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: 1644042
Sex: F
Age: 62
State: AR

Vax Date: 06/29/2021
Onset Date: 06/29/2021
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: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: arm is hurting; dry heaves; throwing up; headaches; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm is hurting), RETCHING (dry heaves), VOMITING (throwing up) and HEADACHE (headaches) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011DZIA) for COVID-19 vaccination. No Medical History information was reported. On 29-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jun-2021, the patient experienced PAIN IN EXTREMITY (arm is hurting), RETCHING (dry heaves), VOMITING (throwing up) and HEADACHE (headaches). At the time of the report, PAIN IN EXTREMITY (arm is hurting), RETCHING (dry heaves), VOMITING (throwing up) and HEADACHE (headaches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications reported. Treatment information not reported.

Other Meds:

Current Illness:

ID: 1644043
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever re-occurred after 4 days; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever re-occurred after 4 days) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 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 PYREXIA (Fever re-occurred after 4 days). At the time of the report, PYREXIA (Fever re-occurred after 4 days) had not 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: 1644044
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: someone received a third dose is that harmful; 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 EXTRA DOSE ADMINISTERED (someone received a third dose is that harmful) 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 EXTRA DOSE ADMINISTERED (someone received a third dose is that harmful). At the time of the report, EXTRA DOSE ADMINISTERED (someone received a third dose is that harmful) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Relevant concomitant medications was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1644045
Sex: M
Age: 58
State: NV

Vax Date: 06/05/2021
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: diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (diarrhea) in a 58-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009B21A) for COVID-19 vaccination. No Medical History information was reported. On 05-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 DIARRHOEA (diarrhea). The patient was treated with LOPERAMIDE HYDROCHLORIDE (IMODIUM) for Diarrhea, at a dose of UNK dosage form. At the time of the report, DIARRHOEA (diarrhea) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant drugs were reported.

Other Meds:

Current Illness:

ID: 1644046
Sex: U
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: "some of my friends had the same experience after their vaccine having severe diarrhea and nausea; experience hives on my back, on right shoulder; "some of my friends had the same experience after their vaccine having severe diarrhea and nausea; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA ("some of my friends had the same experience after their vaccine having severe diarrhea and nausea), URTICARIA (experience hives on my back, on right shoulder) and NAUSEA ("some of my friends had the same experience after their vaccine having severe diarrhea and nausea) 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 ("some of my friends had the same experience after their vaccine having severe diarrhea and nausea), URTICARIA (experience hives on my back, on right shoulder) and NAUSEA ("some of my friends had the same experience after their vaccine having severe diarrhea and nausea). At the time of the report, DIARRHOEA ("some of my friends had the same experience after their vaccine having severe diarrhea and nausea), URTICARIA (experience hives on my back, on right shoulder) and NAUSEA ("some of my friends had the same experience after their vaccine having severe diarrhea and nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. This case is a cluster case.

Other Meds:

Current Illness:

ID: 1644047
Sex: U
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: Terribly itchy; My arm has a rash; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Terribly itchy) and RASH (My arm has a rash) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRURITUS (Terribly itchy) and RASH (My arm has a rash). At the time of the report, PRURITUS (Terribly itchy) and RASH (My arm has a rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported by reporter. No treatment medication was reported by reporter. Patient had adverse events a week after the first shot.

Other Meds:

Current Illness:

ID: 1644048
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: Pyrexia, White blood cell count decreased

Symptoms: losing clumps of hair/hair loss; This spontaneous case was reported by a consumer and describes the occurrence of ALOPECIA (losing clumps of hair/hair loss) 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 ALOPECIA (losing clumps of hair/hair loss). At the time of the report, ALOPECIA (losing clumps of hair/hair loss) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Relevant concomitant medications was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1644049
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: Pharyngeal swelling

Symptoms: I am not feeling well today; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (I am not feeling well today) 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 MALAISE (I am not feeling well today). At the time of the report, MALAISE (I am not feeling well today) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1644050
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: sore arm; sick; chills; throwing up almost everyday for a month; This spontaneous case was reported by an other health care professional and describes the occurrence of PAIN IN EXTREMITY (sore arm), ILLNESS (sick), CHILLS (chills) and VOMITING (throwing up almost everyday for a month) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (sore arm), ILLNESS (sick), CHILLS (chills) and VOMITING (throwing up almost everyday for a month). At the time of the report, PAIN IN EXTREMITY (sore arm), ILLNESS (sick), CHILLS (chills) and VOMITING (throwing up almost everyday for a month) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product information was not provided. Treatment information was not provided. This case was linked to MOD-2021-242091 (Patient Link).

Other Meds:

Current Illness:

ID: 1644051
Sex: U
Age:
State:

Vax Date: 06/18/2021
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: Bad stomach pain; Achy upper shoulder; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (Bad stomach pain) and ARTHRALGIA (Achy upper shoulder) 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 Breast cancer (Patient stated that recently in march beat breast cancer.And did 27 radiation treatments a month an a half ago. Still fatigued from that.). On 18-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ABDOMINAL PAIN UPPER (Bad stomach pain) and ARTHRALGIA (Achy upper shoulder). At the time of the report, ABDOMINAL PAIN UPPER (Bad stomach pain) and ARTHRALGIA (Achy upper shoulder) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1644052
Sex: F
Age:
State: FL

Vax Date: 03/03/2021
Onset Date: 06/29/2021
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: Test Date: 20210629; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive

Allergies:

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

Symptoms: Lack of Drug Effect; COVID-19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (COVID-19) and DRUG INEFFECTIVE (Lack of Drug Effect) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 003B21A and 014MOA) for COVID-19 vaccination. Concomitant products included ESCITALOPRAM OXALATE (LEXAPRO) for an unknown indication. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 29-Jun-2021, the patient experienced COVID-19 (COVID-19). On an unknown date, the patient experienced DRUG INEFFECTIVE (Lack of Drug Effect). At the time of the report, COVID-19 (COVID-19) and DRUG INEFFECTIVE (Lack of Drug Effect) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 29-Jun-2021, SARS-CoV-2 test: positive (Positive) Positive. Patient was exposed to COVID-19 on 20-Jun-2021 and tested positive on 29-Jun-2021. She had nausea and loss of smell as COVID-19 symptoms. No treatment information was provided. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the mRNA-1273 in response to the events was not applicable. This is a case of lack of efficacy of the vaccine with an associated adverse event of Covid-19, therefore causal association between the event is assessed as not applicable.; Sender's Comments: This is a case of lack of efficacy of the vaccine with an associated adverse event of Covid-19, therefore causal association between the event is assessed as not applicable.

Other Meds: LEXAPRO

Current Illness:

ID: 1644053
Sex: U
Age:
State:

Vax Date: 04/21/2021
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: second dose administrated 55 days after 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 INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose administrated 55 days after 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 21-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose administrated 55 days after first dose). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose administrated 55 days after first dose) outcome was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1644054
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: Sore arm; This spontaneous case was reported by a health care professional and describes the occurrence of PAIN IN EXTREMITY (Sore arm) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm). At the time of the report, PAIN IN EXTREMITY (Sore arm) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product information, if any, was not provided by the reporter. Treatment information, if any, was not provided This case was linked to MOD-2021-242072 (Patient Link).

Other Meds:

Current Illness:

ID: 1644055
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: Test Name: Body temperature

Allergies:

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

Symptoms: chilss; body aches; headache; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (chilss), MYALGIA (body aches) 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 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 (chilss), MYALGIA (body aches) and HEADACHE (headache). At the time of the report, CHILLS (chilss), MYALGIA (body aches) and HEADACHE (headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100.8 High.

Other Meds:

Current Illness:

ID: 1644056
Sex: U
Age:
State:

Vax Date: 04/21/2021
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: first vac was in 4/21 is it too late for 2nd; Sick or in hosp; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (first vac was in 4/21 is it too late for 2nd) and ILLNESS (Sick or in hosp) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 21-Apr-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 (first vac was in 4/21 is it too late for 2nd) and ILLNESS (Sick or in hosp). At the time of the report, PRODUCT DOSE OMISSION ISSUE (first vac was in 4/21 is it too late for 2nd) had resolved and ILLNESS (Sick or in hosp) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient stated that she need her 2nd Moderna vaccine. Each time she tried she ended up sick or in hospital. No concomitant medications were provided. No treatment information were given.

Other Meds:

Current Illness:

ID: 1644057
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: residual leg pain; bilat leg stiffnes; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (residual leg pain) and MUSCULOSKELETAL STIFFNESS (bilat leg stiffnes) 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 PAIN IN EXTREMITY (residual leg pain) and MUSCULOSKELETAL STIFFNESS (bilat leg stiffnes). At the time of the report, PAIN IN EXTREMITY (residual leg pain) and MUSCULOSKELETAL STIFFNESS (bilat leg stiffnes) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product information was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1644058
Sex: F
Age: 57
State: OK

Vax Date: 03/26/2021
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: full body rash; covid arm; itchy at rash area; This spontaneous case was reported by a consumer and describes the occurrence of RASH (full body rash), VACCINATION SITE REACTION (covid arm) and RASH PRURITIC (itchy at rash area) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002B21A and 021B21A) for COVID-19 vaccination. Concurrent medical conditions included Psoriasis (Psoriasis has been under control until the vaccine) and Autoimmune disorder. Concomitant products included AMITRIPTYLINE for Sleep disorder NOS, LORATADINE, FUROSEMIDE, SPIRONOLACTONE, VITAMINS NOS, COLLAGEN, MAGNESIUM, POTASSIUM, VITAMIN D3, ZINC, CRAMP BARK and MELATONIN for an unknown indication, BIOTIN. On 26-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 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 RASH (full body rash), VACCINATION SITE REACTION (covid arm) and RASH PRURITIC (itchy at rash area). The patient was treated with PREDNISONE at a dose of two rounds of Prednisone. At the time of the report, RASH (full body rash), VACCINATION SITE REACTION (covid arm) and RASH PRURITIC (itchy at rash area) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Treatment medication includes Antihistamines was provided. This case was linked to MOD-2021-242114 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 08-Jul-2021: Significant : patient Gender and event related information.

Other Meds: LORATADINE; AMITRIPTYLINE; FUROSEMIDE; SPIRONOLACTONE; VITAMINS NOS; COLLAGEN; MAGNESIUM; BIOTIN; POTASSIUM; VITAMIN D3; ZINC; CRAMP BARK; MELATONIN

Current Illness: Autoimmune disorder; Psoriasis (Psoriasis has been under control until the vaccine)

ID: 1644059
Sex: U
Age:
State:

Vax Date: 06/28/2021
Onset Date: 06/01/2021
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: I have been feeling really off; Anxious; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (I have been feeling really off) and ANXIETY (Anxious) 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 28-Jun-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In June 2021, the patient experienced FEELING ABNORMAL (I have been feeling really off) and ANXIETY (Anxious). At the time of the report, FEELING ABNORMAL (I have been feeling really off) and ANXIETY (Anxious) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product information was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1644060
Sex: F
Age: 57
State: OK

Vax Date: 03/26/2021
Onset Date: 07/07/2021
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: itchy at rash area; Full body rash; hematoma is underneath; She states that the vaccine activated her psoriasis; both of her forearms were just itching like crazy; She looked at her elbows and it looks like a blister is underneath; This spontaneous case was reported by a consumer and describes the occurrence of HAEMATOMA INFECTION (hematoma is underneath), PSORIASIS (She states that the vaccine activated her psoriasis), PRURITUS (both of her forearms were just itching like crazy), BLISTER (She looked at her elbows and it looks like a blister is underneath) and RASH PRURITIC (itchy at rash area) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Autoimmune disorder and Psoriasis. Concomitant products included AMITRIPTYLINE for Sleep problem, LORATADINE, FUROSEMIDE, SPIRONOLACTONE, VITAMINS NOS, COLLAGEN, MAGNESIUM, BIOTIN, POTASSIUM, VITAMIN D3, ZINC, VIBURNUM OPULUS BARK (CRAMP BARK) and MELATONIN for an unknown indication. On 26-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-Jul-2021, the patient experienced HAEMATOMA INFECTION (hematoma is underneath), PSORIASIS (She states that the vaccine activated her psoriasis), PRURITUS (both of her forearms were just itching like crazy) and BLISTER (She looked at her elbows and it looks like a blister is underneath). On an unknown date, the patient experienced RASH PRURITIC (itchy at rash area) and RASH (Full body rash). The patient was treated with PREDNISONE at an unspecified dose and frequency. At the time of the report, HAEMATOMA INFECTION (hematoma is underneath), PSORIASIS (She states that the vaccine activated her psoriasis), PRURITUS (both of her forearms were just itching like crazy), BLISTER (She looked at her elbows and it looks like a blister is underneath), RASH PRURITIC (itchy at rash area) and RASH (Full body rash) outcome was unknown. Patient weight provided as 175, with no unit. Patient was treated with two doses of prednisone, Antihistamine and Listerine. Patient was given antihistamines, but symptoms just keeps getting worse and the rash was spreading all over. Patient had autoimmune disorder and psoriasis at baseline and did not take any medications for these conditions. This case was linked to MOD-2021-242099 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 08-Jul-2021: Follow-up received that included added events, concomitant medications, patent weight, treatment information

Other Meds: LORATADINE; AMITRIPTYLINE; FUROSEMIDE; SPIRONOLACTONE; VITAMINS NOS; COLLAGEN; MAGNESIUM; BIOTIN; POTASSIUM; VITAMIN D3; ZINC; CRAMP BARK; MELATONIN

Current Illness: Autoimmune disorder; Psoriasis

ID: 1644061
Sex: U
Age:
State:

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:

Allergies:

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

Symptoms: So I just got my 2 nd dose and now I am experiencing left ear pain.; This spontaneous case was reported by a consumer and describes the occurrence of EAR PAIN (So I just got my 2 nd dose and now I am experiencing left ear pain.) 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 (no medical history 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 EAR PAIN (So I just got my 2 nd dose and now I am experiencing left ear pain.). At the time of the report, EAR PAIN (So I just got my 2 nd dose and now I am experiencing left ear pain.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was not applicable.

Other Meds:

Current Illness:

ID: 1644062
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: Small Lump at the Injection Site months after the injection; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE MASS (Small Lump at the Injection Site months after the injection) 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. In 2021, the patient experienced VACCINATION SITE MASS (Small Lump at the Injection Site months after the injection). At the time of the report, VACCINATION SITE MASS (Small Lump at the Injection Site months after the injection) 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: 1644063
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: Unevaluable event

Symptoms: Muscle aches are so intense that I can't stand for long; fever doesn't stop.; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Muscle aches are so intense that I can't stand for long) and PYREXIA (fever doesn't stop.) 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) 2 dosage form. On an unknown date, the patient experienced MYALGIA (Muscle aches are so intense that I can't stand for long) and PYREXIA (fever doesn't stop.). At the time of the report, MYALGIA (Muscle aches are so intense that I can't stand for long) and PYREXIA (fever doesn't stop.) outcome was unknown. No concomitant medication were reported. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1644064
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: 38 days apart; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (38 days apart) 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 INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (38 days apart). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (38 days apart) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medications was provided by the reporter. No Treatment medications was provided by the reporter.

Other Meds:

Current Illness:

ID: 1644065
Sex: F
Age:
State: FL

Vax Date: 05/06/2021
Onset Date: 06/30/2021
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:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient missed the time frame between the both doses of Moderna COVID-19 vaccine; Stomach flu; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Patient missed the time frame between the both doses of Moderna COVID-19 vaccine) and GASTROENTERITIS VIRAL (Stomach flu) 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 06-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Jun-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Patient missed the time frame between the both doses of Moderna COVID-19 vaccine) and GASTROENTERITIS VIRAL (Stomach flu). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Patient missed the time frame between the both doses of Moderna COVID-19 vaccine) and GASTROENTERITIS VIRAL (Stomach flu) 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 product information was not provided. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 30-Jun-2021: added patient demographics, updated first dose details, added adverse event, updated adverse event detail

Other Meds:

Current Illness:

ID: 1644066
Sex: U
Age:
State: AZ

Vax Date: 06/26/2021
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: Pain; Itchy rash; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Pain) and RASH PRURITIC (Itchy rash) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 26-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN (Pain) and RASH PRURITIC (Itchy rash). At the time of the report, PAIN (Pain) and RASH PRURITIC (Itchy rash) outcome was unknown. No concomitant medications were provided by the reporter. No treatment information was provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 31-Jul-2021: Follow-up received on 31-Jul-2021, indicated reporter's address, no other new information was provided.

Other Meds:

Current Illness:

ID: 1644067
Sex: F
Age: 54
State: AR

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Was very sick for a day; Really bad diarrhea for 12 hours; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Was very sick for a day), DIARRHOEA (Really bad diarrhea for 12 hours) and NAUSEA (Nausea) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026B21A) for COVID-19 vaccination. Concurrent medical conditions included Migraine. Concomitant products included TIZANIDINE for Migraine, TRAZODONE for Sleep disorder, OXYBUTYNIN CHLORIDE, TOPIRAMATE, MONTELUKAST SODIUM, ALPRAZOLAM, PANTOPRAZOLE SODIUM, ARIPIPRAZOLE, DESVENLAFAXINE SUCCINATE MONOHYDRATE (PRISTIQ), ESTRADIOL, VALPROATE SEMISODIUM (DIVALPROEX), GABAPENTIN, TRAMADOL and PRAZOSIN for an unknown indication. On 25-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-May-2021, the patient experienced ILLNESS (Was very sick for a day), DIARRHOEA (Really bad diarrhea for 12 hours) and NAUSEA (Nausea). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, ILLNESS (Was very sick for a day), DIARRHOEA (Really bad diarrhea for 12 hours) and NAUSEA (Nausea) 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. This case was linked to MOD-2021-242179 (Patient Link).

Other Meds: TRAZODONE; TIZANIDINE; OXYBUTYNIN CHLORIDE; TOPIRAMATE; MONTELUKAST SODIUM; ALPRAZOLAM; PANTOPRAZOLE SODIUM; ARIPIPRAZOLE; PRISTIQ; ESTRADIOL; DIVALPROEX; GABAPENTIN; TRAMADOL; PRAZOSIN

Current Illness: Migraine

ID: 1644068
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: missed 2nd dose and it's been 4 months; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (missed 2nd dose and it's been 4 months) 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 PRODUCT DOSE OMISSION ISSUE (missed 2nd dose and it's been 4 months). At the time of the report, PRODUCT DOSE OMISSION ISSUE (missed 2nd dose and it's been 4 months) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided. No treatment medications were provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1644069
Sex: F
Age: 59
State: PA

Vax Date: 04/28/2021
Onset Date: 04/28/2021
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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Panic attack; Impaired work ability; Anxiety; She did not receive the 2nd dose between day 25-35 of getting the 1st dose; This spontaneous case was reported by a consumer and describes the occurrence of ANXIETY (Anxiety), PANIC ATTACK (Panic attack), IMPAIRED WORK ABILITY (Impaired work ability) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (She did not receive the 2nd dose between day 25-35 of getting the 1st dose) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021B21A) for COVID-19 vaccination. No Medical History information was reported. On 28-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Apr-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (She did not receive the 2nd dose between day 25-35 of getting the 1st dose). In May 2021, the patient experienced ANXIETY (Anxiety). On an unknown date, the patient experienced PANIC ATTACK (Panic attack) and IMPAIRED WORK ABILITY (Impaired work ability). The patient was treated with SERTRALINE HYDROCHLORIDE (ZOLOFT) at an unspecified dose and frequency and LORAZEPAM at an unspecified dose and frequency. On 28-Apr-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (She did not receive the 2nd dose between day 25-35 of getting the 1st dose) had resolved. At the time of the report, ANXIETY (Anxiety) had not resolved and PANIC ATTACK (Panic attack) and IMPAIRED WORK ABILITY (Impaired work ability) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered ANXIETY (Anxiety), PANIC ATTACK (Panic attack) and IMPAIRED WORK ABILITY (Impaired work ability) to be possibly related. No further causality assessment was provided for INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (She did not receive the 2nd dose between day 25-35 of getting the 1st dose). Concomitant product use was not provided. Treatment information was not reported. Based on the current available information and temporal association between the use of the product and the start date of the events anxiety, panic attack and impaired work ability, a causal relationship cannot be excluded. This report, also, refers to a case of inappropriate schedule of vaccine administration for mRNA-1273, lot # 021B21A..; 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 anxiety, panic attack and impaired work ability, a causal relationship cannot be excluded. This report, also, refers to a case of inappropriate schedule of vaccine administration for mRNA-1273, lot # 021B21A.

Other Meds:

Current Illness:

ID: 1644070
Sex: M
Age:
State: CA

Vax Date: 01/07/2021
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: Intestinal distress; Gas; Diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN (Intestinal distress), FLATULENCE (Gas) and DIARRHOEA (Diarrhea) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007M20A and 039K20A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included EPINEPHRINE (EPIPEN) for Bee sting. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Feb-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 ABDOMINAL PAIN (Intestinal distress), FLATULENCE (Gas) and DIARRHOEA (Diarrhea). At the time of the report, ABDOMINAL PAIN (Intestinal distress), FLATULENCE (Gas) and DIARRHOEA (Diarrhea) outcome was unknown. No treatment medications were reported. Action taken with mRNA-1273 in response to the events was not applicable. He had experienced similar side effects as the 1st dose after the 2nd dose. This case was linked to MOD-2021-006269 (Patient Link).

Other Meds: EPIPEN

Current Illness:

ID: 1644071
Sex: U
Age:
State: RI

Vax Date: 06/24/2021
Onset Date: 06/24/2021
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: Nausea

Symptoms: received the Moderna Covid-19 vaccine more than 12 hours after the vial was punctured; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (received the Moderna Covid-19 vaccine more than 12 hours after the vial was punctured) 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 24-Jun-2021 at 8:00 AM, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Jun-2021 at 8:00 AM, the patient experienced EXPIRED PRODUCT ADMINISTERED (received the Moderna Covid-19 vaccine more than 12 hours after the vial was punctured). At the time of the report, EXPIRED PRODUCT ADMINISTERED (received the Moderna Covid-19 vaccine more than 12 hours after the vial was punctured) 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 unknown. This case concerns 4 patients.

Other Meds:

Current Illness:

ID: 1644072
Sex: F
Age: 54
State: AR

Vax Date: 05/25/2021
Onset Date: 06/24/2021
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: Runny nose; A rash 2 inches below the injection site; Very hot; Red; Bad headache; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (Very hot), ERYTHEMA (Red), RHINORRHOEA (Runny nose), VACCINATION SITE RASH (A rash 2 inches below the injection site) and HEADACHE (Bad headache) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 208C21A and 026B21A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no medical history reported ). Concomitant products included TRAZODONE, TIZANIDINE, OXYBUTYNIN CHLORIDE, TOPIRAMATE, MONTELUKAST SODIUM, ALPRAZOLAM, PANTOPRAZOLE SODIUM, ARIPIPRAZOLE, DESVENLAFAXINE SUCCINATE MONOHYDRATE (PRISTIQ), ESTRADIOL, VALPROATE SEMISODIUM (DIVALPROEX), GABAPENTIN, TRAMADOL and PRAZOSIN for an unknown indication. On 25-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Jun-2021, the patient experienced HEADACHE (Bad headache). On 29-Jun-2021, the patient experienced FEELING HOT (Very hot), ERYTHEMA (Red) and VACCINATION SITE RASH (A rash 2 inches below the injection site). On an unknown date, the patient experienced RHINORRHOEA (Runny nose). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form and CORTISONE at a dose of Cream. At the time of the report, FEELING HOT (Very hot), ERYTHEMA (Red), RHINORRHOEA (Runny nose), VACCINATION SITE RASH (A rash 2 inches below the injection site) and HEADACHE (Bad headache) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds: TRAZODONE; TIZANIDINE; OXYBUTYNIN CHLORIDE; TOPIRAMATE; MONTELUKAST SODIUM; ALPRAZOLAM; PANTOPRAZOLE SODIUM; ARIPIPRAZOLE; PRISTIQ; ESTRADIOL; DIVALPROEX; GABAPENTIN; TRAMADOL; PRAZOSIN

Current Illness:

ID: 1644073
Sex: F
Age: 33
State: AZ

Vax Date: 05/31/2021
Onset Date: 05/31/2021
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: pain, and soreness in the injection site arm; fatigue; chills; Soreness in the Injection site arm; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (pain, and soreness in the injection site arm), FATIGUE (fatigue), CHILLS (chills) and VACCINATION SITE PAIN (Soreness in the Injection site arm) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036C21A) for COVID-19 vaccination. No Medical History information was reported. On 31-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-May-2021, the patient experienced MYALGIA (pain, and soreness in the injection site arm), FATIGUE (fatigue), CHILLS (chills) and VACCINATION SITE PAIN (Soreness in the Injection site arm). On 02-Jun-2021, MYALGIA (pain, and soreness in the injection site arm), FATIGUE (fatigue), CHILLS (chills) and VACCINATION SITE PAIN (Soreness in the Injection site arm) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant drug details were reported. No treatment details were reported. This case was linked to MOD-2021-242276 (Patient Link).

Other Meds:

Current Illness:

ID: 1644074
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: feeling symptomatic after my second dose; This spontaneous case was reported by an other health care professional and describes the occurrence of VACCINATION COMPLICATION (feeling symptomatic after my 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 second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (feeling symptomatic after my second dose). At the time of the report, VACCINATION COMPLICATION (feeling symptomatic after my second dose) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product information was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1644075
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Are people experiencing respiratory issues weeks after getting the vaccine?; 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 RESPIRATORY SYMPTOM (Are people experiencing respiratory issues weeks after getting the vaccine?) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced RESPIRATORY SYMPTOM (Are people experiencing respiratory issues weeks after getting the vaccine?). At the time of the report, RESPIRATORY SYMPTOM (Are people experiencing respiratory issues weeks after getting the vaccine?) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient's information were not provided. Concomitant medications were not provided. Treatment medications was not given.

Other Meds:

Current Illness:

ID: 1644076
Sex: F
Age: 45
State: NY

Vax Date: 06/30/2021
Onset Date: 06/30/2021
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: Erythema, Pruritus

Symptoms: arm went numb down to the tips of my fingers/Felt like circulation in my forearm down to my fingers had been cut off/As soon as he injected me with the vaccine, my arm went numb; experienced something very strange/very strange feeling/every now and then I get the weird sensation that it's getting numb again; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (arm went numb down to the tips of my fingers/Felt like circulation in my forearm down to my fingers had been cut off/As soon as he injected me with the vaccine, my arm went numb) and FEELING ABNORMAL (experienced something very strange/very strange feeling/every now and then I get the weird sensation that it's getting numb again) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 051C21A) for COVID-19 vaccination. The medical history was not provided by the reporter. Concomitant products included BUPROPION HYDROCHLORIDE (WELLBUTRIN) for an unknown indication. On 30-Jun-2021 at 11:20 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Jun-2021, the patient experienced HYPOAESTHESIA (arm went numb down to the tips of my fingers/Felt like circulation in my forearm down to my fingers had been cut off/As soon as he injected me with the vaccine, my arm went numb) and FEELING ABNORMAL (experienced something very strange/very strange feeling/every now and then I get the weird sensation that it's getting numb again). At the time of the report, HYPOAESTHESIA (arm went numb down to the tips of my fingers/Felt like circulation in my forearm down to my fingers had been cut off/As soon as he injected me with the vaccine, my arm went numb) and FEELING ABNORMAL (experienced something very strange/very strange feeling/every now and then I get the weird sensation that it's getting numb again) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information, if any, was not provided Most recent FOLLOW-UP information incorporated above includes: On 30-Jun-2021: Addition information included primary reporter address, patient details, Added suspect dose batch number, date and route of administration, Added concomitant medicine, Added event dates and outcome.

Other Meds: WELLBUTRIN

Current Illness:

ID: 1644077
Sex: U
Age:
State: MI

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: Eye pain after the shot; 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 EYE PAIN (Eye pain after the shot) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced EYE PAIN (Eye pain after the shot). At the time of the report, EYE PAIN (Eye pain after the shot) outcome was unknown. 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: 1644078
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: 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: A 15 year old patient received the moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (A 15 year old patient received the moderna vaccine) in a 15-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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage form. On an unknown date, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (A 15 year old patient received the moderna vaccine). At the time of the report, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (A 15 year old patient received the moderna vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Relevant concomitant medications was reported. Treatment information was not provided. Reporter did not allow further contact.

Other Meds:

Current Illness:

ID: 1644079
Sex: M
Age:
State:

Vax Date: 01/01/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: wondering if I should get my Vaccine again, because my white blood cell; This spontaneous case was reported by a consumer and describes the occurrence of WHITE BLOOD CELL DISORDER (wondering if I should get my Vaccine again, because my white blood cell) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. The patient's past medical history included Stem cell transplant. Concurrent medical conditions included Cancer. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In February 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 WHITE BLOOD CELL DISORDER (wondering if I should get my Vaccine again, because my white blood cell). At the time of the report, WHITE BLOOD CELL DISORDER (wondering if I should get my Vaccine again, because my white blood cell) outcome was unknown. Concomitant medication was not provided by reporter. No treatment information was provided by the reporter aside from massive chemotherapy last year. Action taken in response to mRNA-1273 was not applicable

Other Meds:

Current Illness: Cancer

ID: 1644080
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: Facial numbness; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (Facial numbness) 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 HYPOAESTHESIA (Facial numbness). At the time of the report, HYPOAESTHESIA (Facial numbness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided No treatment information was reported

Other Meds:

Current Illness:

ID: 1644081
Sex: F
Age: 33
State: AZ

Vax Date: 05/31/2021
Onset Date: 06/29/2021
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: Test Date: 20210629; Test Name: Heart rate; Result Unstructured Data: heart is racing

Allergies:

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

Symptoms: Injection site arm hot/feeling like I am burning up inside; Aanxiety; Nauseous; Sore injection site arm; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (Injection site arm hot/feeling like I am burning up inside), ANXIETY (Aanxiety), NAUSEA (Nauseous) and VACCINATION SITE PAIN (Sore injection site arm) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039D21A and 036C21A) for COVID-19 vaccination. No Medical History information was reported. On 31-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 29-Jun-2021, the patient experienced FEELING HOT (Injection site arm hot/feeling like I am burning up inside), ANXIETY (Aanxiety), NAUSEA (Nauseous) and VACCINATION SITE PAIN (Sore injection site arm). At the time of the report, FEELING HOT (Injection site arm hot/feeling like I am burning up inside), ANXIETY (Aanxiety), NAUSEA (Nauseous) and VACCINATION SITE PAIN (Sore injection site arm) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 29-Jun-2021, Heart rate: increased (High) heart is racing. Concomitant medication list was not provided. Treatment information was not provided. It was reported that the patient's arm was very sore and hot for which she needed to ice her arm. This case was linked to MOD-2021-242206 (Patient Link).

Other Meds:

Current Illness:

ID: 1644082
Sex: F
Age: 34
State: NY

Vax Date: 03/22/2021
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:

Allergies:

Symptom List: Pain in extremity

Symptoms: chills; Headache; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (chills) and HEADACHE (Headache) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038A21A) for COVID-19 vaccination. No Medical History information was reported. On 22-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-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 CHILLS (chills) and HEADACHE (Headache). At the time of the report, CHILLS (chills) and HEADACHE (Headache) outcome was unknown. No treatment details were reported. No concomitant medications were reported. Action taken with mRNA-1273 in response to the events was not Applicable.

Other Meds:

Current Illness:

ID: 1644083
Sex: F
Age: 63
State: PA

Vax Date: 06/02/2021
Onset Date: 06/02/2021
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: lot of arm soreness for the first 3 days; first day it was hard to lift the arm up; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (lot of arm soreness for the first 3 days) and MOBILITY DECREASED (first day it was hard to lift the arm up) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included CORTISONE for an unknown indication. On 02-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Jun-2021, the patient experienced PAIN IN EXTREMITY (lot of arm soreness for the first 3 days) and MOBILITY DECREASED (first day it was hard to lift the arm up). On 02-Jun-2021, MOBILITY DECREASED (first day it was hard to lift the arm up) had resolved. On 05-Jun-2021, PAIN IN EXTREMITY (lot of arm soreness for the first 3 days) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.

Other Meds: CORTISONE

Current Illness:

ID: 1644084
Sex: F
Age: 52
State: NC

Vax Date: 04/14/2021
Onset Date: 04/14/2021
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: The patient has not received the second dose; severe rash/rash 4 inches by 4 inches in size; joint pain; headache; itchy rash; red rash; hives; extreme dizziness; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (extreme dizziness), RASH PRURITIC (itchy rash), RASH ERYTHEMATOUS (red rash), URTICARIA (hives) and PRODUCT DOSE OMISSION ISSUE (The patient has not received the second dose) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Allergy to antibiotic and Drug allergy (epinephrine). On 14-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Apr-2021, the patient experienced DIZZINESS (extreme dizziness). On 20-Apr-2021, the patient experienced RASH PRURITIC (itchy rash), RASH ERYTHEMATOUS (red rash), URTICARIA (hives), RASH (severe rash/rash 4 inches by 4 inches in size), ARTHRALGIA (joint pain) and HEADACHE (headache). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (The patient has not received the second dose). At the time of the report, DIZZINESS (extreme dizziness), RASH PRURITIC (itchy rash), RASH ERYTHEMATOUS (red rash), URTICARIA (hives), PRODUCT DOSE OMISSION ISSUE (The patient has not received the second dose), RASH (severe rash/rash 4 inches by 4 inches in size), ARTHRALGIA (joint pain) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported No treatment medications were reported for mRNA-1273 (Moderna COVID-19 Vaccine) (intramuscular), the reporter did not provide any causality assessment.

Other Meds:

Current Illness: Allergy to antibiotic; Drug allergy (epinephrine)

ID: 1644085
Sex: F
Age: 55
State: WA

Vax Date: 06/22/2021
Onset Date: 06/22/2021
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: weakness in arm; Whole arm was affected,including shoulder and elbow soreness; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULAR WEAKNESS (weakness in arm) and MYALGIA (Whole arm was affected,including shoulder and elbow soreness) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 051C21A) for COVID-19 vaccination. No Medical History information was reported. On 22-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Jun-2021, the patient experienced MUSCULAR WEAKNESS (weakness in arm) and MYALGIA (Whole arm was affected,including shoulder and elbow soreness). The patient was treated with IBUPROFEN at a dose of 1 dosage form. At the time of the report, MUSCULAR WEAKNESS (weakness in arm) and MYALGIA (Whole arm was affected,including shoulder and elbow soreness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant products were reported.

Other Meds:

Current Illness:

ID: 1644086
Sex: F
Age:
State: FL

Vax Date: 05/26/2021
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: weakness; light headiness; super super sore injection arm; headache; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (weakness), DIZZINESS (light headiness), VACCINATION SITE PAIN (super super sore injection arm) and HEADACHE (headache) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 26-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 ASTHENIA (weakness), DIZZINESS (light headiness), VACCINATION SITE PAIN (super super sore injection arm) and HEADACHE (headache). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. At the time of the report, ASTHENIA (weakness), DIZZINESS (light headiness), VACCINATION SITE PAIN (super super sore injection arm) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant products were reported. This case was linked to MOD-2021-242373 (Patient Link).

Other Meds:

Current Illness:

ID: 1644087
Sex: U
Age:
State:

Vax Date: 06/29/2021
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: Eye irritation; This spontaneous case was reported by a consumer and describes the occurrence of EYE IRRITATION (Eye irritation) 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 29-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 EYE IRRITATION (Eye irritation). At the time of the report, EYE IRRITATION (Eye irritation) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

Other Meds:

Current Illness:

ID: 1644088
Sex: F
Age: 68
State: NY

Vax Date: 04/20/2021
Onset Date: 04/20/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: I felt tingling in my fingers; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (I felt tingling in my fingers) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039B21A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension and Cholesterol. Concomitant products included LOSARTAN for Blood pressure, LOVASTATIN for Cholesterol. On 20-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Apr-2021, the patient experienced PARAESTHESIA (I felt tingling in my fingers). At the time of the report, PARAESTHESIA (I felt tingling in my fingers) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment medication was reported. This case was linked to MOD-2021-242471 (Patient Link).

Other Meds: LOVASTATIN; LOSARTAN

Current Illness: Cholesterol; Hypertension

ID: 1644089
Sex: F
Age: 67
State: MI

Vax Date: 02/17/2021
Onset Date: 02/17/2021
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: felt fuzzy; She reports that after the first shot she had a sore arm; little tired; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (felt fuzzy), MYALGIA (She reports that after the first shot she had a sore arm) and FATIGUE (little tired) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023M20A) for COVID-19 vaccination. Concomitant products included ATORVASTATIN for Arterial disorder, MACROGOL 3350 (MIRALAX) for an unknown indication. On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Feb-2021, the patient experienced FEELING ABNORMAL (felt fuzzy), MYALGIA (She reports that after the first shot she had a sore arm) and FATIGUE (little tired). At the time of the report, FEELING ABNORMAL (felt fuzzy), MYALGIA (She reports that after the first shot she had a sore arm) and FATIGUE (little tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information were provided. This case was linked to MOD-2021-242413 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 10-Aug-2021: Follow up received and patient contact information updated.

Other Meds: ATORVASTATIN; MIRALAX

Current Illness:

ID: 1644090
Sex: F
Age:
State: NC

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: "caught covid"; 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 COVID-19 ("caught covid") in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (no medical history 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 ("caught covid"). At the time of the report, COVID-19 ("caught covid") outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1644091
Sex: F
Age:
State: FL

Vax Date: 06/29/2021
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: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: weakness; light headiness; super super sore injection arm; headache; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (weakness), DIZZINESS (light headiness), VACCINATION SITE PAIN (super super sore injection arm) and HEADACHE (headache) in a female 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 29-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced ASTHENIA (weakness), DIZZINESS (light headiness), VACCINATION SITE PAIN (super super sore injection arm) and HEADACHE (headache). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. At the time of the report, ASTHENIA (weakness), DIZZINESS (light headiness), VACCINATION SITE PAIN (super super sore injection arm) and HEADACHE (headache) outcome was unknown. Concomitant medication included anti-depressant in which the product used for unknown indication. This case was linked to MOD-2021-242327 (Patient Link).

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am