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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1644092
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: i had a cough for a week now at times i cough up mucous; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCTIVE COUGH (i had a cough for a week now at times i cough up mucous) 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 PRODUCTIVE COUGH (i had a cough for a week now at times i cough up mucous). The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1644093
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: a patient received an expired vaccine; 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 (a patient received an expired vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced EXPIRED PRODUCT ADMINISTERED (a patient received an expired vaccine). At the time of the report, EXPIRED PRODUCT ADMINISTERED (a patient received an expired vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medication was reported. Pharmacist stated that a patient received an expired vaccine, and wanted to know if he could repeat the dose. No associated adverse events were reported. No treatment medication was reported.

Other Meds:

Current Illness:

ID: 1644094
Sex: U
Age:
State:

Vax Date: 05/03/2021
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: throbbing pain in the arm; heavy and sleepy arm; pain at the injection site similar to the pain experienced two or three days after receiving the second dose; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (throbbing pain in the arm), LIMB DISCOMFORT (heavy and sleepy arm) and VACCINATION SITE PAIN (pain at the injection site similar to the pain experienced two or three days after receiving the second dose) in a patient of an unknown age and gender who received mRNA-1273 (COVID 19 Vaccine Moderna) for COVID-19 vaccination. No Medical History information was reported. On 03-May-2021, the patient received first dose of mRNA-1273 (COVID 19 Vaccine Moderna) (unknown route) 1 dosage form. On 02-Jun-2021, received second dose of mRNA-1273 (COVID 19 Vaccine Moderna) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (throbbing pain in the arm), LIMB DISCOMFORT (heavy and sleepy arm) and VACCINATION SITE PAIN (pain at the injection site similar to the pain experienced two or three days after receiving the second dose). At the time of the report, PAIN IN EXTREMITY (throbbing pain in the arm), LIMB DISCOMFORT (heavy and sleepy arm) and VACCINATION SITE PAIN (pain at the injection site similar to the pain experienced two or three days after receiving the second dose) outcome was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1644095
Sex: F
Age: 67
State: MI

Vax Date: 02/17/2021
Onset Date: 03/17/2021
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: Experience eye pain in both of her eyes/eye pain as a throb; Her extremities hurt/arm pain; Throbbing is a burning feeling; When she wakes up in the morning it is hard for her to open up her eyelids,/he reports it takes her a while to open up her eyes.; This has never happened before the vaccine/Does not know if the vaccine was responsible for it but it all started after taking it.; Symptoms may have been due to sinuses (but that was also cleared).; Wrist pain; a little fogginess; Had a sore arm; Headache/the eye pain gives a headache; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (a little fogginess), EYE PAIN (Experience eye pain in both of her eyes/eye pain as a throb), PAIN IN EXTREMITY (Her extremities hurt/arm pain), BURNING SENSATION (Throbbing is a burning feeling) and OCULAR DISCOMFORT (When she wakes up in the morning it is hard for her to open up her eyelids,/he reports it takes her a while to open up her eyes.) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 044A21A and 023M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included ATORVASTATIN for Arterial injury, 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-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 17-Mar-2021, the patient experienced FEELING ABNORMAL (a little fogginess), MYALGIA (Had a sore arm) and HEADACHE (Headache/the eye pain gives a headache). In April 2021, the patient experienced EYE PAIN (Experience eye pain in both of her eyes/eye pain as a throb), PAIN IN EXTREMITY (Her extremities hurt/arm pain), BURNING SENSATION (Throbbing is a burning feeling), OCULAR DISCOMFORT (When she wakes up in the morning it is hard for her to open up her eyelids,/he reports it takes her a while to open up her eyes.), VACCINATION COMPLICATION (This has never happened before the vaccine/Does not know if the vaccine was responsible for it but it all started after taking it.), SINUS DISORDER (Symptoms may have been due to sinuses (but that was also cleared).) and ARTHRALGIA (Wrist pain). The patient was treated with PARACETAMOL (TYLENOL) for Headache, at an unspecified dose and frequency. At the time of the report, FEELING ABNORMAL (a little fogginess), EYE PAIN (Experience eye pain in both of her eyes/eye pain as a throb), BURNING SENSATION (Throbbing is a burning feeling), VACCINATION COMPLICATION (This has never happened before the vaccine/Does not know if the vaccine was responsible for it but it all started after taking it.) and MYALGIA (Had a sore arm) outcome was unknown, PAIN IN EXTREMITY (Her extremities hurt/arm pain), OCULAR DISCOMFORT (When she wakes up in the morning it is hard for her to open up her eyelids,/he reports it takes her a while to open up her eyes.), HEADACHE (Headache/the eye pain gives a headache) and ARTHRALGIA (Wrist pain) had not resolved and SINUS DISORDER (Symptoms may have been due to sinuses (but that was also cleared).) had resolved. This case was linked to MOD-2021-242347 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 26-Jul-2021: Follow up information was received on 26-Jul-2021. New treatment drug and event (wrist pain) were reported. The outcome of sinus disorder changed from unknown to recovered and for the events headache, arm pain, and ocular discomfort changed from unknown to not resolved. On 26-Jul-2021: Follow-up information received on 26 Jul 2021 contains no new information. On 10-Aug-2021: Follow up received included reporter contact details.

Other Meds: ATORVASTATIN; MIRALAX

Current Illness:

ID: 1644096
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: Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: COVID-19 Positive

Allergies:

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

Symptoms: COVID-19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (COVID-19) in a 35-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 an unknown date, the patient experienced COVID-19 (COVID-19). At the time of the report, COVID-19 (COVID-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: positive (Positive) COVID-19 Positive. 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. This case was linked to MOD-2021-242280 (Patient Link).

Other Meds:

Current Illness:

ID: 1644097
Sex: U
Age:
State:

Vax Date: 06/18/2021
Onset Date: 06/28/2021
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: fever; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever) 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 18-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Jun-2021, the patient experienced PYREXIA (fever). At the time of the report, PYREXIA (fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1644098
Sex: M
Age:
State:

Vax Date: 05/04/2021
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: Pyrexia, White blood cell count decreased

Symptoms: First dose on 4May2021 and did not yet receive second dose; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (First dose on 4May2021 and did not yet receive second dose) 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 04-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (First dose on 4May2021 and did not yet receive second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (First dose on 4May2021 and did not yet receive second dose) 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 concomitant medication were reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1644099
Sex: F
Age: 66
State: NM

Vax Date: 03/10/2021
Onset Date: 03/10/2021
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: Pharyngeal swelling

Symptoms: may be "some kind" of IBS (Irritable bowel syndrome); "terrible diarrhea"; anything she eats causes an upset stomach; has been losing weight; pain in the rectum; This spontaneous case was reported by a consumer and describes the occurrence of PROCTALGIA (pain in the rectum), DIARRHOEA ("terrible diarrhea"), ABDOMINAL DISCOMFORT (anything she eats causes an upset stomach), WEIGHT DECREASED (has been losing weight) and IRRITABLE BOWEL SYNDROME (may be "some kind" of IBS (Irritable bowel syndrome)) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027A21A) for COVID-19 vaccination. The patient's past medical history included Radiation therapy (Patient stated that she received 15 rounds of radiation treatment and did not received any chemotherapy.) from 20-Feb-2021 to 17-Mar-2021. Concurrent medical conditions included Milk allergy, Hypothyroidism and Breast cancer since November 2020. Concomitant products included LEVOTHYROXINE for Hypothyroidism, ANASTROZOLE from 17-Apr-2021 to an unknown date for an unknown indication. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Mar-2021, the patient experienced PROCTALGIA (pain in the rectum) and WEIGHT DECREASED (has been losing weight). On 11-Mar-2021, the patient experienced DIARRHOEA ("terrible diarrhea") and ABDOMINAL DISCOMFORT (anything she eats causes an upset stomach). On an unknown date, the patient experienced IRRITABLE BOWEL SYNDROME (may be "some kind" of IBS (Irritable bowel syndrome)). The patient was treated with HYOSCYAMINE for Diarrhea, at an unspecified dose and frequency. At the time of the report, PROCTALGIA (pain in the rectum), DIARRHOEA ("terrible diarrhea"), ABDOMINAL DISCOMFORT (anything she eats causes an upset stomach), WEIGHT DECREASED (has been losing weight) and IRRITABLE BOWEL SYNDROME (may be "some kind" of IBS (Irritable bowel syndrome)) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient took Anastrozole (estrogen blocker) one month after the completion of radiation treatment (around 17Apr2021). She stated that she will have to take Anastrozole for 5 years. The consumer stated that she had no known drug or food allergies. No relevant Lab Data was provided. This case was linked to MOD-2021-242482, MOD-2021-242482 (Patient Link).

Other Meds: LEVOTHYROXINE; ANASTROZOLE

Current Illness: Breast cancer; Hypothyroidism; Milk allergy

ID: 1644100
Sex: F
Age: 79
State: NY

Vax Date: 01/01/2021
Onset Date: 02/01/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: This spontaneous case reported by a consumer, describes the occurrence of blister (blistering/blistering disease), pruritus (itching) and rash (rash/terrible rash) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. January 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. February 2021, patient received the second dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. February 2021, patient experienced blister (blistering/blistering disease), pruritus (itching) and rash (rash/terrible rash). Patient treated with Rituxan (rituximab) ongoing since an unknown date for blistering, at a dose of 1 dosage form. At the time of the report, blister (blistering/blistering disease), pruritus (itching) and rash (rash/terrible rash) outcome: unknown. No concomitant medications or lab data reported. Most recent follow-up information incorporated: On Jun 30, 2021: Non-significant follow-up appended.

Other Meds:

Current Illness:

ID: 1644101
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: First dose 4 months ago, no second dose yet; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (First dose 4 months ago, no second dose yet) 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 (First dose 4 months ago, no second dose yet). At the time of the report, PRODUCT DOSE OMISSION ISSUE (First dose 4 months ago, no second dose yet) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment was reported.

Other Meds:

Current Illness:

ID: 1644102
Sex: F
Age: 41
State: MS

Vax Date: 06/21/2021
Onset Date: 06/21/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: she has not had a reaction like this after any other shot and doesn't look like a normal reaction; shot site a little raised; only reaction she has experienced has been a headache, specifically a migraine,; Extreme Joint Issues in every joint in her body; where she received the shot is still very red,; Where she received the shot is a little raised; Where she received the shot is extremely itchy; All of her tattoos seem to be welted; All of her tattoos are very itchy; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (only reaction she has experienced has been a headache, specifically a migraine,), ARTHRALGIA (Extreme Joint Issues in every joint in her body), VACCINATION SITE ERYTHEMA (where she received the shot is still very red,), VACCINATION SITE SWELLING (Where she received the shot is a little raised) and VACCINATION SITE PRURITUS (Where she received the shot is extremely itchy) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Allergic reaction. On 21-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Jun-2021, the patient experienced MIGRAINE (only reaction she has experienced has been a headache, specifically a migraine,), ARTHRALGIA (Extreme Joint Issues in every joint in her body), VACCINATION SITE ERYTHEMA (where she received the shot is still very red,), VACCINATION SITE SWELLING (Where she received the shot is a little raised), VACCINATION SITE PRURITUS (Where she received the shot is extremely itchy), URTICARIA (All of her tattoos seem to be welted) and PRURITUS (All of her tattoos are very itchy). On an unknown date, the patient experienced VACCINATION COMPLICATION (she has not had a reaction like this after any other shot and doesn't look like a normal reaction) and VACCINATION SITE RASH (shot site a little raised). At the time of the report, MIGRAINE (only reaction she has experienced has been a headache, specifically a migraine,), ARTHRALGIA (Extreme Joint Issues in every joint in her body), VACCINATION SITE ERYTHEMA (where she received the shot is still very red,), VACCINATION SITE SWELLING (Where she received the shot is a little raised), VACCINATION SITE PRURITUS (Where she received the shot is extremely itchy), URTICARIA (All of her tattoos seem to be welted), PRURITUS (All of her tattoos are very itchy), VACCINATION COMPLICATION (she has not had a reaction like this after any other shot and doesn't look like a normal reaction) and VACCINATION SITE RASH (shot site a little raised) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications was not provided. Treatment medications were not given.

Other Meds:

Current Illness: Allergic reaction

ID: 1644103
Sex: F
Age:
State: IA

Vax Date: 06/07/2021
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: She has a ball in her left arm at injected site/It never dissipated; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE SWELLING (She has a ball in her left arm at injected site/It never dissipated) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 035C21A) for COVID-19 vaccination. No Medical History information was reported. On 07-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE SWELLING (She has a ball in her left arm at injected site/It never dissipated). At the time of the report, VACCINATION SITE SWELLING (She has a ball in her left arm at injected site/It never dissipated) outcome was unknown. No concomitant medication was reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1644104
Sex: F
Age: 63
State: NV

Vax Date: 01/14/2021
Onset Date: 02/11/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Test Date: 20210622; Test Name: SARs-COV-2 virus test; Test Result: Positive.

Allergies:

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

Symptoms: muscular soreness on the upper arms; her symptoms got worse; exhausted; slept most of the time; symptoms of Covid-19; soreness on the injection site (right arm); This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (soreness on the injection site (right arm)), MYALGIA (muscular soreness on the upper arms), FATIGUE (exhausted), SOMNOLENCE (slept most of the time) and COVID-19 (symptoms of Covid-19) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031M20A and 025L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Psoriatic arthritis. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) milliliter. On 11-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to .5 milliliter. On 11-Feb-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced VACCINATION SITE PAIN (soreness on the injection site (right arm)). On 21-Jun-2021, the patient experienced FATIGUE (exhausted), SOMNOLENCE (slept most of the time) and COVID-19 (symptoms of Covid-19). On an unknown date, the patient experienced MYALGIA (muscular soreness on the upper arms) and CONDITION AGGRAVATED (her symptoms got worse). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and MOMETASONE FUROATE (FLONASE [MOMETASONE FUROATE]) at an unspecified dose and frequency. At the time of the report, VACCINATION SITE PAIN (soreness on the injection site (right arm)), MYALGIA (muscular soreness on the upper arms), FATIGUE (exhausted), SOMNOLENCE (slept most of the time), COVID-19 (symptoms of Covid-19) and CONDITION AGGRAVATED (her symptoms got worse) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 22-Jun-2021, SARS-CoV-2 test: Positive.

Other Meds:

Current Illness:

ID: 1644105
Sex: F
Age: 68
State: NY

Vax Date: 05/18/2021
Onset Date: 05/18/2021
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: Now I feel numb in my fingers and feet, The numbness is mainly in the heel of my feet, and mainly on my left foot, The tingling is mainly in my fingers; After the 2nd dose, I felt tingling in my feet; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (After the 2nd dose, I felt tingling in my feet) and HYPOAESTHESIA (Now I feel numb in my fingers and feet, The numbness is mainly in the heel of my feet, and mainly on my left foot, The tingling is mainly in my fingers) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 019C21A) for COVID-19 vaccination. The medical history was not provided by the reporter. Concomitant products included LOSARTAN for Blood pressure management, LOVASTATIN for Cholesterol. On 18-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-May-2021, the patient experienced PARAESTHESIA (After the 2nd dose, I felt tingling in my feet). On an unknown date, the patient experienced HYPOAESTHESIA (Now I feel numb in my fingers and feet, The numbness is mainly in the heel of my feet, and mainly on my left foot, The tingling is mainly in my fingers). At the time of the report, PARAESTHESIA (After the 2nd dose, I felt tingling in my feet) and HYPOAESTHESIA (Now I feel numb in my fingers and feet, The numbness is mainly in the heel of my feet, and mainly on my left foot, The tingling is mainly in my fingers) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment information, if any, was not provided Action taken with mRNA-1273 in response to the event was not applicable. This case was linked to MOD-2021-242346 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 30-Jun-2021: Follow-up information received on 30-Jun-2021 and does not contain any new information.

Other Meds: LOSARTAN; LOVASTATIN.

Current Illness:

ID: 1644106
Sex: F
Age: 27
State: DE

Vax Date: 06/16/2021
Onset Date: 06/16/2021
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: Serious menstrual cramps; Heavy menstrual bleeding; This spontaneous case was reported by a consumer and describes the occurrence of DYSMENORRHOEA (Serious menstrual cramps) and HEAVY MENSTRUAL BLEEDING (Heavy menstrual bleeding) in a 27-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052c21a) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included MINERALS NOS, VITAMINS NOS (PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]) for an unknown indication. On 16-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Jun-2021, the patient experienced DYSMENORRHOEA (Serious menstrual cramps) and HEAVY MENSTRUAL BLEEDING (Heavy menstrual bleeding). At the time of the report, DYSMENORRHOEA (Serious menstrual cramps) and HEAVY MENSTRUAL BLEEDING (Heavy menstrual bleeding) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment drug details were reported.

Other Meds: PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]

Current Illness:

ID: 1644107
Sex: F
Age: 66
State: NM

Vax Date: 03/10/2021
Onset Date: 04/08/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pain in her rectum; Diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of PROCTALGIA (Pain in her rectum) and DIARRHOEA (Diarrhea) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 038B21A and 027A21A) for COVID-19 vaccination. Concurrent medical conditions included Breast cancer since November 2020, Milk allergy (milk intolerance) and Hypothyroidism. Concomitant products included LEVOTHYROXINE for Hypothyroidism, ANASTROZOLE for an unknown indication. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 08-Apr-2021, the patient experienced PROCTALGIA (Pain in her rectum) and DIARRHOEA (Diarrhea). At the time of the report, PROCTALGIA (Pain in her rectum) and DIARRHOEA (Diarrhea) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant Lab Data was provided. No treatment medication information was provided Patient taking radiation to treat breast cancer on 25Feb2021 and ended the radiation treatment on 17Mar2021. Patient stated received 15 rounds of radiation treatment. Patient taking Anastrozole for 5 years. This case was linked to MOD-2021-242430 (Patient Link).

Other Meds: LEVOTHYROXINE; ANASTROZOLE

Current Illness: Breast cancer; Hypothyroidism; Milk allergy (milk intolerance)

ID: 1644108
Sex: F
Age: 62
State: PA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: Discomfort at the site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOMFORT (Discomfort at the site) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) for COVID-19 vaccination. Concurrent medical conditions included Pollen allergy (Allergy to Pollen), Food allergy (Allergy to Pine tart) and Allergy to animal (Allergy to Cat). On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Mar-2021, the patient experienced VACCINATION SITE DISCOMFORT (Discomfort at the site). At the time of the report, VACCINATION SITE DISCOMFORT (Discomfort at the site) 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 products included Allergy injection as patient reported its intake twice a month for past 20-30 years. Concomitant medication included vitamins. Treatment information were not provided. This case was linked to MOD-2021-242526 (Patient Link).

Other Meds:

Current Illness: Allergy to animal (Allergy to Cat); Food allergy (Allergy to Pine tart); Pollen allergy (Allergy to Pollen)

ID: 1644109
Sex: M
Age:
State:

Vax Date: 01/01/2021
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: Did not get second dose within the one month time frame; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Did not get second dose within the one month time frame) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In January 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 (Did not get second dose within the one month time frame). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Did not get second dose within the one month time frame) 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 medication were reported. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1644110
Sex: F
Age: 62
State: PA

Vax Date: 03/17/2021
Onset Date: 04/15/2021
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: leg feel tight/when moving her legs and she hears crack/she bends her leg it feels tight; gets dizzy but does not if it is related to the shot; pain in right hip/pain right hip to right knee to left knee all over the leg comes up quickly and goes away quickly; sore throat; swelling of lips; headache; low grade fever; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (sore throat), LIMB DISCOMFORT (leg feel tight/when moving her legs and she hears crack/she bends her leg it feels tight), DIZZINESS (gets dizzy but does not if it is related to the shot), LIP SWELLING (swelling of lips) and HEADACHE (headache) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concurrent medical conditions included Allergic to cats and Allergic reaction (Allergic to pollen and pine tart). Concomitant products included MULTIVITAMIN [VITAMINS NOS] for an unknown indication. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Apr-2021, the patient experienced OROPHARYNGEAL PAIN (sore throat), LIP SWELLING (swelling of lips), HEADACHE (headache) and PYREXIA (low grade fever). On an unknown date, the patient experienced LIMB DISCOMFORT (leg feel tight/when moving her legs and she hears crack/she bends her leg it feels tight), DIZZINESS (gets dizzy but does not if it is related to the shot) and ARTHRALGIA (pain in right hip/pain right hip to right knee to left knee all over the leg comes up quickly and goes away quickly). The patient was treated with DIETHYLAMINE SALICYLATE, METHYL NICOTINATE (ASPERCREME [DIETHYLAMINE SALICYLATE;METHYL NICOTINATE]) ongoing since an unknown date at an unspecified dose and frequency. On 15-Apr-2021, OROPHARYNGEAL PAIN (sore throat), LIP SWELLING (swelling of lips), HEADACHE (headache) and PYREXIA (low grade fever) had resolved. At the time of the report, LIMB DISCOMFORT (leg feel tight/when moving her legs and she hears crack/she bends her leg it feels tight), DIZZINESS (gets dizzy but does not if it is related to the shot) and ARTHRALGIA (pain in right hip/pain right hip to right knee to left knee all over the leg comes up quickly and goes away quickly) 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 products includes allergic injection. No treatment medication provided. This case was linked to MOD-2021-242504 (Patient Link).

Other Meds: MULTIVITAMIN [VITAMINS NOS.]

Current Illness: Allergic reaction (Allergic to pollen and pine tart); Allergic to cats.

ID: 1644111
Sex: F
Age: 21
State: MI

Vax Date: 06/26/2021
Onset Date: 06/26/2021
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: sore arm; migraine; received her second dose of the Moderna Covid-19 vaccine on 26Jun2021 ( 7 weeks after the first dose); This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (migraine), PAIN IN EXTREMITY (sore arm) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (received her second dose of the Moderna Covid-19 vaccine on 26Jun2021 ( 7 weeks after the first dose)) in a 21-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Type 1 diabetes mellitus. Concomitant products included INSULIN LISPRO (HUMALOG), INSULIN ASPART (NOVOLOG) and LURASIDONE HYDROCHLORIDE (LATUDA) for an unknown indication. 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 26-Jun-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (received her second dose of the Moderna Covid-19 vaccine on 26Jun2021 ( 7 weeks after the first dose)). On 30-Jun-2021, the patient experienced MIGRAINE (migraine). On an unknown date, the patient experienced PAIN IN EXTREMITY (sore arm). On 26-Jun-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (received her second dose of the Moderna Covid-19 vaccine on 26Jun2021 ( 7 weeks after the first dose)) had resolved. At the time of the report, MIGRAINE (migraine) and PAIN IN EXTREMITY (sore arm) outcome was unknown. No treatment details were reported.

Other Meds: HUMALOG; NOVOLOG; LATUDA

Current Illness: Type 1 diabetes mellitus

ID: 1644112
Sex: M
Age:
State: CA

Vax Date: 05/10/2021
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: caller received 1st dose of the Moderna vaccine on 10May2021, but had to travel to another country and couldn't receive the 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (caller received 1st dose of the Moderna vaccine on 10May2021, but had to travel to another country and couldn't receive the 2nd dose) 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 10-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (caller received 1st dose of the Moderna vaccine on 10May2021, but had to travel to another country and couldn't receive the 2nd dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (caller received 1st dose of the Moderna vaccine on 10May2021, but had to travel to another country and couldn't receive the 2nd dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medications were reported by the reporter. Treatment medication for these events were not reported by the reporter.

Other Meds:

Current Illness:

ID: 1644113
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: I am pregnant; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (I am 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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (I am pregnant). At the time of the report, EXPOSURE DURING PREGNANCY (I am pregnant) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter.

Other Meds:

Current Illness:

ID: 1644114
Sex: M
Age:
State: TX

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: Caller's son received the 1st dose of the Moderna vaccine on April, never received the 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Caller's son received the 1st dose of the Moderna vaccine on April, never received the 2nd dose) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Caller's son received the 1st dose of the Moderna vaccine on April, never received the 2nd dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Caller's son received the 1st dose of the Moderna vaccine on April, never received the 2nd dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant drug details were reported. No treatment details were reported.

Other Meds:

Current Illness:

ID: 1644115
Sex: U
Age:
State:

Vax Date:
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: puking; worst headache; This spontaneous case was reported by a consumer and describes the occurrence of VOMITING (puking) and HEADACHE (worst 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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Jun-2021, the patient experienced VOMITING (puking) and HEADACHE (worst headache). At the time of the report, VOMITING (puking) and HEADACHE (worst headache) 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: 1644116
Sex: M
Age: 38
State: TX

Vax Date: 05/26/2021
Onset Date: 06/30/2021
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: if he even touches his head, it hurts; feeling very achy/feels body was crushed; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (if he even touches his head, it hurts) and MYALGIA (feeling very achy/feels body was crushed) in a 38-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039A21A and 021C21A) for COVID-19 vaccination. The patient's past medical history included Back surgery. On 26-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 30-Jun-2021, the patient experienced HEADACHE (if he even touches his head, it hurts) and MYALGIA (feeling very achy/feels body was crushed). At the time of the report, HEADACHE (if he even touches his head, it hurts) and MYALGIA (feeling very achy/feels body was crushed) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was not applicable. Treatment information included Eurafina.

Other Meds:

Current Illness:

ID: 1644117
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: fatigued; joint pain; This spontaneous case was reported by a patient and describes the occurrence of FATIGUE (fatigued) and ARTHRALGIA (joint pain) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced FATIGUE (fatigued) and ARTHRALGIA (joint pain). At the time of the report, FATIGUE (fatigued) and ARTHRALGIA (joint pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. No treatment reported.

Other Meds:

Current Illness:

ID: 1644118
Sex: F
Age: 79
State: FL

Vax Date: 03/01/2021
Onset Date: 03/30/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: dizzy/had crystals out of place in her right inner ear; could not get out of bed; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizzy/had crystals out of place in her right inner ear) and MOVEMENT DISORDER (could not get out of bed) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039A21A and 010A21A) for COVID-19 vaccination. Previously administered products included for an unreported indication: INFLUENZA VACCINE (A month prior to the Moderna shot she did receive a flu shot) in February 2021. Concurrent medical conditions included Blood pressure high. Concomitant products included CLONIDINE, LOSARTAN, ASPIRIN [ACETYLSALICYLIC ACID], HYDRALAZINE, TORSEMIDE, LABETALOL, ALLOPURINOL, ATORVASTATIN, NIFEDIPINE, VITAMIN D [VITAMIN D NOS] and VITAMIN B12 [VITAMIN B12 NOS] for an unknown indication. On 01-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) (Intramuscular) dosage was changed to 1 dosage form. On 30-Mar-2021, the patient experienced DIZZINESS (dizzy/had crystals out of place in her right inner ear) and MOVEMENT DISORDER (could not get out of bed). On 05-Apr-2021, MOVEMENT DISORDER (could not get out of bed) outcome was unknown. In April 2021, DIZZINESS (dizzy/had crystals out of place in her right inner ear) outcome was unknown. It was reported that the patient went to therapy once and wore a brace for 24 hours and was taught how to manipulate the head to help alleviate the symptoms if they should return.

Other Meds: CLONIDINE; LOSARTAN; ASPIRIN [ACETYLSALICYLIC ACID]; HYDRALAZINE; TORSEMIDE; LABETALOL; ALLOPURINOL; ATORVASTATIN; NIFEDIPINE; VITAMIN D [VITAMIN D NOS]; VITAMIN B12 [VITAMIN B12 NOS]

Current Illness: Blood pressure high

ID: 1644119
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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: diarrhea; This spontaneous case was reported by a patient and describes the occurrence of DIARRHOEA (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 (diarrhea). At the time of the report, DIARRHOEA (diarrhea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment and concomitant medication reported.

Other Meds:

Current Illness:

ID: 1644120
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Numbeness; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (Numbeness) 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 HYPOAESTHESIA (Numbeness). At the time of the report, HYPOAESTHESIA (Numbeness) outcome was unknown.

Other Meds:

Current Illness:

ID: 1644121
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: Nausea

Symptoms: very sick; Sore throat; Chills; Fever; Headache; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (very sick), OROPHARYNGEAL PAIN (Sore throat), CHILLS (Chills), PYREXIA (Fever) and HEADACHE (Headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. 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 MALAISE (very sick), OROPHARYNGEAL PAIN (Sore throat), CHILLS (Chills), PYREXIA (Fever) and HEADACHE (Headache). At the time of the report, MALAISE (very sick), OROPHARYNGEAL PAIN (Sore throat), CHILLS (Chills), PYREXIA (Fever) and HEADACHE (Headache) had not resolved. No concomitant medications were provided by the reporter. Treatment information was not reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1644122
Sex: F
Age:
State: CA

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Some pain in right arm; Some tenderness in right arm; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Some pain in right arm) and TENDERNESS (Some tenderness in right 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 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 MYALGIA (Some pain in right arm) and TENDERNESS (Some tenderness in right arm). The patient was treated with IBUPROFEN at a dose of 1 dosage form. At the time of the report, MYALGIA (Some pain in right arm) and TENDERNESS (Some tenderness in right arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided. Treatment medications was not given.

Other Meds:

Current Illness:

ID: 1644123
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Severe cramps; Heavy menstrual bleeding; This spontaneous case was reported by a consumer and describes the occurrence of DYSMENORRHOEA (Severe cramps) and HEAVY MENSTRUAL BLEEDING (Heavy menstrual bleeding) 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 DYSMENORRHOEA (Severe cramps) and HEAVY MENSTRUAL BLEEDING (Heavy menstrual bleeding). At the time of the report, DYSMENORRHOEA (Severe cramps) and HEAVY MENSTRUAL BLEEDING (Heavy menstrual bleeding) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication details were reported. No Treatment Medications were reported.

Other Meds:

Current Illness:

ID: 1644124
Sex: F
Age: 32
State: NY

Vax Date: 03/11/2021
Onset Date: 06/30/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Patient received vaccine after allowed expiry; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received vaccine after allowed expiry) in a 33-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 11-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 30-Jun-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received vaccine after allowed expiry). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Patient received vaccine after allowed expiry) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Most recent FOLLOW-UP information incorporated above includes: On 01-Jul-2021: Follow Up received on 01-JUL-2021 contains No New Information

Other Meds:

Current Illness:

ID: 1644125
Sex: F
Age: 83
State: FL

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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: Sore arm; tired/tired; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm) and FATIGUE (tired/tired) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013M20A and 029L20A) for COVID-19 vaccination. Concurrent medical conditions included Heart disorder. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 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 21-Jan-2021, the patient experienced PAIN IN EXTREMITY (Sore arm) and FATIGUE (tired/tired). On 19-Feb-2021, FATIGUE (tired/tired) had resolved. On 23-Jun-2021, PAIN IN EXTREMITY (Sore arm) had resolved. No concomitant medication was provided. No treatment medication was provided. This case was linked to MOD-2021-243019 (Patient Link).

Other Meds:

Current Illness: Heart disorder.

ID: 1644126
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: tested positive for Covid 19 again/Getting COVID After the Vaccine; This spontaneous case was reported by a consumer and describes the occurrence of SARS-COV-2 TEST POSITIVE (tested positive for Covid 19 again/Getting COVID After the Vaccine) 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 provided). 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 SARS-COV-2 TEST POSITIVE (tested positive for Covid 19 again/Getting COVID After the Vaccine). At the time of the report, SARS-COV-2 TEST POSITIVE (tested positive for Covid 19 again/Getting COVID After the Vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds:

Current Illness:

ID: 1644127
Sex: M
Age: 41
State: IL

Vax Date: 05/19/2021
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: sore arm; inappropriate schedule of drug administration; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (sore arm) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate schedule of drug administration) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014C21A) for COVID-19 vaccination. No Medical History information was reported. On 19-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MYALGIA (sore arm) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate schedule of drug administration). At the time of the report, MYALGIA (sore arm) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (inappropriate schedule of drug administration) outcome was unknown. No concomitant medication information was provided by the reporter. No treatment information was provided by the reporter. Patient took second dose on 14-JUL-2021 (039A21A) in his eft arm. This case was linked to MOD-2021-281234 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 09-Aug-2021: Followup received on 09-Aug-2021. Patient DOB was added. First dose of vaccination date was updated and second dose details were added.New events (sore arm, inappropriate schedule of drug administration) added. Pre-existing event (missed dose) deleted. Corresponding fields and narrative were updated accordingly.

Other Meds:

Current Illness:

ID: 1644128
Sex: U
Age:
State:

Vax Date: 03/01/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: lost my sense of smell; This spontaneous case was reported by a consumer and describes the occurrence of ANOSMIA (lost my sense of smell) 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 COVID-19 in December 2020. In March 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 ANOSMIA (lost my sense of smell). At the time of the report, ANOSMIA (lost my sense of smell) 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: 1644129
Sex: M
Age: 22
State: FL

Vax Date: 06/01/2021
Onset Date: 06/29/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: patient received the second dose from a vial that has expired based on the 12 hour expiration; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (patient received the second dose from a vial that has expired based on the 12 hour expiration) in a 22-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 051C21A and 036C21A) for COVID-19 vaccination. No Medical History information was reported. On 01-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jun-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 EXPIRED PRODUCT ADMINISTERED (patient received the second dose from a vial that has expired based on the 12 hour expiration). At the time of the report, EXPIRED PRODUCT ADMINISTERED (patient received the second dose from a vial that has expired based on the 12 hour expiration) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments. No treatment information was provided by the reporter. No concomitant medication information was provided by the reporter.

Other Meds:

Current Illness:

ID: 1644130
Sex: F
Age: 32
State: AR

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Started spreading around arm, big rash,started separating and moving, spots were separating from each other; Like getting sick; Catching a cold; Was not feeling so great; Arm started swelling up like golf ball under arm at injection site.; Throwing up; Tired; Fever; Body aches,Extremely crashed; Had a really bad reaction; Had really bad flu like symptoms; Could not eat; Had a red spot that looked like a ring worm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Had a really bad reaction), INFLUENZA LIKE ILLNESS (Had really bad flu like symptoms), FEEDING DISORDER (Could not eat), ERYTHEMA (Had a red spot that looked like a ring worm) and FEELING ABNORMAL (Was not feeling so great) in a 32-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21a) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Mar-2021, the patient experienced VACCINATION COMPLICATION (Had a really bad reaction), INFLUENZA LIKE ILLNESS (Had really bad flu like symptoms), FEEDING DISORDER (Could not eat), ERYTHEMA (Had a red spot that looked like a ring worm), VACCINATION SITE SWELLING (Arm started swelling up like golf ball under arm at injection site.), VOMITING (Throwing up), FATIGUE (Tired), PYREXIA (Fever) and MYALGIA (Body aches,Extremely crashed). On 16-Mar-2021, the patient experienced FEELING ABNORMAL (Was not feeling so great), ILLNESS (Like getting sick) and NASOPHARYNGITIS (Catching a cold). On 18-Mar-2021, the patient experienced RASH (Started spreading around arm, big rash,started separating and moving, spots were separating from each other). At the time of the report, VACCINATION COMPLICATION (Had a really bad reaction), INFLUENZA LIKE ILLNESS (Had really bad flu like symptoms), FEEDING DISORDER (Could not eat), ERYTHEMA (Had a red spot that looked like a ring worm), FEELING ABNORMAL (Was not feeling so great), ILLNESS (Like getting sick), NASOPHARYNGITIS (Catching a cold), RASH (Started spreading around arm, big rash,started separating and moving, spots were separating from each other), VACCINATION SITE SWELLING (Arm started swelling up like golf ball under arm at injection site.), VOMITING (Throwing up), FATIGUE (Tired), PYREXIA (Fever) and MYALGIA (Body aches,Extremely crashed) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant drugs were provided. Patient experienced Red spot which looked like a ring worm on 13-Mar-2021 later events were stated as circle started getting bigger on 16-Mar-2021, The circle went down on 17-Mar-2021, The circle came back with a vengeance on 18-Mar-2021 and It was like a roller coaster for two weeks on 18-Mar-2021. Treatment was provided as cream. Most recent FOLLOW-UP information incorporated above includes: On 30-Jun-2021: Follow-up received and contain no other significant information.

Other Meds:

Current Illness:

ID: 1644131
Sex: M
Age: 47
State: GA

Vax Date: 01/04/2021
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: didn't received the second dose; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 30-Jun-2021 and was forwarded to Moderna on 30-Jun-2021. This spontaneous case was reported by a physician and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (didn't received the second dose) in a 48-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026L20A) for COVID-19 vaccination. The patient's past medical history included COVID-19 (In september or October 2020 and fully recovered.). On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (didn't received the second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (didn't received the second dose) 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. Patient stated that 3 weeks after first dose vaccination patient suffered an accident and spent last 5 months away from home. No concomitant medications were provided.

Other Meds:

Current Illness:

ID: 1644132
Sex: F
Age:
State: NV

Vax Date: 05/07/2021
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: now on day 53 and has not yet received her second shot; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (now on day 53 and has not yet received her second shot) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 07-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (now on day 53 and has not yet received her second shot). At the time of the report, PRODUCT DOSE OMISSION ISSUE (now on day 53 and has not yet received her second shot) 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 provided. No treatment was reported for the events.

Other Meds:

Current Illness:

ID: 1644133
Sex: F
Age: 58
State: TX

Vax Date: 03/28/2021
Onset Date: 04/25/2021
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: Test Date: 20210612; Test Name: Fever; Result Unstructured Data: High; Test Date: 20210630; Test Name: Fever; Result Unstructured Data: High

Allergies:

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

Symptoms: Tired; High Fever; chills; This spontaneous case was reported by a non-health professional and describes the occurrence of CHILLS (chills), FATIGUE (Tired) and PYREXIA (High Fever) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 045B21A and 039A21A) for COVID-19 vaccination. The patient's past medical history included No adverse event (no medical history reported). Concomitant products included BISOPROLOL FUMARATE, HYDROCHLOROTHIAZIDE (ZIAC [BISOPROLOL FUMARATE;HYDROCHLOROTHIAZIDE]) and LISINOPRIL for Hypertension, VORTIOXETINE HYDROBROMIDE (TRINTELLIX) and CLONIDINE for an unknown indication. On 28-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Apr-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced CHILLS (chills). On 30-Jun-2021, the patient experienced FATIGUE (Tired) and PYREXIA (High Fever). The patient was treated with NAPROXEN for Fever, at a dose of 500 mg. On 26-Apr-2021, CHILLS (chills) had resolved. At the time of the report, FATIGUE (Tired) and PYREXIA (High Fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Jun-2021, Body temperature: 102 to 103 degree Celsius (High) High. On 30-Jun-2021, Body temperature: 101.4 degree Celsius (High) High. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments.

Other Meds: ZIAC [BISOPROLOL FUMARATE;HYDROCHLOROTHIAZIDE]; LISINOPRIL; TRINTELLIX; CLONIDINE

Current Illness:

ID: 1644134
Sex: U
Age:
State: AL

Vax Date: 12/20/2020
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Scheduling second vaccine appointment, more than 36 days after first dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Scheduling second vaccine appointment, more than 36 days after first dose) 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 20-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Scheduling second vaccine appointment, more than 36 days after first dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Scheduling second vaccine appointment, more than 36 days after first dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication information provided by reporter. No treatment information provided by reporter.

Other Meds:

Current Illness:

ID: 1644135
Sex: U
Age:
State:

Vax Date: 06/01/2021
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: have experienced a side effect; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (have 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. The patient's past medical history included COVID-19 in January 2021. In June 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 VACCINATION COMPLICATION (have experienced a side effect). At the time of the report, VACCINATION COMPLICATION (have experienced a side effect) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant drugs were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1644136
Sex: F
Age: 39
State: CA

Vax Date: 06/02/2021
Onset Date: 06/30/2021
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: administered three shots from a vial left out at room temperature for roughly 20 hours; This spontaneous case was reported by a patient and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (administered three shots from a vial left out at room temperature for roughly 20 hours) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 009D21A and 011D21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 30-Jun-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (administered three shots from a vial left out at room temperature for roughly 20 hours). On 30-Jun-2021, EXPIRED PRODUCT ADMINISTERED (administered three shots from a vial left out at room temperature for roughly 20 hours) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication provided by reporter. No treatment medication provided by reporter. Most recent FOLLOW-UP information incorporated above includes: On 30-Jun-2021: Follow-up received and Consist of Dosage text and dates were added, Primary reporter information was added and consent to safety was given yes.

Other Meds:

Current Illness:

ID: 1644137
Sex: F
Age: 76
State: PA

Vax Date: 03/09/2021
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: felt like could not move or walk; her right hand feels numb and tip of the finger and it could be also the chemotherapy and radiation therapy; hip pain, ankle pain, the ankle pain radiated up and down; This spontaneous case was reported by a consumer and describes the occurrence of GAIT DISTURBANCE (felt like could not move or walk), HYPOAESTHESIA (her right hand feels numb and tip of the finger and it could be also the chemotherapy and radiation therapy) and ARTHRALGIA (hip pain, ankle pain, the ankle pain radiated up and down) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046B21A and 032M20A) for COVID-19 vaccination. The patient's past medical history included Cancer in 2016 and Rheumatoid arthritis. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Apr-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 GAIT DISTURBANCE (felt like could not move or walk), HYPOAESTHESIA (her right hand feels numb and tip of the finger and it could be also the chemotherapy and radiation therapy) and ARTHRALGIA (hip pain, ankle pain, the ankle pain radiated up and down). The patient was treated with DIETHYLAMINE SALICYLATE, METHYL NICOTINATE (ASPERCREME [DIETHYLAMINE SALICYLATE;METHYL NICOTINATE]) at an unspecified dose and frequency. At the time of the report, GAIT DISTURBANCE (felt like could not move or walk), HYPOAESTHESIA (her right hand feels numb and tip of the finger and it could be also the chemotherapy and radiation therapy) and ARTHRALGIA (hip pain, ankle pain, the ankle pain radiated up and down) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported by the reporter.

Other Meds:

Current Illness:

ID: 1644138
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: burning in the injected arm normal; 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 BURNING SENSATION (burning in the injected arm normal) 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 BURNING SENSATION (burning in the injected arm normal). At the time of the report, BURNING SENSATION (burning in the injected arm normal) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product information, if any, was not provided by the reporter. Treatment information, if any, was not provided Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1644139
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fever; Chills; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever) and CHILLS (Chills) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 28-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 28-Jun-2021, the patient experienced PYREXIA (Fever) and CHILLS (Chills). At the time of the report, PYREXIA (Fever) and CHILLS (Chills) outcome was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. Action taken with mRNA-1273 in response to the events were not applicable.

Other Meds:

Current Illness:

ID: 1644140
Sex: F
Age:
State: MO

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

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

Lab Data:

Allergies:

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

Symptoms: Pregnant and fully vaccinated; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (Pregnant and fully vaccinated) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID) and CHLOROQUINE PHOSPHATE (CHLOROCIN [CHLOROQUINE PHOSPHATE]) for an unknown indication. On 12-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. The patient's last menstrual period was on 22-Jan-2021 and the estimated date of delivery was 29-Oct-2021. On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (Pregnant and fully vaccinated). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) during pregnancy. At the time of the report, EXPOSURE DURING PREGNANCY (Pregnant and fully vaccinated) outcome was unknown. The patient mentioned her Date of last menstrual period: 22-Jan-2021. No treatment medications were provided. Most recent FOLLOW-UP information incorporated above includes: On 30-Jun-2021: Non-significant Follow Up - (Source Doc added, contact info updated)

Other Meds: SYNTHROID; CHLOROCIN [CHLOROQUINE PHOSPHATE]

Current Illness:

ID: 1644141
Sex: F
Age: 76
State: CA

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

Lab Data:

Allergies:

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

Symptoms: heart started racing for a period of 4 hours; felt a little dizzy; fatigued the whole month; This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (heart started racing for a period of 4 hours), DIZZINESS (felt a little dizzy) and FATIGUE (fatigued the whole month) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049C21A) 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) (unknown route) 1 dosage form. On an unknown date, the patient experienced PALPITATIONS (heart started racing for a period of 4 hours), DIZZINESS (felt a little dizzy) and FATIGUE (fatigued the whole month). The patient was treated with ASPIRIN [ACETYLSALICYLIC ACID] at an unspecified dose and frequency. At the time of the report, PALPITATIONS (heart started racing for a period of 4 hours), DIZZINESS (felt a little dizzy) and FATIGUE (fatigued the whole month) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medication was reported.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am