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: 1695681
Sex: F
Age:
State: IL

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Flu-like symptoms (1st dose); body aches (1st dose); Fever (1st dose); Bad headache (1st dose); This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu-like symptoms (1st dose)), MYALGIA (body aches (1st dose)), PYREXIA (Fever (1st dose)) and HEADACHE (Bad headache (1st dose)) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Feb-2021, the patient experienced INFLUENZA LIKE ILLNESS (Flu-like symptoms (1st dose)), MYALGIA (body aches (1st dose)), PYREXIA (Fever (1st dose)) and HEADACHE (Bad headache (1st dose)). On 16-Feb-2021, INFLUENZA LIKE ILLNESS (Flu-like symptoms (1st dose)), MYALGIA (body aches (1st dose)), PYREXIA (Fever (1st dose)) and HEADACHE (Bad headache (1st dose)) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication details were not reported by the reporter. Treatment details was not reported by the reporter. This case was linked to MOD-2021-307462 (Patient Link).

Other Meds:

Current Illness:

ID: 1695682
Sex: M
Age:
State:

Vax Date:
Onset Date: 09/03/2021
Rec V Date: 09/13/2021
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: left foot is numb/left leg is getting numb; left leg is twitching; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (left foot is numb/left leg is getting numb) and MUSCLE TWITCHING (left leg is twitching) 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 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 03-Sep-2021, the patient experienced HYPOAESTHESIA (left foot is numb/left leg is getting numb) and MUSCLE TWITCHING (left leg is twitching). At the time of the report, HYPOAESTHESIA (left foot is numb/left leg is getting numb) and MUSCLE TWITCHING (left leg is twitching) outcome was unknown. Concomitant medication was not reported. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1695683
Sex: F
Age: 36
State: FL

Vax Date: 09/01/2021
Onset Date:
Rec V Date: 09/13/2021
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: Chest pain/chest pain started 6 hours after vaccine; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Chest pain/chest pain started 6 hours after vaccine) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. Concomitant products included TRAZODONE, LAMOTRIGINE and CITALOPRAM for an unknown indication. On 01-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced CHEST PAIN (Chest pain/chest pain started 6 hours after vaccine). At the time of the report, CHEST PAIN (Chest pain/chest pain started 6 hours after vaccine) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment medications reported.

Other Meds: TRAZODONE; LAMOTRIGINE; CITALOPRAM.

Current Illness:

ID: 1695684
Sex: M
Age: 31
State: KY

Vax Date: 08/06/2021
Onset Date: 08/16/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: Test Date: 20210816; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Tested positive for COVID-19; This spontaneous case was reported by a pharmacist and describes the occurrence of SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19) in a 31-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. 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. On 16-Aug-2021, the patient experienced SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19). At the time of the report, SARS-COV-2 TEST POSITIVE (Tested positive for COVID-19) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Aug-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant details were not reported by the reporter. Treatment details were not reported by the reporter. Patient reported that he did not took any treatment and had tested negative.

Other Meds:

Current Illness:

ID: 1695685
Sex: F
Age: 60
State: CO

Vax Date: 02/26/2021
Onset Date:
Rec V Date: 09/13/2021
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: Something with the eye/Is fine now but not perfect/Sensitivity to light was bothersome; Weakness; Diarrhea; Site of the shot is crazy; Got really sick; Vomiting; High fever; Achy body; Bad headaches; Chills; Red; This spontaneous case was reported by a consumer and describes the occurrence of PHOTOPHOBIA (Something with the eye/Is fine now but not perfect/Sensitivity to light was bothersome), ASTHENIA (Weakness), DIARRHOEA (Diarrhea), VACCINATION SITE REACTION (Site of the shot is crazy) and ILLNESS (Got really sick) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 035C21A, 02B21A and 013AZ(2)1A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Open heart surgery (Last year) in 2020. Concurrent medical conditions included Diabetes mellitus insulin-dependent, Thyroid disorder NOS and Blood pressure high. Concomitant products included BENAZEPRIL for Blood pressure high, INSULIN LISPRO (HUMALOG) for Diabetes mellitus insulin-dependent, ACETYLSALICYLIC ACID (BABY ASPIRIN) for Open heart surgery, LEVOTHYROXINE SODIUM (SYNTHROID) for Thyroid disorder NOS, BRINZOLAMIDE (AZOPT) and DULOXETINE for an unknown indication. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 31-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 PHOTOPHOBIA (Something with the eye/Is fine now but not perfect/Sensitivity to light was bothersome), ASTHENIA (Weakness), DIARRHOEA (Diarrhea), VACCINATION SITE REACTION (Site of the shot is crazy), ILLNESS (Got really sick), VOMITING (Vomiting), PYREXIA (High fever), MYALGIA (Achy body), HEADACHE (Bad headaches), CHILLS (Chills) and VACCINATION SITE ERYTHEMA (Red). At the time of the report, PHOTOPHOBIA (Something with the eye/Is fine now but not perfect/Sensitivity to light was bothersome), ASTHENIA (Weakness), DIARRHOEA (Diarrhea), VACCINATION SITE REACTION (Site of the shot is crazy), ILLNESS (Got really sick), VOMITING (Vomiting), PYREXIA (High fever), MYALGIA (Achy body), HEADACHE (Bad headaches), CHILLS (Chills) and VACCINATION SITE ERYTHEMA (Red) outcome was unknown. It was reported that the patient was in high risk category. Treatment information was not provided. This case was linked to MOD-2021-307192 (Patient Link).

Other Meds: HUMALOG; SYNTHROID; BENAZEPRIL; BABY ASPIRIN; AZOPT; DULOXETINE.

Current Illness: Blood pressure high; Diabetes mellitus insulin-dependent; Thyroid disorder NOS.

ID: 1695686
Sex: U
Age:
State:

Vax Date: 06/23/2021
Onset Date:
Rec V Date: 09/13/2021
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: more than 35 days since got the first dose and still does not have the second; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (more than 35 days since got the first dose and still does not have the second) 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 23-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (more than 35 days since got the first dose and still does not have the second). At the time of the report, PRODUCT DOSE OMISSION ISSUE (more than 35 days since got the first dose and still does not have the second) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Reportedly, the dose 2 was scheduled on 21-JUL-2021, and she had missed her appointment. Concomitant product use was not provided. Treatment product information was not provided.

Other Meds:

Current Illness:

ID: 1695687
Sex: F
Age: 44
State: CA

Vax Date: 08/05/2021
Onset Date:
Rec V Date: 09/13/2021
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: a lot of side effects; still not feeling good; headache; fatigue; vomiting; chills; body ache; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (a lot of side effects), MALAISE (still not feeling good), HEADACHE (headache), FATIGUE (fatigue) and VOMITING (vomiting) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 02or3Tor5EorC21A and 033C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 05-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Sep-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 VACCINATION COMPLICATION (a lot of side effects), MALAISE (still not feeling good), HEADACHE (headache), FATIGUE (fatigue), VOMITING (vomiting), CHILLS (chills) and MYALGIA (body ache). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, VACCINATION COMPLICATION (a lot of side effects), MALAISE (still not feeling good), HEADACHE (headache), FATIGUE (fatigue), VOMITING (vomiting), CHILLS (chills) and MYALGIA (body ache) outcome was unknown. No concomitant medications were not reported. Patient wants to know if she can take ibuprofen. She also mentioned that she's going to start IVF to get pregnant, and she wants to know if there's awaiting period from the last vaccine to her IVF treatment. The IVF doctor recommended her get the vaccine.

Other Meds:

Current Illness:

ID: 1695688
Sex: F
Age:
State: PA

Vax Date: 02/07/2021
Onset Date: 04/01/2021
Rec V Date: 09/13/2021
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: Inappropriate schedule of vaccine administered; She started experiencing torn Achilles tendon beginning of April; This spontaneous case was reported by a consumer and describes the occurrence of TENDON RUPTURE (She started experiencing torn Achilles tendon beginning of April) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical history was provided by the reporter. Concomitant products included LEVOTHYROXINE, GABAPENTIN and VITAMINS NOS for an unknown indication. On 07-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In April 2021, the patient experienced TENDON RUPTURE (She started experiencing torn Achilles tendon beginning of April). On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered). At the time of the report, TENDON RUPTURE (She started experiencing torn Achilles tendon beginning of April) outcome was unknown and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) had resolved. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds: LEVOTHYROXINE; GABAPENTIN; VITAMINS NOS

Current Illness:

ID: 1695689
Sex: F
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
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: whose disease have flared; This spontaneous case was reported by a consumer and describes the occurrence of CONDITION AGGRAVATED (whose disease have flared) 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 CONDITION AGGRAVATED (whose disease have flared). At the time of the report, CONDITION AGGRAVATED (whose disease have flared) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were not reported. No treatment medications were not provided.

Other Meds:

Current Illness:

ID: 1695690
Sex: U
Age:
State:

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 09/13/2021
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: I started getting itchy, in hands, feet, it was so strange; sleepy; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (sleepy) and PRURITUS (I started getting itchy, in hands, feet, it was so strange) 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 16-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced SOMNOLENCE (sleepy). On 24-Aug-2021, the patient experienced PRURITUS (I started getting itchy, in hands, feet, it was so strange). On 18-Aug-2021, SOMNOLENCE (sleepy) had resolved. At the time of the report, PRURITUS (I started getting itchy, in hands, feet, it was so strange) outcome was unknown. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1695691
Sex: F
Age: 39
State:

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 09/13/2021
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: Chills; Injection site was pretty big; (Injection site) hurt really bad; Made her very sick; Feel really bad/ it was like having covid all over again; Had body aches; Had 100.1 F/ Fever; Ulcers inside my mouth; Very tired; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Made her very sick), FEELING ABNORMAL (Feel really bad/ it was like having covid all over again), MOUTH ULCERATION (Ulcers inside my mouth), MYALGIA (Had body aches) and PYREXIA (Had 100.1 F/ Fever) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included COVID-19 in April 2021. On 07-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Aug-2021, the patient experienced ILLNESS (Made her very sick), FEELING ABNORMAL (Feel really bad/ it was like having covid all over again), MYALGIA (Had body aches) and PYREXIA (Had 100.1 F/ Fever). On an unknown date, the patient experienced MOUTH ULCERATION (Ulcers inside my mouth), CHILLS (Chills), VACCINATION SITE SWELLING (Injection site was pretty big), VACCINATION SITE PAIN ((Injection site) hurt really bad) and FATIGUE (Very tired). The patient was treated with IBUPROFEN (MOTRIN [IBUPROFEN]) at an unspecified dose and frequency. At the time of the report, ILLNESS (Made her very sick), FEELING ABNORMAL (Feel really bad/ it was like having covid all over again), MOUTH ULCERATION (Ulcers inside my mouth), MYALGIA (Had body aches), PYREXIA (Had 100.1 F/ Fever), CHILLS (Chills), VACCINATION SITE SWELLING (Injection site was pretty big), VACCINATION SITE PAIN ((Injection site) hurt really bad) and FATIGUE (Very tired) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were mentioned. Patient stated that Second shot scheduled for 04Sep2021.

Other Meds:

Current Illness:

ID: 1695692
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
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: Elder females do get diarrhea with the Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of DIARRHOEA (Elder females do get diarrhea with the Moderna 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 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 DIARRHOEA (Elder females do get diarrhea with the Moderna vaccine ). At the time of the report, DIARRHOEA (Elder females do get diarrhea with the Moderna vaccine ) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant and Treatment was not specified.

Other Meds:

Current Illness:

ID: 1695693
Sex: M
Age: 74
State: MD

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/13/2021
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: Brain fog; Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Sore arm) and CONFUSIONAL STATE (Brain fog) in a 74-year-old male 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) (unknown route) 1 dosage form. On 30-Aug-2021, the patient experienced VACCINATION SITE PAIN (Sore arm). On 01-Sep-2021, the patient experienced CONFUSIONAL STATE (Brain fog). At the time of the report, VACCINATION SITE PAIN (Sore arm) and CONFUSIONAL STATE (Brain fog) 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: 1695694
Sex: F
Age: 66
State: NY

Vax Date: 01/29/2021
Onset Date:
Rec V Date: 09/13/2021
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: Test Name: antibodies test; Test Result: 192 mg/dl

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: I had like a heart pain/I felt pain in my left side; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (I had like a heart pain/I felt pain in my left side) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Thyroid disorder. 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 CHEST PAIN (I had like a heart pain/I felt pain in my left side). At the time of the report, CHEST PAIN (I had like a heart pain/I felt pain in my left side) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Antibody test (700-1600 mg/dl): 192 mg/dl Low. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was provided. This case was linked to MOD-2021-307662 (Patient Link).

Other Meds:

Current Illness: Thyroid disorder.

ID: 1695695
Sex: F
Age: 58
State: NY

Vax Date: 02/09/2021
Onset Date:
Rec V Date: 09/13/2021
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: itch on her feet and hands; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (itch on her feet and hands) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017E21A, 013L20A and 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced PRURITUS (itch on her feet and hands). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Itch, at a dose of used it as a cream; CORTISONE for Itch, at an unspecified dose and frequency and CAMPHOR, MENTHOL (SARNA [CAMPHOR;MENTHOL]) for Itch, at an unspecified dose and frequency. At the time of the report, PRURITUS (itch on her feet and hands) had not resolved. Concomitant medications were not reported. The patient had a delayed reaction, 8 days after receiving of 3rd dose. She then said the delayed reaction started 25-Aug-2021. The patient was still experiencing the reaction and it was reported as "just consistently bad." She looked online and it was mentioned as delayed reactions. She went to a doctor but had not gone for this reaction yet. The patient stated that she had tried everything,and it felt like it was in her nervous system.; Sender's Comments: Based on the 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. Further information is expected.

Other Meds:

Current Illness:

ID: 1695696
Sex: M
Age: 65
State: ID

Vax Date: 01/23/2021
Onset Date:
Rec V Date: 09/13/2021
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: The patient did not recieve 2nd dose; This spontaneous case was reported by an other health care professional and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (The patient did not recieve 2nd dose) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) 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) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (The patient did not recieve 2nd dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (The patient did not recieve 2nd dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. Treatment information was unknown.

Other Meds:

Current Illness:

ID: 1695697
Sex: M
Age:
State:

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/13/2021
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: Injection site is very sore; Been in bed since 2 last night/feeling very not well; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Been in bed since 2 last night/feeling very not well) and VACCINATION SITE PAIN (Injection site is very sore) in an 18-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Sep-2021, the patient experienced VACCINATION COMPLICATION (Been in bed since 2 last night/feeling very not well). On an unknown date, the patient experienced VACCINATION SITE PAIN (Injection site is very sore). At the time of the report, VACCINATION COMPLICATION (Been in bed since 2 last night/feeling very not well) and VACCINATION SITE PAIN (Injection site is very sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1695698
Sex: U
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
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: upper respiratory infection; This spontaneous case was reported by a consumer and describes the occurrence of UPPER RESPIRATORY TRACT INFECTION (upper respiratory infection) 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) at an unspecified dose. On an unknown date, the patient experienced UPPER RESPIRATORY TRACT INFECTION (upper respiratory infection). The patient was treated with CODEINE (oral) on 19-Aug-2021 for Cough, at an unspecified dose and frequency; HYDROCORTISONE at an unspecified dose and frequency and AZITHROMYCIN (Z-PAK) for Product used for unknown indication, at an unspecified dose and frequency. At the time of the report, UPPER RESPIRATORY TRACT INFECTION (upper respiratory infection) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Concomitant product use was not provided by the reporter. Treatment information also included Z-pack for upper respiratory tract infection started on 21-august-2021, last dose was on 27-august-2021.

Other Meds:

Current Illness:

ID: 1695699
Sex: U
Age:
State: AK

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/13/2021
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: Administered with expired vaccines; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 03-Sep-2021 and was forwarded to Moderna on 03-Sep-2021. Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administered with expired vaccines) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031A21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administered with expired vaccines). On 02-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Administered with expired vaccines) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant product was reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1695700
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: Test Name: Body temperature; Result Unstructured Data: 100.8

Allergies:

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

Symptoms: Very Dizzy; temp. was 100.8?; Tried to vomit but there was nothing in my stomach; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Very Dizzy), PYREXIA (temp. was 100.8?) and VOMITING (Tried to vomit but there was nothing in my stomach) in a 73-year-old patient of an unknown 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 DIZZINESS (Very Dizzy), PYREXIA (temp. was 100.8?) and VOMITING (Tried to vomit but there was nothing in my stomach). At the time of the report, DIZZINESS (Very Dizzy), PYREXIA (temp. was 100.8?) and VOMITING (Tried to vomit but there was nothing in my stomach) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100.8 (High) 100.8. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication details was reported. No treatment medication details was reported.

Other Meds:

Current Illness:

ID: 1695701
Sex: F
Age: 50
State: FL

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 09/13/2021
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: This spontaneous case reported by a consumer, describes the occurrence of dizziness (lightheaded for 1 week), throat irritation (throat scratchy for 2 days) and pain in extremity (her arm hurt half a day) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch/lot# 040C21A) for COVID-19 immunization. No medical history reported. On Aug 6, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Aug 6, 2021, patient experienced dizziness (lightheaded for 1 week), throat irritation (throat scratchy for 2 days) and pain in extremity (her arm hurt half a day). On Aug 6, 2021, pain in extremity (her arm hurt half a day) resolved. On Aug 8, 2021, throat irritation (throat scratchy for 2 days) resolved. On Aug 13, 2021, dizziness (lightheaded for 1 week) resolved. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. The reporter did not provide any causality assessments, concomitant medications or treatment information. This case linked to MOD-2021-307941 (patient link).

Other Meds:

Current Illness:

ID: 1695702
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
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: Report vaccine side effects; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Report vaccine side effects) 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 VACCINATION COMPLICATION (Report vaccine side effects). At the time of the report, VACCINATION COMPLICATION (Report vaccine side effects) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant product was provided by the reporter. No treatment medication was provided.

Other Meds:

Current Illness:

ID: 1695703
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: She is having allergic reaction to booster; This spontaneous case was reported by a consumer and describes the occurrence of ALLERGY TO VACCINE (She is having allergic reaction to booster) 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 ALLERGY TO VACCINE (She is having allergic reaction to booster). At the time of the report, ALLERGY TO VACCINE (She is having allergic reaction to booster) outcome was unknown. No Concomitant medication was reported. No treatment medications were reported

Other Meds:

Current Illness:

ID: 1695704
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: particular reaction; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (particular reaction) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. Concurrent medical conditions included Autoimmune disorder (autoimmune disorders). 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 (particular reaction). At the time of the report, VACCINATION COMPLICATION (particular reaction) outcome was unknown. No concomitant medications were provided by reporter. No treatment medications were provided by reporter. Reporter did not allow further contact

Other Meds:

Current Illness: Autoimmune disorder (autoimmune disorders.)

ID: 1695705
Sex: U
Age:
State:

Vax Date: 04/01/2021
Onset Date:
Rec V Date: 09/13/2021
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: BEING EXPOSED TO SOMEONE WHO MIGHT HAVE BEEN REINFECTED WITH VIRUS; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 02-Sep-2021 and was forwarded to Moderna on 02-Sep-2021. 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 EXPOSURE TO SARS-COV-2 (BEING EXPOSED TO SOMEONE WHO MIGHT HAVE BEEN REINFECTED WITH VIRUS) 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 April 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In April 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 EXPOSURE TO SARS-COV-2 (BEING EXPOSED TO SOMEONE WHO MIGHT HAVE BEEN REINFECTED WITH VIRUS). At the time of the report, EXPOSURE TO SARS-COV-2 (BEING EXPOSED TO SOMEONE WHO MIGHT HAVE BEEN REINFECTED WITH VIRUS) outcome was unknown. No concomitant medications were provided. Treatment information was not provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1695706
Sex: M
Age: 67
State: FL

Vax Date: 02/01/2021
Onset Date:
Rec V Date: 09/13/2021
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: little more soreness; 2 days of fatigue; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (little more soreness) and FATIGUE (2 days of fatigue) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 063E21A) for COVID-19 vaccination. Concurrent medical conditions included Atrial fibrillation and Cholesterol. In February 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In March 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 02-Sep-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 MYALGIA (little more soreness) and FATIGUE (2 days of fatigue). At the time of the report, MYALGIA (little more soreness) and FATIGUE (2 days of fatigue) had resolved. Concomitant medications included A-fib Medication and Cholesterol Medication. No treatment details were reported.

Other Meds:

Current Illness: Atrial fibrillation; Cholesterol.

ID: 1695707
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
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: Is my arm supposed to be hurting; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Is my arm supposed to be hurting) 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 SITE PAIN (Is my arm supposed to be hurting). At the time of the report, VACCINATION SITE PAIN (Is my arm supposed to be hurting) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Treatment medications were provided. No Concomitant medications were reported. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1695708
Sex: U
Age:
State:

Vax Date: 04/03/2021
Onset Date: 09/01/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: Test Date: 20210901; Test Name: SARS-CoV-2; Test Result: Positive ; Result Unstructured Data: Positive

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Positive COVID test after vaccination; Two doses did not stop me from contracting COVID; Bad reaction to the vaccine; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Positive COVID test after vaccination), ADVERSE EVENT FOLLOWING IMMUNISATION (Bad reaction to the vaccine) and DRUG INEFFECTIVE (Two doses did not stop me from contracting 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 03-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In 2021, the patient experienced ADVERSE EVENT FOLLOWING IMMUNISATION (Bad reaction to the vaccine). On 01-Sep-2021, the patient experienced COVID-19 (Positive COVID test after vaccination) and DRUG INEFFECTIVE (Two doses did not stop me from contracting COVID). At the time of the report, COVID-19 (Positive COVID test after vaccination), ADVERSE EVENT FOLLOWING IMMUNISATION (Bad reaction to the vaccine) and DRUG INEFFECTIVE (Two doses did not stop me from contracting COVID) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Sep-2021, SARS-CoV-2 test: positive (Positive) Positive. No concomitant drug details were reported. No treatment details were reported.; Sender's Comments: This case has a limited information. Case is not valid until patient is provided. This is a case of lack of efficacy of the vaccine, therefore causal association between the event is assessed as possible. Based on the mechanism of action of mRNA-1273 ,causal association between the event of COVID-19 infection and mRNA-1273 is assessed as not applicable. However, 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: 1695709
Sex: F
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
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: Received both doses at 16 years old; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Received both doses at 16 years old) in a 16-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Diabetes and Autoimmune disorder. In 2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In 2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In 2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Received both doses at 16 years old). In 2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Received both doses at 16 years old) had resolved. Concomitant medications were not provided by reporter. Treatment information was not provided by reporter. This case was linked to MOD-2021-308656, MOD-2021-299882, MOD-2021-299844, MOD-2021-308669 (Patient Link).

Other Meds:

Current Illness: Autoimmune disorder; Diabetes.

ID: 1695710
Sex: F
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
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: lump under her armpit; This is a spontaneous report from a contactable other health care professional (nurse). A female patient of an unspecified age received bnt162b2 (BNT162B2, PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, batch/lot number: not reported, expiration date: not reported) via an unspecified route of administration on an unspecified date as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 immunisation. The patient's medical history and concomitant medications were not reported. The patient experienced lump under her armpit on an unspecified date. It was reported that the nurse practitioner's mother had the Pfizer COVID 19 vaccine and her mother got a lump but it was under her armpit and now it was barely going away and it has been 9-10 months. She was going to tell her nurse practitioner to call the Pfizer number so her nurse practitioner's mother can report her side effect. She has no further information for reporting. She does not know her nurse practitioner's mother. The outcome of the event was unknown. No further information provided or obtained

Other Meds:

Current Illness:

ID: 1695711
Sex: M
Age:
State: TX

Vax Date: 07/26/2021
Onset Date: 07/01/2021
Rec V Date: 09/13/2021
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: Stuffy Nose; This is a spontaneous report from a contactable consumer. This consumer (parent) reported that, a 44-year-old male patient (son) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 via an unspecified route of administration, administered in Arm Left on 26Jul2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation. Medical history included kidney transplant from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. Reporter Stated, on Monday her/his son, he had his first vaccination, Pfizer and he said he had a stuffy nose and stated, "He says, He alright but his nose is just look stuffy. For treatment, he did not take nothing because he was kidney transplant patient (intent history), and he did not want to take anything. Reporter Stated, He is alright, He says he is alright. The patient experienced stuffy nose on an unspecified date in Jul2021.Outcome of the event was recovered on an unspecified date in Jul2021. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1695712
Sex: F
Age:
State: IL

Vax Date: 04/22/2021
Onset Date: 04/30/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: Test Date: 20210824; Test Name: Covid-19; Result Unstructured Data: Test Result:Pending; Comments: Nasal Swab

Allergies:

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

Symptoms: Burning in the chest; tiredness; headache; muscle pain; chills; joint pain; feeling unwell; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 62-year-old non pregnant female patient received bnt162b2 (BNT162B2, Formulation: Solution for injection), dose 1 via an unspecified route of administration, administered in Arm Right on 22Apr2021 14:00 (Batch/Lot Number: EW0164) as DOSE 1, SINGLE (at the age of 62-year-old) for covid-19 immunisation. Medical history included Allergies: Penicillins, Allergies: Sulfa, Allergies: Iodinated Contrast, Allergies: Nsaids from an unknown date and unknown if ongoing. The patient did not receive other vaccine in four weeks. Concomitant medication(s) included amlodipine, lansoprazole, losartan all taken for an unspecified indication, start and stop date were not reported. The patient previously took codeine, acetaminophen, ibuprofen, tramadol and experienced hypersensitivity. The patient wasnot pregnant at the time of vaccination. The patient did not get Covid prior vaccination. The patient experienced burning in the chest, tiredness, headache, muscle pain, chills, joint pain, feeling unwell on 30Apr2021 05:00. AE resulted in Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care. Gave me medicine for the chest pain and burning. The patient underwent lab tests and procedures which included sars-cov-2 test: pending on 24Aug2021 Nasal Swab. Therapeutic measures were taken as a result of burning in the chest, tiredness, headache, muscle pain, chills, joint pain, feeling unwell. The outcome of the events was not recovered. No Follow-up attempts are needed. No further information is expected.

Other Meds: AMLODIPINE; LANSOPRAZOLE; LOSARTAN

Current Illness:

ID: 1695713
Sex: F
Age:
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 09/13/2021
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: had a little bit of swelling but no fever; This is a spontaneous report from a contactable consumer or other non hcp (patient reported for herself). A 78-year-old female patient received second dose of bnt162b2 (COMIRNATY COVID 19 Vaccine, mRNA, Solution for Injection, Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date in Feb2021 as dose 2, single for COVID-19 immunization. Medical history included two autoimmune situations (but not immunocompromised) from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. The patient previously took first dose of bnt162b2 on an unspecified date in Jan2021 for COVID-19 immunization and flu shot (Patient usually gets the Fluzone high dose. Patient usually gets her flu shot at the end of September). On an unspecified date in Feb2021, the patient experienced had a little bit of swelling but no fever. In (withheld) the booster dose is available after 5-6 months. Here in the US they are stating they're going to start the booster dose for non-immunocompromised people at 8-9 months. Doesn't the vaccine lose a lot of efficacy after 6 months. What are the 6 months topline analysis results of the Pfizer-BioNTech COVID-19 Vaccine. Is there a specific test I can take to check my antibody titers. Patient, female, aged 78, with two autoimmune situations but not immunocompromised is calling about the Pfizer BioNTech Covid 19 vaccine's booster dose. Patient received the first two doses in January and Feb2021. Afterwards she just had a little bit of swelling but no fever or anything else. Patient sees in (withheld) people are getting booster shots after 5-6 months after the two dose series. Is the vaccine booster the same as the original two or is it a new formulation to give better protection against delta and lambda. Or is it the same old dose as the first two doses. Were the immunocompromised patients in the original study. Are the studies for the 8-9 month boosters on the original study participants or a separate study. Patient declined transfer to DSU about the swelling side effect after the vaccine, patient stated it was no big deal. Patient declined to provide PCP information. What was the efficacy in people over the age of 65. How many participants were over the age of 65. Is Pfizer working on a new formulation booster to cover delta and lambda variants. How do they test for the efficacy against delta. Patient is scheduled to have surgery on 22Oct2021, patient is wondering when she should time her flu and COVID booster vaccine. Should she wait 2-3 weeks. Should she get the flu vaccine first. Patient usually gets the Fluzone high dose. Should she wait until after she receives the Pfizer booster. Patient usually gets her flu shot at the end of September. Outcome of the event was unknown. The lot number for the vaccine [BNT162B2] was not provided and will be requested during follow up. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1695714
Sex: U
Age:
State:

Vax Date: 08/29/2021
Onset Date: 08/29/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Sore arm; I have had terrible insomnia; This is a spontaneous report from a contactable consumer. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for Injection, Batch/Lot number: Unknown) via an unspecified route of administration on 29Aug2021 as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 immunisation. The patient's medical history and concomitant medications were not reported. It was reported that, patient got the COVID Vaccine on Sunday evening (29Aug2021) and had a sore arm which was normal. Patient had terrible insomnia from Sunday night (29Aug2021), Monday night and had insomnia, on the date of this report and patient was hoping that patient could sleep. The outcome of the event was unknown. The lot number for the vaccine, [BNT162B2] was not provided and will be requested during follow-up.

Other Meds:

Current Illness:

ID: 1695715
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 09/13/2021
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: has superfical vein thrombus spanning 5 cm in that particular arm; This is a spontaneous report from a Pfizer-sponsored program. A contactable physician reported for female consumer (Patient) of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number and expiration date was not reported), via an unspecified route of administration in left deltoid on an unspecified date as dose number unknown, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. on an unspecified date the physician reported that a young lady experienced who received COVID-19 pfizer vaccine in left deltoid muscle and has superficial vein thrombus spanning 5 cm in that particular arm. Physician further questioned that any one reported cases of superficial vein thrombus at the site of injection. The outcome of the event was unknown. The lot number for the vaccine, [bnt162b2], was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1695716
Sex: F
Age:
State: CT

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: Test Date: 20210224; Test Name: Slight fever; Result Unstructured Data: Test Result:Slight fever

Allergies:

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

Symptoms: Slight fever, chills, body aches, tiredness; Slight fever, chills, body aches, tiredness; Slight fever, chills, body aches, tiredness; Slight fever, chills, body aches, tiredness; This is a spontaneous report received from contactable consumer (Patient). A 55-years-old non-pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number: EL3247) via unspecified route of administration, administered in right arm on 23Feb2021 at 12:00 (age at the time of vaccination was 55 years old) as a single dose for COVID-19 immunization at Workplace clinic. Medical history and concomitant medications were not reported. Previously the patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number: EL3247) via unspecified route of administration, administered in right arm on 02Feb2021 at 12:00 (age at the time of vaccination was 55 years old) as a single dose for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine and no other medications were received within 2 weeks of vaccination. The patient was not diagnosed with COVID-19 prior to vaccination and since the vaccination. On 24Feb2021, Slight fever, chills, body aches and tiredness. Patient did not receive any treatment. On 24Feb2021, the patient underwent lab test and procedure which included Slight fever. The clinical outcome of the events was recovering. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1695717
Sex: F
Age:
State: VA

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: Test Date: 20210226; Test Name: COVID test; Result Unstructured Data: Test Result:Unknown, not resulted yet

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Coughing; Fever; Went downhill fast/Feeling out of it, kind of like an out of body experience that was weird; very, very, very tired; Sore throat; Sore left arm; This is a follow up spontaneous report from a contactable consumer (patient, self-reported). A 61-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number: EN6201 and expiry date was not reported), via an unspecified route of administration, in Arm Left, on 14Feb2021 at 10:30 (age at vaccination: 61 years), as a single dose for COVID-19 immunization. The patient's medical history included ongoing high blood pressure. Family Medical History included patient's father was diabetic and had cancer. Concomitant medications were not reported. The patient did not received any vaccination prior vaccinations (within 4 weeks). On 14Feb2021, the patient experienced sore left arm. She was basically fine. 6 days later on Saturday, 20Feb2021, she started having a very mild sore throat. On Monday, 21Feb2021, she was very tired. On 22Feb2021, she was very, very, very tired and went downhill fast/Feeling out of it, kind of like an out of body experience that was weird. Yesterday, 25Feb2021, she started having coughing and fever. She went to get a COVID test this morning and was still waiting for her results. The patient asked if this could be from the vaccine. She mentioned she did report through the V-safe text system for the first week. The adverse events did not require a visit to emergency room and physician office. There was a Product Complaint. Description of Product Complaint included in response to adverse events ongoing she had COVID test 26Feb2021, but results were unknown at this time, not resulted yet. The patient underwent lab test and procedure included COVID test with unknown result on 26Feb2021. Out-come of the event sore left arm was recovered on an unspecified date, went downhill fast/Feeling out of it, kind of like an out of body experience that was weird was recovering and for all other events, it was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness: Blood pressure high.

ID: 1695718
Sex: U
Age:
State: CA

Vax Date: 01/24/2012
Onset Date:
Rec V Date: 09/13/2021
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: minor allergic reaction; Redness and swelling at the injection site; Redness at the injection site; Swelling at the injection site; Initial information was received on 31-Aug-2021 regarding an unsolicited valid non-serious case from a physician via other health care professional. This case involves a patient (demographics unknown) who had minor allergic reaction (hypersensitivity) and redness and swelling at the injection site (vaccination site inflammation) (with symptoms: vaccination site erythema and vaccination site swelling) after receiving DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE. It was unknown if the patient had any medical history, concomitant disease or risk factor. Medical treatment(s), vaccination(s), concomitant medication(s) and family history were not provided. On 24-Jan-2012, the patient received a dose of suspect DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE produced by unknown manufacturer (lot C418AA, form: suspension for injection, expiry: 14-Nov-2014) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date the patient developed non-serious minor allergic reaction (hypersensitivity) and redness and swelling at the injection site (vaccination site inflammation) (with symptoms: vaccination site erythema and vaccination site swelling) (unknown latency) following the administration of DIPHTHERIA and TETANUS AND ACELLULAR PERTUSSIS VACCINE. It was reported, "She reported that on 24-Jan-2012 a patient received a dose of Sanofi DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE (TDAP) vaccine and had a minor allergic reaction consisting of redness and swelling at the injection site. She reported that the reaction did not require medical intervention" She did not have further adverse event (AE) details. No Product Quality Control (PQC). No additional AEs reported. No additional information provided. The caller was unable to provide the brand name of the TDAP vaccine but did confirm that it was manufactured by Sanofi It was unknown if the patient experienced any additional symptoms/events. It was unknown if there were lab data/results available. At time of reporting, the outcome of the events was unknown.

Other Meds:

Current Illness:

ID: 1695720
Sex: F
Age: 18
State: KS

Vax Date: 09/13/2021
Onset Date: 09/13/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: BLOOD PRESSURE 100/60 PULSE 60

Allergies:

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

Symptoms: PATIENT SEIZED FOR 5 SECONDS NOTHING ELSE HAPPEND, OFFERED TO CALL 911 , PATIENT REFUSED AND SAID THAT SHE IS FINE, BLOOD PRESSURE WAS 100/60, PULSE 60. WE WATCH THE PATIENT FOR 20 MORE MINUTES AND SHE LEFT FINE.

Other Meds: AUROVELA FE 1/20

Current Illness:

ID: 1695721
Sex: F
Age: 48
State: TX

Vax Date: 09/12/2021
Onset Date: 09/13/2021
Rec V Date: 09/13/2021
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: dust, dustmites. bees, cats, pollens and grasses

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

Symptoms: Heart Palpitations, 104 fever, severe red rash on both thighs, chills

Other Meds: allegra

Current Illness: N/A

ID: 1695722
Sex: F
Age: 24
State: AR

Vax Date: 09/12/2021
Onset Date: 09/12/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies: Iodine, glucosamine, shellfish, nuts, soy

Symptom List: Pain in extremity

Symptoms: Lightheaded within 15 minutes of the shot and chest pain within 50 minutes after the shot. Chest pain on right side, inflammation/swollen at site of pain and warm to touch compared to the normal other side of chest. Swollen arm at site of injection and discomfort when lifting arm.

Other Meds: Kyleena

Current Illness:

ID: 1695723
Sex: F
Age: 43
State: MI

Vax Date: 04/12/2021
Onset Date: 09/02/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data:

Allergies: Betadine [Povidone Iodine] Skin Rashes/Hives Chlorhexidine Skin Rashes/Hives Latex Rash Sulfa Drugs Rash

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

Symptoms: Hospitalized; COVID-19 positive (9.2.21); fully vaccinated Admission Date: 9/3/2021 Discharge Date: 09/04/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Stroke-like symptom [R29.90] Cerebrovascular accident (CVA), unspecified mechanism COVID-19 HOSPITAL COURSE: SUBJECTIVE: Patient is a 43 y.o. female who presents today with her husband at bedside. After she developed symptoms of acute aphasia, left sided weakness, left sided numbness and a headache at a ball game 9/2/2021 @ 1430, she remembers it being the bottom of the third, she felt whole body tingling sensation, had a brief "black out" for seconds and felt hot, ushers took her to the medical bay at the park, she then was sent to hospital due to concern for stroke. She was given tPA at 1600 9/2/2021. She recalls the providers talking to her about tPA and the risks and they had to call her husband because she was unable to answer their questions. Then she was in the ED, and they told her they were going to get an MRI and stroke evaluation, though there were no beds available in the ICU and she would need to be watched in the ED. Patient states she did not feel like she was being observed in the ED, so she left AMA with her husband to drive 3 hours from hospital to another facility for management and workup for possible stroke. 43 y.o. female presenting from Hospital after patient left AMA status post tPA. Reportedly patient was at baseball game. She was in the lower section, sitting in the sun and went to walk up the steps. She said there were a lot of them. During the ascension she started feeling warm and needed to sit down. She felt tingling on both sides of her body. She said paramedics took her BP and all she recalls was being told it was low in the 80's and that they couldn't measure the other number. She also recalls having difficulty getting words out. She was taken to the hospital where it was suggested that she may have a facial droop. She was given a mirror and recalls telling them that it looked like her face. She was given tPA at 4:00 p.m with resolution of symptoms approximately 5:30 p.m on 09/02/2021. Onset of symptoms was roughly 2-3 pm. Patient was unhappy with the care received via an emergency room and decided to seek care elsewhere. Now at this hospital, patient reports she is back to normal. MRI brain was negative for acute abnormality. It was not obtained with contrast but there is no evidence of chronic lesions with demyelinating appearance. Etiology considered likely pre-syncopal d/t hypotensive event. Echo without clear abnormality but suggesting atypical septal motion in one sequence. I discussed with cardio who suggested this would not be expected to elicit a syncopal event and did not require follow-up. Patient with sinus arrythmia while tele and will obtain ziopatch at discharge. Patient should modify stroke risk factors for primary prevention, including glycemic control through diet and exercise as A1c 6.0. Recommend marijuana cessation. Otherwise patient should f/u with PCP post-hospitalization and for resolution of UTI treated with Azithromycin. Otherwise EEG pending read at discharge. Patient discharged home.

Other Meds: albuterol (PROVENTIL, VENTOLIN, PROAIR) 108 (90 BASE) MCG/ACT inhaler aspirin 81 MG chewable tablet CRANBERRY PO fluticasone-salmeterol (ADVAIR DISKUS) 100-50 MCG/DOSE AEPB levothyroxine (SYNTHROID) 112 MCG tablet

Current Illness: NA

ID: 1695724
Sex: M
Age: 50
State: OR

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/13/2021
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: n/a

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Severe, nonstop shoulder pain since I got this second Pfizer shot at a Farmer's Market. [No badge/ID; verbally identified] The whole shoulder joint is stiff and painful and I cannot use my arm normally. I can't help but wonder if "Dr." knew he hit an underlying shoulder structure because mid-injection, unprompted by any words/actions by me, he asked me if I was OK. The injection itself lasted a very long time, perhaps 5 seconds, and felt deep. My arm was not abducted out to the side, nor did he pinch the muscle up and away from the bone. Most concerning, however, is that the injection was placed in the upper 1/3 of the deltoid muscle, only 1.5 inches below the acromion.

Other Meds: n/a

Current Illness: n/a

ID: 1695725
Sex: F
Age: 57
State: MD

Vax Date: 04/01/2021
Onset Date: 04/05/2021
Rec V Date: 09/13/2021
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: N/A

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

Symptoms: Multiple blood clots in left calf and lower thigh

Other Meds: synthroid ( 125 mcg) yaz

Current Illness: N/A

ID: 1695726
Sex: F
Age: 29
State: NV

Vax Date: 03/09/2021
Onset Date: 09/13/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: Ultrasound on August 18th, 2021. Results mentioned above.

Allergies: Sulfa

Symptom List: Vomiting

Symptoms: I noticed an abnormal growth in my left breast when doing my monthly self-examination. I mentioned it to my obgyn and she mentioned that it could be related to the site that I received the vaccine. She requested an ultrasound and the results showed that my breasts have denser tissue than average but nothing to be concerned about. The left breast was denser than the right breast.

Other Meds: Medication: Allegra Supplements: Iron, vitamin D, vitamin B12

Current Illness:

ID: 1695727
Sex: F
Age: 54
State: CA

Vax Date: 08/16/2021
Onset Date: 08/17/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: none mentioned

Allergies: none listed

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient developed some bruising on different sites of body (arms, legs) after getting the first shot. Patient denied trauma to the sites of bruising. Did not state whether she was on any blood thinning medications or anticoagulants at the time. Didn't mention that she went to hospital for medical care. No other symptoms mentioned. Was reported to pharmacy when presenting for second shot. Second shot was deferred due to reaction to first dose and patient advised to follow-up with PCP to discuss candidacy for second dose.

Other Meds: unknown

Current Illness: none listed

ID: 1695728
Sex: M
Age: 9
State: MA

Vax Date: 09/13/2021
Onset Date: 09/13/2021
Rec V Date: 09/13/2021
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: the patient was sent to the hospital for evulation.

Allergies:

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

Symptoms: fainted it/passed out minutes after the shots.

Other Meds:

Current Illness:

ID: 1695729
Sex: M
Age: 54
State: KY

Vax Date: 08/06/2021
Onset Date: 08/22/2021
Rec V Date: 09/13/2021
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: No labs

Allergies: Previously allergy mapped with only minor responses (sneezing/tearing) to: cats cockroaches molds Never had an allergy to any chemical, food, or medicine in 54 years!

Symptom List: Injection site swelling, Limb discomfort

Symptoms: While on work assignment, I was returning from lunch where I began to exhibit normal allergy symptoms-sneezing. I had eaten the exact same menu item at the exact same restaurant roughly 4 days prior. (The order was identical and I have eaten at the location many times before) I have never in my life had a food or medicinal allergy. Likewise in over 30 years experience in the aerospace field, I have been exposed to a number of chemicals and never had any sort of severe response to any checmical. Upon reaching my office within approximately 5-10 muntes of the allergy manifesting, I continued to sneeze so I took a 25mg benadryl tablet. Shortly after (within 5 minutes) that I noted that my face felt flush so I took my temperature which was normal. I then noted my forearms were beginning to turn red & itch. I noted that I felt like I wanted to sneeze but couldn't but noted that my airway was clear with no adverse breathing. At that point I took a second benadryl tablet and notified a coworker that something was amiss and to keep an eye on me. I returned back to my office and within another 5-10 minutes, I noted my scalp began to itch severely along with the soles of my feet. My tongue became thick and I noted that my breathing was becoming slightly labored. At that point I took a tird benadryl tablet & two hits of fluticasone propionate (50mcg) nasal spray and notified my coworkers that I was experiencing some sort of anaphylaxis event and that if things did not improve in the next 10-15 minutes we would need to call EMS as only epinehrine was likely to help! I also noted at this time that my torso was blotched and covered with numerous hives. Fortunately within the next 10 minutes as we prepared to forgo EMS and make a run to the nearest ER, the symptoms began to subside. Most notably the thickened tongue and breathing issues, then slowly the itching dimished and began to return to normal. After allowing myself to relax for another 30-45 minutes, I then decided I felt well enough to drive myself to a local ER near my hotel and I had a coworker follow me there where I received follow-up treatment. The ER administered methylprednisone Sod Suc (steroidal shot) and famotidine while they kept me under observation for any rebound activity. I was prescribed an Epipen upon being discharged a couple hours later.

Other Meds: losartan 12.5mg

Current Illness: None

ID: 1695730
Sex: F
Age: 26
State: CO

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: Echo, ekg , Trop

Allergies: Penicillin amoxicillin

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

Symptoms: Post Covid vaccination associated myopericarditis

Other Meds: None

Current Illness: No

ID: 1695731
Sex: F
Age: 23
State: MD

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Friday evening (9/10): fatigue, muscle aches, joint pain, fever all began Saturday (9/11): major fatigue, malaise, muscle aches, joint pain, bad headaches, fever and chills, dizziness, sore throat, terrible mouth pain with swollen and red gums and splotchiness on roof of mouth Sunday (9/12): fatigue, malaise aches, headaches, fever and chills, dizziness, sore throat, mouth pain, swollen lymphnodes under armpits Monday (9/13): mouth and throat pain, inflammation, redness, headaches, fatigue

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am