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: 1691482
Sex: F
Age: 22
State: AL

Vax Date: 03/19/2021
Onset Date: 08/07/2021
Rec V Date: 09/11/2021
Hospital:

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

Lab Data: Test Name: Pregnancy test; Test Result: Negative ; Result Unstructured Data: Not pregnant

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: 4 moths since last period; Got second dose recently on 07Aug2021; This spontaneous case was reported by a consumer and describes the occurrence of MENSTRUATION DELAYED (4 moths since last period) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Got second dose recently on 07Aug2021) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 052E21A and 025A2114) for COVID-19 vaccination. Concurrent medical conditions included Polycystic ovarian syndrome. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Got second dose recently on 07Aug2021). On an unknown date, the patient experienced MENSTRUATION DELAYED (4 moths since last period). On 07-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Got second dose recently on 07Aug2021) had resolved. At the time of the report, MENSTRUATION DELAYED (4 moths since last period) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Pregnancy test: negative (Negative) Not pregnant. No concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness: Polycystic ovarian syndrome

ID: 1691483
Sex: F
Age: 62
State: LA

Vax Date: 02/26/2021
Onset Date: 08/18/2021
Rec V Date: 09/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: She experienced inflammation of subcutaneous tissue in her right leg below the right knee and below the joint anteriorly over the tibial plateau./similar area has appeared distally down the right leg not in the same location as the first.; Legs were hurting as if she had restless leg syndrome; She could not get out of bed; Noticed a large soft knot inside her leg above the knee/tearing feeling in her leg and developed another knot above the first one; Sore arm/shooting pains in the front of her; Limping around and stuff due to the pain; Not immunocompromised; Blood clot; Area was experiencing swelling and tenderness in a 1 inch diameter.; Area was experiencing swelling and tenderness in a 1 inch diameter.; This spontaneous case was reported by a physician and describes the occurrence of INFLAMMATION (She experienced inflammation of subcutaneous tissue in her right leg below the right knee and below the joint anteriorly over the tibial plateau./similar area has appeared distally down the right leg not in the same location as the first.), RESTLESS LEGS SYNDROME (Legs were hurting as if she had restless leg syndrome), MOBILITY DECREASED (She could not get out of bed), LIMB MASS (Noticed a large soft knot inside her leg above the knee/tearing feeling in her leg and developed another knot above the first one) and PAIN IN EXTREMITY (Sore arm/shooting pains in the front of her) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039B21A and 046A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19 (last march or April of last year). On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 19-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced SWELLING (Area was experiencing swelling and tenderness in a 1 inch diameter.) and TENDERNESS (Area was experiencing swelling and tenderness in a 1 inch diameter.). On 22-Aug-2021, the patient experienced THROMBOSIS (Blood clot). On an unknown date, the patient experienced INFLAMMATION (She experienced inflammation of subcutaneous tissue in her right leg below the right knee and below the joint anteriorly over the tibial plateau./similar area has appeared distally down the right leg not in the same location as the first.). an unknown date, the patient experienced RESTLESS LEGS SYNDROME (Legs were hurting as if she had restless leg syndrome), MOBILITY DECREASED (She could not get out of bed), LIMB MASS (Noticed a large soft knot inside her leg above the knee/tearing feeling in her leg and developed another knot above the first one), PAIN IN EXTREMITY (Sore arm/shooting pains in the front of her), GAIT DISTURBANCE (Limping around and stuff due to the pain) and OFF LABEL USE (Not immunocompromised). The patient was treated with BETAMETHASONE (CELESTONE [BETAMETHASONE]) for Swelling, at a dose of 1 UNK; TRAMADOL for Adverse event, at an unspecified dose and frequency; PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency; IBUPROFEN (ADVIL [IBUPROFEN]) for Adverse event, at an unspecified dose and frequency; CORTISONE for Adverse event, at an unspecified dose and frequency and MELOXICAM for Adverse event, at a dose of 15 mg. On 23-Aug-2021, INFLAMMATION (She experienced inflammation of subcutaneous tissue in her right leg below the right knee and below the joint anteriorly over the tibial plateau./similar area has appeared distally down the right leg not in the same location as the first.), SWELLING (Area was experiencing swelling and tenderness in a 1 inch diameter.), TENDERNESS (Area was experiencing swelling and tenderness in a 1 inch diameter.) and GAIT DISTURBANCE (Limping around and stuff due to the pain) had resolved. At the time of the report, RESTLESS LEGS SYNDROME (Legs were hurting as if she had restless leg syndrome), MOBILITY DECREASED (She could not get out of bed), LIMB MASS (Noticed a large soft knot inside her leg above the knee/tearing feeling in her leg and developed another knot above the first one), PAIN IN EXTREMITY (Sore arm/shooting pains in the front of her) and THROMBOSIS (Blood clot) outcome was unknown and OFF LABEL USE (Not immunocompromised) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant product information was provided. Additional information reported include that the patient had a large soft knot inside the legs, above the knees and close to tibia which the physician ruled out as blood clot. This case was linked to MOD-2021-295607, MOD-2021-295596 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 24-Aug-2021: New events, treatment drugs, suspect product details and new reporter details were added.

Other Meds:

Current Illness:

ID: 1691484
Sex: F
Age: 55
State: AR

Vax Date: 03/19/2021
Onset Date:
Rec V Date: 09/11/2021
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: Achiness; Tiredness; Slight soreness in my upper left arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Slight soreness in my upper left arm), PAIN (Achiness) and FATIGUE (Tiredness) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030B21A and 001B21A) for COVID-19 vaccination. Concurrent medical conditions included Allergy to metals and Diabetes since 01-Aug-2019. Concomitant products included METFORMIN from 01-Aug-2019 to an unknown date, GLIPIZIDE from 15-Aug-2019 to an unknown date and EMPAGLIFLOZIN (JARDIANCE) from 07-Jan-2021 to an unknown date for Diabetes. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Apr-2021 at 10:30 AM, 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 IN EXTREMITY (Slight soreness in my upper left arm), PAIN (Achiness) and FATIGUE (Tiredness). At the time of the report, PAIN IN EXTREMITY (Slight soreness in my upper left arm), PAIN (Achiness) and FATIGUE (Tiredness) had resolved. Not Provided Treatment information was not provided by the reporter. other concomitant medications included centrum silver multi-vitamin from 01-jan-2016 and still ongoing, it was used for general health purpose and taken orally 1 per day and Ester-c vitamin was taken from 01-jan-2003 and still ongoing, it was used for Immune system health and taken orally 500mg/1 per day. This case was linked to MOD-2021-056082 (Patient Link).

Other Meds: METFORMIN; GLIPIZIDE; JARDIANCE

Current Illness: Allergy to metals; Diabetes

ID: 1691485
Sex: M
Age: 33
State: IL

Vax Date: 08/16/2021
Onset Date:
Rec V Date: 09/11/2021
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: sleeping non stop 15 hours per day, and cannot stay awake; Arm was also sore; Every time he woke up, his body would shut down.; He reports that after the vaccine, he feels drained, and depleted of energy completed.; He is very fatigued, and cannot drink coffee to help with fatigue; This spontaneous case was reported by a consumer and describes the occurrence of HYPERSOMNIA (sleeping non stop 15 hours per day, and cannot stay awake), PAIN IN EXTREMITY (Arm was also sore), MOVEMENT DISORDER (Every time he woke up, his body would shut down.), ASTHENIA (He reports that after the vaccine, he feels drained, and depleted of energy completed.) and FATIGUE (He is very fatigued, and cannot drink coffee to help with fatigue) in a 33-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. Concurrent medical conditions included Anxiety, Degeneration of intervertebral disc, site unspecified and Supraventricular tachycardia. Concomitant products included ALPRAZOLAM and CLONAZEPAM for Anxiety, ASPIRIN [ACETYLSALICYLIC ACID] for Degeneration of intervertebral disc, site unspecified. On 16-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 HYPERSOMNIA (sleeping non stop 15 hours per day, and cannot stay awake), PAIN IN EXTREMITY (Arm was also sore), MOVEMENT DISORDER (Every time he woke up, his body would shut down.), ASTHENIA (He reports that after the vaccine, he feels drained, and depleted of energy completed.) and FATIGUE (He is very fatigued, and cannot drink coffee to help with fatigue). At the time of the report, HYPERSOMNIA (sleeping non stop 15 hours per day, and cannot stay awake), ASTHENIA (He reports that after the vaccine, he feels drained, and depleted of energy completed.) and FATIGUE (He is very fatigued, and cannot drink coffee to help with fatigue) had not resolved and PAIN IN EXTREMITY (Arm was also sore) and MOVEMENT DISORDER (Every time he woke up, his body would shut down.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.

Other Meds: ALPRAZOLAM; CLONAZEPAM; ASPIRIN [ACETYLSALICYLIC ACID]

Current Illness: Anxiety; Degeneration of intervertebral disc, site unspecified; Supraventricular tachycardia

ID: 1691486
Sex: M
Age: 26
State: KS

Vax Date: 08/02/2021
Onset Date: 08/23/2021
Rec V Date: 09/11/2021
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: They gave a patient his 2nd dose yesterday, 23Aug2021 after giving him his first dose on 2Aug2021; This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (They gave a patient his 2nd dose yesterday, 23Aug2021 after giving him his first dose on 2Aug2021) in a 26-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 939902 and 091D21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, received second 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 INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (They gave a patient his 2nd dose yesterday, 23Aug2021 after giving him his first dose on 2Aug2021). On 23-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (They gave a patient his 2nd dose yesterday, 23Aug2021 after giving him his first dose on 2Aug2021) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications were not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1691487
Sex: M
Age: 23
State: PA

Vax Date: 04/22/2021
Onset Date:
Rec V Date: 09/11/2021
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: Missed second dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Missed second dose) in a 24-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016B21A) for COVID-19 vaccination. No Medical History information was reported. On 22-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Missed second dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Missed second dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications were not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1691488
Sex: F
Age: 88
State: TX

Vax Date: 08/23/2021
Onset Date:
Rec V Date: 09/11/2021
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: Sore arm; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Sore arm) and NAUSEA (Nausea) in an 88-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 23-Aug-2021, the patient 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 received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced MYALGIA (Sore arm) and NAUSEA (Nausea). At the time of the report, MYALGIA (Sore arm) and NAUSEA (Nausea) outcome was unknown. Concomitant medications were not provided. Treatment information was not provided. This case was linked to US-MODERNATX, INC.-MOD-2021-295365 (E2B Linked Report).; Sender's Comments: US-MODERNATX, INC.-MOD-2021-295365:same reporter, same event and different patient

Other Meds:

Current Illness:

ID: 1691489
Sex: M
Age: 66
State: PA

Vax Date: 12/23/2020
Onset Date: 01/01/2021
Rec V Date: 09/11/2021
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: Terrible itch all over his body; Terrible red rash all over his body; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (Terrible itch all over his body) and RASH ERYTHEMATOUS (Terrible red rash all over his body) in a 66-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013L20A and 011J20A) for COVID-19 vaccination. No Medical History information was reported. On 23-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In January 2021, the patient experienced PRURITUS (Terrible itch all over his body) and RASH ERYTHEMATOUS (Terrible red rash all over his body). The patient was treated with CLOBETASOL for Adverse event, at an unspecified dose and frequency; PREDNISONE for Adverse event, at an unspecified dose and frequency and FEXOFENADINE HYDROCHLORIDE (ALLEGRA) for Adverse event, at an unspecified dose and frequency. At the time of the report, PRURITUS (Terrible itch all over his body) and RASH ERYTHEMATOUS (Terrible red rash all over his body) had not resolved. No concomitant medications were reported. Patient has been using treatments but it was reported that nothing seemed to help his side effects to completely go away. He was reported to be under doctor's care.

Other Meds:

Current Illness:

ID: 1691490
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
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: Constipation; Sharp pain; Fever; This spontaneous case was reported by a consumer and describes the occurrence of CONSTIPATION (constipation), PAIN (sharp pain) and PYREXIA (fever) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. No Medical History information was reported. On 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 CONSTIPATION (constipation), PAIN (sharp pain) and PYREXIA (fever). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 dosage form. At the time of the report, CONSTIPATION (constipation) and PAIN (sharp pain) outcome was unknown and PYREXIA (fever) had resolved. No concomitant medication were reported.

Other Meds:

Current Illness:

ID: 1691491
Sex: F
Age: 76
State: CA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 09/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: blood coming out of her right nostril; This spontaneous case was reported by a consumer and describes the occurrence of EPISTAXIS (blood coming out of her right nostril) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042L20A) for COVID-19 vaccination. No Medical History information was reported. On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Jan-2021, the patient experienced EPISTAXIS (blood coming out of her right nostril). On 23-Jan-2021, EPISTAXIS (blood coming out of her right nostril) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. No concomitant medications were reported No treatment information was provided This case was linked to MOD-2021-026419 (Patient Link).

Other Meds:

Current Illness:

ID: 1691492
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
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: Muscle pain at left arm; This spontaneous case was reported by a patient and describes the occurrence of MYALGIA (Muscle pain at left arm) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MYALGIA (Muscle pain at left arm). At the time of the report, MYALGIA (Muscle pain at left arm) was resolving. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication were reported. No treatment information were reported.

Other Meds:

Current Illness:

ID: 1691493
Sex: F
Age: 62
State: LA

Vax Date: 02/26/2021
Onset Date: 03/26/2021
Rec V Date: 09/11/2021
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: Could not get out of bed; Legs were hurting as if she had restless leg syndrome; Tiredness; Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of BEDRIDDEN (Could not get out of bed), PAIN IN EXTREMITY (Legs were hurting as if she had restless leg syndrome), VACCINATION SITE PAIN (Sore arm) and FATIGUE (Tiredness) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046A21A) for COVID-19 vaccination. Concurrent medical conditions included Restless leg syndrome. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Mar-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced VACCINATION SITE PAIN (Sore arm). On 27-Mar-2021, the patient experienced BEDRIDDEN (Could not get out of bed), PAIN IN EXTREMITY (Legs were hurting as if she had restless leg syndrome) and FATIGUE (Tiredness). At the time of the report, BEDRIDDEN (Could not get out of bed), PAIN IN EXTREMITY (Legs were hurting as if she had restless leg syndrome), VACCINATION SITE PAIN (Sore arm) and FATIGUE (Tiredness) outcome was unknown. No concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness: Restless leg syndrome

ID: 1691494
Sex: U
Age:
State:

Vax Date:
Onset Date: 08/24/2021
Rec V Date: 09/11/2021
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: I got the Moderna shot on Sunday. Today I have green poop. Is that a side effect?; This spontaneous case was reported by a consumer and describes the occurrence of FAECES DISCOLOURED (I got the Moderna shot on Sunday. Today I have green poop. Is that a side effect?) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced FAECES DISCOLOURED (I got the Moderna shot on Sunday. Today I have green poop. Is that a side effect?). At the time of the report, FAECES DISCOLOURED (I got the Moderna shot on Sunday. Today I have green poop. Is that a side effect?) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medications were reported. No Treatment information was reported.

Other Meds:

Current Illness:

ID: 1691495
Sex: F
Age: 72
State:

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 09/11/2021
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: flu symptoms; severe headache; aches; chills; This spontaneous case was reported by a non-health professional and describes the occurrence of INFLUENZA (flu symptoms), HEADACHE (severe headache), MYALGIA (aches) and CHILLS (chills) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029L20A) for COVID-19 vaccination. No Medical History information was reported. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Jan-2021, the patient experienced INFLUENZA (flu symptoms), HEADACHE (severe headache), MYALGIA (aches) and CHILLS (chills). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date for Adverse event, at an unspecified dose and frequency. On 27-Jan-2021, HEADACHE (severe headache) had resolved. At the time of the report, INFLUENZA (flu symptoms), MYALGIA (aches) and CHILLS (chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. This case was linked to MOD-2021-295648 (Patient Link).

Other Meds:

Current Illness:

ID: 1691496
Sex: F
Age: 72
State:

Vax Date: 01/22/2021
Onset Date: 02/20/2021
Rec V Date: 09/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: flu like symptoms; severe headache; chills; aches; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (flu like symptoms), HEADACHE (severe headache), CHILLS (chills) and MYALGIA (aches) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 024M20A, 029L20A and 040C21A) for COVID-19 vaccination. Medical history was not provided. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Feb-2021, the patient experienced INFLUENZA LIKE ILLNESS (flu like symptoms). 20-Feb-2021, the patient experienced HEADACHE (severe headache), CHILLS (chills) and MYALGIA (aches). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date at a dose of 1 dosage form. At the time of the report, INFLUENZA LIKE ILLNESS (flu like symptoms), HEADACHE (severe headache), CHILLS (chills) and MYALGIA (aches) outcome was unknown. This case was linked to MOD-2021-295649, MOD-2021-295635 (Patient Link).

Other Meds:

Current Illness:

ID: 1691497
Sex: M
Age:
State: NY

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/11/2021
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: Received Moderna vaccine when he wanted Pfizer vaccine; This spontaneous case was reported by a consumer and describes the occurrence of NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) 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) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine). At the time of the report, NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided. This spontaneous case was reported by a consumer and describes the occurrence of NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) 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 NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine). At the time of the report, NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1691498
Sex: F
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
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: Received 3rd dose 6 months after 2nd dose as a precaution; This spontaneous case was reported by a consumer and describes the occurrence of EXTRA DOSE ADMINISTERED (Received 3rd dose 6 months after 2nd dose as a precaution) 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 third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced EXTRA DOSE ADMINISTERED (Received 3rd dose 6 months after 2nd dose as a precaution). At the time of the report, EXTRA DOSE ADMINISTERED (Received 3rd dose 6 months after 2nd dose as a precaution) had resolved. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1691499
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
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: Dose of the Moderna Covid vaccine is given after the expiration; 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 (Dose of the Moderna Covid vaccine is given after the expiration) 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 EXPIRED PRODUCT ADMINISTERED (Dose of the Moderna Covid vaccine is given after the expiration). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Dose of the Moderna Covid vaccine is given after the expiration) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication were provided by the reporter No treatment medication were provided by the reporter

Other Meds:

Current Illness:

ID: 1691500
Sex: F
Age: 52
State: FL

Vax Date: 08/18/2021
Onset Date: 08/19/2021
Rec V Date: 09/11/2021
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: red hot patch; big red square right underneath injection site; tired; nauseous; feel pain in my left side of chest / pain in chest sharp short pain; dizzy; Burning; Aching; throbbing; pain shoulder to fingers; under arm lymph note was swollen; arm was severally sore; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (feel pain in my left side of chest / pain in chest sharp short pain), DIZZINESS (dizzy), BURNING SENSATION (Burning), PAIN IN EXTREMITY (Aching) and MYALGIA (throbbing) in a 52-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. No Medical History information was reported. On 18-Aug-2021 at 9:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Aug-2021, the patient experienced MYALGIA (arm was severally sore). On 20-Aug-2021, the patient experienced BURNING SENSATION (Burning), PAIN IN EXTREMITY (Aching), MYALGIA (throbbing), LYMPHADENOPATHY (under arm lymph note was swollen) and ARTHRALGIA (pain shoulder to fingers). On 23-Aug-2021, the patient experienced CHEST PAIN (feel pain in my left side of chest / pain in chest sharp short pain). 23-Aug-2021, the patient experienced DIZZINESS (dizzy), NAUSEA (nauseous) and FATIGUE (tired). On 24-Aug-2021, the patient experienced INJECTION SITE ERYTHEMA (big red square right underneath injection site). On 25-Aug-2021, the patient experienced RASH (red hot patch). At the time of the report, CHEST PAIN (feel pain in my left side of chest / pain in chest sharp short pain), RASH (red hot patch) and MYALGIA (arm was severally sore) outcome was unknown and DIZZINESS (dizzy), BURNING SENSATION (Burning), PAIN IN EXTREMITY (Aching), MYALGIA (throbbing), NAUSEA (nauseous), LYMPHADENOPATHY (under arm lymph note was swollen), INJECTION SITE ERYTHEMA (big red square right underneath injection site), FATIGUE (tired) and ARTHRALGIA (pain shoulder to fingers) had not resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was withdrawn on an unknown date. Patient was extremely healthy and great cardio shape. Patient states that she took birth control pills. No treatment medications were provided by reporter. Most recent FOLLOW-UP information incorporated above includes: On 26-Aug-2021: Follow-up received and updated concomitant medication.

Other Meds:

Current Illness:

ID: 1691501
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
Hospital:

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

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1691502
Sex: U
Age:
State:

Vax Date: 08/25/2021
Onset Date:
Rec V Date: 09/11/2021
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: My leg has been asleep for about an hour after 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (My leg has been asleep for about an hour after 2nd dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 25-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced HYPOAESTHESIA (My leg has been asleep for about an hour after 2nd dose). At the time of the report, HYPOAESTHESIA (My leg has been asleep for about an hour after 2nd dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. no concomitant medications were reported. no treatment drugs were reported.

Other Meds:

Current Illness:

ID: 1691503
Sex: F
Age:
State: CA

Vax Date: 04/02/2021
Onset Date:
Rec V Date: 09/11/2021
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: patient did not receive the second dose injection; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (patient did not receive the second dose injection) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016B21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (patient did not receive the second dose injection). At the time of the report, PRODUCT DOSE OMISSION ISSUE (patient did not receive the second dose injection) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant drug was not reported. Treatment medication was not reported.

Other Meds:

Current Illness:

ID: 1691504
Sex: U
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
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: Family members experienced a rash; 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 RASH (Family members experienced a rash) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced RASH (Family members experienced a rash). At the time of the report, RASH (Family members experienced a rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1691505
Sex: M
Age: 41
State: MO

Vax Date: 03/24/2021
Onset Date: 04/25/2021
Rec V Date: 09/11/2021
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: pain scale; Result Unstructured Data: Pain scale could range from 8 to 9 out of 10, 10 being the highest, indicates Very severe pain

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: cant grasp, hand start to shake; can barely lift without elbow pain; pain on injected arm; Elbow pain; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (cant grasp, hand start to shake), PAIN (can barely lift without elbow pain), PAIN IN EXTREMITY (pain on injected arm) and ARTHRALGIA (Elbow pain) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007B21A and 038A21A) for COVID-19 vaccination. Concurrent medical conditions included Rheumatoid arthritis (he was born with rheumatoid arthritis), Seasonal allergy and Shellfish allergy. Concomitant products included LISINOPRIL for an unknown indication. On 24-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Apr-2021, the patient experienced TREMOR (cant grasp, hand start to shake), PAIN (can barely lift without elbow pain), PAIN IN EXTREMITY (pain on injected arm) and ARTHRALGIA (Elbow pain). The patient was treated with PREDNISONE at an unspecified dose and frequency and NAPROXEN SODIUM (ALEVE) for Pain, at an unspecified dose and frequency. At the time of the report, TREMOR (cant grasp, hand start to shake), PAIN (can barely lift without elbow pain), PAIN IN EXTREMITY (pain on injected arm) and ARTHRALGIA (Elbow pain) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Pain assessment: 8 to 9 (abnormal) Pain scale could range from 8 to 9 out of 10, 10 being the highest, indicates Very severe pain. The patient stated that he was born with rheumatoid arthritis, but after his 1st dose, his knees swell incredibly. After 2nd dose, it was not nearly as bad but he can barely lift without elbow pain. Pain scale could range from 8 to 9 out of 10, 10 being the highest. This case was linked to MOD-2021-295807 (Patient Link).

Other Meds: LISINOPRIL

Current Illness: Rheumatoid arthritis (he was born with rheumatoid arthritis); Seasonal allergy; Shellfish allergy

ID: 1691506
Sex: F
Age: 58
State: CA

Vax Date: 08/03/2021
Onset Date:
Rec V Date: 09/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: pain from neck to shoulder area; both arms are hurting/opposite arm that got the shot is hurting,stabbing pain her left leg,; both real stiff; cough; Runny nose; could not leep last night; had a slight headache; body is achy; Received pfizer as the first dose and Moderna as the second; This spontaneous case was reported by a consumer and describes the occurrence of NECK PAIN (pain from neck to shoulder area), PAIN IN EXTREMITY (both arms are hurting/opposite arm that got the shot is hurting,stabbing pain her left leg,), MUSCULOSKELETAL STIFFNESS (both real stiff), COUGH (cough) and RHINORRHOEA (Runny nose) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 034CZ1A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) for COVID-19 vaccination. Concomitant products included LAMOTRIGINE and IBUPROFEN (MOTRIN [IBUPROFEN]) for an unknown indication. On 03-Aug-2021, the patient received first dose of TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 24-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced NECK PAIN (pain from neck to shoulder area), PAIN IN EXTREMITY (both arms are hurting/opposite arm that got the shot is hurting,stabbing pain her left leg,), MUSCULOSKELETAL STIFFNESS (both real stiff), COUGH (cough), RHINORRHOEA (Runny nose), INSOMNIA (could not leep last night), HEADACHE (had a slight headache), MYALGIA (body is achy) and INTERCHANGE OF VACCINE PRODUCTS (Received pfizer as the first dose and Moderna as the second). At the time of the report, NECK PAIN (pain from neck to shoulder area), PAIN IN EXTREMITY (both arms are hurting/opposite arm that got the shot is hurting,stabbing pain her left leg,), MUSCULOSKELETAL STIFFNESS (both real stiff), COUGH (cough), RHINORRHOEA (Runny nose), INSOMNIA (could not leep last night), HEADACHE (had a slight headache) and MYALGIA (body is achy) outcome was unknown and INTERCHANGE OF VACCINE PRODUCTS (Received pfizer as the first dose and Moderna as the second) had resolved. Reportedly, Patient was planning to visit Emergency room if she did not feel better. No treatment medication was provided Most recent FOLLOW-UP information incorporated above includes: On 31-Aug-2021: significant Follow up appended.Suspect product information : Start date and Dose number was updated, Events added

Other Meds: LAMOTRIGINE; MOTRIN [IBUPROFEN]

Current Illness:

ID: 1691507
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
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: Issues with being fuzzy headed; Achy joints; 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 (Issues with being fuzzy headed) and ARTHRALGIA (Achy joints) 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 (Issues with being fuzzy headed) and ARTHRALGIA (Achy joints). At the time of the report, FEELING ABNORMAL (Issues with being fuzzy headed) and ARTHRALGIA (Achy joints) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication were not reported. Treatment medication were not reported.

Other Meds:

Current Illness:

ID: 1691508
Sex: M
Age:
State: FL

Vax Date: 07/28/2021
Onset Date:
Rec V Date: 09/11/2021
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: COVID-19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (COVID-19) 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 an unknown date, the patient experienced COVID-19 (COVID-19). At the time of the report, COVID-19 (COVID-19) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1691509
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
Hospital:

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

Lab Data: Test Name: Heart rate increased; Result Unstructured Data: Increased

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: bad peroid; insomnia; drowsiness; sore arm; tired; bad body pains; This spontaneous case was reported by a consumer and describes the occurrence of MENSTRUAL DISORDER (bad peroid), INSOMNIA (insomnia), SOMNOLENCE (drowsiness), PAIN IN EXTREMITY (sore arm) and FATIGUE (tired) in a 28-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. No Medical History information was reported. Concomitant products included INTRAUTERINE CONTRACEPTIVE DEVICE (IUD NOS) for an unknown indication. 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 MENSTRUAL DISORDER (bad peroid), INSOMNIA (insomnia), SOMNOLENCE (drowsiness), PAIN IN EXTREMITY (sore arm), FATIGUE (tired) and MYALGIA (bad body pains). The patient was treated with DEXTROMETHORPHAN HYDROBROMIDE, DOXYLAMINE SUCCINATE, EPHEDRINE SULFATE, ETHANOL, PARACETAMOL (NYQUIL) for Adverse event, at an unspecified dose and frequency and IBUPROFEN for Pain in arm, at an unspecified dose and frequency. At the time of the report, MENSTRUAL DISORDER (bad peroid), INSOMNIA (insomnia), SOMNOLENCE (drowsiness), PAIN IN EXTREMITY (sore arm), FATIGUE (tired) and MYALGIA (bad body pains) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Heart rate increased: higher (High) Increased. Patient mentioned that Would get tired and then by the time she she gets in bed drowsiness goes away and heart rate will increases preventing her from falls asleep and is no longer tired and took Nyquil and other medications to fall asleep which did not help.

Other Meds: IUD NOS

Current Illness:

ID: 1691510
Sex: F
Age:
State: VA

Vax Date: 05/15/2021
Onset Date:
Rec V Date: 09/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: got first dose on 15/May/2021 and didn't get second dose; This spontaneous case was reported by an other health care professional and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (got first dose on 15/May/2021 and didn't get second dose) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 15-May-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (got first dose on 15/May/2021 and didn't get second dose). The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1691511
Sex: F
Age: 57
State: AL

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 09/11/2021
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: 20210805; Test Name: SARS-COV-2; Test Result: Positive ; Result Unstructured Data: POSITVE

Allergies:

Symptom List: Nausea

Symptoms: first dose on 17 july, second dose not yet taken; my skin was itching; headache; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (my skin was itching), HEADACHE (headache) and PRODUCT DOSE OMISSION ISSUE (first dose on 17 july, second dose not yet taken) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 17-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 17-Jul-2021, the patient experienced PRURITUS (my skin was itching) and HEADACHE (headache). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (first dose on 17 july, second dose not yet taken). On 19-Jul-2021, PRURITUS (my skin was itching) and HEADACHE (headache) had resolved. At the time of the report, PRODUCT DOSE OMISSION ISSUE (first dose on 17 july, second dose not yet taken) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-Aug-2021, SARS-CoV-2 test: positve (Positive) POSITVE. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Treatment information was not provided. Concomitant medication was not provided.

Other Meds:

Current Illness:

ID: 1691512
Sex: F
Age: 62
State: MI

Vax Date: 03/16/2021
Onset Date: 03/23/2021
Rec V Date: 09/11/2021
Hospital:

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

Lab Data: Test Name: body temperature; Test Result: 98.7 {DF}; Result Unstructured Data: 98.7 degree F; Test Name: heart rate; Result Unstructured Data: Beats per minute; Test Name: heart rate; Result Unstructured Data: >100 beats per min

Allergies:

Symptom List: Injection site pain

Symptoms: sudden loss of memory/memory problems; Head fullness; Tinnitus; Irregular heart rate/palpitations; Difficulty breathing; Hoarseness; Numbness; Inner ear pain; Acid reflux; This spontaneous case was reported by a consumer and describes the occurrence of AMNESIA (sudden loss of memory/memory problems), HEAD DISCOMFORT (Head fullness), TINNITUS (Tinnitus), PALPITATIONS (Irregular heart rate/palpitations) and DYSPNOEA (Difficulty breathing) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Allergy to antibiotic (Ciproflocxin drug allergy neuropathy temporary 5 most) since 23-Jun-2021 and Drug hypersensitivity (Botox drug allergy throat tightness for one week.) since 01-Apr-2009. Concomitant products included VITAMIN D NOS for an unknown indication. On 16-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Mar-2021, the patient experienced AMNESIA (sudden loss of memory/memory problems), HEAD DISCOMFORT (Head fullness), TINNITUS (Tinnitus), PALPITATIONS (Irregular heart rate/palpitations), DYSPNOEA (Difficulty breathing), DYSPHONIA (Hoarseness), HYPOAESTHESIA (Numbness), EAR PAIN (Inner ear pain) and GASTROOESOPHAGEAL REFLUX DISEASE (Acid reflux). At the time of the report, AMNESIA (sudden loss of memory/memory problems), HEAD DISCOMFORT (Head fullness), TINNITUS (Tinnitus), PALPITATIONS (Irregular heart rate/palpitations), DYSPNOEA (Difficulty breathing), DYSPHONIA (Hoarseness), HYPOAESTHESIA (Numbness), EAR PAIN (Inner ear pain) and GASTROOESOPHAGEAL REFLUX DISEASE (Acid reflux) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 98.7 ?F (normal) 98.7 degree F. On an unknown date, Heart rate: 120 (High) Beats per minute and >100 (High) >100 beats per min. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment medication were provided by the reporter. Patient taken X-RAY on July 2021 by ENT.

Other Meds: VITAMIN D NOS

Current Illness: Allergy to antibiotic (Ciproflocxin drug allergy neuropathy temporary 5 most); Drug hypersensitivity (Botox drug allergy throat tightness for one week.)

ID: 1691513
Sex: F
Age: 37
State: NJ

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 09/11/2021
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: My migraines have gotten worse; dizzy spells; My allergies have gotten worse; Don't eat much; My arm is still sore from where the injection was; nausea; High fever; Intravenous route of administration; Body felt like brittle glass; cold sweat; dehydrated; trouble breathing; This spontaneous case was reported by a consumer and describes the occurrence of COLD SWEAT (cold sweat), DEHYDRATION (dehydrated), DYSPNOEA (trouble breathing), MIGRAINE (My migraines have gotten worse) and BODY DYSMORPHIC DISORDER (Body felt like brittle glass) in a 38-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040A21A and 028A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Migraine NOS. Concurrent medical conditions included Food allergy and Chemical sensitivity. On 10-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intravenous) 1 dosage form. On 07-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intravenous) dosage was changed to 1 dosage form. On 10-Mar-2021, the patient experienced COLD SWEAT (cold sweat), DEHYDRATION (dehydrated), DYSPNOEA (trouble breathing), BODY DYSMORPHIC DISORDER (Body felt like brittle glass), NAUSEA (nausea), PYREXIA (High fever) and INCORRECT ROUTE OF PRODUCT ADMINISTRATION (Intravenous route of administration). On an unknown date, the patient experienced MIGRAINE (My migraines have gotten worse), DIZZINESS (dizzy spells), HYPERSENSITIVITY (My allergies have gotten worse), EATING DISORDER (Don't eat much) and INJECTION SITE PAIN (My arm is still sore from where the injection was). On 10-Mar-2021, INCORRECT ROUTE OF PRODUCT ADMINISTRATION (Intravenous route of administration) had resolved. At the time of the report, COLD SWEAT (cold sweat), DEHYDRATION (dehydrated), DYSPNOEA (trouble breathing), BODY DYSMORPHIC DISORDER (Body felt like brittle glass), NAUSEA (nausea) and PYREXIA (High fever) had not resolved and MIGRAINE (My migraines have gotten worse), DIZZINESS (dizzy spells), HYPERSENSITIVITY (My allergies have gotten worse), EATING DISORDER (Don't eat much) and INJECTION SITE PAIN (My arm is still sore from where the injection was) outcome was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness: Chemical sensitivity; Food allergy

ID: 1691514
Sex: U
Age:
State: FL

Vax Date: 03/11/2021
Onset Date:
Rec V Date: 09/11/2021
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: sight problems; 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 VISUAL IMPAIRMENT (sight problems) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 024M20A and 020B21A) for COVID-19 vaccination. The patient's past medical history included Thrombosis (Patients had blood clot that affected their retina and they can hardly see with that eye). On 11-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-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 VISUAL IMPAIRMENT (sight problems). At the time of the report, VISUAL IMPAIRMENT (sight problems) outcome was unknown. Patient reported, saw online that other people had sight problems after getting the vaccine. Concomitant product use was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1691515
Sex: F
Age:
State: TX

Vax Date: 08/13/2021
Onset Date: 08/01/2021
Rec V Date: 09/11/2021
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: 20210814; Test Name: 103 degrees F; Result Unstructured Data: High

Allergies:

Symptom List: Tremor

Symptoms: shivering jaw clenched; experienced 2-3 hours of chest pain severe heart burn; felt nauseated sick to stomach; running 103 degrees F/ she laid back down at 7 or 8am and was still running a fever; fatigue; Headache; migraine; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (migraine), BRUXISM (shivering jaw clenched), NON-CARDIAC CHEST PAIN (experienced 2-3 hours of chest pain severe heart burn), NAUSEA (felt nauseated sick to stomach) and PYREXIA (running 103 degrees F/ she laid back down at 7 or 8am and was still running a fever) in a 41-year-old female 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. The patient's past medical history included COVID-19 (Treatment received: Steroids) in November 2020. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Aug-2021, the patient experienced BRUXISM (shivering jaw clenched), NON-CARDIAC CHEST PAIN (experienced 2-3 hours of chest pain severe heart burn), NAUSEA (felt nauseated sick to stomach) and PYREXIA (running 103 degrees F/ she laid back down at 7 or 8am and was still running a fever). In August 2021, the patient experienced MIGRAINE (migraine), FATIGUE (fatigue) and HEADACHE (Headache). The patient was treated with IBUPROFEN for Adverse event, at a dose of took 4 total that morning; CALCIUM CARBONATE (TUMS [CALCIUM CARBONATE]) for Adverse event, at a dose of 1 dosage form and PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 dosage form. On 14-Aug-2021, BRUXISM (shivering jaw clenched), NON-CARDIAC CHEST PAIN (experienced 2-3 hours of chest pain severe heart burn) and PYREXIA (running 103 degrees F/ she laid back down at 7 or 8am and was still running a fever) had resolved. On 17-Aug-2021, MIGRAINE (migraine), NAUSEA (felt nauseated sick to stomach) and FATIGUE (fatigue) had resolved. At the time of the report, HEADACHE (Headache) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Aug-2021, Body temperature: 103 degrees f (High) High. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitants were reported. Patient stated that Tried to have crackers and bread to settle stomach, went to lay back down took more ibuprofen took 4 total that morning. Slept until 10:30-11AM. Could not drink water, nauseated. Patient had COVID-19 last year in November2020 and said that symptoms from 1st dose was similar to COVID-19 she had except for the nausea. Patient was in bed the most of the day. Patient woke up 3pm tried to eat soup broth and experienced 2-3 hours of chest pain ,severe heart burn.

Other Meds:

Current Illness:

ID: 1691516
Sex: M
Age: 65
State:

Vax Date: 01/29/2021
Onset Date: 08/24/2021
Rec V Date: 09/11/2021
Hospital:

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

Lab Data: Test Name: Blood pressure; Result Unstructured Data: Normal; Test Name: EKG; Result Unstructured Data: Normal

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Headache; Pain in the shoulder blade; vision blurs or has blurry in the eye; pain in arm, left arm hurt, was really painful/left arm was really sore; skin on both arms feels like sandpaper; dark spots that look like skin cancer; dryness and crackling in the skin; chest pain, pain in the heart,felt like someone was stabbing him to the chest, chest pain is more extreme; There are lumps or bumps on both arms,The bump or lump in the arm got more severe on the left; Sharp pain in the chest or back; He had chest pain and headache after both shots; Nerves wrapping around, agitated nerve issue from his back surgery; Little bump in the arm and tissue, a bump with spongy dead tissue, lumps or bumps on both arms, The bump or lump in the arm got more severe on the left; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (He had chest pain and headache after both shots), NEURALGIA (Nerves wrapping around, agitated nerve issue from his back surgery), MASS (Little bump in the arm and tissue, a bump with spongy dead tissue, lumps or bumps on both arms, The bump or lump in the arm got more severe on the left), VISION BLURRED (vision blurs or has blurry in the eye) and PAIN IN EXTREMITY (pain in arm, left arm hurt, was really painful/left arm was really sore) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Back surgery. 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 28-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Aug-2021, the patient experienced VISION BLURRED (vision blurs or has blurry in the eye), PAIN IN EXTREMITY (pain in arm, left arm hurt, was really painful/left arm was really sore), SKIN TEXTURE ABNORMAL (skin on both arms feels like sandpaper), SKIN DISCOLOURATION (dark spots that look like skin cancer), DRY SKIN (dryness and crackling in the skin), CHEST PAIN (chest pain, pain in the heart,felt like someone was stabbing him to the chest, chest pain is more extreme), MASS (There are lumps or bumps on both arms,The bump or lump in the arm got more severe on the left), BACK PAIN (Sharp pain in the chest or back) and ARTHRALGIA (Pain in the shoulder blade). On an unknown date, the patient experienced CHEST PAIN (He had chest pain and headache after both shots), NEURALGIA (Nerves wrapping around, agitated nerve issue from his back surgery), MASS (Little bump in the arm and tissue, a bump with spongy dead tissue, lumps or bumps on both arms, The bump or lump in the arm got more severe on the left) and HEADACHE (Headache). At the time of the report, CHEST PAIN (He had chest pain and headache after both shots), NEURALGIA (Nerves wrapping around, agitated nerve issue from his back surgery), MASS (Little bump in the arm and tissue, a bump with spongy dead tissue, lumps or bumps on both arms, The bump or lump in the arm got more severe on the left) and HEADACHE (Headache) had resolved and VISION BLURRED (vision blurs or has blurry in the eye), PAIN IN EXTREMITY (pain in arm, left arm hurt, was really painful/left arm was really sore), SKIN TEXTURE ABNORMAL (skin on both arms feels like sandpaper), SKIN DISCOLOURATION (dark spots that look like skin cancer), DRY SKIN (dryness and crackling in the skin), CHEST PAIN (chest pain, pain in the heart,felt like someone was stabbing him to the chest, chest pain is more extreme), MASS (There are lumps or bumps on both arms,The bump or lump in the arm got more severe on the left), BACK PAIN (Sharp pain in the chest or back) and ARTHRALGIA (Pain in the shoulder blade) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: normal (normal) Normal. On an unknown date, Electrocardiogram: normal (normal) Normal. Relevant concomitant medications were not provided by the reporter. Treatment medication was not reported. Patient took high dose Flu shot on 24-AUG-2021. This case was linked to MOD-2021-296305.

Other Meds:

Current Illness: COPD

ID: 1691517
Sex: F
Age: 64
State: NC

Vax Date: 04/01/2021
Onset Date:
Rec V Date: 09/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient did not receive 2nd dose of the Moderna vaccine in over 36 days after 1st dose of the Moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Patient did not receive 2nd dose of the Moderna vaccine in over 36 days after 1st dose of the Moderna vaccine) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19 in January 2021. In April 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 did not receive 2nd dose of the Moderna vaccine in over 36 days after 1st dose of the Moderna vaccine). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Patient did not receive 2nd dose of the Moderna vaccine in over 36 days after 1st dose of the Moderna vaccine) had resolved. The concomitant medications were not reported. The treatment information was not provided. Patient reported that she had not received the second dose of Moderna vaccine. She reported that people who had COVID-19 have more antibodies and also she expressed her interest in clinical trial participation.

Other Meds:

Current Illness:

ID: 1691518
Sex: F
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
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: Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Sore arm) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 018B21A) 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 MYALGIA (Sore arm). At the time of the report, MYALGIA (Sore arm) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. Concomitant medications details were not reported. Treatment details was not reported by the reporter. This case was linked to MOD-2021-296287 (Patient Link).

Other Meds:

Current Illness:

ID: 1691519
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
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: contracted covid after receiving the first dose of the vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (contracted covid after receiving the first dose of the vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced COVID-19 (contracted covid after receiving the first dose of the vaccine). At the time of the report, COVID-19 (contracted covid after receiving the first dose of the vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was mentioned. No treatment medication was mentioned.

Other Meds:

Current Illness:

ID: 1691520
Sex: F
Age: 50
State: NV

Vax Date: 05/27/2021
Onset Date:
Rec V Date: 09/11/2021
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: Sore arm; This spontaneous case was reported by a pharmacist and describes the occurrence of PAIN IN EXTREMITY (Sore arm) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049C21A) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy (Allergic to pen K). On 27-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm). At the time of the report, PAIN IN EXTREMITY (Sore arm) outcome was unknown. Not Provided mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. No treatment information was provided. This case was linked to MOD-2021-182314 (Patient Link).

Other Meds:

Current Illness: Penicillin allergy (Allergic to pen K)

ID: 1691521
Sex: U
Age:
State: MT

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
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: shingles; nerve damage; 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 HERPES ZOSTER (shingles) and NERVE INJURY (nerve damage) 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 HERPES ZOSTER (shingles) and NERVE INJURY (nerve damage). At the time of the report, HERPES ZOSTER (shingles) and NERVE INJURY (nerve damage) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. It was reported that these people are in support groups for vaccinated people with symptoms. No treatment details were reported. This case was linked to MOD-2021-296653, MOD-2021-296654 (Patient Link).

Other Meds:

Current Illness:

ID: 1691522
Sex: F
Age:
State: PA

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 09/11/2021
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: lightheadedness; mild chest pain; feeling yucky; resting heart rate went up / had 3 episodes of rapid heart rate; fever; chills; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (mild chest pain), FEELING ABNORMAL (feeling yucky), DIZZINESS (lightheadedness), HEART RATE INCREASED (resting heart rate went up / had 3 episodes of rapid heart rate) and PYREXIA (fever) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046B21A and 018B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 23-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Apr-2021, the patient experienced FEELING ABNORMAL (feeling yucky), HEART RATE INCREASED (resting heart rate went up / had 3 episodes of rapid heart rate), PYREXIA (fever) and CHILLS (chills). On an unknown date, the patient experienced CHEST PAIN (mild chest pain) and DIZZINESS (lightheadedness). In May 2021, HEART RATE INCREASED (resting heart rate went up / had 3 episodes of rapid heart rate) had resolved. At the time of the report, CHEST PAIN (mild chest pain), FEELING ABNORMAL (feeling yucky), DIZZINESS (lightheadedness), PYREXIA (fever) and CHILLS (chills) outcome was unknown. No concomitant medications reported. No treatment information was provided. This case was linked to MOD-2021-296280 (Patient Link).

Other Meds:

Current Illness:

ID: 1691523
Sex: M
Age: 20
State: UT

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 09/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data: Test Date: 202101; Test Name: Body temperature; Result Unstructured Data: 100.8F

Allergies:

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

Symptoms: Doses 7 months apart; Sore arm; Fever of 100.8 F; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Doses 7 months apart), VACCINATION SITE PAIN (Sore arm) and PYREXIA (Fever of 100.8 F) in a 20-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. No Medical History information was reported. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Jan-2021, the patient experienced VACCINATION SITE PAIN (Sore arm) and PYREXIA (Fever of 100.8 F). On 25-Aug-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Doses 7 months apart). On 09-Jan-2021, VACCINATION SITE PAIN (Sore arm) and PYREXIA (Fever of 100.8 F) had resolved. On 25-Aug-2021, PRODUCT DOSE OMISSION ISSUE (Doses 7 months apart) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In January 2021, Body temperature: 100.8 (High) 100.8F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. It was reported that the patient had an appointment to take his second dose on 25-Aug-2021. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1691524
Sex: F
Age: 72
State: FL

Vax Date: 01/04/2021
Onset Date:
Rec V Date: 09/11/2021
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: was so sick; nauseous/throwing up; terrible aches & pains in her neck; headache; tired; her arm hurts; aches & pains in her neck and back with her back feeling like it was broken; Throwing up; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (was so sick), NAUSEA (nauseous/throwing up), NECK PAIN (terrible aches & pains in her neck), HEADACHE (headache) and FATIGUE (tired) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011D21A and 025J20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-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 ILLNESS (was so sick), NAUSEA (nauseous/throwing up), NECK PAIN (terrible aches & pains in her neck), HEADACHE (headache), FATIGUE (tired), PAIN IN EXTREMITY (her arm hurts), BACK PAIN (aches & pains in her neck and back with her back feeling like it was broken) and VOMITING (Throwing up). At the time of the report, ILLNESS (was so sick), NAUSEA (nauseous/throwing up), NECK PAIN (terrible aches & pains in her neck), HEADACHE (headache), FATIGUE (tired), PAIN IN EXTREMITY (her arm hurts), BACK PAIN (aches & pains in her neck and back with her back feeling like it was broken) and VOMITING (Throwing up) outcome was unknown. No concomitant medication listed. No treatment information provided.

Other Meds:

Current Illness:

ID: 1691525
Sex: F
Age: 54
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 09/11/2021
Hospital:

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

Lab Data: Test Date: 20210120; Test Name: SARS-CoV-2 antibody test; Test Result: Positive ; Result Unstructured Data: Positive; Test Date: 20210208; Test Name: SARS-CoV-2 antibody test; Test Result: Negative ; Result Unstructured Data: Negative

Allergies:

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: patient never received the second dose; she got the two shots of Pfizer; Patient was so ill; Patient was positive for covid; high fever; Horrific headache on the lower right side of head / headache never stopped; This spontaneous case was reported by an other health care professional and describes the occurrence of ILLNESS (Patient was so ill), COVID-19 (Patient was positive for covid), HEADACHE (Horrific headache on the lower right side of head / headache never stopped), PYREXIA (high fever) and PRODUCT DOSE OMISSION ISSUE (patient never received the second dose) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) for COVID-19 vaccination. Concurrent medical conditions included Gout. On 12-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 received dose of TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 12-Jan-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced HEADACHE (Horrific headache on the lower right side of head / headache never stopped). On 20-Jan-2021, the patient experienced COVID-19 (Patient was positive for covid) and PYREXIA (high fever). On 29-Jan-2021, the patient experienced ILLNESS (Patient was so ill). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (patient never received the second dose) and INTERCHANGE OF VACCINE PRODUCTS (she got the two shots of Pfizer). On 08-Feb-2021, COVID-19 (Patient was positive for covid) had resolved with sequelae. At the time of the report, ILLNESS (Patient was so ill), HEADACHE (Horrific headache on the lower right side of head / headache never stopped) and PYREXIA (high fever) outcome was unknown and PRODUCT DOSE OMISSION ISSUE (patient never received the second dose) and INTERCHANGE OF VACCINE PRODUCTS (she got the two shots of Pfizer) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 20-Jan-2021, SARS-CoV-2 antibody test: positive (Positive) Positive. On 08-Feb-2021, SARS-CoV-2 antibody test: negative (Negative) Negative. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was withdrawn on an unknown date. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient received monoclonal antibodies on 29 Jan 2021 The neurologist made her wait 100 days after receiving the monoclonal antibodies and she got the two shots of Pfizer and the patient is now taking migraine medicine. Patient taking Medicine for Gout as concomitant. The neurologist of the patient made her wait 100 days after receiving the monoclonal antibodies and then patient got two shots of Pfizer.

Other Meds:

Current Illness: Gout

ID: 1691526
Sex: F
Age: 58
State: MO

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 09/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Test Date: 20210304; Test Name: Blood Pressure; Result Unstructured Data: Blood pressure went up to 200/120; Test Date: 20210304; Test Name: EKG; Result Unstructured Data: Heart was strong; Test Date: 20210304; Test Name: Pulse rate; Result Unstructured Data: High

Allergies:

Symptom List: Vomiting

Symptoms: Lip swelling; Tongue Swelling; Chest tightness; dizziness; irregular heat rate; Not received second dose; anaphylaytic reaction; Within 15 minutes blood pressure went up to 200/120; Diastolic went down to 95; Super racy heart / pulse was really high/ heart was beating through her chest; Super super sensitive; This spontaneous case was reported by a consumer and describes the occurrence of ANAPHYLACTIC REACTION (anaphylaytic reaction) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Co-suspect product included non-company product ATENOLOL for an unknown indication. Previously administered products included for an unreported indication: INFLUENZA VACCINE in 2014 and MUCINEX. Concurrent medical conditions included Hypersensitivity (Sensitivity to petroleum type products), Drug allergy (atenolol) on 25-Aug-2021 and Egg allergy. Concomitant products included FISH OIL, VITAMIN D NOS and PROBIOTICS NOS for an unknown indication. On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient started ATENOLOL (unknown route) Low dose. On 04-Mar-2021, the patient experienced ANAPHYLACTIC REACTION (anaphylaytic reaction) (seriousness criterion medically significant), HYPERTENSION (Within 15 minutes blood pressure went up to 200/120), BLOOD PRESSURE DIASTOLIC DECREASED (Diastolic went down to 95), TACHYCARDIA (Super racy heart / pulse was really high/ heart was beating through her chest), ALLERGY TO VACCINE (Super super sensitive), HEART RATE IRREGULAR (irregular heat rate) and PRODUCT DOSE OMISSION ISSUE (Not received second dose). On an unknown date, the patient experienced LIP SWELLING (Lip swelling), SWOLLEN TONGUE (Tongue Swelling), CHEST DISCOMFORT (Chest tightness) and DIZZINESS (dizziness). On 07-Mar-2021, HYPERTENSION (Within 15 minutes blood pressure went up to 200/120), BLOOD PRESSURE DIASTOLIC DECREASED (Diastolic went down to 95), DIZZINESS (dizziness) and HEART RATE IRREGULAR (irregular heat rate) had resolved. At the time of the report, ANAPHYLACTIC REACTION (anaphylaytic reaction), TACHYCARDIA (Super racy heart / pulse was really high/ heart was beating through her chest), ALLERGY TO VACCINE (Super super sensitive), LIP SWELLING (Lip swelling), SWOLLEN TONGUE (Tongue Swelling) and CHEST DISCOMFORT (Chest tightness) outcome was unknown and PRODUCT DOSE OMISSION ISSUE (Not received second dose) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 04-Mar-2021, Blood pressure measurement: 200/120 mmhg (High) Blood pressure went up to 200/120. On 04-Mar-2021, Electrocardiogram: normal (normal) Heart was strong. On 04-Mar-2021, Heart rate: high (High) High. 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. Patient reported having an allergy to PEG ingredient in the Moderna vaccine. No treatment medications were provided. Company comment: This case concerns a 58-year-old female with a serious expected event of anaphylactic reaction, and non-serious tachycardia, allergy to vaccine, lip swelling, swollen tongue, chest discomfort, and product dose omission issue. Event latency within 15 minutes after first dose mRNA-1273. Events resolved. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. This case was linked to MODERNATX, INC.-MOD-2021-296548 (E2B Linked Report). Most recent FOLLOW-UP information incorporated above includes: On 01-Sep-2021: Significant Follow-up received on 01-SEP-21, updating new historical drug, historical conditions and allergy, event added and event outcome was changed; Sender's Comments: This case concerns a 58-year-old female with a serious expected event of anaphylactic reaction, and non-serious tachycardia, allergy to vaccine, lip swelling, swollen tongue, chest discomfort, and product dose omission issue. Event latency within 15 minutes after first dose mRNA-1273. Events resolved. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. MODERNATX, INC.-MOD-2021-296548:Cross linked case

Other Meds: FISH OIL; VITAMIN D NOS; PROBIOTICS NOS

Current Illness: Egg allergy; Hypersensitivity (Sensitivity to petroleum type products)

ID: 1691527
Sex: M
Age: 72
State: AR

Vax Date: 07/01/2021
Onset Date: 08/20/2021
Rec V Date: 09/11/2021
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: Interchange of vaccine products; This spontaneous case was reported by a nurse and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (Interchange of vaccine products) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) for COVID-19 vaccination. No Medical History information was reported. In July 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Aug-2021, the patient started TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 20-Aug-2021, the patient experienced INTERCHANGE OF VACCINE PRODUCTS (Interchange of vaccine products). At the time of the report, INTERCHANGE OF VACCINE PRODUCTS (Interchange of vaccine products) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided. Treatment information was not provided. Pateint was received the second dose (lot # FD8448) of Pfizer.

Other Meds:

Current Illness:

ID: 1691528
Sex: M
Age:
State: NV

Vax Date: 08/25/2021
Onset Date:
Rec V Date: 09/11/2021
Hospital: Y

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: Pfizer COVID19 Vaccine in 04Jul2021 and a dose (lot 052E21A) of Moderna COVID19 Vaccine today 25Aug2021; This spontaneous case was reported by a pharmacist and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (Pfizer COVID19 Vaccine in 04Jul2021 and a dose (lot # 052E21A) of Moderna COVID19 Vaccine today 25Aug2021) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. The patient's past medical history included COVID-19 (Hospitalized with COVID) on 06-Jul-2021 and Organ transplant. Previously administered products included for COVID-19 vaccination: Pfizer Biotech vaccine on 04-Jul-2021. On 25-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Jul-2021, the patient experienced INTERCHANGE OF VACCINE PRODUCTS (Pfizer COVID19 Vaccine in 04Jul2021 and a dose (lot # 052E21A) of Moderna COVID19 Vaccine today 25Aug2021) (seriousness criterion hospitalization). The patient was hospitalized from 06-Jul-2021 to 13-Jul-2021 due to INTERCHANGE OF VACCINE PRODUCTS. At the time of the report, INTERCHANGE OF VACCINE PRODUCTS (Pfizer COVID19 Vaccine in 04Jul2021 and a dose (lot # 052E21A) of Moderna COVID19 Vaccine today 25Aug2021) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication reported. No treatment information was reported. company comment: This report refers to a case of Interchange of vaccine products for mRNA-1273 (lot # 052E21A). with no associated adverse events. Further information has been requested.; Sender's Comments: This report refers to a case of Interchange of vaccine products for mRNA-1273 (lot # 052E21A). with no associated adverse events. Further information has been requested.

Other Meds:

Current Illness:

ID: 1691529
Sex: M
Age: 26
State: NJ

Vax Date: 08/15/2021
Onset Date: 08/01/2021
Rec V Date: 09/11/2021
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: A bit pink; Chest tightness; Weird sensation initially on the left arm then it resolved and moved to his right leg; Right leg started twitching; Feels like cramping and constantly present from the knee down to the right calf area.; Itchy (area of the injection); Rash at the area of the injection; Swelling at the area of the injection (left arm); This spontaneous case was reported by a consumer and describes the occurrence of CHEST DISCOMFORT (Chest tightness), FEELING ABNORMAL (Weird sensation initially on the left arm then it resolved and moved to his right leg), MUSCLE TWITCHING (Right leg started twitching), MUSCLE SPASMS (Feels like cramping and constantly present from the knee down to the right calf area.) and VACCINATION SITE ERYTHEMA (A bit pink) in a 26-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Asthmatic attack. On 15-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, the patient experienced CHEST DISCOMFORT (Chest tightness). In August 2021, the patient experienced FEELING ABNORMAL (Weird sensation initially on the left arm then it resolved and moved to his right leg), MUSCLE TWITCHING (Right leg started twitching), MUSCLE SPASMS (Feels like cramping and constantly present from the knee down to the right calf area.), INJECTION SITE PRURITUS (Itchy (area of the injection)), VACCINATION SITE RASH (Rash at the area of the injection) and VACCINATION SITE SWELLING (Swelling at the area of the injection (left arm)). On an unknown date, the patient experienced VACCINATION SITE ERYTHEMA (A bit pink). At the time of the report, CHEST DISCOMFORT (Chest tightness), MUSCLE TWITCHING (Right leg started twitching), MUSCLE SPASMS (Feels like cramping and constantly present from the knee down to the right calf area.), VACCINATION SITE ERYTHEMA (A bit pink), INJECTION SITE PRURITUS (Itchy (area of the injection)), VACCINATION SITE RASH (Rash at the area of the injection) and VACCINATION SITE SWELLING (Swelling at the area of the injection (left arm)) had not resolved and FEELING ABNORMAL (Weird sensation initially on the left arm then it resolved and moved to his right leg) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided. Patient reported that symptom started, few hours after the vaccination on the same day (15Aug2021).

Other Meds:

Current Illness: Asthmatic attack

ID: 1691530
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/11/2021
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: Has not gotten second vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Has not gotten second vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received 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 (Has not gotten second vaccine). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Has not gotten second vaccine) had resolved. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1691531
Sex: U
Age: 73
State: TX

Vax Date: 01/02/2021
Onset Date:
Rec V Date: 09/11/2021
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: arm has swollen up; had a really bad day. He thought it would go down; has knots in his left arm / it is like a golf ball on his arm; was also real sick; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (arm has swollen up), FEELING ABNORMAL (had a really bad day. He thought it would go down), SKIN MASS (has knots in his left arm / it is like a golf ball on his arm) and ILLNESS (was also real sick) in a 73-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037K20A, 041L20A1 and 088D21A) for COVID-19 vaccination. No medical history was provided by the reporter. On 02-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Jan-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 an unknown date, the patient experienced PERIPHERAL SWELLING (arm has swollen up), FEELING ABNORMAL (had a really bad day. He thought it would go down), SKIN MASS (has knots in his left arm / it is like a golf ball on his arm) and ILLNESS (was also real sick). At the time of the report, PERIPHERAL SWELLING (arm has swollen up), FEELING ABNORMAL (had a really bad day. He thought it would go down) and SKIN MASS (has knots in his left arm / it is like a golf ball on his arm) outcome was unknown and ILLNESS (was also real sick) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was not applicable Treatment included a cold wash cloth was put on the patient's arm. No concomitant medications reported.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am