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: 1691782
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 2021; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Infected with COVID

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Infected with COVID; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Infected with COVID) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced COVID-19 (Infected with COVID). At the time of the report, COVID-19 (Infected with COVID) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, SARS-CoV-2 test: positive (Positive) Infected with COVID. 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: 1691783
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Had an adverse reaction; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Had an adverse reaction) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Had an adverse reaction). At the time of the report, VACCINATION COMPLICATION (Had an adverse reaction) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1691784
Sex: F
Age: 67
State: NC

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: Having burning pain in her arm, veins are burning; Her legs were having burning sensation; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Having burning pain in her arm, veins are burning) and BURNING SENSATION (Her legs were having burning sensation) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003A21A) for COVID-19 vaccination. No medical history was reported. Concurrent medical conditions included Acid reflux (oesophageal). Concomitant products included OMEPRAZOLE for Acid reflux (oesophageal), MULTI VITAMIN & MINERAL for an unknown indication. On 08-Mar-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 08-Mar-2021, the patient experienced PAIN (Having burning pain in her arm, veins are burning) and BURNING SENSATION (Her legs were having burning sensation). At the time of the report, PAIN (Having burning pain in her arm, veins are burning) and BURNING SENSATION (Her legs were having burning sensation) had not resolved. Concomitant medications included Multi-Vitamin and ultra-mega vitamins. Treatment information was not provided.

Other Meds: OMEPRAZOLE; MULTI VITAMIN & MINERAL

Current Illness: Acid reflux (oesophageal)

ID: 1691785
Sex: F
Age: 28
State: TX

Vax Date: 07/30/2021
Onset Date: 08/01/2021
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: left side chest pain like someone was pushing down on chest; shortness of breath/hurts to take a deep breath in; Flu like symptoms; lightheaded; cold tingling sensation along both arms and both legs; very tired; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (left side chest pain like someone was pushing down on chest), DYSPNOEA (shortness of breath/hurts to take a deep breath in), INFLUENZA LIKE ILLNESS (Flu like symptoms), DIZZINESS (lightheaded) and PARAESTHESIA (cold tingling sensation along both arms and both legs) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017E21A and 088D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 30-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In August 2021, the patient experienced INFLUENZA LIKE ILLNESS (Flu like symptoms), PARAESTHESIA (cold tingling sensation along both arms and both legs) and FATIGUE (very tired). August 2021, the patient experienced DIZZINESS (lightheaded). On 30-Aug-2021, the patient experienced CHEST PAIN (left side chest pain like someone was pushing down on chest) and DYSPNOEA (shortness of breath/hurts to take a deep breath in). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) for Sleeplessness, at a dose of Unknown and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Sleeplessness, at a dose of Unknown. At the time of the report, CHEST PAIN (left side chest pain like someone was pushing down on chest) and DYSPNOEA (shortness of breath/hurts to take a deep breath in) had not resolved and INFLUENZA LIKE ILLNESS (Flu like symptoms), DIZZINESS (lightheaded), PARAESTHESIA (cold tingling sensation along both arms and both legs) and FATIGUE (very tired) outcome was unknown. No concomitant medication were reported. This case was linked to MOD-2021-301521 (Patient Link).

Other Meds:

Current Illness:

ID: 1691786
Sex: F
Age: 49
State: GA

Vax Date: 08/21/2021
Onset Date: 08/22/2021
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: vision changes/it was swirling; milky-cloudy-like vision. my vision is a little cloudy; This spontaneous case was reported by a consumer and describes the occurrence of VISUAL IMPAIRMENT (vision changes/it was swirling) and VISION BLURRED (milky-cloudy-like vision. my vision is a little cloudy) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939901) for COVID-19 vaccination. No Medical History information was reported. On 21-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Aug-2021, the patient experienced VISION BLURRED (milky-cloudy-like vision. my vision is a little cloudy). On an unknown date, the patient experienced VISUAL IMPAIRMENT (vision changes/it was swirling). At the time of the report, VISUAL IMPAIRMENT (vision changes/it was swirling) and VISION BLURRED (milky-cloudy-like vision. my vision is a little cloudy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant information was provided by the reporter. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 29-Aug-2021: Follow-up information received on 30-AUG-2021 contains significant information. New events were updated.

Other Meds:

Current Illness:

ID: 1691787
Sex: U
Age:
State:

Vax Date:
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: Patient may be getting a vaccine from a refrozen vial; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT STORAGE ERROR (Patient may be getting a vaccine from a refrozen vial) 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 PRODUCT STORAGE ERROR (Patient may be getting a vaccine from a refrozen vial). At the time of the report, PRODUCT STORAGE ERROR (Patient may be getting a vaccine from a refrozen vial) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not reported. Treatment information was not reported.

Other Meds:

Current Illness:

ID: 1691788
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: adverse event; This spontaneous case was reported by a consumer and describes the occurrence of ADVERSE EVENT (adverse event) 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 (adverse event). At the time of the report, ADVERSE EVENT (adverse event) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product was not provided by the reporter Treatment information was not provided

Other Meds:

Current Illness:

ID: 1691789
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: patient missed her second dose of Modena; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (patient missed her second dose of Modena) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (patient missed her second dose of Modena). At the time of the report, PRODUCT DOSE OMISSION ISSUE (patient missed her second dose of Modena) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medications were provided. No treatment medications were provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1691790
Sex: U
Age:
State:

Vax Date: 08/12/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: tested positive for COVID; This spontaneous case was reported by an other health care professional and describes the occurrence of CORONAVIRUS INFECTION (tested positive for COVID) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced CORONAVIRUS INFECTION (tested positive for COVID). At the time of the report, CORONAVIRUS INFECTION (tested positive for COVID) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment medications were provided. Patient stated that- patient got the vaccine on 8/12 and tested positive for Covid on Monday could it be a false positive?; Sender's Comments: Based on the information that the vaccine does not include virus capable of transmitting COVID-19, the event is assessed as not applicable.

Other Meds:

Current Illness:

ID: 1691791
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Yesterday and today I'm having diarrhea; This spontaneous case was reported by a physician and describes the occurrence of DIARRHOEA (Yesterday and today I'm having diarrhea) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced DIARRHOEA (Yesterday and today I'm having diarrhea). At the time of the report, DIARRHOEA (Yesterday and today I'm having diarrhea) 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 was provided. No Treatment medication was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1691792
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: If the vaccine causes a sore throat; Chills; Body aches; Fatigue; 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 OROPHARYNGEAL PAIN (If the vaccine causes a sore throat), CHILLS (Chills), MYALGIA (Body aches) and FATIGUE (Fatigue) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced OROPHARYNGEAL PAIN (If the vaccine causes a sore throat), CHILLS (Chills), MYALGIA (Body aches) and FATIGUE (Fatigue). At the time of the report, OROPHARYNGEAL PAIN (If the vaccine causes a sore throat), CHILLS (Chills), MYALGIA (Body aches) and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided by reporter. No treatment details were provided by reporter.

Other Meds:

Current Illness:

ID: 1691793
Sex: F
Age: 74
State: CA

Vax Date: 01/24/2021
Onset Date: 08/28/2021
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: I was very very sweaty/ I woke up in a pool of sweat; Symptoms are much worse; I was a little tired; slight fever; chills; I am very weak; I can hardly walk; I totally lost my appetite; The injection site blew; It is very hard/ It is like a ball; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (I am very weak), MOBILITY DECREASED (I can hardly walk), DECREASED APPETITE (I totally lost my appetite), HYPERHIDROSIS (I was very very sweaty/ I woke up in a pool of sweat) and CONDITION AGGRAVATED (Symptoms are much worse) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 052E21A and 042L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Diabetes and Polymyalgia rheumatica. Concomitant products included INSULIN, METFORMIN and DULAGLUTIDE (TRULICITY) for Diabetes, METHOTREXATE for Polymyalgia rheumatica, LISINOPRIL for an unknown indication. On 24-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 28-Aug-2021, the patient experienced ASTHENIA (I am very weak), MOBILITY DECREASED (I can hardly walk), DECREASED APPETITE (I totally lost my appetite), INJECTION SITE SWELLING (The injection site blew) and VACCINATION SITE INDURATION (It is very hard/ It is like a ball). On 29-Aug-2021, the patient experienced PYREXIA (slight fever) and CHILLS (chills). On an unknown date, the patient experienced HYPERHIDROSIS (I was very very sweaty/ I woke up in a pool of sweat), CONDITION AGGRAVATED (Symptoms are much worse) and FATIGUE (I was a little tired). At the time of the report, ASTHENIA (I am very weak), MOBILITY DECREASED (I can hardly walk) and DECREASED APPETITE (I totally lost my appetite) had not resolved and HYPERHIDROSIS (I was very very sweaty/ I woke up in a pool of sweat), CONDITION AGGRAVATED (Symptoms are much worse), INJECTION SITE SWELLING (The injection site blew), VACCINATION SITE INDURATION (It is very hard/ It is like a ball), PYREXIA (slight fever), CHILLS (chills) and FATIGUE (I was a little tired) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication includes FIBRIC ACID for Diabetes. No treatment medication were provided by the reporter This case was linked to MOD-2021-301856, MOD-2021-301864 (Patient Link).

Other Meds: INSULIN; METFORMIN; LISINOPRIL; TRULICITY; METHOTREXATE

Current Illness: Diabetes; Polymyalgia rheumatica

ID: 1691794
Sex: M
Age:
State: NJ

Vax Date:
Onset Date: 08/30/2021
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: couldn't move; was unable to walk; This spontaneous case was reported by a consumer and describes the occurrence of MOBILITY DECREASED (couldn't move) and GAIT INABILITY (was unable to walk) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Aug-2021, the patient experienced MOBILITY DECREASED (couldn't move) and GAIT INABILITY (was unable to walk). At the time of the report, MOBILITY DECREASED (couldn't move) and GAIT INABILITY (was unable to walk) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient experienced "stuff like that" on 30-aug-2021 No Concomitant drugs were reported. No Treatment information were reported.

Other Meds:

Current Illness:

ID: 1691795
Sex: F
Age: 74
State: CA

Vax Date: 01/24/2021
Onset Date:
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: I was a little tired; I had a slight fever; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (I was a little tired) and PYREXIA (I had a slight fever) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 042L20A and 052E21A) for COVID-19 vaccination. Concurrent medical conditions included Diabetes and Polymyalgia rheumatica. Concomitant products included INSULIN, METFORMIN and DULAGLUTIDE (TRULICITY) for Diabetes, METHOTREXATE for Polymyalgia rheumatica, LISINOPRIL for an unknown indication. On 24-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 27-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced FATIGUE (I was a little tired) and PYREXIA (I had a slight fever). At the time of the report, FATIGUE (I was a little tired) and PYREXIA (I had a slight fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication Fibric acid for the indication of Diabetes was reported. No Treatment medications were provided. This case was linked to MOD-2021-301830 (Patient Link).

Other Meds: INSULIN; METFORMIN; LISINOPRIL; TRULICITY; METHOTREXATE

Current Illness: Diabetes; Polymyalgia rheumatica

ID: 1691796
Sex: M
Age: 74
State: CA

Vax Date: 02/17/2021
Onset Date: 03/08/2021
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: Received the second dose less than 25 days from the first dose; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received the second dose less than 25 days from the first dose) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 08-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Mar-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received the second dose less than 25 days from the first dose). On 08-Mar-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received the second dose less than 25 days from the first dose) had resolved. No concomitant medications were provided by the reporter. No treatment medications were provided by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 01-Sep-2021: Follow up received , contains non significant information experiencing any adverse events aftereither dose of vaccine and denied further follow up.

Other Meds:

Current Illness:

ID: 1691797
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Coughing since received booster; This spontaneous case was reported by a consumer and describes the occurrence of COUGH (Coughing since received booster) 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. In 2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In 2021, the patient experienced COUGH (Coughing since received booster). At the time of the report, COUGH (Coughing since received booster) outcome was unknown. NO concomitants were provided. No treatment is reported. requested for follow-up since incomplete patient and dosage details provided.

Other Meds:

Current Illness:

ID: 1691798
Sex: U
Age:
State:

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: Fever; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PYREXIA (Fever). At the time of the report, PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant and treatment drugs were not provided.

Other Meds:

Current Illness:

ID: 1691799
Sex: U
Age:
State:

Vax Date:
Onset Date: 01/01/2021
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: minor body aches for a few hours; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (minor body aches for a few hours) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Arthritis and Prostate cancer. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In January 2021, the patient experienced PAIN (minor body aches for a few hours). At the time of the report, PAIN (minor body aches for a few hours) had resolved. Concomitant medications was not provided by the reporter. Treatment information was not provided. This case was linked to MOD-2021-302008 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness: Arthritis; Prostate cancer

ID: 1691800
Sex: F
Age: 38
State: FL

Vax Date: 08/13/2021
Onset Date:
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: severe eczema after receiving the first dose / eczema all over her body, the back of legs, shoulders, arms.; can't move her right hand; making more sick; crying; This spontaneous case was reported by a consumer and describes the occurrence of ECZEMA (severe eczema after receiving the first dose / eczema all over her body, the back of legs, shoulders, arms.), MOBILITY DECREASED (can't move her right hand), ILLNESS (making more sick) and CRYING (crying) in a 38-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011D21A) for COVID-19 vaccination. Concurrent medical conditions included Eczema (prone to eczema her whole life.). On 13-Aug-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 ECZEMA (severe eczema after receiving the first dose / eczema all over her body, the back of legs, shoulders, arms.), MOBILITY DECREASED (can't move her right hand), ILLNESS (making more sick) and CRYING (crying). At the time of the report, ECZEMA (severe eczema after receiving the first dose / eczema all over her body, the back of legs, shoulders, arms.) had not resolved and MOBILITY DECREASED (can't move her right hand), ILLNESS (making more sick) and CRYING (crying) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatment information was reported. Patient reported that in april after seeing her doctor she was able to get it under control and it all went away.

Other Meds:

Current Illness: Eczema (prone to eczema her whole life.)

ID: 1691801
Sex: U
Age:
State:

Vax Date: 03/24/2021
Onset Date: 03/01/2021
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: stiffness; Patient had osteoarthritis but it seems to explain exacerbated; overall joint and muscle pain; muscle pain; This spontaneous case was reported by a consumer and describes the occurrence of MUSCULOSKELETAL STIFFNESS (stiffness), OSTEOARTHRITIS (Patient had osteoarthritis but it seems to explain exacerbated), ARTHRALGIA (overall joint and muscle pain) and MYALGIA (muscle pain) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 24-Mar-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. In March 2021, the patient experienced MUSCULOSKELETAL STIFFNESS (stiffness), OSTEOARTHRITIS (Patient had osteoarthritis but it seems to explain exacerbated), ARTHRALGIA (overall joint and muscle pain) and MYALGIA (muscle pain). At the time of the report, MUSCULOSKELETAL STIFFNESS (stiffness), OSTEOARTHRITIS (Patient had osteoarthritis but it seems to explain exacerbated), ARTHRALGIA (overall joint and muscle pain) and MYALGIA (muscle pain) outcome was unknown. Concomitant product was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1691802
Sex: U
Age:
State:

Vax Date:
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: Consumer answered Yes when asked if they had received the Moderna COVID-19 Vaccine and experienced a side effect.; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Consumer answered Yes asked if they had received the Moderna COVID-19 Vaccine and experienced a side effect.) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Consumer answered Yes when the ChatBot asked if they had received the Moderna COVID-19 Vaccine and experienced a side effect.). At the time of the report, VACCINATION COMPLICATION (Consumer answered asked if they had received the Moderna COVID-19 Vaccine and experienced a side effect.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications was not reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1691803
Sex: F
Age:
State:

Vax Date: 08/27/2021
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: Slight soreness when touching the injection site; My underarm area feels itchy and hurts; Arm pit lymph nodes continued to be sensitive three days after the vaccine; Arm pit lymph nodes continued to be sensitive three days after the vaccine; My underarm area feels itchy and hurts; This spontaneous case was reported by a consumer and describes the occurrence of SENSITISATION (Arm pit lymph nodes continued to be sensitive three days after the vaccine), PRURITUS (My underarm area feels itchy and hurts), VACCINATION SITE PAIN (Slight soreness when touching the injection site), AXILLARY PAIN (My underarm area feels itchy and hurts) and LYMPHADENOPATHY (Arm pit lymph nodes continued to be sensitive three days after the vaccine) 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 27-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced SENSITISATION (Arm pit lymph nodes continued to be sensitive three days after the vaccine) and VACCINATION SITE PAIN (Slight soreness when touching the injection site). an unknown date, the patient experienced PRURITUS (My underarm area feels itchy and hurts), AXILLARY PAIN (My underarm area feels itchy and hurts) and LYMPHADENOPATHY (Arm pit lymph nodes continued to be sensitive three days after the vaccine). On 01-Sep-2021, SENSITISATION (Arm pit lymph nodes continued to be sensitive three days after the vaccine), PRURITUS (My underarm area feels itchy and hurts), AXILLARY PAIN (My underarm area feels itchy and hurts) and LYMPHADENOPATHY (Arm pit lymph nodes continued to be sensitive three days after the vaccine) had resolved. At the time of the report, VACCINATION SITE PAIN (Slight soreness when touching the injection site) had not resolved. Concomitant medications were not provided. Treatment medication was not provided. This case was linked to MOD-2021-304953, MOD-2021-304944 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 02-Sep-2021: Follow-up received: events were added and events outcome were updated; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1691804
Sex: U
Age:
State:

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: Nose is somewhat bloody and full of mucous; Nose full of mucous; This spontaneous case was reported by a consumer and describes the occurrence of EPISTAXIS (Nose is somewhat bloody and full of mucous) and NASAL CONGESTION (Nose full of mucous) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced EPISTAXIS (Nose is somewhat bloody and full of mucous) and NASAL CONGESTION (Nose full of mucous). At the time of the report, EPISTAXIS (Nose is somewhat bloody and full of mucous) and NASAL CONGESTION (Nose full of mucous) outcome was unknown. Treatment medication was not reported. Concomitant medications were not provided by the reporter.

Other Meds:

Current Illness:

ID: 1691805
Sex: M
Age: 44
State: CA

Vax Date: 08/20/2021
Onset Date: 08/21/2021
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 Date: 20210821; Test Name: Heart rate; Result Unstructured Data: Heart rate elevated - high; Test Date: 20210901; Test Name: Heart rate; Result Unstructured Data: still high

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: it's actually in pain/ it's hurting; still having heart trouble; heart is beating fast; Legs are shaking, legs started really really shaking; Clonus; Really nervous; This spontaneous case was reported by a consumer and describes the occurrence of ANGINA PECTORIS (it's actually in pain/ it's hurting) in a 44-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Spinal cord injury (T12 vertebrae fracture), Vertebral fracture, Heart rate increased (had a little episode of a little bit of a fast heart rate and they gave him heart monitors, but he did not have any heart condition, it was just one episode.) in 1998 and Surgery (Fused from T10 to L2.). Concurrent medical conditions included Disability. On 20-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, the patient experienced TREMOR (Legs are shaking, legs started really really shaking), CLONUS (Clonus) and NERVOUSNESS (Really nervous). 21-Aug-2021, the patient experienced HEART RATE INCREASED (heart is beating fast). On 01-Sep-2021, the patient experienced ANGINA PECTORIS (it's actually in pain/ it's hurting) (seriousness criterion medically significant) and CARDIAC DISORDER (still having heart trouble). At the time of the report, ANGINA PECTORIS (it's actually in pain/ it's hurting), TREMOR (Legs are shaking, legs started really really shaking), CLONUS (Clonus), NERVOUSNESS (Really nervous) and HEART RATE INCREASED (heart is beating fast) had not resolved and CARDIAC DISORDER (still having heart trouble) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 21-Aug-2021, Heart rate: high (High) Heart rate elevated - high. On 01-Sep-2021, Heart rate: high (High) still 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. Relevant concomitant medications were not reported. The treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 01-Sep-2021: Follow up received contains significant information. Events Angina pectoris, Cardiac disorder and Heart rate increased are added; Case is upgraded to serious.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness: Disability

ID: 1691806
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: Injection site pain, Menorrhagia

Symptoms: Customer has not received their second dose 3-4 months after getting first dose; 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 PRODUCT DOSE OMISSION ISSUE (Customer has not received their second dose 3-4 months after getting first dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In 2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Customer has not received their second dose 3-4 months after getting first dose). In 2021, PRODUCT DOSE OMISSION ISSUE (Customer has not received their second dose 3-4 months after getting first dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant product information was provided. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1691807
Sex: F
Age: 33
State: AK

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: dose from this expired vial was given to a patient; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (dose from this expired vial was given to a patient) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031A21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (dose from this expired vial was given to a patient). On 30-Aug-2021, EXPIRED PRODUCT ADMINISTERED (dose from this expired vial was given to a patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant and treatment medication was reported by patient. Patient reported that vial was moved from the freezer to the refrigerator on 22Aug2021 and the vial remained in the refrigerator, The caller verified the vial never went through any temperature excursions. Also, the caller confirmed the vial was first punctured on 30 Aug 2021. Caller wanted to know that whether she needed to repeat the dose or can they continue with the vaccine series as normal.

Other Meds:

Current Illness:

ID: 1691808
Sex: F
Age:
State:

Vax Date: 08/28/2021
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: My injection site is magnetic, a magnet stuck to my arm; My arm is swollen and has soreness; My arm is swollen and has soreness; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (My injection site is magnetic, a magnet stuck to my arm), PERIPHERAL SWELLING (My arm is swollen and has soreness) and MYALGIA (My arm is swollen and has soreness) 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 28-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 VACCINATION SITE REACTION (My injection site is magnetic, a magnet stuck to my arm), PERIPHERAL SWELLING (My arm is swollen and has soreness) and MYALGIA (My arm is swollen and has soreness). At the time of the report, VACCINATION SITE REACTION (My injection site is magnetic, a magnet stuck to my arm) outcome was unknown and PERIPHERAL SWELLING (My arm is swollen and has soreness) and MYALGIA (My arm is swollen and has soreness) had not resolved. Reportedly, The patient went to her nail salon and was told that the Moderna COVID-19 vaccine makes the patient magnetic, and at the nail salon a paperclip had stuck to her injection site. The patient did not provide concern for safety to follow up. Treatment product information was not provided. Concomitant product use was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1691809
Sex: M
Age: 36
State: WA

Vax Date: 08/13/2021
Onset Date: 08/13/2021
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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: loss of sexual desire; This spontaneous case was reported by a consumer and describes the occurrence of LOSS OF LIBIDO (loss of sexual desire) in a 36-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049E21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Aug-2021, the patient experienced LOSS OF LIBIDO (loss of sexual desire). At the time of the report, LOSS OF LIBIDO (loss of sexual desire) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not provided Treatment information was not reported

Other Meds:

Current Illness:

ID: 1691810
Sex: F
Age:
State: NV

Vax Date: 08/06/2021
Onset Date: 08/01/2021
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: Test Date: 202108; Test Name: Body temperature; Result Unstructured Data: fever; Test Date: 202108; Test Name: Body temperature; Result Unstructured Data: fever

Allergies:

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

Symptoms: Both arms hurt for almost a week; Didn't feel good for about 4 days; Both in bed for 2 days/couldn't get out of bed; Got sick/felt sick for 4 days.; Fever of 102/My fever was 100.7; Vomited; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Both arms hurt for almost a week), MALAISE (Didn't feel good for about 4 days), BEDRIDDEN (Both in bed for 2 days/couldn't get out of bed), ILLNESS (Got sick/felt sick for 4 days.) and PYREXIA (Fever of 102/My fever was 100.7) in a 63-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. The patient's past medical history included COVID-19 (she and her husband both had COVID a year ago.) in 2020. On 06-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In August 2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PAIN IN EXTREMITY (Both arms hurt for almost a week), MALAISE (Didn't feel good for about 4 days), BEDRIDDEN (Both in bed for 2 days/couldn't get out of bed), ILLNESS (Got sick/felt sick for 4 days.), PYREXIA (Fever of 102/My fever was 100.7) and VOMITING (Vomited). The patient was treated with PARACETAMOL (TYLENOL) in August 2021 for Fever, at an unspecified dose and frequency. In August 2021, PAIN IN EXTREMITY (Both arms hurt for almost a week), MALAISE (Didn't feel good for about 4 days) and ILLNESS (Got sick/felt sick for 4 days.) had resolved. At the time of the report, BEDRIDDEN (Both in bed for 2 days/couldn't get out of bed), PYREXIA (Fever of 102/My fever was 100.7) and VOMITING (Vomited) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In August 2021, Body temperature: 102 (High) fever and 100.7 (High) fever. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not provided. Caller stated that the second dose is coming up on this Saturday. This case was linked to MOD-2021-301975 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 02-Sep-2021: Follow up received on 02-sep-2021 contains significant information( as reported of fever updated)

Other Meds:

Current Illness:

ID: 1691811
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: Nausea

Symptoms: rash after my 2nd injection; This spontaneous case was reported by a consumer and describes the occurrence of RASH (rash after my 2nd injection) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced RASH (rash after my 2nd injection). At the time of the report, RASH (rash after my 2nd injection) outcome was unknown. No relevant concomitant medications were reported. No treatment information was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1691812
Sex: F
Age: 66
State: FL

Vax Date: 01/09/2021
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: Injection site pain

Symptoms: Shingles on the left side of their face; Cyst on the left side of their neck; Cyst was big and tender and ended up being removed; This spontaneous case was reported by an other health care professional and describes the occurrence of HERPES ZOSTER (Shingles on the left side of their face), CYST (Cyst on the left side of their neck) and TENDERNESS (Cyst was big and tender and ended up being removed) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included NEBIVOLOL HYDROCHLORIDE (BYSTOLIC), CELECOXIB (CELEXA [CELECOXIB]), WARFARIN SODIUM (COUMADIN), OMEPRAZOLE and LEVOTHYROXINE for an unknown indication. On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In January 2021, the patient experienced HERPES ZOSTER (Shingles on the left side of their face), CYST (Cyst on the left side of their neck) and TENDERNESS (Cyst was big and tender and ended up being removed). The patient was treated with ACYCLOVIR [ACICLOVIR] for Shingles, at an unspecified dose and frequency and Surgery for Cyst. In 2021, CYST (Cyst on the left side of their neck) and TENDERNESS (Cyst was big and tender and ended up being removed) had resolved. At the time of the report, HERPES ZOSTER (Shingles on the left side of their face) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The consumer stated that she had shingles on the left side of their face and a cyst on the left side of their neck, starting a couple of weeks after the first dose. The consumer stated that the cyst was big and tender and ended up being removed. The provider seemed worried about the caller having spiked proteins. This case was linked to MOD-2021-302081 (Patient Link).

Other Meds: BYSTOLIC; CELEXA [CELECOXIB]; COUMADIN; OMEPRAZOLE; LEVOTHYROXINE

Current Illness:

ID: 1691813
Sex: F
Age: 79
State: MA

Vax Date: 02/12/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Little reaction at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (Little reaction at the injection site) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006M20A) for COVID-19 vaccination. Concurrent medical conditions included Thyroid disorder (Thyroid condition for about 40 years ) and Addison's disease (Addison's disease for about 20 years). Concomitant products included PREDNISONE, FLUDROCORTISONE and LEVOTHYROXINE SODIUM (SYNTHROID) for an unknown indication. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE REACTION (Little reaction at the injection site). At the time of the report, VACCINATION SITE REACTION (Little reaction at the injection site) 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. Treatment information was not provided. This case was linked to MOD-2021-301960 (Patient Link).

Other Meds: PREDNISONE; FLUDROCORTISONE; SYNTHROID

Current Illness: Addison's disease (Addison's disease for about 20 years); Thyroid disorder (Thyroid condition for about 40 years)

ID: 1691814
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Vaccine symptoms second dose; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Vaccine symptoms second dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (Vaccine symptoms second dose). At the time of the report, VACCINATION COMPLICATION (Vaccine symptoms second dose) outcome was unknown. Concomitant medications were not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1691815
Sex: U
Age:
State: MO

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: Tremor

Symptoms: Vials used that were more than 30 days in refrigerator administered to patients; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Vials used that were more than 30 days in refrigerator administered to patients) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 019B21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced EXPIRED PRODUCT ADMINISTERED (Vials used that were more than 30 days in refrigerator administered to patients). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Vials used that were more than 30 days in refrigerator administered to patients) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications reported. No treatment information was reported by reporter. Crosslinked to MOD21-136212, MOD21-136213, MOD21-136214, MOD21-136215, MOD21-136216, MOD21-136217, MOD21-136218

Other Meds:

Current Illness:

ID: 1691816
Sex: F
Age: 14
State: VA

Vax Date: 08/30/2021
Onset Date: 08/30/2021
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: Erythema, Pruritus

Symptoms: Administered 1st dose of Moderna COVID-19 vaccine to 14 year old; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Administered 1st dose of Moderna COVID-19 vaccine to 14 year old) in a 14-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Aug-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Administered 1st dose of Moderna COVID-19 vaccine to 14 year old). On 30-Aug-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Administered 1st dose of Moderna COVID-19 vaccine to 14 year old) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1691817
Sex: M
Age: 70
State: CA

Vax Date: 01/29/2021
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: you lift up your arm and you go, oh ok.; soreness/ very mild soreness; This spontaneous case was reported by a pharmacist and describes the occurrence of VACCINATION SITE MOVEMENT IMPAIRMENT (you lift up your arm and you go, oh ok.) and MYALGIA (soreness/ very mild soreness) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. The patient's past medical history included Exposure to fungus (had previously been exposed to black mold.). Concurrent medical conditions included Type 2 diabetes mellitus (Type 2 Diabetes on medication.) and Asthma. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE MOVEMENT IMPAIRMENT (you lift up your arm and you go, oh ok.) and MYALGIA (soreness/ very mild soreness). At the time of the report, VACCINATION SITE MOVEMENT IMPAIRMENT (you lift up your arm and you go, oh ok.) and MYALGIA (soreness/ very mild soreness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medications were provided by the reporter. No Treatment information was reported. This case was linked to MOD-2021-302002, MOD-2021-302003 (Patient Link).

Other Meds:

Current Illness: Asthma; Type 2 diabetes mellitus (Type 2 Diabetes on medication.)

ID: 1691818
Sex: M
Age:
State: FL

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: he had the same symptoms as me/he said it was worse than the 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (he had the same symptoms as me/he said it was worse than the 2nd dose) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION COMPLICATION (he had the same symptoms as me/he said it was worse than the 2nd dose). At the time of the report, VACCINATION COMPLICATION (he had the same symptoms as me/he said it was worse than the 2nd dose) outcome was unknown. The concomitant history was not reported. The treatment history was not provided.

Other Meds:

Current Illness:

ID: 1691819
Sex: U
Age:
State:

Vax Date: 02/01/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: received first dose on February but did not get second one; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (received first dose on February but did not get second one) 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. In February 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 (received first dose on February but did not get second one). At the time of the report, PRODUCT DOSE OMISSION ISSUE (received first dose on February but did not get second one) had resolved. Concomitant medications were not reported. Treatment medications were not reported.

Other Meds:

Current Illness:

ID: 1691820
Sex: M
Age:
State: NV

Vax Date: 08/06/2021
Onset Date: 08/01/2021
Rec V Date: 09/11/2021
Hospital:

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

Lab Data: Test Name: Body temperature; Result Unstructured Data: fever of 100.2

Allergies:

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

Symptoms: both in bed for 2 days; didn't feel good for about 4 days; couldn't get out of bed; felt sick for 4 days; fever of 107; chills; both arms hurt for almost a week; This spontaneous case was reported by a patient family member or friend and describes the occurrence of BEDRIDDEN (both in bed for 2 days), FEELING ABNORMAL (didn't feel good for about 4 days), MOBILITY DECREASED (couldn't get out of bed), ILLNESS (felt sick for 4 days) and PYREXIA (fever of 107) in a 71-year-old male 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. On 06-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In August 2021, the patient experienced BEDRIDDEN (both in bed for 2 days), FEELING ABNORMAL (didn't feel good for about 4 days), MOBILITY DECREASED (couldn't get out of bed), ILLNESS (felt sick for 4 days), PYREXIA (fever of 107), CHILLS (chills) and PAIN IN EXTREMITY (both arms hurt for almost a week). The patient was treated with PARACETAMOL (TYLENOL) for Fever, at an unspecified dose and frequency. At the time of the report, BEDRIDDEN (both in bed for 2 days), FEELING ABNORMAL (didn't feel good for about 4 days) and ILLNESS (felt sick for 4 days) had resolved and MOBILITY DECREASED (couldn't get out of bed), PYREXIA (fever of 107), CHILLS (chills) and PAIN IN EXTREMITY (both arms hurt for almost a week) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100.2 (High) fever of 100.2. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient was tested positive for COVID-19 a year ago Concomitant product was not provided by the reporter This case was linked to MOD-2021-301937 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 30-Aug-2021: Additional information included lab data and new event.

Other Meds:

Current Illness:

ID: 1691821
Sex: U
Age:
State: WA

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Name: body temperature; Result Unstructured Data: low

Allergies:

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

Symptoms: severely sick/sickness after the second shot was very weird, different and severe than normal flu symptoms; developed swollen and bruised injection site; not move and it took 2 days to get out of her bed; body was on fire.; soreness with red and hot muscle; rash down the arm/covid arm; soreness in whole body- including joints, muscle; Chills/chills made them stay under the cover at all the time.; still have a little fatigue; developed swollen and bruised injection site; nauseous due to the sickness; fever with 100.9 F; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (severely sick/sickness after the second shot was very weird, different and severe than normal flu symptoms), VACCINATION SITE BRUISING (developed swollen and bruised injection site), MOBILITY DECREASED (not move and it took 2 days to get out of her bed), BURNING SENSATION (body was on fire.) and ERYTHEMA (soreness with red and hot muscle) in a 63-year-old patient of an unknown gender 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. On 25-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 ILLNESS (severely sick/sickness after the second shot was very weird, different and severe than normal flu symptoms), VACCINATION SITE BRUISING (developed swollen and bruised injection site), MOBILITY DECREASED (not move and it took 2 days to get out of her bed), BURNING SENSATION (body was on fire.), ERYTHEMA (soreness with red and hot muscle), INJECTION SITE RASH (rash down the arm/covid arm), ARTHRALGIA (soreness in whole body- including joints, muscle), CHILLS (Chills/chills made them stay under the cover at all the time.), FATIGUE (still have a little fatigue), VACCINATION SITE SWELLING (developed swollen and bruised injection site), NAUSEA (nauseous due to the sickness) and PYREXIA (fever with 100.9 F). At the time of the report, ILLNESS (severely sick/sickness after the second shot was very weird, different and severe than normal flu symptoms), VACCINATION SITE BRUISING (developed swollen and bruised injection site), MOBILITY DECREASED (not move and it took 2 days to get out of her bed), BURNING SENSATION (body was on fire.), ERYTHEMA (soreness with red and hot muscle), INJECTION SITE RASH (rash down the arm/covid arm), ARTHRALGIA (soreness in whole body- including joints, muscle), CHILLS (Chills/chills made them stay under the cover at all the time.), FATIGUE (still have a little fatigue), VACCINATION SITE SWELLING (developed swollen and bruised injection site), NAUSEA (nauseous due to the sickness) and PYREXIA (fever with 100.9 F) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100.9 (Low) low. No concomitant medication were provided by the reporter. No treatment medication were provided by the reporter. This case was linked to MOD-2021-301986 (Patient Link).

Other Meds:

Current Illness:

ID: 1691822
Sex: M
Age: 70
State: CA

Vax Date: 01/29/2021
Onset Date: 08/01/2021
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: Severe depression; Had no appetite; Slept most the day; Felt very fatigued; Mild soreness in the same right arm; This spontaneous case was reported by a pharmacist and describes the occurrence of DEPRESSION (Severe depression), DECREASED APPETITE (Had no appetite), SOMNOLENCE (Slept most the day), FATIGUE (Felt very fatigued) and MYALGIA (Mild soreness in the same right arm) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. The patient's past medical history included Exposure to mold (Exposed to black mold) and Solid organ transplant. Concurrent medical conditions included Type 2 diabetes mellitus (Type 2 diabetes on medication) and Asthma. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 27-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. In August 2021, the patient experienced DEPRESSION (Severe depression), DECREASED APPETITE (Had no appetite), SOMNOLENCE (Slept most the day), FATIGUE (Felt very fatigued) and MYALGIA (Mild soreness in the same right arm). The patient was treated with PARACETAMOL (TYLENOL 8 HOUR) for Adverse drug reaction, at a dose of 1500 mg. At the time of the report, DEPRESSION (Severe depression), DECREASED APPETITE (Had no appetite), SOMNOLENCE (Slept most the day), FATIGUE (Felt very fatigued) and MYALGIA (Mild soreness in the same right arm) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication information was provided. This case was linked to MOD-2021-302002, MOD-2021-301965 (Patient Link).

Other Meds:

Current Illness: Asthma

ID: 1691823
Sex: U
Age:
State: MD

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: People lost their appetite within 24 hours; 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 DECREASED APPETITE (people lost their appetite within 24 hours) 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 DECREASED APPETITE (people lost their appetite within 24 hours). At the time of the report, DECREASED APPETITE (people lost their appetite within 24 hours) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medications were provided. No Treatment medications were provided.

Other Meds:

Current Illness:

ID: 1691824
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Freezing cold; Low grade fever; Headache; This spontaneous case was reported by a consumer and describes the occurrence of NASOPHARYNGITIS (Freezing cold), PYREXIA (Low grade fever) and HEADACHE (Headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced NASOPHARYNGITIS (Freezing cold), PYREXIA (Low grade fever) and HEADACHE (Headache). At the time of the report, NASOPHARYNGITIS (Freezing cold), PYREXIA (Low grade fever) and HEADACHE (Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitants were reported. No treatment were reported.

Other Meds:

Current Illness:

ID: 1691825
Sex: F
Age:
State:

Vax Date: 02/02/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Feb 2,2021 my wife had 1 shot of Moderna vaccine. She did not get the second shot; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Feb 2,2021 my wife had 1 shot of Moderna vaccine. She did not get the second shot) 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 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In 2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Feb 2,2021 my wife had 1 shot of Moderna vaccine. She did not get the second shot). In 2021, PRODUCT DOSE OMISSION ISSUE (Feb 2,2021 my wife had 1 shot of Moderna vaccine. She did not get the second shot) had resolved. Concomitant and treatment drugs were not provided Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1691826
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: migraines; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (migraines) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MIGRAINE (migraines). At the time of the report, MIGRAINE (migraines) had not resolved. Patient had last dose of the Moderna vaccine 2 months ago. No concomitant medication was reported by the reporter. No treatment was reported by the reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1691827
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: second shot is given 2 months after the first; Missed dose; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second shot is given 2 months after the first) and PRODUCT DOSE OMISSION ISSUE (Missed dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second shot is given 2 months after the first) and PRODUCT DOSE OMISSION ISSUE (Missed dose). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second shot is given 2 months after the first) and PRODUCT DOSE OMISSION ISSUE (Missed dose) had resolved. No concomitant medications were provided. No treatment information were provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1691828
Sex: F
Age:
State: KS

Vax Date: 02/02/2021
Onset Date: 05/15/2021
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: Test Name: Heart rate; Result Unstructured Data: Elevated 90-130 bpm.

Allergies:

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

Symptoms: Chest pains, Occasional stabbing chest; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Chest pains, Occasional stabbing chest) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002A21A and 010M20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021 at 3:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Mar-2021 at 3:30 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-May-2021 at 8:00 AM, the patient experienced CHEST PAIN (Chest pains, Occasional stabbing chest). At the time of the report, CHEST PAIN (Chest pains, Occasional stabbing chest) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Heart rate: high (High) Elevated 90-130 bpm.. Since June 2021, Patient experienced sharp stabbing chest pain in the left side upper chest which radiated through left shoulder and down left arm. when this happened, heart rate was elevated from 90-130 bpm.. Patient experienced at very random times and was not a constant issue, when it happened it lasts for 20 mins to hours. Concomitant medications were not provided. Treatment medication was not provided. Most recent FOLLOW-UP information incorporated above includes: On 01-Sep-2021: Significant information included Reporter details ,Patient demographics, Suspect Product details and Event information and narrative was updated accordingly.

Other Meds:

Current Illness:

ID: 1691829
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I had itching where I had calcifications removed from my breast; This spontaneous case was reported by a patient and describes the occurrence of PRURITUS (I had itching where I had calcifications removed from my breast) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Breast calcifications (calcifications removed from my breast). On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRURITUS (I had itching where I had calcifications removed from my breast). At the time of the report, PRURITUS (I had itching where I had calcifications removed from my breast) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications were not provided. Treatment medication was not provided. This case was linked to MOD-2021-302098 (Patient Link). Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1691830
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: Epigastric pain; Diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (Epigastric pain) and DIARRHOEA (Diarrhea) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ABDOMINAL PAIN UPPER (Epigastric pain) and DIARRHOEA (Diarrhea). At the time of the report, ABDOMINAL PAIN UPPER (Epigastric pain) and DIARRHOEA (Diarrhea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant and treatment medications were provided Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1691831
Sex: F
Age: 75
State: FL

Vax Date: 08/16/2021
Onset Date: 08/01/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Stripe of redness/looks like a stripe of redness, like a burn; It is a rash, but not raised; lethargic; This spontaneous case was reported by a consumer and describes the occurrence of LETHARGY (lethargic), VACCINATION SITE ERYTHEMA (Stripe of redness/looks like a stripe of redness, like a burn) and VACCINATION SITE RASH (It is a rash, but not raised) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. No Medical History information was reported. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In August 2021, the patient experienced LETHARGY (lethargic) and VACCINATION SITE RASH (It is a rash, but not raised). On 29-Aug-2021, the patient experienced VACCINATION SITE ERYTHEMA (Stripe of redness/looks like a stripe of redness, like a burn). At the time of the report, LETHARGY (lethargic), VACCINATION SITE ERYTHEMA (Stripe of redness/looks like a stripe of redness, like a burn) and VACCINATION SITE RASH (It is a rash, but not raised) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient was not on any blood thinner. They are on daily medication, one medication they have been on for 20 years, and the other they have been on for 5 years. Patient declined to mention names of the Concomitant medication. Treatment information was not provided. The stripe of redness is about 2 inches by 3 inches, like a burn. It appeared below where the syringe was inserted.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am