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: 1672517
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/04/2021
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: Developed shortness of breath; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Developed shortness of breath) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced DYSPNOEA (Developed shortness of breath). At the time of the report, DYSPNOEA (Developed shortness of breath) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The patient developed shortness of breath after first dose of vaccination, which lasted approximately 5 days. The patient used rescue inhaler for relieving the symptom. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1672518
Sex: F
Age: 70
State: SC

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 09/04/2021
Hospital:

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

Lab Data: Test Name: SARS-CoV-2 test; Test Result: Negative ; Result Unstructured Data: Negative

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: had little pain at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (had little pain at the injection site) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048A21A) for COVID-19 vaccination. The patient's past medical history included Cancer and Back pain. On 05-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-May-2021, the patient experienced VACCINATION SITE PAIN (had little pain at the injection site). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 05-May-2021, VACCINATION SITE PAIN (had little pain at the injection site) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) Negative. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. This case was linked to MOD-2021-290939 (Patient Link).

Other Meds:

Current Illness:

ID: 1672519
Sex: F
Age: 70
State: SC

Vax Date: 05/05/2021
Onset Date: 06/02/2021
Rec V Date: 09/04/2021
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: Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: COVID-19 virus test was negative

Allergies:

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

Symptoms: she experienced pain; felt horrible / felt terrible; felt sick; could not eat or drink; could not even move to use the restroom; fever; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (she experienced pain), FEELING ABNORMAL (felt horrible / felt terrible), MALAISE (felt sick), FEEDING DISORDER (could not eat or drink) and HYPOKINESIA (could not even move to use the restroom) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Cancer. Concurrent medical conditions included Back pain. On 05-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 02-Jun-2021, the patient experienced PAIN (she experienced pain), FEELING ABNORMAL (felt horrible / felt terrible), MALAISE (felt sick), FEEDING DISORDER (could not eat or drink), HYPOKINESIA (could not even move to use the restroom) and PYREXIA (fever). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, PAIN (she experienced pain), FEELING ABNORMAL (felt horrible / felt terrible), MALAISE (felt sick), FEEDING DISORDER (could not eat or drink), HYPOKINESIA (could not even move to use the restroom) and PYREXIA (fever) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) COVID-19 virus test was negative. No concomitant medications was provided. It was reported that the adverse events lasted few days 2 to 3 days. Consumer states that because she was taking Tylenol, she could not take her back-pain medications. This case was linked to MOD-2021-290917 (Patient Link).

Other Meds:

Current Illness: Back pain

ID: 1672520
Sex: F
Age:
State: FL

Vax Date: 08/05/2021
Onset Date: 08/10/2021
Rec V Date: 09/04/2021
Hospital:

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

Lab Data: Test Date: 20210810; Test Name: Covid 19 test; Test Result: Positive ; Result Unstructured Data: positive

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: wasn't feelin good; tested positive for Covid; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (tested positive for Covid) and MALAISE (wasn't feelin good) 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 05-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Aug-2021, the patient experienced COVID-19 (tested positive for Covid). On an unknown date, the patient experienced MALAISE (wasn't feelin good). At the time of the report, COVID-19 (tested positive for Covid) and MALAISE (wasn't feelin good) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 10-Aug-2021, SARS-CoV-2 test: positive (Positive) positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication were provided by the reporter No treatment medication were provided by the reporter Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1672521
Sex: F
Age: 39
State: ME

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 09/04/2021
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: Her jaw hurt for 3 days; Her sinuses hurt for 3 days; The left side of her neck numbed up/ the left side of her face numbed up; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (The left side of her neck numbed up/ the left side of her face numbed up), PAIN IN JAW (Her jaw hurt for 3 days) and SINUS PAIN (Her sinuses hurt for 3 days) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Aug-2021, the patient experienced HYPOAESTHESIA (The left side of her neck numbed up/ the left side of her face numbed up). On 04-Aug-2021, the patient experienced PAIN IN JAW (Her jaw hurt for 3 days) and SINUS PAIN (Her sinuses hurt for 3 days). On 04-Aug-2021, HYPOAESTHESIA (The left side of her neck numbed up/ the left side of her face numbed up) had resolved. In August 2021, PAIN IN JAW (Her jaw hurt for 3 days) and SINUS PAIN (Her sinuses hurt for 3 days) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant product use was provided by the reporter. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1672522
Sex: M
Age: 66
State: NC

Vax Date: 02/26/2021
Onset Date: 08/18/2021
Rec V Date: 09/04/2021
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: second on 15Apr2021 and third dose of the vaccine on 18Aug2021; third dose of the vaccine on 18Aug2021; gave patient their 3rd vaccine dose from the expired vial; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (gave patient their 3rd vaccine dose from the expired vial), INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second on 15Apr2021 and third dose of the vaccine on 18Aug2021) and EXTRA DOSE ADMINISTERED (third dose of the vaccine on 18Aug2021) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M20A) for COVID-19 vaccination. Concurrent medical conditions included Immunocompromised. Concomitant products included PREDNISONE for an unknown indication. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (gave patient their 3rd vaccine dose from the expired vial) and EXTRA DOSE ADMINISTERED (third dose of the vaccine on 18Aug2021). On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second on 15Apr2021 and third dose of the vaccine on 18Aug2021). At the time of the report, EXPIRED PRODUCT ADMINISTERED (gave patient their 3rd vaccine dose from the expired vial) outcome was unknown and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second on 15Apr2021 and third dose of the vaccine on 18Aug2021) and EXTRA DOSE ADMINISTERED (third dose of the vaccine on 18Aug2021) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment information were not provided by the reporter. Patient received 3rd dose of vaccine on 18th Aug 2021 at 02:50 PM (Batch#: 088D21A) in the left arm. Vial has been dispose as of now confirmed by the pharmacist. Patient received second dose of vaccine on 15th April 2021 (Batch#: 036B21A) This case was linked to MOD-2021-291158 (Patient Link).

Other Meds: PREDNISONE

Current Illness: Immunocompromised

ID: 1672523
Sex: U
Age:
State:

Vax Date: 02/08/2021
Onset Date:
Rec V Date: 09/04/2021
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: One dose of the moderna on February 8 and did not receive my second shot; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (One dose of the moderna on February 8 and did not receive my second shot) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 08-Feb-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 (One dose of the moderna on February 8 and did not receive my second shot). At the time of the report, PRODUCT DOSE OMISSION ISSUE (One dose of the moderna on February 8 and did not receive my second shot) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1672524
Sex: F
Age: 37
State: TX

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 09/04/2021
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: red in colour; knot that keeps getting bigger; hot to the touch; redness and swelling started at the injection site and grew from there; redness and swelling started at the injection site and grew from there; swelling of the left upper arm; fever; chills; flu-like symptoms; body aches; This spontaneous case was reported by an other health care professional and describes the occurrence of PYREXIA (fever), CHILLS (chills), INFLUENZA LIKE ILLNESS (flu-like symptoms), PAIN (body aches) and ERYTHEMA (red in colour) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 10-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Aug-2021, the patient experienced PYREXIA (fever), CHILLS (chills), INFLUENZA LIKE ILLNESS (flu-like symptoms) and PAIN (body aches). On 11-Aug-2021, the patient experienced ERYTHEMA (red in colour), MASS (knot that keeps getting bigger), FEELING HOT (hot to the touch), VACCINATION SITE ERYTHEMA (redness and swelling started at the injection site and grew from there), VACCINATION SITE SWELLING (redness and swelling started at the injection site and grew from there) and PERIPHERAL SWELLING (swelling of the left upper arm). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. On 10-Aug-2021, PYREXIA (fever), CHILLS (chills), INFLUENZA LIKE ILLNESS (flu-like symptoms) and PAIN (body aches) had resolved. At the time of the report, ERYTHEMA (red in colour), MASS (knot that keeps getting bigger), FEELING HOT (hot to the touch), VACCINATION SITE ERYTHEMA (redness and swelling started at the injection site and grew from there), VACCINATION SITE SWELLING (redness and swelling started at the injection site and grew from there) and PERIPHERAL SWELLING (swelling of the left upper arm) 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. It was reported that the patient was not on any concomitant medication. It was reported that the next day 11 Aug 2021after the vaccine was administered the patient had swelling of the left upper arm, a knot that keeps getting bigger, it is hot to the touch, red in color, and measures 3x3. The patient described the redness and swelling started at the injection site and grew from there.

Other Meds:

Current Illness:

ID: 1672525
Sex: F
Age: 68
State:

Vax Date: 07/20/2021
Onset Date: 08/18/2021
Rec V Date: 09/04/2021
Hospital:

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

Lab Data: Test Name: body temperature; Result Unstructured Data: 100.4 degrees Farenheight

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: feel dizzy/dizzy; Headache; Chills; Sore left deltoid muscle; Fever 100.4 degrees Farenheight; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (feel dizzy/dizzy), HEADACHE (Headache), CHILLS (Chills), MYALGIA (Sore left deltoid muscle) and PYREXIA (Fever 100.4 degrees Farenheight) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021B21A-1) for COVID-19 vaccination. No Medical History information was reported. On 20-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced DIZZINESS (feel dizzy/dizzy), HEADACHE (Headache), CHILLS (Chills), MYALGIA (Sore left deltoid muscle) and PYREXIA (Fever 100.4 degrees Farenheight). At the time of the report, DIZZINESS (feel dizzy/dizzy), HEADACHE (Headache), CHILLS (Chills), MYALGIA (Sore left deltoid muscle) and PYREXIA (Fever 100.4 degrees Farenheight) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100.4 (High) 100.4 degrees Farenheight. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. The treatment information was unknown.

Other Meds:

Current Illness:

ID: 1672526
Sex: F
Age: 71
State: KY

Vax Date: 08/09/2021
Onset Date: 08/16/2021
Rec V Date: 09/04/2021
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: Experienced a hot; Covid arm; itchy; red spot/Rash; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Experienced a hot), VACCINATION COMPLICATION (Covid arm), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE ERYTHEMA (red spot/Rash) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E27A) for COVID-19 vaccination. No Medical History information was reported. On 09-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced VACCINATION SITE WARMTH (Experienced a hot), VACCINATION COMPLICATION (Covid arm), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE ERYTHEMA (red spot/Rash). At the time of the report, VACCINATION SITE WARMTH (Experienced a hot), VACCINATION COMPLICATION (Covid arm), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE ERYTHEMA (red spot/Rash) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. No concomitant medications were reported. No Treatment medications were reported.

Other Meds:

Current Illness:

ID: 1672527
Sex: U
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 09/04/2021
Hospital:

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

Lab Data: Test Name: COVID-19 Virus test; Test Result: Positive ; Result Unstructured Data: tested positive for COVID

Allergies:

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

Symptoms: tested positive for 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 (tested positive for Covid) 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 COVID-19 (tested positive for Covid). At the time of the report, COVID-19 (tested positive for Covid) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: positive (Positive) tested positive for COVID. 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: 1672528
Sex: M
Age: 16
State: MD

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 09/04/2021
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: Under 18 child was erroneously given the first shot of the Moderna vaccine and now cannot get the 2nd shot; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Under 18 child was erroneously given the first shot of the Moderna vaccine and now cannot get the 2nd shot) in a 16-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 03-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Apr-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Under 18 child was erroneously given the first shot of the Moderna vaccine and now cannot get the 2nd shot). On 03-Apr-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Under 18 child was erroneously given the first shot of the Moderna vaccine and now cannot get the 2nd shot) had resolved. Concomitant product use was not provided. Treatment information was not provided. now the patient cannot get second dose.

Other Meds:

Current Illness:

ID: 1672529
Sex: M
Age: 69
State: LA

Vax Date: 07/20/2021
Onset Date: 08/18/2021
Rec V Date: 09/04/2021
Hospital:

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

Lab Data: Test Name: Body temperature; Result Unstructured Data: 101.7F

Allergies:

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

Symptoms: side effects; Hand muscles are weak after second shot; Trouble holding things in his hands after second shot; Dropsy after second shot; Fever 101.7F unresponsive to Excedrin after second shot; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (side effects), MUSCULAR WEAKNESS (Hand muscles are weak after second shot), LIMB DISCOMFORT (Trouble holding things in his hands after second shot), SWELLING (Dropsy after second shot) and PYREXIA (Fever 101.7F unresponsive to Excedrin after second shot) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002F21A and 052C21A) for COVID-19 vaccination. No Medical History information was reported. On 20-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced MUSCULAR WEAKNESS (Hand muscles are weak after second shot), LIMB DISCOMFORT (Trouble holding things in his hands after second shot), SWELLING (Dropsy after second shot) and PYREXIA (Fever 101.7F unresponsive to Excedrin after second shot). On an unknown date, the patient experienced VACCINATION COMPLICATION (side effects). The patient was treated with ACETYLSALICYLIC ACID, CAFFEINE, PARACETAMOL (EXCEDRIN EXTRA STRENGTH) for Fever, at a dose of Extra Strength. At the time of the report, VACCINATION COMPLICATION (side effects), MUSCULAR WEAKNESS (Hand muscles are weak after second shot), LIMB DISCOMFORT (Trouble holding things in his hands after second shot), SWELLING (Dropsy after second shot) and PYREXIA (Fever 101.7F unresponsive to Excedrin after second shot) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 101.7 (High) 101.7F. No concomitant medications were provided by the reporter. This case was linked to MOD-2021-290928 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 18-Aug-2021: FU received on 18-AUG-2021 contains no new information

Other Meds:

Current Illness:

ID: 1672530
Sex: F
Age: 67
State: IL

Vax Date: 07/26/2021
Onset Date: 07/29/2021
Rec V Date: 09/04/2021
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: developed rash on injection site 2 weeks later/She reports it as a covid arm.; sore left arm after 3 days; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore left arm after 3 days) and VACCINATION SITE RASH (developed rash on injection site 2 weeks later/She reports it as a covid arm.) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 054C21A) for COVID-19 vaccination. Concomitant products included POTASSIUM, ACETYLSALICYLIC ACID (BABY ASPIRIN), CARVEDILOL (COREG) and LEVOTHYROXINE SODIUM (LEVOXYL) for an unknown indication. On 26-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced PAIN IN EXTREMITY (sore left arm after 3 days). On 08-Aug-2021, the patient experienced VACCINATION SITE RASH (developed rash on injection site 2 weeks later/She reports it as a covid arm.). The patient was treated with CAMPHOR, MENTHOL (ICY HOT ADVANCED RELIEF [CAMPHOR;MENTHOL]) at an unspecified dose and frequency and LIDOCAINE (SALONPAS LIDOCAINE) at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (sore left arm after 3 days) and VACCINATION SITE RASH (developed rash on injection site 2 weeks later/She reports it as a covid arm.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: Potassium; Baby Aspirin; Coreg; Levoxyl

Current Illness:

ID: 1672531
Sex: F
Age: 21
State: IN

Vax Date: 06/02/2021
Onset Date:
Rec V Date: 09/04/2021
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: I did not have a period in over a year, and the day after the first and second vaccination I had my period; More than 35 days between first and second shot; This spontaneous case was reported by a consumer and describes the occurrence of THERAPEUTIC RESPONSE UNEXPECTED (I did not have a period in over a year, and the day after the first and second vaccination I had my period) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot) in a 21-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041C21A) for COVID-19 vaccination. Concurrent medical conditions included Menstrual cycle abnormal. Concomitant products included TESTOSTERONE for Menses irregular, ESCITALOPRAM OXALATE (LEXAPRO) and ARIPIPRAZOLE (ABILIFY) for an unknown indication. On 02-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In 2021, the patient experienced THERAPEUTIC RESPONSE UNEXPECTED (I did not have a period in over a year, and the day after the first and second vaccination I had my period) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot). At the time of the report, THERAPEUTIC RESPONSE UNEXPECTED (I did not have a period in over a year, and the day after the first and second vaccination I had my period) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No treatment information was reported. This case was linked to MOD-2021-291011 (Patient Link).

Other Meds: LEXAPRO; TESTOSTERONE; ABILIFY

Current Illness: Menstrual cycle abnormal

ID: 1672532
Sex: F
Age: 21
State: IN

Vax Date: 06/02/2021
Onset Date: 08/16/2021
Rec V Date: 09/04/2021
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: I did not have a period in over a year, and the day after the first and second vaccination I had my period; More than 35 days between first and second shot; This spontaneous case was reported by a consumer and describes the occurrence of MENSTRUAL DISORDER (I did not have a period in over a year, and the day after the first and second vaccination I had my period) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot) in a 21-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 05392114 and 041C21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included ESCITALOPRAM OXALATE (LEXAPRO), TESTOSTERONE and ARIPIPRAZOLE (ABILIFY) 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 16-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot). On 17-Aug-2021, the patient experienced MENSTRUAL DISORDER (I did not have a period in over a year, and the day after the first and second vaccination I had my period). On 16-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot) had resolved. At the time of the report, MENSTRUAL DISORDER (I did not have a period in over a year, and the day after the first and second vaccination I had my period) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient says she takes testosterone as her body does not produce Estrogen and that she never has a period. treatment information was not provided This case was linked to MOD-2021-291006 (Patient Link).

Other Meds: LEXAPRO; TESTOSTERONE; ABILIFY

Current Illness:

ID: 1672533
Sex: F
Age: 72
State: FL

Vax Date: 01/13/2021
Onset Date: 08/17/2021
Rec V Date: 09/04/2021
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: Horrible severe fatigue; Multiple joint worse than what she normally experiences with her multiple sclerosis; Muscle pain worse than what she normally experiences with her multiple sclerosis; Extra dose administered; This spontaneous case was reported by a consumer and describes the occurrence of EXTRA DOSE ADMINISTERED (Extra dose administered), FATIGUE (Horrible severe fatigue), ARTHRALGIA (Multiple joint worse than what she normally experiences with her multiple sclerosis) and MYALGIA (Muscle pain worse than what she normally experiences with her multiple sclerosis) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017E21A, 012M20A and 012L20A) for COVID-19 vaccination. Concurrent medical conditions included Multiple sclerosis (diagnosed 6 years ago). On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXTRA DOSE ADMINISTERED (Extra dose administered). On 18-Aug-2021, the patient experienced FATIGUE (Horrible severe fatigue), ARTHRALGIA (Multiple joint worse than what she normally experiences with her multiple sclerosis) and MYALGIA (Muscle pain worse than what she normally experiences with her multiple sclerosis). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date for Adverse event, at an unspecified dose and frequency. On 17-Aug-2021, EXTRA DOSE ADMINISTERED (Extra dose administered) had resolved. At the time of the report, FATIGUE (Horrible severe fatigue), ARTHRALGIA (Multiple joint worse than what she normally experiences with her multiple sclerosis) and MYALGIA (Muscle pain worse than what she normally experiences with her multiple sclerosis) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient stated that about 24 hours after getting the booster shot, she had horrible severe fatigue, multiple joint and muscle pain; worse than what she normally experiences with her multiple sclerosis. She also used Medical Marijuana gummies; but she was still having the symptoms. Her husband stated that she takes lots of other medication but did not provide them.

Other Meds:

Current Illness: Multiple sclerosis (diagnosed 6 years ago)

ID: 1672534
Sex: F
Age: 53
State: TX

Vax Date: 08/07/2021
Onset Date: 08/12/2021
Rec V Date: 09/04/2021
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: leg pain/that her left leg kept giving out on her; back pain; difficulty walking; This spontaneous case was reported by a pharmacist and describes the occurrence of PAIN IN EXTREMITY (leg pain/that her left leg kept giving out on her), BACK PAIN (back pain) and GAIT DISTURBANCE (difficulty walking) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052D21A) for COVID-19 vaccination. Concomitant products included LOSARTAN, HYDROCHLOROTHIAZIDE and Nexium for an unknown indication. On 07-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Aug-2021, the patient experienced PAIN IN EXTREMITY (leg pain/that her left leg kept giving out on her), BACK PAIN (back pain) and GAIT DISTURBANCE (difficulty walking). At the time of the report, PAIN IN EXTREMITY (leg pain/that her left leg kept giving out on her), BACK PAIN (back pain) and GAIT DISTURBANCE (difficulty walking) was resolving. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment product information was not provided.

Other Meds: LOSARTAN; HYDROCHLOROTHIAZIDE; Nexium

Current Illness:

ID: 1672535
Sex: F
Age:
State: TX

Vax Date: 07/22/2021
Onset Date:
Rec V Date: 09/04/2021
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: eyes started getting crusty and watery/can barely open her eyes or see for 30 minutes to 1 hour in the morning; eyes started getting crusty and watery; fatigue; headache; This spontaneous case was reported by a consumer and describes the occurrence of EYELID MARGIN CRUSTING (eyes started getting crusty and watery/can barely open her eyes or see for 30 minutes to 1 hour in the morning), LACRIMATION INCREASED (eyes started getting crusty and watery), FATIGUE (fatigue) and HEADACHE (headache) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038C21A) for COVID-19 vaccination. The patient's past medical history included Peripheral neuropathy. Concurrent medical conditions included Sinus disorder NOS (Patient state that she takes cold medications for her sinus allergy.). On 22-Jul-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced EYELID MARGIN CRUSTING (eyes started getting crusty and watery/can barely open her eyes or see for 30 minutes to 1 hour in the morning), LACRIMATION INCREASED (eyes started getting crusty and watery), FATIGUE (fatigue) and HEADACHE (headache). The patient was treated with ACETYLSALICYLIC ACID (ASPIRINE) for Headache, at an unspecified dose and frequency. At the time of the report, EYELID MARGIN CRUSTING (eyes started getting crusty and watery/can barely open her eyes or see for 30 minutes to 1 hour in the morning) and LACRIMATION INCREASED (eyes started getting crusty and watery) outcome was unknown and FATIGUE (fatigue) and HEADACHE (headache) had not resolved. The cold medications are concomitant medications. This case was linked to MOD-2021-132097 (Patient Link).

Other Meds:

Current Illness:

ID: 1672536
Sex: M
Age: 68
State: FL

Vax Date: 02/12/2021
Onset Date:
Rec V Date: 09/04/2021
Hospital:

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

Lab Data: Test Date: 2021; Test Name: SARS-CoV-2 test; Test Result: Negative ; Result Unstructured Data: Negative

Allergies:

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

Symptoms: He thinks he has COVID; Full blown sick; Upset stomach; Like he had a flu; Running nose; Wasn't sleeping that good; Woke up in sweats; Nasal congestion; cold; Saturday was his bad day; immunocompromised; A little tired; Fever; Body ache; Headache; This spontaneous case was reported by a consumer and describes the occurrence of SUSPECTED COVID-19 (He thinks he has COVID), ILLNESS (Full blown sick), ABDOMINAL DISCOMFORT (Upset stomach), INFLUENZA LIKE ILLNESS (Like he had a flu) and RHINORRHOEA (Running nose) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 048A21A and 030M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Oral cancer stage unspecified in 2020, Radiation therapy and Tooth extraction (The patient's all upper teeth was removed last year.) in 2020. Concomitant products included MIRTAZAPINE, ALPRAZOLAM, PANTOPRAZOLE and MORPHINE for an unknown indication. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Mar-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 SUSPECTED COVID-19 (He thinks he has COVID), ILLNESS (Full blown sick), ABDOMINAL DISCOMFORT (Upset stomach), INFLUENZA LIKE ILLNESS (Like he had a flu), RHINORRHOEA (Running nose), POOR QUALITY SLEEP (Wasn't sleeping that good), HYPERHIDROSIS (Woke up in sweats), NASAL CONGESTION (Nasal congestion), NASOPHARYNGITIS (cold), FEELING ABNORMAL (Saturday was his bad day), IMMUNODEFICIENCY (immunocompromised), FATIGUE (A little tired), PYREXIA (Fever), MYALGIA (Body ache) and HEADACHE (Headache). The patient was treated with DEXTROMETHORPHAN HYDROBROMIDE, DOXYLAMINE SUCCINATE, EPHEDRINE SULFATE, ETHANOL, PARACETAMOL (NYQUIL) for Runny nose and Nasal congestion, at an unspecified dose and frequency; IBUPROFEN (ADVIL [IBUPROFEN]) for Headache, at an unspecified dose and frequency and ACETYLSALICYLIC ACID, CAFFEINE, PARACETAMOL, SALICYLAMIDE (EXCEDRIN [ACETYLSALICYLIC ACID;CAFFEINE;PARACETAMOL;SALICYLAMIDE]) for Headache, at an unspecified dose and frequency. At the time of the report, SUSPECTED COVID-19 (He thinks he has COVID), ILLNESS (Full blown sick), ABDOMINAL DISCOMFORT (Upset stomach), INFLUENZA LIKE ILLNESS (Like he had a flu), RHINORRHOEA (Running nose), POOR QUALITY SLEEP (Wasn't sleeping that good), HYPERHIDROSIS (Woke up in sweats), NASAL CONGESTION (Nasal congestion), NASOPHARYNGITIS (cold), FEELING ABNORMAL (Saturday was his bad day), IMMUNODEFICIENCY (immunocompromised), FATIGUE (A little tired), PYREXIA (Fever), MYALGIA (Body ache) and HEADACHE (Headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, SARS-CoV-2 test: negative (Negative) Negative. On 18 Aug 2021, the patient retested for COVID-19 and waiting for the result at the time of call. Treatment also included a decongestion spray. The patient had tested negative for COVID-19 on last Friday, but the patient thinks that the test was performed wrong and he has COVID-19. The patient thinks that he caught COVID-19 from his dog as his dog had running nose initially. The patient states that his weight is in the upper 130 lbs now and putting on weight was difficult as it was hard for him to eat without teeth. Most recent FOLLOW-UP information incorporated above includes: On 23-Aug-2021: Significant FU received: Events updated.

Other Meds: MIRTAZAPINE; ALPRAZOLAM; PANTOPRAZOLE; MORPHINE

Current Illness:

ID: 1672537
Sex: F
Age: 55
State: NC

Vax Date: 03/19/2021
Onset Date:
Rec V Date: 09/04/2021
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: Severe flu like symptoms; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Severe flu like symptoms) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19 (Patient stated that she got infected with COVID-19) on 15-Dec-2020. Concurrent medical conditions included Breathing difficult (Patient had to go to a pulmonologist and a physical therapist to get better). On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced INFLUENZA LIKE ILLNESS (Severe flu like symptoms). At the time of the report, INFLUENZA LIKE ILLNESS (Severe flu like symptoms) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant and treatment medications were provided On an unspecified date Patient's primary care physician referred her to a spine specialist, and they ordered her to get X-Ray and CT- Scan. Patient stated that her spine doctor told her that her X-ray and CT-scan both were fine, and she might have arthritis. Patient went to physical therapist and acupuncture therapist but she has not felt any improvement. This case was linked to MOD-2021-291122 (Patient Link).

Other Meds:

Current Illness: Breathing difficult (Patient had to go to a pulmonologist and a physical therapist to get better)

ID: 1672538
Sex: M
Age: 25
State: MI

Vax Date: 12/01/2020
Onset Date:
Rec V Date: 09/04/2021
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: only received one dose of the moderna vaccine; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (only received one dose of the moderna vaccine) in a 26-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In December 2020, 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 (only received one dose of the moderna vaccine). At the time of the report, PRODUCT DOSE OMISSION ISSUE (only received one dose of the moderna vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1672539
Sex: M
Age: 42
State: AL

Vax Date: 08/15/2021
Onset Date: 08/15/2021
Rec V Date: 09/04/2021
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: Chills; A high heart rate, sitting still it was 125 bpm; Had cold chills; He was not feeling good,he felt bad all day; Had 102 fever which then went normal,102 fever,101.5 fever; Sore shoulder; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE INCREASED (A high heart rate, sitting still it was 125 bpm), FEELING ABNORMAL (He was not feeling good,he felt bad all day), CHILLS (Had cold chills), ARTHRALGIA (Sore shoulder) and PYREXIA (Had 102 fever which then went normal,102 fever,101.5 fever) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. #052E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 15-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, the patient experienced ARTHRALGIA (Sore shoulder). On 16-Aug-2021, the patient experienced FEELING ABNORMAL (He was not feeling good,he felt bad all day) and PYREXIA (Had 102 fever which then went normal,102 fever,101.5 fever). On 17-Aug-2021, the patient experienced HEART RATE INCREASED (A high heart rate, sitting still it was 125 bpm) and CHILLS (Had cold chills). On 18-Aug-2021, the patient experienced CHILLS (Chills). At the time of the report, HEART RATE INCREASED (A high heart rate, sitting still it was 125 bpm), FEELING ABNORMAL (He was not feeling good,he felt bad all day), CHILLS (Had cold chills), ARTHRALGIA (Sore shoulder), PYREXIA (Had 102 fever which then went normal,102 fever,101.5 fever) and CHILLS (Chills) outcome was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1672540
Sex: M
Age:
State: AR

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 09/04/2021
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: 17 year old got the first Moderna vaccine; This spontaneous case was reported by an other health care professional and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17 year old got the first Moderna vaccine) in a 17-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008B21A) for COVID-19 vaccination. No Medical History information was reported. On 11-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Aug-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17 year old got the first Moderna vaccine). On 11-Aug-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17 year old got the first Moderna vaccine) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments. No concomitant information was reported. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1672541
Sex: F
Age: 61
State: CA

Vax Date: 07/19/2021
Onset Date: 08/17/2021
Rec V Date: 09/04/2021
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: 20210817; Test Name: Body temperature; Result Unstructured Data: Running high temperature, two lines over 102

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Very hot to the touch; Very red around injection site; Swollen at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Very hot to the touch), VACCINATION SITE ERYTHEMA (Very red around injection site) and VACCINATION SITE SWELLING (Swollen at the injection site) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 088D21A and 027D21A) for COVID-19 vaccination. No Medical History information was reported. On 19-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, the patient experienced VACCINATION SITE WARMTH (Very hot to the touch), VACCINATION SITE ERYTHEMA (Very red around injection site) and VACCINATION SITE SWELLING (Swollen at the injection site). At the time of the report, VACCINATION SITE WARMTH (Very hot to the touch), VACCINATION SITE ERYTHEMA (Very red around injection site) and VACCINATION SITE SWELLING (Swollen at the injection site) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Aug-2021, Body temperature: high (High) Running high temperature, two lines over 102. No concomitant medications were reported. The patient kept ice on vaccination site as her Pharmacist recommended to do.

Other Meds:

Current Illness:

ID: 1672542
Sex: F
Age: 74
State: MA

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 09/04/2021
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: gave patient a dose from an expired vial; gave patient their 3rd vaccine dose; Extra dose adminstered; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (gave patient a dose from an expired vial), OFF LABEL USE (gave patient their 3rd vaccine dose) and EXTRA DOSE ADMINISTERED (Extra dose adminstered) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Kidney disorder (Kidney issues.). On 18-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (gave patient a dose from an expired vial), OFF LABEL USE (gave patient their 3rd vaccine dose) and EXTRA DOSE ADMINISTERED (Extra dose adminstered). At the time of the report, EXPIRED PRODUCT ADMINISTERED (gave patient a dose from an expired vial), OFF LABEL USE (gave patient their 3rd vaccine dose) and EXTRA DOSE ADMINISTERED (Extra dose adminstered) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness: Kidney disorder (Kidney issues.)

ID: 1672543
Sex: F
Age:
State: CA

Vax Date: 02/02/2021
Onset Date: 03/12/2021
Rec V Date: 09/04/2021
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: Her injection site arm was sore; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Her injection site arm was sore) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 001B21A and 013M20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 12-Mar-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PAIN IN EXTREMITY (Her injection site arm was sore). At the time of the report, PAIN IN EXTREMITY (Her injection site arm was sore) outcome was unknown. No concomitant medication was reported. The Partial date of birth was provided as13 May, year was declined. Treatment medication was not provided by the reporter. This case was linked to MOD-2021-291045, MOD-2021-291120 (Patient Link).

Other Meds:

Current Illness:

ID: 1672544
Sex: M
Age:
State: CT

Vax Date: 02/01/2021
Onset Date:
Rec V Date: 09/04/2021
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: My arm was sore; I had a fever; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (My arm was sore) and PYREXIA (I had a fever) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In February 2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, 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 (My arm was sore) and PYREXIA (I had a fever). At the time of the report, PAIN IN EXTREMITY (My arm was sore) and PYREXIA (I had a fever) outcome was unknown. No concomitant medications were reported. The patient had first 2 injections of moderna Covid-19 vaccine on an unknown date in Feb-2021 which went well. Patient received third dose on 13-Aug-2021 and experienced a sore arm and tiredness. Patient was scheduled for another dose, the 2nd one (Booster), which he wanted to get the scheduled 4th dose. Treatment information was not provided. This case was linked to MOD-2021-291170 (Patient Link).

Other Meds:

Current Illness:

ID: 1672545
Sex: F
Age: 56
State: CT

Vax Date: 12/31/2020
Onset Date: 01/30/2021
Rec V Date: 09/04/2021
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: hurts/problems with her arm/couldn't lift it all the way up/couldn't sleep on it/couldn't move it; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (hurts/problems with her arm/couldn't lift it all the way up/couldn't sleep on it/couldn't move it ) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 028L20A and 026L20A) for COVID-19 vaccination. No Medical History information was reported. On 31-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 30-Jan-2021, the patient experienced MYALGIA (hurts/problems with her arm/couldn't lift it all the way up/couldn't sleep on it/couldn't move it ). At the time of the report, MYALGIA (hurts/problems with her arm/couldn't lift it all the way up/couldn't sleep on it/couldn't move it ) outcome was unknown. Concomitant medications were not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1672546
Sex: F
Age:
State: CA

Vax Date: 02/02/2021
Onset Date: 08/17/2021
Rec V Date: 09/04/2021
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 her booster dose of the Moderna Covid-19 vaccine; her injection site arm was sore; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (her injection site arm was sore) and EXTRA DOSE ADMINISTERED (Received her booster dose of the Moderna Covid-19 vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 939901, 001B21A and 013M20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, the patient experienced VACCINATION SITE PAIN (her injection site arm was sore). On an unknown date, the patient experienced EXTRA DOSE ADMINISTERED (Received her booster dose of the Moderna Covid-19 vaccine). At the time of the report, VACCINATION SITE PAIN (her injection site arm was sore) and EXTRA DOSE ADMINISTERED (Received her booster dose of the Moderna Covid-19 vaccine) outcome was unknown. Patient Date of Birth was mentioned as 13May (declined yr) Concomitant product use was not provided by the reporter. Treatment information was not provided. This case was linked to MOD-2021-291045.

Other Meds:

Current Illness:

ID: 1672547
Sex: F
Age: 77
State: FL

Vax Date: 02/16/2021
Onset Date: 03/16/2021
Rec V Date: 09/04/2021
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: Arm was swollen to the elbow; Began to itch again,itching; Redness/swelling/lumpiness began to wrap around her arm to her armpit; Arm hurt; Migraine; Vertigo; Dizziness; Flu like; Lumps the size of quarters in a 4 x4 inch patch, 3 inches below injection site; Just didn't feel good,Very sick and went to bed; Arm was red; Nausea; Achy Muscle and joints; (Right arm) was sore; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Arm was swollen to the elbow), PRURITUS (Began to itch again,itching), SKIN MASS (Redness/swelling/lumpiness began to wrap around her arm to her armpit), PAIN IN EXTREMITY (Arm hurt) and MIGRAINE (Migraine) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for an unknown indication. On 16-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Mar-2021, the patient experienced PERIPHERAL SWELLING (Arm was swollen to the elbow), PRURITUS (Began to itch again,itching), SKIN MASS (Redness/swelling/lumpiness began to wrap around her arm to her armpit), PAIN IN EXTREMITY (Arm hurt), MIGRAINE (Migraine), VERTIGO (Vertigo), DIZZINESS (Dizziness), INFLUENZA LIKE ILLNESS (Flu like), VACCINATION SITE MASS (Lumps the size of quarters in a 4 x4 inch patch, 3 inches below injection site), MALAISE (Just didn't feel good,Very sick and went to bed), ERYTHEMA (Arm was red), NAUSEA (Nausea), ARTHRALGIA (Achy Muscle and joints) and MYALGIA ((Right arm) was sore). On 24-Mar-2021, PERIPHERAL SWELLING (Arm was swollen to the elbow), PAIN IN EXTREMITY (Arm hurt), MIGRAINE (Migraine), VERTIGO (Vertigo), DIZZINESS (Dizziness), INFLUENZA LIKE ILLNESS (Flu like), VACCINATION SITE MASS (Lumps the size of quarters in a 4 x4 inch patch, 3 inches below injection site), MALAISE (Just didn't feel good,Very sick and went to bed), ERYTHEMA (Arm was red), NAUSEA (Nausea), ARTHRALGIA (Achy Muscle and joints) and MYALGIA ((Right arm) was sore) had resolved. At the time of the report, PRURITUS (Began to itch again,itching) and SKIN MASS (Redness/swelling/lumpiness began to wrap around her arm to her armpit) had not resolved. The Treatment history was not reported. Patient's all of the symptoms went away again after 7-8 days except for the itching and redness/swelling of her arm. Patient feeled about 70%. This case was linked to MOD-2021-290851, MOD-2021-291781 (Patient Link).

Other Meds: BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]

Current Illness:

ID: 1672548
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/04/2021
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: Chills; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Chills) 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 CHILLS (Chills). At the time of the report, CHILLS (Chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1672549
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/04/2021
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: I contract covid around two weeks after the first dose; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (I contract covid around two weeks after the first dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced COVID-19 (I contract covid around two weeks after the first dose). At the time of the report, COVID-19 (I contract covid around two weeks after the first dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatment mediations were provided. Patient would like to know if patient contract covid around two weeks after the first dose, how long do patient have to wait for the second dose.

Other Meds:

Current Illness:

ID: 1672550
Sex: M
Age: 66
State: MO

Vax Date: 07/19/2021
Onset Date: 08/16/2021
Rec V Date: 09/04/2021
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: Headache after the second shot; Pain all over body after the second shot; Low Grade Fever after the second shot; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache after the second shot), MYALGIA (Pain all over body after the second shot) and PYREXIA (Low Grade Fever after the second shot) in a 56-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. Concurrent medical conditions included Amputee (Left leg above knee). On 19-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced HEADACHE (Headache after the second shot), MYALGIA (Pain all over body after the second shot) and PYREXIA (Low Grade Fever after the second shot). On 18-Aug-2021, HEADACHE (Headache after the second shot), MYALGIA (Pain all over body after the second shot) and PYREXIA (Low Grade Fever after the second shot) had resolved. No Concomitant Medications were provided. No Treatment Medications were provided.

Other Meds:

Current Illness: Amputee (Left leg above knee)

ID: 1672551
Sex: U
Age:
State: OR

Vax Date: 03/02/2021
Onset Date:
Rec V Date: 09/04/2021
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: first dose on 2March2021 and did not get his second 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 PRODUCT DOSE OMISSION ISSUE (first dose on 2March2021 and did not get his second 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 02-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (first dose on 2March2021 and did not get his second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (first dose on 2March2021 and did not get his second dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1672552
Sex: F
Age: 24
State: GA

Vax Date: 04/15/2021
Onset Date:
Rec V Date: 09/04/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Patient waited to get the second dose; Left arm hurt; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Left arm hurt) and PRODUCT ADMINISTRATION INTERRUPTED (Patient waited to get the second dose) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047A21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 in December 2020. On 15-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 PAIN IN EXTREMITY (Left arm hurt) and PRODUCT ADMINISTRATION INTERRUPTED (Patient waited to get the second dose). At the time of the report, PAIN IN EXTREMITY (Left arm hurt) and PRODUCT ADMINISTRATION INTERRUPTED (Patient waited to get the second dose) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. Concomitant product use was not provided by the reporter. The patient reported that the reason behind a large gap between the first dose and the second dose was due to she had no facility close to her that supplied the Moderna vaccine. No treatment information was provided. This case was linked to MOD-2021-291331 (Patient Link).

Other Meds:

Current Illness:

ID: 1672553
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/04/2021
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: Headaches; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headaches) 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 HEADACHE (Headaches). At the time of the report, HEADACHE (Headaches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment product information was not provided. Concomitant product use was not provided.

Other Meds:

Current Illness:

ID: 1672554
Sex: F
Age:
State: NY

Vax Date: 04/15/2021
Onset Date: 06/19/2021
Rec V Date: 09/04/2021
Hospital:

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

Lab Data: Test Name: Test nos; Result Unstructured Data: normal; Test Name: ultrasound; Result Unstructured Data: normal; Test Name: X-ray; Result Unstructured Data: normal

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: She had all the problems that everyone has but it was really severe; leg lump/subcutaneous fat lobule that created a tumor like lump in her inner right thigh; was feeling terrible; base of her spine still hurts; started having chest pains; got the same inflammation and it hurt so bad she could not sit down or bend over, it was terrible; got the same inflammation and it hurt so bad she could not sit down or bend over, it was terrible; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (She had all the problems that everyone has but it was really severe), SKIN MASS (leg lump/subcutaneous fat lobule that created a tumor like lump in her inner right thigh), FEELING ABNORMAL (was feeling terrible), INFLAMMATION (got the same inflammation and it hurt so bad she could not sit down or bend over, it was terrible) and SPINAL PAIN (base of her spine still hurts) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 038C21A and 039B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 15-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 19-Jun-2021, the patient experienced INFLAMMATION (got the same inflammation and it hurt so bad she could not sit down or bend over, it was terrible). On an unknown date, the patient experienced VACCINATION COMPLICATION (She had all the problems that everyone has but it was really severe), SKIN MASS (leg lump/subcutaneous fat lobule that created a tumor like lump in her inner right thigh), FEELING ABNORMAL (was feeling terrible), SPINAL PAIN (base of her spine still hurts), CHEST PAIN (started having chest pains) and MOBILITY DECREASED (got the same inflammation and it hurt so bad she could not sit down or bend over, it was terrible). At the time of the report, VACCINATION COMPLICATION (She had all the problems that everyone has but it was really severe), SKIN MASS (leg lump/subcutaneous fat lobule that created a tumor like lump in her inner right thigh), FEELING ABNORMAL (was feeling terrible), INFLAMMATION (got the same inflammation and it hurt so bad she could not sit down or bend over, it was terrible), SPINAL PAIN (base of her spine still hurts), CHEST PAIN (started having chest pains) and MOBILITY DECREASED (got the same inflammation and it hurt so bad she could not sit down or bend over, it was terrible) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood test: normal (normal) normal. On an unknown date, Ultrasound scan: normal (normal) normal. On an unknown date, X-ray: normal (normal) normal. Concomitant medication was not provided Patient stated she had all the problems that everyone has but it was really severe, she was feeling terrible. On 19-Jun-2021, 5 weeks later, she got the same inflammation and it hurt so bad she could not sit down or bend over, it was terrible. This went on for 12 days. She got a leg lump as well, her doctor said it is a subcutaneous fat lobule that created a tumor like lump in her inner right thigh. It was extremely terrifying. She thought at first it might be a bug bite but it got bigger and would not go away, she waited 2 weeks for it to go away and then went to the ER they said it was cancer or something. The base of her spine still hurts, the inflammation is not as bad but it's been 2 months later and she still has a little bit of pain in the base of her spine, she had not had this before. ER did all this tests, an ultrasound and an X-ray, everything came back normal, no one can explain it. Now the leg lump has slowly gone down but it's still there, she's still having pain when she sits down and also she started having chest pains. Treatment information was not reported This case was linked to MOD-2021-290987 (Patient Link).

Other Meds:

Current Illness:

ID: 1672555
Sex: U
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 09/04/2021
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: Sick/Horribly ill; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Sick/Horribly ill) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ILLNESS (Sick/Horribly ill). At the time of the report, ILLNESS (Sick/Horribly ill) outcome was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1672556
Sex: M
Age: 85
State: MD

Vax Date: 01/09/2021
Onset Date: 08/16/2021
Rec V Date: 09/04/2021
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 Name: Body temperature; Result Unstructured Data: 100F

Allergies:

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

Symptoms: Sore arm; Fever 100F; Tired; A day in bed; This spontaneous case was reported by a consumer and describes the occurrence of BEDRIDDEN (A day in bed), PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever 100F) and FATIGUE (Tired) in an 85-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025J20A and 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 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 16-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced BEDRIDDEN (A day in bed). On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever 100F) and FATIGUE (Tired). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 dosage form. On 17-Aug-2021, BEDRIDDEN (A day in bed) had resolved. At the time of the report, PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever 100F) and FATIGUE (Tired) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100f (High) 100F. Concomitant product use was not provided by the reporter. On 18 Aug 2021, the patient was feeling fine but not 100 percent. This case was linked to MOD-2021-290368, MOD-2021-290627 (Patient Link).

Other Meds:

Current Illness:

ID: 1672557
Sex: F
Age:
State: CA

Vax Date: 02/19/2021
Onset Date:
Rec V Date: 09/04/2021
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: sore arm; Lots of energy; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (sore arm) and THERAPEUTIC RESPONSE UNEXPECTED (Lots of energy) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022M20A) for COVID-19 vaccination. No Medical History information was reported. On 19-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In 2021, the patient experienced PAIN IN EXTREMITY (sore arm) and THERAPEUTIC RESPONSE UNEXPECTED (Lots of energy). At the time of the report, PAIN IN EXTREMITY (sore arm) and THERAPEUTIC RESPONSE UNEXPECTED (Lots of energy) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. She stated that her side effects were good because she could do some garden work. No relevant concomitant medications were reported. No treatment information was provided.; Sender's Comments: US-MODERNATX, INC.-MOD-2021-291002:Dose 2 case

Other Meds:

Current Illness:

ID: 1672558
Sex: F
Age:
State:

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 09/04/2021
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: Dizziness; Leg tremor; Arm pain; Huge rash that comes and goes; Nausea; Headache; Subcutaneous administration; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), TREMOR (Leg tremor), PAIN IN EXTREMITY (Arm pain), RASH (Huge rash that comes and goes) and NAUSEA (Nausea) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 10-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Subcutaneous) 1 dosage form. On 10-Aug-2021, the patient experienced INCORRECT ROUTE OF PRODUCT ADMINISTRATION (Subcutaneous administration). On an unknown date, the patient experienced DIZZINESS (Dizziness), TREMOR (Leg tremor), PAIN IN EXTREMITY (Arm pain), RASH (Huge rash that comes and goes), NAUSEA (Nausea) and HEADACHE (Headache). At the time of the report, DIZZINESS (Dizziness), TREMOR (Leg tremor), PAIN IN EXTREMITY (Arm pain), NAUSEA (Nausea) and HEADACHE (Headache) outcome was unknown, RASH (Huge rash that comes and goes) had not resolved and INCORRECT ROUTE OF PRODUCT ADMINISTRATION (Subcutaneous administration) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Subcutaneous) was unknown. The patient stated that she experienced a huge rash two to three days post-vaccination, which went away then came back. She also experienced nausea, dizziness, headache, tremors in her leg, pain on her arm. The patient stated that her entire arm was in pain the day before the call. No concomitant product use was provided by the reporter. No treatment medications were reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1672559
Sex: F
Age: 43
State: NY

Vax Date: 05/04/2021
Onset Date:
Rec V Date: 09/04/2021
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: Knot in the arm/Lump in the arm; This spontaneous case was reported by a consumer and describes the occurrence of SKIN MASS (Knot in the arm/Lump in the arm) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038A21A) for COVID-19 vaccination. Concurrent medical conditions included Sickle cell anemia. On 04-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In 2021, the patient experienced SKIN MASS (Knot in the arm/Lump in the arm). At the time of the report, SKIN MASS (Knot in the arm/Lump in the arm) had resolved. Relevant concomitant medications were not provided. Treatment information was not provided. The patient stated that she should be taking medications but she does not. This case was linked to MOD-2021-290615 (Patient Link).

Other Meds:

Current Illness: Sickle cell anemia

ID: 1672560
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/04/2021
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: New adverse effects 3 o 4 days ago; 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 ADVERSE EVENT (New adverse effects 3 o 4 days ago) 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 ADVERSE EVENT (New adverse effects 3 o 4 days ago). At the time of the report, ADVERSE EVENT (New adverse effects 3 o 4 days ago) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. No treatment information was reported.

Other Meds:

Current Illness:

ID: 1672561
Sex: F
Age: 48
State: NM

Vax Date: 03/07/2021
Onset Date: 08/18/2021
Rec V Date: 09/04/2021
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: my heart is skipping/it stops beating for a second; Inappropriate schedule of vaccine administered; fever; This spontaneous case was reported by a consumer and describes the occurrence of EXTRASYSTOLES (my heart is skipping/it stops beating for a second), INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) and PYREXIA (fever) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026A21A and 003A21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included FLUTICASONE for an unknown indication. On 07-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced PYREXIA (fever). On an unknown date, the patient experienced EXTRASYSTOLES (my heart is skipping/it stops beating for a second). an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered). At the time of the report, EXTRASYSTOLES (my heart is skipping/it stops beating for a second) and PYREXIA (fever) outcome was unknown and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) had resolved. Treatment information was not provided. This case was linked to MOD-2021-291503 (Patient Link).

Other Meds: FLUTICASONE

Current Illness:

ID: 1672562
Sex: F
Age:
State:

Vax Date: 08/17/2021
Onset Date: 08/01/2021
Rec V Date: 09/04/2021
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: Fever; Chills; Her body hurts; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever), CHILLS (Chills) and MYALGIA (Her body hurts) 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 17-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In August 2021, the patient experienced PYREXIA (Fever), CHILLS (Chills) and MYALGIA (Her body hurts). At the time of the report, PYREXIA (Fever), CHILLS (Chills) and MYALGIA (Her body hurts) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1672563
Sex: F
Age: 66
State: NH

Vax Date: 07/17/2021
Onset Date: 08/15/2021
Rec V Date: 09/04/2021
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: This spontaneous case was reported by a consumer and describes the occurrence of VASCULAR INJURY (second one was definitely worse she thinks because the woman that gave her the shot hit a blood vessel), VACCINATION SITE PRURITUS (rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash. It is also very itchy), VACCINATION SITE PAIN (achy where she got the shot/burns a little), VACCINATION SITE RASH (rash near where she got the shot/rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash) and HEADACHE (headachy) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included FLUTICASONE PROPIONATE (FLOVENT) for Asthma, AZELASTINE for Rhinitis, METOPROLOL for an unknown indication. On 17-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Aug-2021, the patient experienced VACCINATION SITE RASH (rash near where she got the shot/rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash). On an unknown date, the patient experienced VASCULAR INJURY (second one was definitely worse she thinks because the woman that gave her the shot hit a blood vessel), VACCINATION SITE PRURITUS (rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash. It is also very itchy), VACCINATION SITE PAIN (achy where she got the shot/burns a little), HEADACHE (headachy) and FATIGUE (extremely tired). At the time of the report, VASCULAR INJURY (second one was definitely worse she thinks because the woman that gave her the shot hit a blood vessel), VACCINATION SITE PRURITUS (rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash. It is also very itchy), VACCINATION SITE PAIN (achy where she got the shot/burns a little), VACCINATION SITE RASH (rash near where she got the shot/rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash), HEADACHE (headachy) and FATIGUE (extremely tired) outcome was unknown. No treatment medication were reported. This case was linked to MOD-2021-291193.

Other Meds: METOPROLOL; FLOVENT; AZELASTINE

Current Illness:

ID: 1672564
Sex: F
Age: 24
State: GA

Vax Date: 04/15/2021
Onset Date: 08/16/2021
Rec V Date: 09/04/2021
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: first dose of the Moderna COVID-19 vaccine on 15Apr2021 and the second on 16Aug2021; pressure headache; swelling where the injection was given; Rash the size of an eye patch where the injection was given; sweats; fever; chills; body aches; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (sweats), PYREXIA (fever), CHILLS (chills), MYALGIA (body aches) and HEADACHE (pressure headache) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 04C21A and 047A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19 in December 2020. On 15-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced HYPERHIDROSIS (sweats), PYREXIA (fever), CHILLS (chills) and MYALGIA (body aches). On 17-Aug-2021, the patient experienced HEADACHE (pressure headache), VACCINATION SITE SWELLING (swelling where the injection was given) and VACCINATION SITE ERYTHEMA (Rash the size of an eye patch where the injection was given). On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (first dose of the Moderna COVID-19 vaccine on 15Apr2021 and the second on 16Aug2021). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) for Headache, at an unspecified dose and frequency. On 17-Aug-2021, HYPERHIDROSIS (sweats), PYREXIA (fever), CHILLS (chills) and MYALGIA (body aches) had resolved. At the time of the report, HEADACHE (pressure headache), VACCINATION SITE SWELLING (swelling where the injection was given) and VACCINATION SITE ERYTHEMA (Rash the size of an eye patch where the injection was given) had not resolved and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (first dose of the Moderna COVID-19 vaccine on 15Apr2021 and the second on 16Aug2021) had resolved. No concomitant medications were provided by reporter.

Other Meds:

Current Illness:

ID: 1672565
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/04/2021
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: Vertigo; This spontaneous case was reported by a consumer and describes the occurrence of VERTIGO (Vertigo) 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 VERTIGO (Vertigo). At the time of the report, VERTIGO (Vertigo) 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: 1672566
Sex: M
Age:
State: AZ

Vax Date: 03/24/2021
Onset Date:
Rec V Date: 09/04/2021
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: his fatigue after getting vaccine took much longer; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (his fatigue after getting vaccine took much longer) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026A21A) for COVID-19 vaccination. Concurrent medical conditions included Myasthenia gravis (Autoimmune disease). Concomitant products included CICLOSPORIN (CYCLOSPORINE) for an unknown indication. On 24-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced FATIGUE (his fatigue after getting vaccine took much longer). At the time of the report, FATIGUE (his fatigue after getting vaccine took much longer) outcome was unknown. Treatment information was not provided by the reporter.

Other Meds: CYCLOSPORINE

Current Illness: Myasthenia gravis (Autoimmune disease)

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am