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: 1683582
Sex: F
Age: 62
State: TX

Vax Date: 07/21/2021
Onset Date:
Rec V Date: 09/08/2021
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: Injection site warm to the touch; The patient said it spread from the injection site and there was a bruise/The area was the size a tangerine; The fingers of the left hand started swelling and almost had to have the wedding ring cut off; Joints are swelling; The injection site red; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Injection site warm to the touch), VACCINATION SITE BRUISING (The patient said it spread from the injection site and there was a bruise/The area was the size a tangerine), PERIPHERAL SWELLING (The fingers of the left hand started swelling and almost had to have the wedding ring cut off), JOINT SWELLING (Joints are swelling) and VACCINATION SITE ERYTHEMA (The injection site red) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021C21A) for COVID-19 vaccination. No Medical History information was reported. On 21-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE WARMTH (Injection site warm to the touch), VACCINATION SITE BRUISING (The patient said it spread from the injection site and there was a bruise/The area was the size a tangerine), PERIPHERAL SWELLING (The fingers of the left hand started swelling and almost had to have the wedding ring cut off), JOINT SWELLING (Joints are swelling) and VACCINATION SITE ERYTHEMA (The injection site red). At the time of the report, VACCINATION SITE WARMTH (Injection site warm to the touch), VACCINATION SITE BRUISING (The patient said it spread from the injection site and there was a bruise/The area was the size a tangerine), PERIPHERAL SWELLING (The fingers of the left hand started swelling and almost had to have the wedding ring cut off), JOINT SWELLING (Joints are swelling) and VACCINATION SITE ERYTHEMA (The injection site red) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1683583
Sex: F
Age: 78
State: LA

Vax Date: 08/20/2021
Onset Date: 08/21/2021
Rec V Date: 09/08/2021
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 Date: 20210821; Test Name: Blood glucose; Result Unstructured Data: very High

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: left arm is very very sore; laryngitis; very very fatigue; nauseated; throw up several times; slight headache; This spontaneous case was reported by a consumer and describes the occurrence of LARYNGITIS (laryngitis), PAIN IN EXTREMITY (left arm is very very sore), FATIGUE (very very fatigue), NAUSEA (nauseated) and VOMITING (throw up several times) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Type 2 diabetes mellitus. Concomitant products included METFORMIN, ESCITALOPRAM OXALATE (LEXAPRO), SIMVASTATIN, LISINOPRIL, ACETYLSALICYLIC ACID (ASPIRIN 81), FISH OIL and VITAMIN D [VITAMIN D NOS] for an unknown indication. On 20-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, the patient experienced FATIGUE (very very fatigue), NAUSEA (nauseated), VOMITING (throw up several times) and HEADACHE (slight headache). On 23-Aug-2021, the patient experienced LARYNGITIS (laryngitis). On an unknown date, the patient experienced PAIN IN EXTREMITY (left arm is very very sore). At the time of the report, LARYNGITIS (laryngitis), PAIN IN EXTREMITY (left arm is very very sore), FATIGUE (very very fatigue), NAUSEA (nauseated), VOMITING (throw up several times) and HEADACHE (slight headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 21-Aug-2021, Blood glucose: high (High) very High. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Relevant concomitant medications also includes unspecified Vitamins. Treatment information was not provided.

Other Meds: METFORMIN; LEXAPRO; SIMVASTATIN; LISINOPRIL; ASPIRIN 81; FISH OIL; VITAMIN D [VITAMIN D NOS]

Current Illness: Type 2 diabetes mellitus

ID: 1683584
Sex: F
Age: 65
State: SC

Vax Date: 02/10/2021
Onset Date: 08/20/2021
Rec V Date: 09/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: diarrhea; feels very sinusy but nose is not running; it feels like when you have an allergy; cold like symptoms mainly in nose and eyes; pain; loss of appetite; fatigue; body aches/arm was sore; runned a fever of a 100; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (pain), DECREASED APPETITE (loss of appetite), NASOPHARYNGITIS (cold like symptoms mainly in nose and eyes), DIARRHOEA (diarrhea) and SINUS DISORDER (feels very sinusy but nose is not running) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 038K20A, 27A21A and 038K20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported. Concomitant products included CLONAZEPAM for an unknown indication. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 20-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 20-Aug-2021, the patient experienced PAIN (pain), DECREASED APPETITE (loss of appetite), FATIGUE (fatigue), MYALGIA (body aches/arm was sore) and PYREXIA (runned a fever of a 100). On 21-Aug-2021, the patient experienced NASOPHARYNGITIS (cold like symptoms mainly in nose and eyes), SINUS DISORDER (feels very sinusy but nose is not running) and ALLERGY TO VACCINE (it feels like when you have an allergy). On 23-Aug-2021, the patient experienced DIARRHOEA (diarrhea). On 21-Aug-2021, DECREASED APPETITE (loss of appetite) and PYREXIA (runned a fever of a 100) had resolved. On 22-Aug-2021, PAIN (pain) and MYALGIA (body aches/arm was sore) had resolved. On 24-Aug-2021, DIARRHOEA (diarrhea) had resolved. At the time of the report, NASOPHARYNGITIS (cold like symptoms mainly in nose and eyes), SINUS DISORDER (feels very sinusy but nose is not running), ALLERGY TO VACCINE (it feels like when you have an allergy) and FATIGUE (fatigue) outcome was unknown. Patient is immunocompromised since she had her spleen removed No treatment information was received This case was linked to MOD-2021-295308 (Patient Link).

Other Meds: CLONAZEPAM

Current Illness:

ID: 1683585
Sex: F
Age: 30
State: LA

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

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: it hurts; it is numb; itchy; irritated; she can't really do nothing; she has the left side of her lip swollen, the right side is not swollen anymore; right side of her jaw started swelling on that night; right side of her lip swelling on that night/she had the right side of her lip swollen/she had both sides swollen of her bottom lip; This spontaneous case was reported by a consumer and describes the occurrence of LIP SWELLING (right side of her lip swelling on that night/she had the right side of her lip swollen/she had both sides swollen of her bottom lip), LIP SWELLING (she has the left side of her lip swollen, the right side is not swollen anymore), SWELLING FACE (right side of her jaw started swelling on that night), LIP PAIN (it hurts) and HYPOAESTHESIA ORAL (it is numb) in a 30-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. Concurrent medical conditions included Tooth ache. Concomitant products included PARACETAMOL (TYLENOL) for Tooth ache. On 20-Aug-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Aug-2021, the patient experienced LIP SWELLING (right side of her lip swelling on that night/she had the right side of her lip swollen/she had both sides swollen of her bottom lip) and SWELLING FACE (right side of her jaw started swelling on that night). On 24-Aug-2021, the patient experienced LIP SWELLING (she has the left side of her lip swollen, the right side is not swollen anymore), LIP PAIN (it hurts), HYPOAESTHESIA ORAL (it is numb), LIP PRURITUS (itchy), CHEILITIS (irritated) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (she can't really do nothing). On 24-Aug-2021, LIP SWELLING (right side of her lip swelling on that night/she had the right side of her lip swollen/she had both sides swollen of her bottom lip) had resolved, SWELLING FACE (right side of her jaw started swelling on that night) outcome was unknown. At the time of the report, LIP SWELLING (she has the left side of her lip swollen, the right side is not swollen anymore), LIP PAIN (it hurts), HYPOAESTHESIA ORAL (it is numb), LIP PRURITUS (itchy), CHEILITIS (irritated) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (she can't really do nothing) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Other concomitant medication included birth control . The first dose of moderna Covid-19 Vaccine taken on 20-Aug-2021 at around 11 am. The patient had right side of her lip and jaw started swelling on that night. It was stated Friday night and Saturday 21-Aug-2021, she had the right side of her lip and jaw swollen. It started going down, but on 22-Aug-2021 she had both sides swollen of her bottom lip, and jaw just in the right side. This lasted until 24-Aug-2021, but on 24-Aug-2021 she has the left side of her lip swollen, the right side was not swollen anymore. No Treatment medications were reported.

Other Meds: TYLENOL

Current Illness: Tooth ache

ID: 1683586
Sex: M
Age:
State: MO

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/08/2021
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: Punctured vial greater than 12 hours in refrigerator; punctured vial greater than 12 hours in refrigerator; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (punctured vial greater than 12 hours in refrigerator) and PRODUCT STORAGE ERROR (Punctured vial greater than 12 hours in refrigerator) in a 48-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016C21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (punctured vial greater than 12 hours in refrigerator). On an unknown date, the patient experienced PRODUCT STORAGE ERROR (Punctured vial greater than 12 hours in refrigerator). On 24-Aug-2021, EXPIRED PRODUCT ADMINISTERED (punctured vial greater than 12 hours in refrigerator) had resolved. At the time of the report, PRODUCT STORAGE ERROR (Punctured vial greater than 12 hours in refrigerator) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product was not provided by the reporter Treatment information was not provided. Cross-Linked with Case Numbers: MOD21-134712, MOD21-134781, MOD21-134783, MOD21-134784, MOD21-134785, MOD21-134787.

Other Meds:

Current Illness:

ID: 1683587
Sex: F
Age: 69
State: OR

Vax Date: 08/24/2021
Onset Date:
Rec V Date: 09/08/2021
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: Right side of neck is swollen; Feel lightheaded; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING (Right side of neck is swollen) and DIZZINESS (Feel lightheaded) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049E21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced SWELLING (Right side of neck is swollen) and DIZZINESS (Feel lightheaded). At the time of the report, SWELLING (Right side of neck is swollen) and DIZZINESS (Feel lightheaded) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The concomitant medication were not reported. No treatment information was mentioned by the reporter.

Other Meds:

Current Illness:

ID: 1683588
Sex: U
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 09/08/2021
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: Received third dose even though it is not 8 months yet; Extra dose administered; 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 OFF LABEL USE (Received third dose even though it is not 8 months yet) and EXTRA DOSE ADMINISTERED (Extra dose administered) 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 third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form and second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced OFF LABEL USE (Received third dose even though it is not 8 months yet) and EXTRA DOSE ADMINISTERED (Extra dose administered). At the time of the report, OFF LABEL USE (Received third dose even though it is not 8 months yet) and EXTRA DOSE ADMINISTERED (Extra dose administered) had resolved. No relevant concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1683589
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/08/2021
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: Headache the same day as getting your first shot; Tired; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache the same day as getting your first shot) and FATIGUE (Tired) 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 HEADACHE (Headache the same day as getting your first shot) and FATIGUE (Tired). At the time of the report, HEADACHE (Headache the same day as getting your first shot) and FATIGUE (Tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported. No treatment information was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1683590
Sex: F
Age: 36
State: TX

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: broke out in hives that evening; magnetic at the injection site/stuck at the injection site, not the whole arm; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (broke out in hives that evening) and VACCINATION SITE REACTION (magnetic at the injection site/stuck at the injection site, not the whole arm) in a 36-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In August 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In August 2021, the patient experienced URTICARIA (broke out in hives that evening) and VACCINATION SITE REACTION (magnetic at the injection site/stuck at the injection site, not the whole arm). At the time of the report, URTICARIA (broke out in hives that evening) and VACCINATION SITE REACTION (magnetic at the injection site/stuck at the injection site, not the whole arm) 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. Patient was advised not to get the second dose The patient stated that she and her coworker are magnetic at the injection site. Three of them received the Pfizer COVID19 Vaccine , two coworkers also received the Moderna COVID19 Vaccine , and two coworkers received the Johnson & Johnson COVID19 Vaccine. They messed around with their name badges.

Other Meds:

Current Illness:

ID: 1683591
Sex: M
Age:
State: TX

Vax Date: 07/27/2021
Onset Date: 07/29/2021
Rec V Date: 09/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 20210729; Test Name: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: Positive

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: tested porsitive for COVID; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (tested porsitive for COVID) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 27-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In August 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 29-Jul-2021, the patient experienced COVID-19 (tested porsitive for COVID). At the time of the report, COVID-19 (tested porsitive for COVID) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 29-Jul-2021, SARS-CoV-2 test: positive (Positive) Positive. No concomitant medications were reported. On 29-Jul-2021, patient received a Regeneron treatment (monoclonal antibodies for COVID). Patient was not aware that he had to wait 90 days to get another dose. Patient consider that probably got COVID before getting the vaccine. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 24-Aug-2021: Follow-up received and contains no new information.

Other Meds:

Current Illness:

ID: 1683592
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: I have pain in my; a lump in my breast; This spontaneous case was reported by a consumer and describes the occurrence of BREAST PAIN (I have pain in my) and BREAST MASS (a lump in my breast) 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 BREAST PAIN (I have pain in my) and BREAST MASS (a lump in my breast). At the time of the report, BREAST PAIN (I have pain in my) and BREAST MASS (a lump in my breast) outcome was unknown. 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: 1683593
Sex: F
Age: 76
State: CO

Vax Date: 01/05/2021
Onset Date:
Rec V Date: 09/08/2021
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: was not feeling well; She stayed in bed for the next day and that was it; She didn't run a high temperature then. Her arm had a rectangle 4" by 6", it was swollen and hard.; This time, her arm didn't get hard but got very swollen and hot; Her arm had a rectangle 4" by 6", it was swollen and hard. The hard area was 3/4 inch thick.; very tired; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (was not feeling well), MOBILITY DECREASED (She stayed in bed for the next day and that was it), PERIPHERAL SWELLING (She didn't run a high temperature then. Her arm had a rectangle 4" by 6", it was swollen and hard.), FEELING HOT (This time, her arm didn't get hard but got very swollen and hot) and INJECTION SITE INDURATION (Her arm had a rectangle 4" by 6", it was swollen and hard. The hard area was 3/4 inch thick.) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 029L20A, 025120-2A and 088D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Immunocompromised and Drug allergy. Concomitant products included INSULIN, CLOPIDOGREL BISULFATE (PLAVIX), EZETIMIBE (ZETIA) and ATORVASTATIN for an unknown indication. On 05-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 13-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced MALAISE (was not feeling well), MOBILITY DECREASED (She stayed in bed for the next day and that was it), PERIPHERAL SWELLING (She didn't run a high temperature then. Her arm had a rectangle 4" by 6", it was swollen and hard.), FEELING HOT (This time, her arm didn't get hard but got very swollen and hot), INJECTION SITE INDURATION (Her arm had a rectangle 4" by 6", it was swollen and hard. The hard area was 3/4 inch thick.) and FATIGUE (very tired). At the time of the report, MALAISE (was not feeling well), MOBILITY DECREASED (She stayed in bed for the next day and that was it), PERIPHERAL SWELLING (She didn't run a high temperature then. Her arm had a rectangle 4" by 6", it was swollen and hard.), FEELING HOT (This time, her arm didn't get hard but got very swollen and hot), INJECTION SITE INDURATION (Her arm had a rectangle 4" by 6", it was swollen and hard. The hard area was 3/4 inch thick.) and FATIGUE (very tired) outcome was unknown. No treatment medication was reported.

Other Meds: INSULIN; PLAVIX; ZETIA; ATORVASTATIN

Current Illness: Drug allergy; Immunocompromised

ID: 1683594
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: This spontaneous case reported by a consumer, describes the occurrence of hypoesthesia (I have numbness in my arm & leg on left-side) in a patient, of an unknown age and gender, who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. On an unknown date, patient received a dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On an unknown date, patient experienced hypoesthesia (I have numbness in my arm & leg on left-side). At the time of the report, hypoesthesia (I have numbness in my arm & leg on left-side): unresolved. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. Concomitant medications and treatment information not provided.

Other Meds:

Current Illness:

ID: 1683595
Sex: M
Age: 81
State: PA

Vax Date: 02/21/2021
Onset Date: 08/23/2021
Rec V Date: 09/08/2021
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: Diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea) in an 82-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088O21A) for COVID-19 vaccination. No Medical History information was reported. On 21-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 23-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced DIARRHOEA (Diarrhea). At the time of the report, DIARRHOEA (Diarrhea) had not resolved. No concomitant medication was reported by the reporter. No treatment was reported by the reporter. About 4-5 hours after getting vaccinated, the patient developed diarrhea with no gas pain/stomach pain. He mentioned that it just flowed. It was still on going at the time report.

Other Meds:

Current Illness:

ID: 1683596
Sex: F
Age: 82
State: MA

Vax Date: 03/23/2021
Onset Date:
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: Test Name: X-ray; Result Unstructured Data: Arthritis

Allergies:

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

Symptoms: pain, She has been in constant constant pain; can't use my shoulder; they found it was arthritis; trouble breathing, affected her breathing; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (pain, She has been in constant constant pain), MUSCULOSKELETAL DISCOMFORT (can't use my shoulder), ARTHRITIS (they found it was arthritis) and DYSPNOEA (trouble breathing, affected her breathing) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 0U7B21A and 007321A) for COVID-19 vaccination. The patient's past medical history included Polio. Concurrent medical conditions included COPD, Emphysema and Heart failure. On 23-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PAIN (pain, She has been in constant constant pain), MUSCULOSKELETAL DISCOMFORT (can't use my shoulder), ARTHRITIS (they found it was arthritis) and DYSPNOEA (trouble breathing, affected her breathing). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of 500 mg twice a day; OXYCODONE for Pain, at an unspecified dose and frequency and EUPATORIUM CANNABINUM ESSENTIAL OIL (HEMP SEED OIL) for Pain, at an unspecified dose and frequency. At the time of the report, PAIN (pain, She has been in constant constant pain), MUSCULOSKELETAL DISCOMFORT (can't use my shoulder), ARTHRITIS (they found it was arthritis) and DYSPNOEA (trouble breathing, affected her breathing) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, X-ray: arthritis (abnormal) Arthritis. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported.

Other Meds:

Current Illness: COPD; Emphysema; Heart failure

ID: 1683597
Sex: F
Age: 53
State: OH

Vax Date: 08/21/2021
Onset Date: 08/01/2021
Rec V Date: 09/08/2021
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: arm were she got the injection was stiff which goes up to the neck; arm were she got the injection was more painful; joint soreness; fever; chills; muscle soreness; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULOSKELETAL STIFFNESS (arm were she got the injection was stiff which goes up to the neck), ARTHRALGIA (joint soreness), PYREXIA (fever), CHILLS (chills) and MYALGIA (muscle soreness) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017E21A) 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 21-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In August 2021, the patient experienced ARTHRALGIA (joint soreness), PYREXIA (fever), CHILLS (chills) and MYALGIA (muscle soreness). On 24-Aug-2021, the patient experienced MUSCULOSKELETAL STIFFNESS (arm were she got the injection was stiff which goes up to the neck) and VACCINATION SITE PAIN (arm were she got the injection was more painful). At the time of the report, MUSCULOSKELETAL STIFFNESS (arm were she got the injection was stiff which goes up to the neck), ARTHRALGIA (joint soreness), PYREXIA (fever), CHILLS (chills), MYALGIA (muscle soreness) and VACCINATION SITE PAIN (arm were she got the injection was more painful) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication information was provided by the reporter. No treatment information was provided by the reporter.

Other Meds:

Current Illness:

ID: 1683598
Sex: F
Age: 70
State: CA

Vax Date: 02/03/2021
Onset Date:
Rec V Date: 09/08/2021
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: Arm being a different size since receiving the vaccine, has no idea if it is associated with the inoculation, it is very odd; It looks like her muscle is bigger, from the elbow to shoulder, her arm is like an inch bigger on the left side than the right side, it does not hurt or anything, it has not changed; It looks weird; Swelling at the injection site; Headache; Tired for the day; A little nausea; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Arm being a different size since receiving the vaccine, has no idea if it is associated with the inoculation, it is very odd), MUSCLE SWELLING (It looks like her muscle is bigger, from the elbow to shoulder, her arm is like an inch bigger on the left side than the right side, it does not hurt or anything, it has not changed), FEELING ABNORMAL (It looks weird), VACCINATION SITE SWELLING (Swelling at the injection site) and HEADACHE (Headache) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011A21A and 024M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Hypertension and Depression. Concomitant products included BUPROPION for Antidepressant therapy, AMLODIPINE and VALSARTAN for Hypertension, VITAMIN D NOS and VITAMINS NOS for an unknown indication. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PERIPHERAL SWELLING (Arm being a different size since receiving the vaccine, has no idea if it is associated with the inoculation, it is very odd), MUSCLE SWELLING (It looks like her muscle is bigger, from the elbow to shoulder, her arm is like an inch bigger on the left side than the right side, it does not hurt or anything, it has not changed), FEELING ABNORMAL (It looks weird), VACCINATION SITE SWELLING (Swelling at the injection site), HEADACHE (Headache), FATIGUE (Tired for the day) and NAUSEA (A little nausea). At the time of the report, PERIPHERAL SWELLING (Arm being a different size since receiving the vaccine, has no idea if it is associated with the inoculation, it is very odd), MUSCLE SWELLING (It looks like her muscle is bigger, from the elbow to shoulder, her arm is like an inch bigger on the left side than the right side, it does not hurt or anything, it has not changed), FEELING ABNORMAL (It looks weird), VACCINATION SITE SWELLING (Swelling at the injection site), HEADACHE (Headache), FATIGUE (Tired for the day) and NAUSEA (A little nausea) outcome was unknown. She stated her muscle is different size from the site of vaccination elbow to shoulder and her left side inch bigger than right. Patient stated she didn't took any medications. Patient stated she just had a pneumonia shot about 2 weeks ago,

Other Meds: AMLODIPINE; VALSARTAN; BUPROPION; VITAMIN D NOS; VITAMINS NOS

Current Illness: Depression; Hypertension

ID: 1683599
Sex: F
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 09/08/2021
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: Blistering rash (Second Dose); This spontaneous case was reported by a consumer and describes the occurrence of RASH VESICULAR (Blistering rash (Second Dose)) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19 (hospitalized due to Covid19 in December for a week). Concurrent medical conditions included Fibromyalgia, Blood pressure high and Sleep loss. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced RASH VESICULAR (Blistering rash (Second Dose)). At the time of the report, RASH VESICULAR (Blistering rash (Second Dose)) outcome was unknown. Concomitant medication was not provided. Treatment information was not provided. This case was linked to MOD-2021-295024, MOD-2021-295772 (Patient Link).

Other Meds:

Current Illness: Blood pressure high; Fibromyalgia; Sleep loss

ID: 1683600
Sex: F
Age:
State: PA

Vax Date: 03/01/2021
Onset Date:
Rec V Date: 09/08/2021
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: Blistering rash experienced whit the first shoot of the vaccine; This spontaneous case was reported by a consumer and describes the occurrence of RASH VESICULAR (Blistering rash experienced whit the first shoot of the vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19 (Was hospitalized due to Covid19 in December for a week before receiving the first shoot of the Moderna vaccine in march) in December 2020. Concurrent medical conditions included Blood pressure high, Fibromyalgia and Sleep loss. In March 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced RASH VESICULAR (Blistering rash experienced whit the first shoot of the vaccine). At the time of the report, RASH VESICULAR (Blistering rash experienced whit the first shoot of the vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The concomitant medication were not reported. No treatment information was provided by the reporter. This case was linked to MOD-2021-295770, MOD-2021-295024 (Patient Link).

Other Meds:

Current Illness: Blood pressure high; Fibromyalgia; Sleep loss

ID: 1683601
Sex: F
Age: 67
State: FL

Vax Date: 04/06/2021
Onset Date:
Rec V Date: 09/08/2021
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: 2009; Test Name: Blood work; Result Unstructured Data: Pancreas is not producing insulin

Allergies:

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

Symptoms: Strange swishing sound on her right ear; Arm got a little sore; This spontaneous case was reported by an other health care professional and describes the occurrence of TINNITUS (Strange swishing sound on her right ear) and PAIN IN EXTREMITY (Arm got a little sore) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020B21A) for COVID-19 vaccination. The patient's past medical history included Gallbladder disorder NOS (admitted in the ICU) in 2009 and Pancreatitis (admitted in the ICU) in 2009. Concurrent medical conditions included Type 1 diabetes mellitus (at 65 years old), Osteoarthritis, Hay fever and Fibromyalgia. Concomitant products included INSULIN for Type 1 diabetes mellitus. On 06-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In 2021, the patient experienced TINNITUS (Strange swishing sound on her right ear) and PAIN IN EXTREMITY (Arm got a little sore). At the time of the report, TINNITUS (Strange swishing sound on her right ear) and PAIN IN EXTREMITY (Arm got a little sore) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2009, Blood test: abnormal (abnormal) Pancreas is not producing insulin. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment information was provided. The 2nd dose was given on 04 May 2021 with lot number 008C21A. This case was linked to MOD-2021-295852 (Patient Link).

Other Meds: INSULIN

Current Illness: Fibromyalgia; Hay fever; Osteoarthritis; Type 1 diabetes mellitus (at 65 years old)

ID: 1683602
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 07/17/2021
Rec V Date: 09/08/2021
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: Probably 39 days since first dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Probably 39 days since first dose) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003C21A) 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 17-Jul-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Probably 39 days since first dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Probably 39 days since first dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1683603
Sex: M
Age:
State: NY

Vax Date: 05/01/2021
Onset Date:
Rec V Date: 09/08/2021
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: Fingers being swollen his pinky thumb and his ring finger; Pink spots down his legs, arms and back.; Itchy; Rash now for two and a half months; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Fingers being swollen his pinky thumb and his ring finger), SKIN DISCOLOURATION (Pink spots down his legs, arms and back.), PRURITUS (Itchy) and RASH (Rash now for two and a half months) in a 43-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Type 2 diabetes mellitus and Psoriasis. In May 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In June 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. In 2021, the patient experienced PERIPHERAL SWELLING (Fingers being swollen his pinky thumb and his ring finger), SKIN DISCOLOURATION (Pink spots down his legs, arms and back.), PRURITUS (Itchy) and RASH (Rash now for two and a half months). At the time of the report, PERIPHERAL SWELLING (Fingers being swollen his pinky thumb and his ring finger), SKIN DISCOLOURATION (Pink spots down his legs, arms and back.), PRURITUS (Itchy) and RASH (Rash now for two and a half months) had not resolved. Additional concurrent medical condition included Sparkling Disposition. Concomitant medications was not provided by the reporter. Treatment information was not provided. First vaccine was given around the 05-MAY-2021 or 06-MAY-2021, patient was unsure of the exact date.Second vaccine was given around the 05-JUN-2021 or 06-JUN-2021, patient was unsure of the exact date. The patient had a rash now for two and a half months. It started with his fingers being swollen his pinky thumb and his ring finger. He had pink spots down his legs, arms and back. It was worse, down his arms and hands. Itchy.

Other Meds:

Current Illness: Psoriasis; Type 2 diabetes mellitus.

ID: 1683604
Sex: F
Age: 78
State: MD

Vax Date: 01/26/2021
Onset Date: 02/01/2021
Rec V Date: 09/08/2021
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: She started feeling little light headed some time after receiving 2nd dose; Once in a while she loses her balance, She still has that issue; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (She started feeling little light headed some time after receiving 2nd dose) and BALANCE DISORDER (Once in a while she loses her balance, She still has that issue) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013L20A and 007M20A) for COVID-19 vaccination. No medical history reported. Concomitant products included LISINOPRIL for an unknown indication. On 26-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In February 2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced BALANCE DISORDER (Once in a while she loses her balance, She still has that issue). On 23-Feb-2021, the patient experienced DIZZINESS (She started feeling little light headed some time after receiving 2nd dose). At the time of the report, DIZZINESS (She started feeling little light headed some time after receiving 2nd dose) and BALANCE DISORDER (Once in a while she loses her balance, She still has that issue) had not resolved. Treatment medication was not provided. Patient started feeling little lightheaded sometime after receiving 2nd dose and it was not constant however every once in a while, patient loses balance and still has that issue.

Other Meds: LISINOPRIL

Current Illness:

ID: 1683605
Sex: F
Age: 39
State: MA

Vax Date: 03/19/2021
Onset Date:
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: Test Name: Leg ultrasound; Result Unstructured Data: No blood clots were found.

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: tachycardia increased; Period got weird spotting in middle of month and cycle shorter with spotting before and after; Sever leg pain; migraine; Period got weird spotting in middle of month and cycle shorter with spotting before and after; chronic pain getting worse; fatigue; This spontaneous case was reported by a consumer and describes the occurrence of TACHYCARDIA (tachycardia increased), VAGINAL HAEMORRHAGE (Period got weird spotting in middle of month and cycle shorter with spotting before and after), PAIN IN EXTREMITY (Sever leg pain), MIGRAINE (migraine) and POLYMENORRHOEA (Period got weird spotting in middle of month and cycle shorter with spotting before and after) in a 39-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 LORATADINE for an unknown indication. On 19-Mar-2021, the patient 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 received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced TACHYCARDIA (tachycardia increased), VAGINAL HAEMORRHAGE (Period got weird spotting in middle of month and cycle shorter with spotting before and after), PAIN IN EXTREMITY (Sever leg pain), MIGRAINE (migraine), POLYMENORRHOEA (Period got weird spotting in middle of month and cycle shorter with spotting before and after), PAIN (chronic pain getting worse) and FATIGUE (fatigue). The patient was treated with ASPIRIN [ACETYLSALICYLIC ACID] at an unspecified dose and frequency. At the time of the report, TACHYCARDIA (tachycardia increased), VAGINAL HAEMORRHAGE (Period got weird spotting in middle of month and cycle shorter with spotting before and after), PAIN IN EXTREMITY (Sever leg pain), MIGRAINE (migraine), POLYMENORRHOEA (Period got weird spotting in middle of month and cycle shorter with spotting before and after), PAIN (chronic pain getting worse) and FATIGUE (fatigue) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Ultrasound scan: normal (normal) No blood clots were found.. Patient reported that she is on IUD.

Other Meds: Loratadine

Current Illness:

ID: 1683606
Sex: M
Age:
State: FL

Vax Date: 07/28/2021
Onset Date:
Rec V Date: 09/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Received the vaccine and has an active Covid-19 infection; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Received the vaccine and has an active Covid-19 infection) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 28-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced COVID-19 (Received the vaccine and has an active Covid-19 infection). At the time of the report, COVID-19 (Received the vaccine and has an active Covid-19 infection) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant drug details were reported. No treatment details were reported.

Other Meds:

Current Illness:

ID: 1683607
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/08/2021
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: No second dose after 6 weeks; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (No second dose after 6 weeks) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (No second dose after 6 weeks). At the time of the report, PRODUCT DOSE OMISSION ISSUE (No second dose after 6 weeks) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing was delayed on an unknown date. No concomitant product was provided by the reporter. No treatment medication was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1683608
Sex: U
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 09/08/2021
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: Chemo fog (brain fog) months later; Headache; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Chemo fog (brain fog) months later) and HEADACHE (Headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced FEELING ABNORMAL (Chemo fog (brain fog) months later) and HEADACHE (Headache). At the time of the report, FEELING ABNORMAL (Chemo fog (brain fog) months later) and HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The concomitant medications were not reported. The treatment information was not provided. This case was linked to MOD-2021-295786 (Patient Link).

Other Meds:

Current Illness:

ID: 1683609
Sex: F
Age: 35
State: NM

Vax Date: 02/11/2021
Onset Date: 03/18/2021
Rec V Date: 09/08/2021
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: wife had tinnitus 1 month after had Moderna Covid-19 Vaccine; This spontaneous case was reported by a consumer and describes the occurrence of TINNITUS (wife had tinnitus 1 month after had Moderna Covid-19 Vaccine) in a 36-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031M20A) for COVID-19 vaccination. No Medical History information was reported. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Mar-2021, the patient experienced TINNITUS (wife had tinnitus 1 month after had Moderna Covid-19 Vaccine). At the time of the report, TINNITUS (wife had tinnitus 1 month after had Moderna Covid-19 Vaccine) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment medication was reported. On 10-Mar-2021 patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) in unknown route with batch no. 031M20A. Patient reported that she developed tinnitus 1 month and a half after getting the vaccine and that she's still having it. she first noticed it between 18 Mar 2021 - 21 Mar 2021. Most recent FOLLOW-UP information incorporated above includes: On 27-Aug-2021: Follow up received contains Vaccine information.

Other Meds:

Current Illness:

ID: 1683610
Sex: F
Age:
State: OH

Vax Date: 05/14/2021
Onset Date: 05/19/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: Test Name: Bone density test; Result Unstructured Data: normal; Test Name: Chest X-Ray; Result Unstructured Data: was nothing wrong with the breathing and nothing was wrong with it's body; Test Name: CAT scan; Result Unstructured Data: was nothing wrong with the breathing and nothing was wrong with it's body; Test Name: Covid; Test Result: Negative ; Result Unstructured Data: negative; Test Name: Covid; Test Result: Positive ; Result Unstructured Data: tested positive for COVID in November.; Test Name: PAP; Result Unstructured Data: normal

Allergies:

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

Symptoms: stomach hurt really bad; other trouble with my body; trouble breathing/taking deep breath was the worst/nothing wrong with the breathing /still have trouble for taking deep breaths; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (trouble breathing/taking deep breath was the worst/nothing wrong with the breathing /still have trouble for taking deep breaths), ABDOMINAL PAIN UPPER (stomach hurt really bad) and DISCOMFORT (other trouble with my body) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 005C21A) for COVID-19 vaccination. The patient's past medical history included Epilepsy (patient suffered epilepsy for 14th years .) and Surgery (patient had brain surgery which stopped it from having seizures.). Concurrent medical conditions included Taste loss (almost been a year since lost the taste). Concomitant products included CLONAZEPAM for Epilepsy. On 14-May-2021, the patient 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 received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-May-2021, the patient experienced DYSPNOEA (trouble breathing/taking deep breath was the worst/nothing wrong with the breathing /still have trouble for taking deep breaths). On an unknown date, the patient experienced ABDOMINAL PAIN UPPER (stomach hurt really bad) and DISCOMFORT (other trouble with my body). At the time of the report, DYSPNOEA (trouble breathing/taking deep breath was the worst/nothing wrong with the breathing /still have trouble for taking deep breaths), ABDOMINAL PAIN UPPER (stomach hurt really bad) and DISCOMFORT (other trouble with my body) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Bone densitometry: normal (normal) normal. On an unknown date, Chest X-ray: normal (normal) was nothing wrong with the breathing and nothing was wrong with it's body. On an unknown date, Computerised tomogram: normal (normal) was nothing wrong with the breathing and nothing was wrong with it's body. On an unknown date, SARS-CoV-2 test: negative (Negative) negative and positive (Positive) tested positive for COVID in November.. On an unknown date, Smear cervix: normal (normal) normal. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The patient reported that 5 days after receiving the first dose having trouble breathing. Patient told that from time to time was running out of breath when talking and started on 19 and 20 May. Patient reported various lab tests like chest x-ray ,pulmonary study is done on 24-Jun and computerized tomography scan. The patient also had an entire bone density test and a pap. Patient did not had any seizures but needs to take the Clonazepam which has been taking for 30 years. Patient taking inhaler as a treatment medication.

Other Meds: CLONAZEPAM

Current Illness: Taste loss (almost been a year since lost the taste)

ID: 1683611
Sex: F
Age: 62
State: AL

Vax Date: 08/14/2021
Onset Date: 08/21/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data: Test Date: 20210822; Test Name: Body temperature; Result Unstructured Data: Fever-100.4F

Allergies:

Symptom List: Nausea

Symptoms: Fever; arm was swollen/ the swelling is spreading around the arm; arm was hard underneath; Below injection site above elbow she developed a blister that itches; blister that itches; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (arm was swollen/ the swelling is spreading around the arm), INDURATION (arm was hard underneath), BLISTER (Below injection site above elbow she developed a blister that itches), PRURITUS (blister that itches) and PYREXIA (Fever) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Aug-2021, the patient experienced PERIPHERAL SWELLING (arm was swollen/ the swelling is spreading around the arm), INDURATION (arm was hard underneath), BLISTER (Below injection site above elbow she developed a blister that itches) and PRURITUS (blister that itches). On 22-Aug-2021, the patient experienced PYREXIA (Fever). On 23-Aug-2021, PYREXIA (Fever) had resolved. At the time of the report, PERIPHERAL SWELLING (arm was swollen/ the swelling is spreading around the arm), INDURATION (arm was hard underneath), BLISTER (Below injection site above elbow she developed a blister that itches) and PRURITUS (blister that itches) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 22-Aug-2021, Body temperature: 100.4 (High) Fever-100.4F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant and treatment was not provided. Pharmacist suggested patient a cold pack and Benadryl.

Other Meds:

Current Illness:

ID: 1683612
Sex: F
Age: 75
State: NJ

Vax Date: 05/26/2021
Onset Date:
Rec V Date: 09/08/2021
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: skin reaction; rash; Tiredness; This spontaneous case was reported by a pharmacist and describes the occurrence of SKIN REACTION (skin reaction), RASH (rash) and FATIGUE (Tiredness) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 033B21A and 033B21) for COVID-19 vaccination. No Medical History information was reported. On 26-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced SKIN REACTION (skin reaction), RASH (rash) and FATIGUE (Tiredness). The patient was treated with HYDROGEN PEROXIDE for Adverse event, at an unspecified dose and frequency. At the time of the report, SKIN REACTION (skin reaction), RASH (rash) and FATIGUE (Tiredness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications was not reported. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1683613
Sex: M
Age: 65
State:

Vax Date: 01/29/2021
Onset Date:
Rec V Date: 09/08/2021
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: He had chest pain after both shots; Nerves wrapping around, agitated nerve issue from his back surgery; Had no feeling/ bump with spongy dead tissue.; Little bump in the arm and tissue, a bump with spongy dead tissue; He had headache after both shots; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (He had chest pain after both shots), NERVE INJURY (Nerves wrapping around, agitated nerve issue from his back surgery), PERIPHERAL SWELLING (Little bump in the arm and tissue, a bump with spongy dead tissue), HEADACHE (He had headache after both shots) and HYPOAESTHESIA (Had no feeling/ bump with spongy dead tissue.) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. The patient's past medical history included Back surgery (patient says he has an agitated nerve issue from his back surgery and always has some sort of chest pain). Concurrent medical conditions included COPD. On 29-Jan-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 CHEST PAIN (He had chest pain after both shots), NERVE INJURY (Nerves wrapping around, agitated nerve issue from his back surgery), PERIPHERAL SWELLING (Little bump in the arm and tissue, a bump with spongy dead tissue), HEADACHE (He had headache after both shots) and HYPOAESTHESIA (Had no feeling/ bump with spongy dead tissue.). At the time of the report, CHEST PAIN (He had chest pain after both shots), NERVE INJURY (Nerves wrapping around, agitated nerve issue from his back surgery) and HEADACHE (He had headache after both shots) had resolved and PERIPHERAL SWELLING (Little bump in the arm and tissue, a bump with spongy dead tissue) and HYPOAESTHESIA (Had no feeling/ bump with spongy dead tissue.) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) dosing remained unchanged. The concomitant medications were not reported. The treatment information was not provided. This case was linked to MOD-2021-296249 (Patient Link).

Other Meds:

Current Illness: COPD

ID: 1683614
Sex: F
Age: 57
State: WI

Vax Date: 03/23/2021
Onset Date: 07/25/2021
Rec V Date: 09/08/2021
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: My legs and feet are tingling, my hands are tingling, face is tingling, my lips are tingling; I ended up with a surface blood cloth in my leg; This spontaneous case was reported by a consumer and describes the occurrence of THROMBOPHLEBITIS SUPERFICIAL (I ended up with a surface blood cloth in my leg) and PARAESTHESIA (My legs and feet are tingling, my hands are tingling, face is tingling, my lips are tingling) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 044B21A and 046A21A) for COVID-19 vaccination. Concurrent medical conditions included Breast cancer and Autoimmune disorder. On 23-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Jul-2021, the patient experienced THROMBOPHLEBITIS SUPERFICIAL (I ended up with a surface blood cloth in my leg). In August 2021, the patient experienced PARAESTHESIA (My legs and feet are tingling, my hands are tingling, face is tingling, my lips are tingling). At the time of the report, THROMBOPHLEBITIS SUPERFICIAL (I ended up with a surface blood cloth in my leg) had resolved and PARAESTHESIA (My legs and feet are tingling, my hands are tingling, face is tingling, my lips are tingling) had not resolved. It was reported that patient takes steroids as concomitant medication Treatment information was not reported by reporter

Other Meds:

Current Illness: Autoimmune disorder; Breast cancer

ID: 1683615
Sex: F
Age: 42
State: LA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 09/08/2021
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 Date: 20210525; Test Name: Audio test; Result Unstructured Data: Normal; Test Date: 20210525; Test Name: Balance test; Result Unstructured Data: Normal; Test Date: 20210318; Test Name: Heart rate; Result Unstructured Data: Increased (my heart rate was going about 100 even though I was sitting down); Test Date: 20210519; Test Name: MRI of brain; Result Unstructured Data: It showed fluid in the mastoids in both sides; Test Date: 20210405; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: Negative; Test Date: 20210405; Test Name: X ray; Result Unstructured Data: something close to pneumonia

Allergies:

Symptom List: Tremor

Symptoms: this showed some abdominal gases; (patches for dizziness) actually dropped my blood pressure too low; I had a flu in my ears; I had an ear infection; upper neck pains; back pains; joint pains; Second shot on 17jun2021; fluid in the mastoids in both sides; all of a sudden, I couldn't stand up anymore; I was dizzy; I couldn't open my eyes; It felt like I drunk a glas of wine and I couldn't control the hangover; I couldn't read the words in the computer anymore; I had confusion, I couldn't understand what I was reading; migraines; I had really severe stomach cramps\ intense stomach pains; loose bowels; I had intense gastro issues; Tachycardia, my heart was completely not normal,; shortness of breath; I got like spotter veins\ some veins popped in the arm; it started to itchy; Red arm; hot due to the rash; it was actually an allergic reaction; I got tired, had to take a nap in the afternoon (which I never do); rash all over my left arm; I felt like I got punched in the arm; arm pain at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (it started to itchy), ERYTHEMA (Red arm), SKIN WARM (hot due to the rash), HYPERSENSITIVITY (it was actually an allergic reaction) and FATIGUE (I got tired, had to take a nap in the afternoon (which I never do)) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Clot blood. Concurrent medical conditions included Bug bite. Concomitant products included FEXOFENADINE HYDROCHLORIDE (ALLEGRA) for an unknown indication. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Mar-2021, the patient experienced PRURITUS (it started to itchy), ERYTHEMA (Red arm), SKIN WARM (hot due to the rash), HYPERSENSITIVITY (it was actually an allergic reaction), FATIGUE (I got tired, had to take a nap in the afternoon (which I never do)), VEIN DISORDER (I got like spotter veins\ some veins popped in the arm), RASH (rash all over my left arm), MYALGIA (I felt like I got punched in the arm) and VACCINATION SITE PAIN (arm pain at the injection site). On 18-Mar-2021, the patient experienced TACHYCARDIA (Tachycardia, my heart was completely not normal,) and DYSPNEA (shortness of breath). On 19-Mar-2021, the patient experienced ABDOMINAL PAIN UPPER (I had really severe stomach cramps\ intense stomach pains), DIARRHEA (loose bowels) and GASTROINTESTINAL DISORDER (I had intense gastro issues). On 14-Apr-2021, the patient experienced MIGRAINE (migraines). On 17-Apr-2021, the patient experienced DYSSTASIA (all of a sudden, I couldn't stand up anymore), DIZZINESS (I was dizzy), OCULAR DISCOMFORT (I couldn't open my eyes), FEELING DRUNK (It felt like I drunk a glas of wine and I couldn't control the hangover), READING DISORDER (I couldn't read the words in the computer anymore) and CONFUSIONAL STATE (I had confusion, I couldn't understand what I was reading). On 19-May-2021, the patient experienced MASTOID EFFUSION (fluid in the mastoids in both sides). On 17-Jun-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second shot on 17jun2021). On an unknown date, the patient experienced FLATULENCE (this showed some abdominal gases), HYPOTENSION ((patches for dizziness) actually dropped my blood pressure too low), INFLUENZA (I had a flu in my ears), EAR INFECTION (I had an ear infection), NECK PAIN (upper neck pains), BACK PAIN (back pains) and ARTHRALGIA (joint pains). The patient was treated with MENTHA X PIPERITA ESSENTIAL OIL (PEPPERMINT OIL [MENTHA X PIPERITA ESSENTIAL OIL]) for Shortness of breath, at a dose of 1 dosage form; METOPROLOL SUCCINATE (TOPROL) from 18-Mar-2021 to 06-Jul-2021 for Heart disorder, at a dose of 1 dosage form; PARACETAMOL (TYLENOL) on 17-Mar-2021 for Pain, at a dose of 1 dosage form; ACETYLSALICYLIC ACID (BABY ASPIRIN) on 18-Mar-2021 for Heart attack, at a dose of 1 dosage form; PANTOPRAZOLE on 29-Mar-2021 for Stomach cramps, at a dose of 1 dosage form; PREDNISONE on 05-Apr-2021 for Shortness of breath, at a dose of 1 dosage form; EPHEDRINE HYDROCHLORIDE (ASTHMA [EPHEDRINE HYDROCHLORIDE]) on 05-Apr-2021 for Shortness of breath, at a dose of 1 dosage form and MECLIZINE [MECLOZINE] from 17-Apr-2021 to 22-Apr-2021 for Vertigo, at a dose of 1 dosage form. On 18-Mar-2021, PRURITUS (it started to itchy), ERYTHEMA (Red arm), SKIN WARM (hot due to the rash), HYPERSENSITIVITY (it was actually an allergic reaction) and RASH (rash all over my left arm) had resolved. On 19-Mar-2021, FATIGUE (I got tired, had to take a nap in the afternoon (which I never do)) and VACCINATION SITE PAIN (arm pain at the injection site) had resolved. On 17-Jun-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second shot on 17jun2021) had resolved. At the time of the report, ABDOMINAL PAIN UPPER (I had really severe stomach cramps\ intense stomach pains), VEIN DISORDER (I got like spotter veins\ some veins popped in the arm), TACHYCARDIA (Tachycardia, my heart was completely not normal,), MASTOID EFFUSION (fluid in the mastoids in both sides), MIGRAINE (migraines), DYSPNOEA (shortness of breath), DIARRHEA (loose bowels), GASTROINTESTINAL DISORDER (I had intense gastro issues), FLATULENCE (this showed some abdominal gases), DYSSTASIA (all of a sudden, I couldn't stand up anymore), DIZZINESS (I was dizzy), OCULAR DISCOMFORT (I couldn't open my eyes), FEELING DRUNK (It felt like I drunk a glas of wine and I couldn't control the hangover), READING DISORDER (I couldn't read the words in the computer anymore), CONFUSIONAL STATE (I had confusion, I couldn't understand what I was reading), HYPOTENSION ((patches for dizziness) actually dropped my blood pressure too low), INFLUENZA (I had a flu in my ears), EAR INFECTION (I had an ear infection), NECK PAIN (upper neck pains), BACK PAIN (back pains), MYALGIA (I felt like I got punched in the arm) and ARTHRALGIA (joint pains) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Mar-2021, Heart rate: increased (High) Increased (my heart rate was going about 100 even though I was sitting down). On 05-Apr-2021, SARS-CoV-2 test: negative (Negative) Negative. On 05-Apr-2021, X-ray: abnormal (abnormal) something close to pneumonia. On 19-May-2021, Magnetic resonance imaging head: abnormal (abnormal) It showed fluid in the mastoids in both sides. On 25-May-2021, Audiogram: normal (normal) Normal. On 25-May-2021, Balance test: normal (normal) Normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. On 17mar2021, Patient took anti histamines for rash. On 23mar2021, visited gastrologist. On 05apr2021, visited walking clinic and took asthma pump and breathing treatment for shortness of breath.On 14Apr2021, patient started to have migraine and ordered a special natural oils to control it but didn't work. She took Tylenol but it didn't worked.On 22apr2021 visited family doctor. On 26apr2021, visited ENT and took prednisone and antibiotics for ear infection. Also took, anti inflammatory medicine and steroid injections for pains. On 29mar2021, she did some blood test, and an ultrasound.This showed some abdominal gases. This case was linked to MOD-2021-297205 (Patient Link).

Other Meds: ALLEGRA

Current Illness: Bug bite

ID: 1683616
Sex: U
Age:
State: CA

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 09/08/2021
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: Used a vial that was expired yesterday to administer 7 employees, today; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Used a vial that was expired yesterday to administer 7 employees, today) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025A21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Used a vial that was expired yesterday to administer 7 employees, today). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Used a vial that was expired yesterday to administer 7 employees, today) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was reported. No treatment medication was reported.

Other Meds:

Current Illness:

ID: 1683617
Sex: F
Age:
State:

Vax Date:
Onset Date: 08/24/2021
Rec V Date: 09/08/2021
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: Test Name: Body temperature; Result Unstructured Data: 101.5

Allergies:

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

Symptoms: From the bottom of her elbow all the way to her shoulder blade she could not move; ears are hurting; legs were like jelly; fever 101.5; arm is hurting from her shoulder to her elbow; nauseated; getting sick; sore throat; plugged up nose; can't smell anything; light-headed; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (getting sick), OROPHARYNGEAL PAIN (sore throat), NASAL CONGESTION (plugged up nose), ANOSMIA (can't smell anything) and DIZZINESS (light-headed) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Diabetes. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced ILLNESS (getting sick), OROPHARYNGEAL PAIN (sore throat), NASAL CONGESTION (plugged up nose), ANOSMIA (can't smell anything), DIZZINESS (light-headed), PAIN IN EXTREMITY (arm is hurting from her shoulder to her elbow) and NAUSEA (nauseated). On an unknown date, the patient experienced MOBILITY DECREASED (From the bottom of her elbow all the way to her shoulder blade she could not move), EAR PAIN (ears are hurting), LIMB DISCOMFORT (legs were like jelly) and PYREXIA (fever 101.5). At the time of the report, ILLNESS (getting sick), OROPHARYNGEAL PAIN (sore throat), NASAL CONGESTION (plugged up nose), ANOSMIA (can't smell anything), DIZZINESS (light-headed), MOBILITY DECREASED (From the bottom of her elbow all the way to her shoulder blade she could not move), EAR PAIN (ears are hurting), LIMB DISCOMFORT (legs were like jelly), PAIN IN EXTREMITY (arm is hurting from her shoulder to her elbow), NAUSEA (nauseated) and PYREXIA (fever 101.5) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 101.5 (High) 101.5. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Symptoms: It was reported that the patient could not take any food and water down, she took a sleeping pill and she fell down and broke her left side toe. Treatment medication was taken but not specified. No concomitant medications were reported

Other Meds:

Current Illness: Diabetes

ID: 1683618
Sex: F
Age: 59
State: FL

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 09/08/2021
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: There is something or pain in the left neck area.; Pain went up to her jaw and to her left temple; She felt like she had to throw up, and she still feels that way.; Massive headache; Something in the muscle between arm and neck; This spontaneous case was reported by a consumer and describes the occurrence of NECK PAIN (There is something or pain in the left neck area.), PAIN IN JAW (Pain went up to her jaw and to her left temple), NAUSEA (She felt like she had to throw up, and she still feels that way.), HEADACHE (Massive headache) and MUSCLE DISCOMFORT (Something in the muscle between arm and neck) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036B21A) for COVID-19 vaccination. The patient's past medical history included Open heart surgery (a couple of heart procedures last year.). Concurrent medical conditions included Diabetes and Cancer. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, the patient experienced NECK PAIN (There is something or pain in the left neck area.), PAIN IN JAW (Pain went up to her jaw and to her left temple), NAUSEA (She felt like she had to throw up, and she still feels that way.), HEADACHE (Massive headache) and MUSCLE DISCOMFORT (Something in the muscle between arm and neck). At the time of the report, NECK PAIN (There is something or pain in the left neck area.), PAIN IN JAW (Pain went up to her jaw and to her left temple), NAUSEA (She felt like she had to throw up, and she still feels that way.), HEADACHE (Massive headache) and MUSCLE DISCOMFORT (Something in the muscle between arm and neck) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The concomitant medications were not reported. The treatment information was not provided. Patient consented to safety follow up through her phone or email. She consented to safety follow up to her doctor.

Other Meds:

Current Illness: Cancer; Diabetes

ID: 1683619
Sex: F
Age:
State: WA

Vax Date: 07/27/2021
Onset Date: 08/25/2021
Rec V Date: 09/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Dose administered more than 24 hours after the vial was first punctured; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose administered more than 24 hours after the vial was first punctured) in a 29-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 052E21A and 040C21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021 at 4:28 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose administered more than 24 hours after the vial was first punctured). On 25-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Dose administered more than 24 hours after the vial was first punctured) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant product use was provided by the reporter. No treatment medication was provided. The syringe was pre-drawn from a previously unopened vial at 12:27 pm on 24-Aug-2021 and was administered at 4:28 pm all on 25 Aug 2021

Other Meds:

Current Illness:

ID: 1683620
Sex: U
Age:
State:

Vax Date: 08/20/2021
Onset Date: 08/23/2021
Rec V Date: 09/08/2021
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: Mouth ulcers; This spontaneous case was reported by a consumer and describes the occurrence of MOUTH ULCERATION (Mouth ulcers) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 20-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced MOUTH ULCERATION (Mouth ulcers). At the time of the report, MOUTH ULCERATION (Mouth ulcers) outcome was unknown. The concomitant medications were not reported. The treatment information was not provided.

Other Meds:

Current Illness:

ID: 1683621
Sex: F
Age:
State: WA

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 09/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: dose given more than 24 hours after the vial was first punctured; This spontaneous case was reported by a medical assistant and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (dose given more than 24 hours after the vial was first punctured) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (dose given more than 24 hours after the vial was first punctured). On 25-Aug-2021, EXPIRED PRODUCT ADMINISTERED (dose given more than 24 hours after the vial was first punctured) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant and treatment information provided.

Other Meds:

Current Illness:

ID: 1683622
Sex: U
Age: 48
State: AR

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 09/08/2021
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: Didn't turned all the way in into the patient/not all the vaccine was actually injected into the patient; This spontaneous case was reported by a nurse and describes the occurrence of ACCIDENTAL UNDERDOSE (Didn't turned all the way in into the patient/not all the vaccine was actually injected into the patient) in a 48-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Aug-2021, the patient experienced ACCIDENTAL UNDERDOSE (Didn't turned all the way in into the patient/not all the vaccine was actually injected into the patient). On 26-Aug-2021, ACCIDENTAL UNDERDOSE (Didn't turned all the way in into the patient/not all the vaccine was actually injected into the patient) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The reported wanted to know if should re administer. No concomitant medications provided. No treatment medications provided.

Other Meds:

Current Illness:

ID: 1683623
Sex: U
Age:
State:

Vax Date: 08/24/2021
Onset Date: 08/01/2021
Rec V Date: 09/08/2021
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: the injection site was red and warm to the touch; injection site was red; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (the injection site was red and warm to the touch) and VACCINATION SITE ERYTHEMA (injection site was red) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In August 2021, the patient experienced VACCINATION SITE WARMTH (the injection site was red and warm to the touch) and VACCINATION SITE ERYTHEMA (injection site was red). At the time of the report, VACCINATION SITE WARMTH (the injection site was red and warm to the touch) and VACCINATION SITE ERYTHEMA (injection site was red) had not resolved. No concomitant medication was reported. No treatment medication was reported.

Other Meds:

Current Illness:

ID: 1683624
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/08/2021
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: Patient experienced side effects; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Patient experienced side effects) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Patient experienced side effects). At the time of the report, VACCINATION COMPLICATION (Patient experienced side effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1683625
Sex: F
Age: 78
State: PA

Vax Date: 05/15/2021
Onset Date: 05/16/2021
Rec V Date: 09/08/2021
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: Bottom teeth pulled, as she has jagged teeth underneath the bridge; Chills; This spontaneous case was reported by a consumer and describes the occurrence of TOOTH INJURY (Bottom teeth pulled, as she has jagged teeth underneath the bridge) and CHILLS (Chills) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002C21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 (was hospitalized.) in November 2020 and Arm discomfort (Patient was attacked by some kinds on November 2019. Required surgeries and rehab).). Concurrent medical conditions included Blood disorder and Spinal disorder (Had a spine condition that didn't let patient put the hands in front of the body when falls. Patient went to see a lot of doctors: her general practitioner, but also a neurologist to check if she hit her head when she fell. Patient got a brain scan.). Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID), GABAPENTIN and PARACETAMOL (TYLENOL) for an unknown indication. On 15-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-May-2021, the patient experienced CHILLS (Chills). On 18-May-2021, the patient experienced TOOTH INJURY (Bottom teeth pulled, as she has jagged teeth underneath the bridge). The patient was treated with Surgery (bottom teeth pulled) for Tooth injury. On 17-May-2021, CHILLS (Chills) had resolved. At the time of the report, TOOTH INJURY (Bottom teeth pulled, as she has jagged teeth underneath the bridge) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided. The had other operations: knee cap replacement surgery, shoulder surgery, and a cataracts surgery, that had to be postponed due to the symptoms experienced after the second shot. This case was linked to MOD-2021-297469 (Patient Link).

Other Meds: SYNTHROID; GABAPENTIN; TYLENOL

Current Illness: Blood disorder; Spinal disorder (Had a spine condition that didn't let patient put the hands in front of the body when falls. Patient went to see a lot of doctors: her general practitioner, but also a neurologist to check if she hit her head when she fell. Patient got a brain scan.)

ID: 1683626
Sex: M
Age: 50
State: UT

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 09/08/2021
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: Sore arm (left); This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore arm (left)) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included MULTIVITAMINS [VITAMINS NOS] for an unknown indication. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In January 2021, the patient experienced PAIN IN EXTREMITY (Sore arm (left)). At the time of the report, PAIN IN EXTREMITY (Sore arm (left)) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No treatment information was provided. This case was linked to MOD-2021-297408.

Other Meds: MULTIVITAMINS [VITAMINS NOS]

Current Illness:

ID: 1683627
Sex: M
Age:
State: AZ

Vax Date: 07/25/2021
Onset Date: 08/26/2021
Rec V Date: 09/08/2021
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: administered expired dose at 17 hours and 35 minutes; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (administered expired dose at 17 hours and 35 minutes) in a 29-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 0939901 and 023D21A) for COVID-19 vaccination. No Medical History information was reported. On 25-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 26-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (administered expired dose at 17 hours and 35 minutes). On 26-Aug-2021, EXPIRED PRODUCT ADMINISTERED (administered expired dose at 17 hours and 35 minutes) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant product information was provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1683628
Sex: M
Age: 45
State: MA

Vax Date: 08/04/2021
Onset Date: 08/25/2021
Rec V Date: 09/08/2021
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: Anxiety; Bad nasty headaches; Pain in arm/ Bizarre pain in his arms; His weakened arm on fire; His weakened arm on fire; Severe pain on the injection site; Hang over effects/ Feeling awful, crappy/ Noise upsetting him; His body hurting; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Hang over effects/ Feeling awful, crappy/ Noise upsetting him), FEELING HOT (His weakened arm on fire), ANXIETY (Anxiety), PAIN IN EXTREMITY (Pain in arm/ Bizarre pain in his arms) and PAIN (His body hurting) in a 45-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 059e21a) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Family history included Pericarditis (Patient's father had pericarditis when he was younger). On 04-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Aug-2021, the patient experienced FEELING HOT (His weakened arm on fire), MUSCULAR WEAKNESS (His weakened arm on fire) and VACCINATION SITE PAIN (Severe pain on the injection site). On 26-Aug-2021, the patient experienced PAIN IN EXTREMITY (Pain in arm/ Bizarre pain in his arms). On an unknown date, the patient experienced FEELING ABNORMAL (Hang over effects/ Feeling awful, crappy/ Noise upsetting him), ANXIETY (Anxiety), PAIN (His body hurting) and HEADACHE (Bad nasty headaches). The patient was treated with IBUPROFEN for Adverse event, at an unspecified dose and frequency. At the time of the report, FEELING ABNORMAL (Hang over effects/ Feeling awful, crappy/ Noise upsetting him), FEELING HOT (His weakened arm on fire), PAIN (His body hurting), MUSCULAR WEAKNESS (His weakened arm on fire), VACCINATION SITE PAIN (Severe pain on the injection site) and HEADACHE (Bad nasty headaches) had resolved, ANXIETY (Anxiety) outcome was unknown and PAIN IN EXTREMITY (Pain in arm/ Bizarre pain in his arms) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not provided. The patient experienced events following vaccination for a week. The patient experienced pain in arm which then it disappeared and now it comes and goes in the same spot on the injection site. The patient took ibuprofen but it did not helped.

Other Meds:

Current Illness:

ID: 1683629
Sex: F
Age:
State: CA

Vax Date: 03/13/2021
Onset Date:
Rec V Date: 09/08/2021
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: Patient never received her 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Patient never received her 2nd dose) 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 13-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 PRODUCT DOSE OMISSION ISSUE (Patient never received her 2nd dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Patient never received her 2nd dose) had resolved. No concomitant medications were reported. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1683630
Sex: U
Age: 0
State: CA

Vax Date: 07/20/2021
Onset Date:
Rec V Date: 09/08/2021
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: low grade fever; fatigue; This spontaneous case was reported by an other health care professional and describes the occurrence of PYREXIA (low grade fever) and FATIGUE (fatigue) in a 4-month-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 3004956 and 3003657) 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 20-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PYREXIA (low grade fever) and FATIGUE (fatigue). At the time of the report, PYREXIA (low grade fever) and FATIGUE (fatigue) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications were not reported. Treatment medications were not reported.

Other Meds:

Current Illness:

ID: 1683631
Sex: F
Age: 54
State: OK

Vax Date: 03/16/2021
Onset Date: 04/01/2021
Rec V Date: 09/08/2021
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: got sick after both shots; fever; chills; headache; developed a chronic, raspy sound; it's like a raspy cough; voice and throat have been groggy; throat gets sore; short of breath; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (got sick after both shots), DYSPHONIA (developed a chronic, raspy sound), COUGH (it's like a raspy cough), SOMNOLENCE (voice and throat have been groggy) and OROPHARYNGEAL PAIN (throat gets sore) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007B21A and 038A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 16-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Apr-2021, the patient experienced ILLNESS (got sick after both shots), PYREXIA (fever), CHILLS (chills) and HEADACHE (headache). In April 2021, the patient experienced DYSPHONIA (developed a chronic, raspy sound), COUGH (it's like a raspy cough), SOMNOLENCE (voice and throat have been groggy), OROPHARYNGEAL PAIN (throat gets sore) and DYSPNOEA (short of breath). In April 2021, PYREXIA (fever), CHILLS (chills) and HEADACHE (headache) had resolved. At the time of the report, ILLNESS (got sick after both shots), DYSPHONIA (developed a chronic, raspy sound), COUGH (it's like a raspy cough), SOMNOLENCE (voice and throat have been groggy), OROPHARYNGEAL PAIN (throat gets sore) and DYSPNOEA (short of breath) had not resolved. Concomitant product was not provided by the reporter. Treatment information was not provided. This case was linked to MOD-2021-297681 (Patient Link).

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am