUSION (bruises in arm of vaccination) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022B21A) for COVID-19 vaccination. No Medical History information was reported. On 25-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced CONTUSION (bruises in arm of vaccination). The patient was treated with IBUPROFEN at an unspecified dose and frequency. At the time of the report, CONTUSION (bruises in arm of vaccination) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication details was reported.

Other Meds:

Current Illness:

ID: 1643688
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: Second Dose Side Effects; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Second Dose Side Effects) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Second Dose Side Effects). At the time of the report, VACCINATION COMPLICATION (Second Dose Side Effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The concomitant medications information was not reported. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1643689
Sex: F
Age:
State: RI

Vax Date: 06/25/2021
Onset Date: 06/25/2021
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: An unauthorized age group patient received 1st dose of moderna vaccine instead of Pfizer vaccine; This spontaneous case was reported by an other health care professional and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (An unauthorized age group patient received 1st dose of moderna vaccine instead of Pfizer vaccine) in a 12-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053C21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Jun-2021 at 8:53 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Jun-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (An unauthorized age group patient received 1st dose of moderna vaccine instead of Pfizer vaccine). On 25-Jun-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (An unauthorized age group patient received 1st dose of moderna vaccine instead of Pfizer vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was reported. No treatment medication was reported. Most recent FOLLOW-UP information incorporated above includes: On 29-Jul-2021: Non significant follow up appended

Other Meds:

Current Illness:

ID: 1643690
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: RA

Lab Data:

Allergies:

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

Symptoms: Spot is red; Spot is itchy; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Spot is red) and PRURITUS (Spot is itchy) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ERYTHEMA (Spot is red) and PRURITUS (Spot is itchy). At the time of the report, ERYTHEMA (Spot is red) and PRURITUS (Spot is itchy) outcome was unknown.

Other Meds:

Current Illness:

ID: 1643691
Sex: F
Age: 96
State: IL

Vax Date: 01/21/2021
Onset Date: 02/15/2021
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: Her body is deteriorating; hard at hearing; She doesn't know what is happening; Tongue doesn't look right.; I have all of the symptoms after the vaccine; She has been experiencing pain; Her gums are sore; Her tongue is turning red; Her throat is sore now; inappropriate dose scheduling; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (Her throat is sore now), PAIN (She has been experiencing pain), GINGIVAL PAIN (Her gums are sore), TONGUE ERYTHEMA (Her tongue is turning red) and GENERAL PHYSICAL HEALTH DETERIORATION (Her body is deteriorating) in a 96-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Feb-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate dose scheduling). On 26-Jun-2021, the patient experienced OROPHARYNGEAL PAIN (Her throat is sore now). On 05-Jul-2021, the patient experienced PAIN (She has been experiencing pain), GINGIVAL PAIN (Her gums are sore) and TONGUE ERYTHEMA (Her tongue is turning red). On 26-Jul-2021, the patient experienced PARAESTHESIA ORAL (Tongue doesn't look right.) and DISCOMFORT (I have all of the symptoms after the vaccine). On an unknown date, the patient experienced GENERAL PHYSICAL HEALTH DETERIORATION (Her body is deteriorating), HYPOACUSIS (hard at hearing) and CONFUSIONAL STATE (She doesn't know what is happening). On 15-Feb-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate dose scheduling) had resolved. At the time of the report, OROPHARYNGEAL PAIN (Her throat is sore now), PAIN (She has been experiencing pain), GINGIVAL PAIN (Her gums are sore), TONGUE ERYTHEMA (Her tongue is turning red), GENERAL PHYSICAL HEALTH DETERIORATION (Her body is deteriorating), HYPOACUSIS (hard at hearing), CONFUSIONAL STATE (She doesn't know what is happening), PARAESTHESIA ORAL (Tongue doesn't look right.) and DISCOMFORT (I have all of the symptoms after the vaccine) outcome was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. On an unknown date, it was reported that the patient was administered the COVID-19 molecular test. The results were negative. Most recent FOLLOW-UP information incorporated above includes: On 26-Jul-2021: Follow-up recieved- Event updated , dose details updated

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am