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: 1707106
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: I got my second shot of Moderna vaccine a week too early/Second dose received less than 25 days after the first dose of the Moderna Covid-19 vaccine; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (I got my second shot of Moderna vaccine a week too early/Second dose received less than 25 days after the first dose of the Moderna Covid-19 vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, 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 INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (I got my second shot of Moderna vaccine a week too early/Second dose received less than 25 days after the first dose of the Moderna Covid-19 vaccine). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (I got my second shot of Moderna vaccine a week too early/Second dose received less than 25 days after the first dose of the Moderna Covid-19 vaccine) had resolved. No concomitant medications were provided. No treatment medications were provided.

Other Meds:

Current Illness:

ID: 1707107
Sex: M
Age: 76
State: CA

Vax Date: 01/22/2021
Onset Date: 09/01/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: Test Name: Blood sugar; Result Unstructured Data: normal

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Fell; Felt dizzy; felt sick; Felt kind of weak; kind of like getting over the flu; Body started aching; Nausea; blood pressure is high; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Felt kind of weak), INFLUENZA LIKE ILLNESS (kind of like getting over the flu), HYPERTENSION (blood pressure is high), FALL (Fell) and MALAISE (felt sick) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037C21A, 023M20A and 004M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history provided by the reporter. The patient's past medical history included Heart attack (had heart attack in the past). Concurrent medical conditions included Low sodium diet. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 01-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In 2021, the patient experienced HYPERTENSION (blood pressure is high). On 01-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PAIN (Body started aching) and NAUSEA (Nausea). On 02-Sep-2021, the patient experienced ASTHENIA (Felt kind of weak), INFLUENZA LIKE ILLNESS (kind of like getting over the flu) and MALAISE (felt sick). On 04-Sep-2021, the patient experienced FALL (Fell) and DIZZINESS (Felt dizzy). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. On 03-Sep-2021, ASTHENIA (Felt kind of weak), INFLUENZA LIKE ILLNESS (kind of like getting over the flu), MALAISE (felt sick), PAIN (Body started aching) and NAUSEA (Nausea) had resolved. At the time of the report, HYPERTENSION (blood pressure is high), FALL (Fell) and DIZZINESS (Felt dizzy) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood glucose: normal (normal) normal. The concomitant medication were not reported. Patient also took blood thinners. The physician suggested that it was good that the patient took the third dose. Patient got the 1st dose of the vaccine on 22Jan2021 (Lot-004M20A), 2nd dose on 26Feb2021 (lot-023M20A), and 3rd dose on 01Sep2021 (lot-037C21A). Consumer did not have the expiration dates for the products. Patient states that had possible adverse events after 3rd dose of the vaccine. On the vaccination day patient had nausea, and body was aching. On 2nd day Patient felt kind of weak and felt like getting over the flu. On Thursday Patient felt sick. Friday Patient was fine and then when Patient woke up in the morning on 04Sep2021, felt dizzy and fell, patient experienced dizziness and blood pressure is high. Patient had heart attack in the past and took blood thinners. Patent having condition of only low sodium diet and blood sugar is normal. Patient took Tylenol which helped with possible adverse events and didn't informed the medication for Dizziness

Other Meds:

Current Illness: Low sodium diet

ID: 1707108
Sex: F
Age: 65
State:

Vax Date: 09/04/2021
Onset Date: 09/04/2021
Rec V Date: 09/17/2021
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: not feeling well/feel so sick after taking the Moderna booster; not able to do anything/still laying around unable to do anything; swelling underneath armpit/swollen lymph nodes; swelling underneath armpit/swollen lymph nodes; headache; muscle aches; fatigue/fatigued; have chills; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (not feeling well/feel so sick after taking the Moderna booster), DECREASED ACTIVITY (not able to do anything/still laying around unable to do anything), HYPERHIDROSIS (swelling underneath armpit/swollen lymph nodes), LYMPHADENOPATHY (swelling underneath armpit/swollen lymph nodes) and HEADACHE (headache) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 04-Sep-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) (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 04-Sep-2021, the patient experienced MALAISE (not feeling well/feel so sick after taking the Moderna booster), DECREASED ACTIVITY (not able to do anything/still laying around unable to do anything), HYPERHIDROSIS (swelling underneath armpit/swollen lymph nodes), LYMPHADENOPATHY (swelling underneath armpit/swollen lymph nodes), HEADACHE (headache), MYALGIA (muscle aches), FATIGUE (fatigue/fatigued) and CHILLS (have chills). At the time of the report, MALAISE (not feeling well/feel so sick after taking the Moderna booster), DECREASED ACTIVITY (not able to do anything/still laying around unable to do anything), HYPERHIDROSIS (swelling underneath armpit/swollen lymph nodes), LYMPHADENOPATHY (swelling underneath armpit/swollen lymph nodes), HEADACHE (headache), MYALGIA (muscle aches), FATIGUE (fatigue/fatigued) and CHILLS (have chills) had not resolved. No concomitant medication was provided by reporter. No treatment information was provided was provided by reporter. The patient was completely fine after receiving the second dose of vaccine. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 04-Sep-2021: Follow up received included updated outcome of all events

Other Meds:

Current Illness:

ID: 1707109
Sex: U
Age:
State: NJ

Vax Date:
Onset Date: 09/03/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: Test Date: 20210903; Test Name: COVID-19 test; Test Result: Positive ; Result Unstructured Data: Positive

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: son came in contact with 3 other people that got the shot and still got COVID-19; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (son came in contact with 3 other people that got the shot and still got COVID-19) 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 03-Sep-2021, the patient experienced COVID-19 (son came in contact with 3 other people that got the shot and still got COVID-19). At the time of the report, COVID-19 (son came in contact with 3 other people that got the shot and still got COVID-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Sep-2021, SARS-CoV-2 test: positive (Positive) Positive. 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: 1707110
Sex: M
Age:
State: OK

Vax Date:
Onset Date: 09/03/2021
Rec V Date: 09/17/2021
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: skin was peeling off their fingers; This spontaneous case was reported by a pharmacist and describes the occurrence of SKIN EXFOLIATION (skin was peeling off their fingers) 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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Sep-2021, the patient experienced SKIN EXFOLIATION (skin was peeling off their fingers). At the time of the report, SKIN EXFOLIATION (skin was peeling off their fingers) 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 reported No treatment drug was reported

Other Meds:

Current Illness:

ID: 1707111
Sex: F
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: Many women have experienced breast issues; This spontaneous case was reported by a consumer and describes the occurrence of BREAST DISCOMFORT (Many women have experienced breast issues) 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 BREAST DISCOMFORT (Many women have experienced breast issues). At the time of the report, BREAST DISCOMFORT (Many women have experienced breast issues) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. It was reported that these women had to do mammograms. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1707112
Sex: M
Age: 63
State: PA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 09/17/2021
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: Pain on the right arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain on the right arm) in a 63-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. Concomitant products included BUDESONIDE, FORMOTEROL FUMARATE (SYMBICORT), ALBUTEROL [SALBUTAMOL], CARVEDILOL, LISINOPRIL and FUROSEMIDE for an unknown indication. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Jan-2021, the patient experienced PAIN IN EXTREMITY (Pain on the right arm). At the time of the report, PAIN IN EXTREMITY (Pain on the right arm) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications also included Nebulizer (4 treatments per day) and Hydroziline. No treatment medications were reported. This case was linked to MOD-2021-307454, MOD-2021-307468 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 08-Sep-2021: Follow up received contains no new information On 08-Sep-2021: Follow up received contains no new information On 08-Sep-2021: Non significant follow up received on 08-Sep-2021

Other Meds: SYMBICORT; ALBUTEROL [SALBUTAMOL]; CARVEDILOL; LISINOPRIL; FUROSEMIDE

Current Illness:

ID: 1707113
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: Im I suppose to still the knot/soreness in my are 3 months after receiving the moderna; Im I suppose to still the knot/soreness in my are 3 months after receiving the moderna; This spontaneous case was reported by a consumer and describes the occurrence of MASS (Im I suppose to still the knot/soreness in my are 3 months after receiving the moderna) and MYALGIA (Im I suppose to still the knot/soreness in my are 3 months after receiving the moderna) 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 MASS (Im I suppose to still the knot/soreness in my are 3 months after receiving the moderna) and MYALGIA (Im I suppose to still the knot/soreness in my are 3 months after receiving the moderna). At the time of the report, MASS (Im I suppose to still the knot/soreness in my are 3 months after receiving the moderna) and MYALGIA (Im I suppose to still the knot/soreness in my are 3 months after receiving the moderna) 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: 1707114
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: just received my first vaccine shot yesterday today I'm starting to feel bad; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (just received my first vaccine shot yesterday today I'm starting to feel bad) 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 FEELING ABNORMAL (just received my first vaccine shot yesterday today I'm starting to feel bad). At the time of the report, FEELING ABNORMAL (just received my first vaccine shot yesterday today I'm starting to feel bad) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant drug was not reported. Treatment medication was not reported.

Other Meds:

Current Illness:

ID: 1707115
Sex: F
Age:
State: NC

Vax Date: 08/06/2021
Onset Date: 08/10/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: Test Date: 20210810; Test Name: COVID-19; Test Result: Positive ; Result Unstructured Data: positive

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: got COVID positive; This spontaneous case was reported by a pharmacist and describes the occurrence of SARS-COV-2 TEST POSITIVE (got COVID positive) 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 06-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Aug-2021, the patient experienced SARS-COV-2 TEST POSITIVE (got COVID positive). At the time of the report, SARS-COV-2 TEST POSITIVE (got COVID positive) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 10-Aug-2021, SARS-CoV-2 test: 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. No concomitant medications reported. No treatment reported.

Other Meds:

Current Illness:

ID: 1707116
Sex: M
Age:
State: PA

Vax Date:
Onset Date: 02/24/2021
Rec V Date: 09/17/2021
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: fever; pain on the left arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain on the left arm) and PYREXIA (fever) in a 63-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. Concomitant products included Symbicort inhaler, albuterol, nebulizer (4 treatments per day), cardiovil, lisonopril, FUROSEMIDE and Hydroziline for an unknown indication. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Feb-2021, the patient experienced PAIN IN EXTREMITY (pain on the left arm). On 18-Aug-2021, the patient experienced PYREXIA (fever). At the time of the report, PAIN IN EXTREMITY (pain on the left arm) and PYREXIA (fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. This case was linked to MOD-2021-307413, MOD-2021-307468. Treatment information was not reported.

Other Meds: Symbicort inhaler; albuterol; nebulizer (4 treatments per day); cardiovil; lisonopril; FUROSEMIDE; Hydroziline

Current Illness:

ID: 1707117
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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 don't feel well after the second dose; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (I don't feel well after the second dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. No Medical History information was reported. On 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 MALAISE (I don't feel well after the second dose). At the time of the report, MALAISE (I don't feel well after the second dose) outcome was unknown. No concomitant medication was mentioned. No treatment medication was mentioned.

Other Meds:

Current Illness:

ID: 1707118
Sex: F
Age:
State: IL

Vax Date: 02/15/2021
Onset Date: 03/15/2021
Rec V Date: 09/17/2021
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: Flu-like symptoms (2nd dose); Bad headache (2nd dose); Body aches (2nd dose); Fever (2nd dose); This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu-like symptoms (2nd dose)), HEADACHE (Bad headache (2nd dose)), MYALGIA (Body aches (2nd dose)) and PYREXIA (Fever (2nd dose)) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Asthmatic. On 15-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Mar-2021, the patient experienced INFLUENZA LIKE ILLNESS (Flu-like symptoms (2nd dose)), HEADACHE (Bad headache (2nd dose)), MYALGIA (Body aches (2nd dose)) and PYREXIA (Fever (2nd dose)). On 16-Mar-2021, INFLUENZA LIKE ILLNESS (Flu-like symptoms (2nd dose)), HEADACHE (Bad headache (2nd dose)), MYALGIA (Body aches (2nd dose)) and PYREXIA (Fever (2nd dose)) had resolved. No Concomitant medication was reported. No Treatment medications were reported This case was linked to MOD-2021-307233 (Patient Link).

Other Meds:

Current Illness: Asthmatic.

ID: 1707119
Sex: F
Age: 77
State: FL

Vax Date: 01/22/2021
Onset Date:
Rec V Date: 09/17/2021
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 Date: 20210902; Test Name: fever; Result Unstructured Data: 101.1 fever

Allergies:

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

Symptoms: Pyrexia; Chills; a little bit of a sore arm but better by the 2nd day, Achy, Lots of pain in the lower left hand in the back which went up to the thoracic area; fatigue; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Pyrexia), CHILLS (Chills), MYALGIA (a little bit of a sore arm but better by the 2nd day, Achy, Lots of pain in the lower left hand in the back which went up to the thoracic area) and FATIGUE (fatigue) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 029K20A, 010M20A and 062E21A) for COVID-19 vaccination. Concurrent medical conditions included Ovarian cancer and Brain tumor (Patient reported they were immunocompromised). Concomitant products included METFORMIN, PITAVASTATIN CALCIUM (LIVALO), EZETIMIBE (ZETIA), DENOSUMAB (PROLIA), ACETYLSALICYLIC ACID (ASPIRIN 81), CALCIUM LACTATE, DL- LACTIC ACID (VAGISAN COMBI), TRAMADOL and GABAPENTIN (NEURONTIN) for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 01-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 PYREXIA (Pyrexia), CHILLS (Chills), MYALGIA (a little bit of a sore arm but better by the 2nd day, Achy, Lots of pain in the lower left hand in the back which went up to the thoracic area) and FATIGUE (fatigue). The patient was treated with IBUPROFEN (ADVIL 12 HOUR) for Adverse event, at a dose of 1 dosage form and PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 dosage form. At the time of the report, PYREXIA (Pyrexia), CHILLS (Chills), MYALGIA (a little bit of a sore arm but better by the 2nd day, Achy, Lots of pain in the lower left hand in the back which went up to the thoracic area) and FATIGUE (fatigue) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 02-Sep-2021, Pyrexia: 101.1 (High) 101.1 fever. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The first night after receiving the second dose the patient started experiencing fever and chills, a little bit of a sore arm but better by the second day, and fatigue. This case was linked to MOD-2021-307114, MOD-2021-307467 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 07-Sep-2021: Significant F/U Case.: Patient weight , concomitant medication , Event start date added

Other Meds: METFORMIN; LIVALO; ZETIA; PROLIA; ASPIRIN 81; VAGISAN COMBI; TRAMADOL; NEURONTIN

Current Illness: Brain tumor (Patient reported they were immunocompromised); Ovarian cancer

ID: 1707120
Sex: M
Age: 63
State: PA

Vax Date: 01/27/2021
Onset Date: 08/18/2021
Rec V Date: 09/17/2021
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: Weakness; Pain on the right arm; Fever; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Weakness), PAIN IN EXTREMITY (Pain on the right arm) and PYREXIA (Fever) in a 63-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 091D21A, 031L20A and 010M20A) for COVID-19 vaccination. No Relevant Medical History was provided. Concomitant products included BUDESONIDE, FORMOTEROL FUMARATE (SYMBICORT FORTE), SALBUTAMOL (ALBUTEROL HFA), LISINOPRIL, FUROSEMIDE, CARVEDILOL and HYDRALAZINE for an unknown indication. On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced ASTHENIA (Weakness), PAIN IN EXTREMITY (Pain on the right arm) and PYREXIA (Fever). At the time of the report, ASTHENIA (Weakness), PAIN IN EXTREMITY (Pain on the right arm) and PYREXIA (Fever) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment information was not provided. Nebulizer (4 treatments per day) was used as Concomitant medication. This case was linked to MOD-2021-307454, MOD-2021-307413 (Patient Link).

Other Meds: SYMBICORT FORTE; ALBUTEROL HFA; LISINOPRIL; FUROSEMIDE; CARVEDILOL; HYDRALAZINE

Current Illness:

ID: 1707121
Sex: F
Age:
State: GA

Vax Date: 02/12/2021
Onset Date:
Rec V Date: 09/17/2021
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: patient did a mammogram because developed and irregular looking thing in the breast.; This spontaneous case was reported by a consumer and describes the occurrence of BREAST MASS (patient did a mammogram because developed and irregular looking thing in the breast.) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 041M20A and 015M20A) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In 2021, the patient experienced BREAST MASS (patient did a mammogram because developed and irregular looking thing in the breast.). At the time of the report, BREAST MASS (patient did a mammogram because developed and irregular looking thing in the breast.) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient did a mammogram and will have the results on Thursday, when a biopsy will be made.Lymph nodes are looking okay Concomitant product use was not provided by the reporter. Treatment information was not provided by the reporter.

Other Meds:

Current Illness:

ID: 1707122
Sex: M
Age: 76
State: CA

Vax Date: 01/16/2021
Onset Date:
Rec V Date: 09/17/2021
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: Little bit of soreness; Moderate to severe diarrhea; Minimal side effects; This spontaneous case was reported by a physician and describes the occurrence of PAIN (Little bit of soreness), DIARRHEA (Moderate to severe diarrhea) and VACCINATION COMPLICATION (Minimal side effects) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011D21A, 006M20A and 027120A) for COVID-19 vaccination. Concurrent medical conditions included Cancer. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 30-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 PAIN (Little bit of soreness), DIARRHEA (Moderate to severe diarrhea) and VACCINATION COMPLICATION (Minimal side effects). At the time of the report, PAIN (Little bit of soreness), DIARRHEA (Moderate to severe diarrhea) and VACCINATION COMPLICATION (Minimal side effects) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The patient was treated for cancer in the past. No concomitant medication information was provided. No treatment information was provided.

Other Meds:

Current Illness: Cancer

ID: 1707123
Sex: F
Age: 90
State: FL

Vax Date: 01/22/2021
Onset Date: 02/20/2021
Rec V Date: 09/17/2021
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: chills for 2hrs; fever; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (chills for 2hrs) and PYREXIA (fever) in a 90-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039K20A and 029K20A) for COVID-19 vaccination. No Medical History information was reported. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 20-Feb-2021, the patient experienced CHILLS (chills for 2hrs) and PYREXIA (fever). On 20-Feb-2021, CHILLS (chills for 2hrs) had resolved. On 21-Feb-2021, PYREXIA (fever) had resolved. Concomitant medication includes chemotherapy. No Treatment informations were reported.

Other Meds:

Current Illness:

ID: 1707124
Sex: M
Age:
State:

Vax Date: 05/06/2021
Onset Date:
Rec V Date: 09/17/2021
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: only received one dose of the moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (only received one dose of the moderna vaccine) 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 06-May-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 (only received one dose of the moderna vaccine). At the time of the report, PRODUCT DOSE OMISSION ISSUE (only received one dose of the moderna vaccine) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant drug details were reported. No treatment details were reported.

Other Meds:

Current Illness:

ID: 1707125
Sex: M
Age: 59
State: AR

Vax Date: 07/18/2021
Onset Date: 07/01/2021
Rec V Date: 09/17/2021
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: Vaccination site pain; 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. This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Vaccination site pain) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 048C021A and 053E21A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure abnormal, Abdominal disorder and Pain. Concomitant products included PANTOPRAZOLE for Abdominal disorder, LISINOPRIL, AMLODIPINE and DILTIAZEM for Blood pressure abnormal, TRAMADOL for Pain, PRAVASTATIN for an unknown indication. On 18-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In July 2021, the patient experienced VACCINATION SITE PAIN (Vaccination site pain). At the time of the report, VACCINATION SITE PAIN (Vaccination site pain) outcome was unknown. This case was linked to MOD-2021-307173 (Patient Link).

Other Meds: LISINOPRIL; PANTOPRAZOLE; AMLODIPINE; PRAVASTATIN; TRAMADOL; DILTIAZEM

Current Illness: Abdominal disorder; Blood pressure abnormal; Pain

ID: 1707126
Sex: U
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: lot of people are getting injured with the kids and heart stuff; heart stuff; 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 INJURY (lot of people are getting injured with the kids and heart stuff) and CARDIAC DISCOMFORT (heart stuff) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INJURY (lot of people are getting injured with the kids and heart stuff) and CARDIAC DISCOMFORT (heart stuff). At the time of the report, INJURY (lot of people are getting injured with the kids and heart stuff) and CARDIAC DISCOMFORT (heart stuff) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided. This case was linked to MOD-2021-307789, MOD-2021-308041 (Patient Link).

Other Meds:

Current Illness:

ID: 1707127
Sex: U
Age:
State:

Vax Date: 07/15/2021
Onset Date:
Rec V Date: 09/17/2021
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: More than 36 days since first dose, no second dose received at this time; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (More than 36 days since first dose, no second dose received at this time) 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 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (More than 36 days since first dose, no second dose received at this time). At the time of the report, PRODUCT DOSE OMISSION ISSUE (More than 36 days since first dose, no second dose received at this time) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported by reporter. Treatment information was not provided by reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1707128
Sex: F
Age: 40
State: TX

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 09/17/2021
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 was told it is covid arm,a delayed reaction in the skin; A delayed reaction in the skin; Severe pain in her arm; Itches like crazy; a small nut since at the injection site, which on 02Sep2021 it got bigger; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (She was told it is covid arm,a delayed reaction in the skin), SKIN REACTION (A delayed reaction in the skin), VACCINATION SITE SWELLING (a small nut since at the injection site, which on 02Sep2021 it got bigger), VACCINATION SITE PAIN (Severe pain in her arm) and VACCINATION SITE PRURITUS (Itches like crazy) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Aug-2021, the patient experienced VACCINATION SITE SWELLING (a small nut since at the injection site, which on 02Sep2021 it got bigger). On 02-Sep-2021, the patient experienced VACCINATION SITE REACTION (She was told it is covid arm,a delayed reaction in the skin), SKIN REACTION (A delayed reaction in the skin), VACCINATION SITE PAIN (Severe pain in her arm) and VACCINATION SITE PRURITUS (Itches like crazy). At the time of the report, VACCINATION SITE REACTION (She was told it is covid arm,a delayed reaction in the skin), SKIN REACTION (A delayed reaction in the skin), VACCINATION SITE SWELLING (a small nut since at the injection site, which on 02Sep2021 it got bigger), VACCINATION SITE PAIN (Severe pain in her arm) and VACCINATION SITE PRURITUS (Itches like crazy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1707129
Sex: U
Age:
State: NJ

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: 10 Moderna COVID-19 vials were in the freezer and experienced a temperature excursion; The caller confirms 18 patients were involved but the caller does not have any of that information with them to provide at this time.; 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 STORAGE ERROR (10 Moderna COVID-19 vials were in the freezer and experienced a temperature excursion) and EXPIRED PRODUCT ADMINISTERED (The caller confirms 18 patients were involved but the caller does not have any of that information with them to provide at this time.) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048C21A) 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 (10 Moderna COVID-19 vials were in the freezer and experienced a temperature excursion) and EXPIRED PRODUCT ADMINISTERED (The caller confirms 18 patients were involved but the caller does not have any of that information with them to provide at this time.). At the time of the report, PRODUCT STORAGE ERROR (10 Moderna COVID-19 vials were in the freezer and experienced a temperature excursion) and EXPIRED PRODUCT ADMINISTERED (The caller confirms 18 patients were involved but the caller does not have any of that information with them to provide at this time.) 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 details was reported. No treatment medication details was reported.

Other Meds:

Current Illness:

ID: 1707130
Sex: U
Age:
State: AL

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: a homeless person who received 1st dose and missed 2nd, more than 42 days have passed; 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 (a homeless person who received 1st dose and missed 2nd, more than 42 days have passed) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (a homeless person who received 1st dose and missed 2nd, more than 42 days have passed). At the time of the report, PRODUCT DOSE OMISSION ISSUE (a homeless person who received 1st dose and missed 2nd, more than 42 days have passed) had resolved. No concomitant medications were reported. No treatment medications were reported.

Other Meds:

Current Illness:

ID: 1707131
Sex: F
Age:
State:

Vax Date: 01/01/2021
Onset Date: 09/04/2021
Rec V Date: 09/17/2021
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: chest pain; missed second dose; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (chest pain) and PRODUCT DOSE OMISSION ISSUE (missed second dose) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Sep-2021, the patient experienced CHEST PAIN (chest pain) and PRODUCT DOSE OMISSION ISSUE (missed second dose). At the time of the report, CHEST PAIN (chest pain) outcome was unknown and PRODUCT DOSE OMISSION ISSUE (missed second dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Treatment medication was not provided by the reporter. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1707132
Sex: F
Age: 54
State: MI

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/17/2021
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: Test Date: 20210901; Test Name: Body temperature; Result Unstructured Data: After vaccination, got fever of 102 F. Later the fever went down a little bit to 100 F and then went up to 102 F; Test Date: 20210903; Test Name: Body temperature; Result Unstructured Data: 100 F

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Runny nose; Could not taste the food; Felt sick; Throat was dry; Nose congestion; After eating like having diarrhea but not; Chills; Fever of 102F/ Fever went down a little bit to 100 F/ Fever then went up to 102 F; Muscle soreness; Headache; Nausea; Felt dizzy; Throat sore; Cold; Feels like a Flu; Chest pain; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Felt dizzy), OROPHARYNGEAL PAIN (Throat sore), NASOPHARYNGITIS (Cold), INFLUENZA LIKE ILLNESS (Feels like a Flu) and CHEST PAIN (Chest pain) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Q47C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Allergy to vaccine (Flu vaccine allergy) and Drug allergy (Metformin drug allergy). Concomitant products included INSULIN GLARGINE (LANTUS), GABAPENTIN, FOLIC ACID, EMPAGLIFLOZIN (JARDIANCE), METHOTREXATE, ATORVASTATIN, CAPSAICIN, PREDNISONE, ONDANSETRON (ZOFRAN [ONDANSETRON]), SPIRONOLACTONE, TREPROSTINIL DIOLAMIN (ORENITRAM), RIOCIGUAT (ADEMPAS), TIOTROPIUM BROMIDE MONOHYDRATE (SPIRIVA), FLUTICASONE PROPIONATE (FLONASE [FLUTICASONE PROPIONATE]), DOCUSATE SODIUM (COLACE), LEVOTHYROXINE, OMEPRAZOLE (PROTONIX [OMEPRAZOLE]), MIRABEGRON (MYRBETRIQ), TORSEMIDE, HYDROXYZINE EMBONATE (VISTARIL [HYDROXYZINE EMBONATE]), OXYCODONE HYDROCHLORIDE, PARACETAMOL (PERCOCET [OXYCODONE HYDROCHLORIDE;PARACETAMOL]), APIXABAN (ELIQUIS), DICLOFENAC (VOLTAREN [DICLOFENAC]), POTASSIUM CHLORIDE, SERTRALINE HYDROCHLORIDE (ZOLOF), SALBUTAMOL (PROVENTIL [SALBUTAMOL]), MELATONIN, RISPERIDONE (RISPERDAL), SOTALOL, MIRTAZAPINE (REMERON), VITAMIN D2, MEDROXYPROGESTERONE ACETATE (PROVERA), LATANOPROST and MYCOPHENOLATE MOFETIL HYDROCHLORIDE (CELLCEPT [MYCOPHENOLATE MOFETIL HYDROCHLORIDE]) for an unknown indication. On 01-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Sep-2021, the patient experienced DIZZINESS (Felt dizzy), OROPHARYNGEAL PAIN (Throat sore), NASOPHARYNGITIS (Cold), INFLUENZA LIKE ILLNESS (Feels like a Flu), CHEST PAIN (Chest pain), CHILLS (Chills), PYREXIA (Fever of 102F/ Fever went down a little bit to 100 F/ Fever then went up to 102 F), MYALGIA (Muscle soreness), HEADACHE (Headache) and NAUSEA (Nausea). On 03-Sep-2021, the patient experienced RHINORRHOEA (Runny nose), AGEUSIA (Could not taste the food), ILLNESS (Felt sick), DRY THROAT (Throat was dry), NASAL CONGESTION (Nose congestion) and FEELING ABNORMAL (After eating like having diarrhea but not). The patient was treated with IBUPROFEN (MOTRIN CHILDREN'S) for Fever, at an unspecified dose and frequency. At the time of the report, DIZZINESS (Felt dizzy), OROPHARYNGEAL PAIN (Throat sore), NASOPHARYNGITIS (Cold), INFLUENZA LIKE ILLNESS (Feels like a Flu), CHEST PAIN (Chest pain), RHINORRHOEA (Runny nose), AGEUSIA (Could not taste the food), ILLNESS (Felt sick), DRY THROAT (Throat was dry), NASAL CONGESTION (Nose congestion), FEELING ABNORMAL (After eating like having diarrhea but not), CHILLS (Chills), PYREXIA (Fever of 102F/ Fever went down a little bit to 100 F/ Fever then went up to 102 F), MYALGIA (Muscle soreness), HEADACHE (Headache) and NAUSEA (Nausea) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Sep-2021, Body temperature: high (High) After vaccination, got fever of 102 F. Later the fever went down a little bit to 100 F and then went up to 102 F. On 03-Sep-2021, Body temperature: high (High) 100 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The concomitant medication included Flumetadine 20 milligram and T-D natal plus. The patient still had the same thing but with nose congestion, during the time of reporting.

Other Meds: LANTUS; GABAPENTIN; FOLIC ACID; JARDIANCE; METHOTREXATE; ATORVASTATIN; CAPSAICIN; PREDNISONE; ZOFRAN [ONDANSETRON]; SPIRONOLACTONE; ORENITRAM; ADEMPAS; SPIRIVA; FLONASE [FLUTICASONE PROPIONATE]; COLACE; LEVOTHYROXINE; PROTONIX [OMEPRAZOLE];

Current Illness: Allergy to vaccine (Flu vaccine allergy); Drug allergy (Metformin drug allergy.)

ID: 1707133
Sex: F
Age:
State: WY

Vax Date:
Onset Date: 09/03/2021
Rec V Date: 09/17/2021
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: lethargy; I feel blah; headache; nausea; This spontaneous case was reported by a consumer and describes the occurrence of LETHARGY (lethargy), FEELING ABNORMAL (I feel blah), HEADACHE (headache) and NAUSEA (nausea) in a 72-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 an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Sep-2021, the patient experienced LETHARGY (lethargy), FEELING ABNORMAL (I feel blah), HEADACHE (headache) and NAUSEA (nausea). At the time of the report, LETHARGY (lethargy), FEELING ABNORMAL (I feel blah), HEADACHE (headache) and NAUSEA (nausea) 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 medication was provided by the reporter No treatment information was provided by the reporter Most recent FOLLOW-UP information incorporated above includes: On 08-Sep-2021: Significant Follow up received and outcome of events updated to recovered

Other Meds:

Current Illness:

ID: 1707134
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: the size of the shot of numbness from my face down; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (the size of the shot of numbness from my face down) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced HYPOAESTHESIA (the size of the shot of numbness from my face down). At the time of the report, HYPOAESTHESIA (the size of the shot of numbness from my face down) outcome was unknown. No concomitant medications reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1707135
Sex: M
Age: 79
State: CO

Vax Date: 12/29/2020
Onset Date: 01/26/2021
Rec V Date: 09/17/2021
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: flu like symptoms; "went down for a day"; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (flu like symptoms) and MALAISE ("went down for a day") in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025J202A and 025J20214) for COVID-19 vaccination. The patient's past medical history included Heart attack (no recent change was observed in its status) on 14-Jul-2014. Concomitant products included LISINOPRIL, ACETYLSALICYLIC ACID (ASPIRINE) from 14-Jul-2014 to an unknown date, ATORVASTATIN CALCIUM (LIPITOR) and CARVEDILOL (COREG) for an unknown indication. On 29-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Jan-2021, the patient experienced INFLUENZA LIKE ILLNESS (flu like symptoms) and MALAISE ("went down for a day"). On 27-Jan-2021, INFLUENZA LIKE ILLNESS (flu like symptoms) and MALAISE ("went down for a day") 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. Treatment information was not provided. Allergies to food, medications and other products were none. This case was linked to MOD-2021-307592 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 10-Sep-2021: significant Follow up was received which has updated patient's demographics: start date of medical history; revised date of dose 1; anatomical location; provided start date and dose information of concomitant medications.

Other Meds: LISINOPRIL; ASPIRINE; LIPITOR; COREG

Current Illness:

ID: 1707136
Sex: F
Age:
State: MD

Vax Date: 06/18/2021
Onset Date:
Rec V Date: 09/17/2021
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: More than 35 days since first dose was received and still does not have the second; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (More than 35 days since first dose was received and still does not have the second) in a 23-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 18-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 first dose was received and still does not have the second). At the time of the report, PRODUCT DOSE OMISSION ISSUE (More than 35 days since first dose was received and still does not have the second) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication were provided by the reporter No treatment medication were provided by the reporter

Other Meds:

Current Illness:

ID: 1707137
Sex: F
Age:
State: CA

Vax Date: 06/03/2021
Onset Date: 08/05/2021
Rec V Date: 09/17/2021
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: Dizziness; Bad cramps like menstrual cramps; Back ache/ back pain; Felt flu-like; Super sweaty; Acid reflux; Feeling fuzzy headed; Big and warm knot at the injection site; Excess sleeping; Congestion; Swollen nose; Big and warm knot at the injection site; Chills at night; Joint pain/ pain in knees; Fever; Pain at the injection site; Exhausted; Headache; Deviation from dosing schedule (more then 35 days between 1st and 2nd dose); This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), DYSMENORRHOEA (Bad cramps like menstrual cramps), BACK PAIN (Back ache/ back pain), INFLUENZA LIKE ILLNESS (Felt flu-like) and HYPERHIDROSIS (Super sweaty) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 038B21A and 026B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 03-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 05-Aug-2021, the patient experienced DIZZINESS (Dizziness), DYSMENORRHOEA (Bad cramps like menstrual cramps), BACK PAIN (Back ache/ back pain), INFLUENZA LIKE ILLNESS (Felt flu-like), HYPERHIDROSIS (Super sweaty), GASTROOESOPHAGEAL REFLUX DISEASE (Acid reflux), FEELING ABNORMAL (Feeling fuzzy headed), VACCINATION SITE MASS (Big and warm knot at the injection site), HYPERSOMNIA (Excess sleeping), NASAL CONGESTION (Congestion), NASAL OEDEMA (Swollen nose), VACCINATION SITE WARMTH (Big and warm knot at the injection site), CHILLS (Chills at night), ARTHRALGIA (Joint pain/ pain in knees), PYREXIA (Fever), VACCINATION SITE PAIN (Pain at the injection site), FATIGUE (Exhausted), HEADACHE (Headache) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Deviation from dosing schedule (more then 35 days between 1st and 2nd dose)). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of extra strength. On 05-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Deviation from dosing schedule (more then 35 days between 1st and 2nd dose)) had resolved. At the time of the report, DIZZINESS (Dizziness), DYSMENORRHOEA (Bad cramps like menstrual cramps), BACK PAIN (Back ache/ back pain), INFLUENZA LIKE ILLNESS (Felt flu-like), HYPERHIDROSIS (Super sweaty), GASTROOESOPHAGEAL REFLUX DISEASE (Acid reflux), FEELING ABNORMAL (Feeling fuzzy headed), VACCINATION SITE MASS (Big and warm knot at the injection site), HYPERSOMNIA (Excess sleeping), NASAL CONGESTION (Congestion), NASAL OEDEMA (Swollen nose), VACCINATION SITE WARMTH (Big and warm knot at the injection site), CHILLS (Chills at night), ARTHRALGIA (Joint pain/ pain in knees), PYREXIA (Fever), VACCINATION SITE PAIN (Pain at the injection site), FATIGUE (Exhausted) and HEADACHE (Headache) outcome was unknown. No concomitant medication listed. This case was linked to MOD-2021-254078 (Patient Link).

Other Meds:

Current Illness:

ID: 1707138
Sex: M
Age:
State: IL

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 09/17/2021
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: flu-like symptoms; body aches; fever; bad headache; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (flu-like symptoms), MYALGIA (body aches), PYREXIA (fever) and HEADACHE (bad headache) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 15-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Mar-2021, the patient experienced INFLUENZA LIKE ILLNESS (flu-like symptoms), MYALGIA (body aches), PYREXIA (fever) and HEADACHE (bad headache). On 16-Mar-2021, INFLUENZA LIKE ILLNESS (flu-like symptoms), MYALGIA (body aches), PYREXIA (fever) and HEADACHE (bad headache) had resolved. It was reported that the patient had received Booster Dose of Moderna vaccine on 28 AUG 2021, which is 5.5 Months after the second dose of Moderna vaccine, and he feels fine without experiencing any Adverse Events. No concomitant medications were reported No treatment medications were reported. This case was linked to MOD-2021-307152 (Patient Link).

Other Meds:

Current Illness:

ID: 1707139
Sex: M
Age: 79
State: CO

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/17/2021
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: My body hurts all over with flu symptoms.; I could not sleep in my bed.; Got a 3rd dose - not immunocompromised; arm hurt. He is still having problems with his left arm (injection site) and the left shoulder.; joints hurt, can hardly lift the arm up/ I could not lift my arm above my elbow; Feeling Abnormal; "really got sick"; ached all over/Very painfull; This case was initially received via an unknown source (no reference has been entered for a health authority or license partner) on 03-Sep-2021. The most recent information was received on 10-Sep-2021 and was forwarded to Moderna on 10-Sep-2021. This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Feeling Abnormal), VACCINATION COMPLICATION ("really got sick"), PAIN (ached all over/Very painfull), INFLUENZA LIKE ILLNESS (My body hurts all over with flu symptoms.) and INSOMNIA (I could not sleep in my bed.) in a 79-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 019B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Heart attack. Concomitant products included LISINOPRIL, Aspirin 81 mg, ATORVASTATIN CALCIUM (LIPITOR) and Col-Rite for an unknown indication. On 01-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Sep-2021, the patient experienced FEELING ABNORMAL (Feeling Abnormal), VACCINATION COMPLICATION ("really got sick"), PAIN (ached all over/Very painfull), OFF LABEL USE (Got a 3rd dose - not immunocompromised), VACCINATION SITE PAIN (arm hurt. He is still having problems with his left arm (injection site) and the left shoulder.) and ARTHRALGIA (joints hurt, can hardly lift the arm up/ I could not lift my arm above my elbow). On an unknown date, the patient experienced INFLUENZA LIKE ILLNESS (My body hurts all over with flu symptoms.) and INSOMNIA (I could not sleep in my bed.). On 01-Sep-2021, OFF LABEL USE (Got a 3rd dose - not immunocompromised) had resolved. On 02-Sep-2021, FEELING ABNORMAL (Feeling Abnormal), VACCINATION COMPLICATION ("really got sick") and PAIN (ached all over/Very painfull) had resolved. At the time of the report, INFLUENZA LIKE ILLNESS (My body hurts all over with flu symptoms.), INSOMNIA (I could not sleep in my bed.), VACCINATION SITE PAIN (arm hurt. He is still having problems with his left arm (injection site) and the left shoulder.) and ARTHRALGIA (joints hurt, can hardly lift the arm up/ I could not lift my arm above my elbow) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was reported. No treatment medication use was reported. This case was linked to MOD-2021-307560 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 10-Sep-2021: Follow-up received included events added.

Other Meds: LISINOPRIL; Aspirin 81 mg; LIPITOR; Col-Rite

Current Illness:

ID: 1707140
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: received the vaccination yesterday! I am currently dealing with me not being able to get warm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (received the vaccination yesterday! I am currently dealing with me not being able to get warm) 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 (received the vaccination yesterday! I am currently dealing with me not being able to get warm). At the time of the report, VACCINATION COMPLICATION (received the vaccination yesterday! I am currently dealing with me not being able to get warm) 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. No treatment information was provided. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1707141
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: Joint pain; This spontaneous case was reported by a consumer and describes the occurrence of ARTHRALGIA (Joint 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 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 ARTHRALGIA (Joint pain). At the time of the report, ARTHRALGIA (Joint pain) 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. Reporter did not allow further contact

Other Meds:

Current Illness:

ID: 1707142
Sex: M
Age:
State: IL

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 09/17/2021
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: Flu-like symptoms (1st dose); This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu-like symptoms (1st dose)) in a 21-year-old male 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)). On 16-Feb-2021, INFLUENZA LIKE ILLNESS (Flu-like symptoms (1st dose)) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. Concomitant medication information was not reported Treatment information was not reported This case was linked to MOD-2021-307667 (Patient Link).

Other Meds:

Current Illness:

ID: 1707143
Sex: F
Age: 20
State: CA

Vax Date: 08/23/2021
Onset Date: 08/25/2021
Rec V Date: 09/17/2021
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: Sore throat; Bells palsy; Light thou painful paralysis of the face; Hand redness; Feet itchiness/Hand itchiness; Pain in the left armpit; Tingling sensation in hands/Tingling sensation in face; This spontaneous case was reported by a consumer and describes the occurrence of FACIAL PARALYSIS (Light thou painful paralysis of the face) and BELL'S PALSY (Bells palsy) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 054C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concurrent medical conditions included Hormone replacement therapy. Concomitant products included ESTRADIOL for Hormone replacement therapy. On 23-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Aug-2021, the patient experienced PARAESTHESIA (Tingling sensation in hands/Tingling sensation in face) and AXILLARY PAIN (Pain in the left armpit). On 27-Aug-2021, the patient experienced FACIAL PARALYSIS (Light thou painful paralysis of the face) (seriousness criterion medically significant), ERYTHEMA (Hand redness) and PRURITUS (Feet itchiness/Hand itchiness). On an unknown date, the patient experienced BELL'S PALSY (Bells palsy) (seriousness criterion medically significant) and OROPHARYNGEAL PAIN (Sore throat). At the time of the report, FACIAL PARALYSIS (Light thou painful paralysis of the face), BELL'S PALSY (Bells palsy), PARAESTHESIA (Tingling sensation in hands/Tingling sensation in face), OROPHARYNGEAL PAIN (Sore throat), ERYTHEMA (Hand redness), PRURITUS (Feet itchiness/Hand itchiness) and AXILLARY PAIN (Pain in the left armpit) 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. Additional concomitant medication included Polycaprolactone 25mg twice a day for Hormone replacement therapy. Treatment included a Topical cream for itchiness. Patient reportedly did not used it. Patient was under hormone replacement treatment. Patient's endocrinologist told her that the adverse events are not linked to the hormone replacement treatment, but to the vaccine. Company Comment: 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.; 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: ESTRADIOL

Current Illness: Hormone replacement therapy

ID: 1707144
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Is dizziness a common side effect?; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Is dizziness a common 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 DIZZINESS (Is dizziness a common side effect?). At the time of the report, DIZZINESS (Is dizziness a common side effect?) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported by the reporter. No treatment was reported by the reporter.

Other Meds:

Current Illness:

ID: 1707145
Sex: F
Age:
State: OH

Vax Date: 09/02/2021
Onset Date:
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pink eye in both eyes; painful in the left eye; This spontaneous case was reported by a consumer and describes the occurrence of CONJUNCTIVITIS (Pink eye in both eyes) and EYE PAIN (painful in the left eye) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. No Medical History information was reported. On 02-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 CONJUNCTIVITIS (Pink eye in both eyes) and EYE PAIN (painful in the left eye). At the time of the report, CONJUNCTIVITIS (Pink eye in both eyes) and EYE PAIN (painful in the left eye) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. Treatment medication was not provided by the reporter.

Other Meds:

Current Illness:

ID: 1707146
Sex: F
Age: 66
State: NY

Vax Date: 01/29/2021
Onset Date:
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: Test Name: Antibody; Result Unstructured Data: 192

Allergies:

Symptom List: Pain in extremity

Symptoms: I had a little bit allergy; pain when I opened my mouth and chewed/The pain in my mouth was in the left side; I couldn't eat; This spontaneous case was reported by a consumer and describes the occurrence of ALLERGY TO VACCINE (I had a little bit allergy), ORAL PAIN (pain when I opened my mouth and chewed/The pain in my mouth was in the left side) and MASTICATION DISORDER (I couldn't eat) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Autoimmune thyroid disorder. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced ALLERGY TO VACCINE (I had a little bit allergy), ORAL PAIN (pain when I opened my mouth and chewed/The pain in my mouth was in the left side) and MASTICATION DISORDER (I couldn't eat). At the time of the report, ALLERGY TO VACCINE (I had a little bit allergy), ORAL PAIN (pain when I opened my mouth and chewed/The pain in my mouth was in the left side) and MASTICATION DISORDER (I couldn't eat) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Antibody test: 192 192. Treatment medications included anti-inflammatories for a week. Patient reported that the dentist told he didn't think that it (Mouth pain) was from the Moderna shot. This case was linked to MOD-2021-307545 (Patient Link).

Other Meds:

Current Illness: Autoimmune thyroid disorder

ID: 1707147
Sex: M
Age:
State: IL

Vax Date: 02/15/2021
Onset Date: 03/15/2021
Rec V Date: 09/17/2021
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: flu-like symptoms (2nd dose); This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (flu-like symptoms (2nd dose)) in a 21-year-old male 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-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Mar-2021, the patient experienced INFLUENZA LIKE ILLNESS (flu-like symptoms (2nd dose)). On 16-Mar-2021, INFLUENZA LIKE ILLNESS (flu-like symptoms (2nd dose)) had resolved. No concomitant medications were provided. No treatment medications were provided. This case was linked to MOD-2021-307638 (Patient Link).

Other Meds:

Current Illness:

ID: 1707148
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
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: Second dose was missed; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Second dose was missed) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Second dose was missed). At the time of the report, PRODUCT DOSE OMISSION ISSUE (Second dose was missed) had resolved. The Treatment history was not reported .The concomitant medication was not reported.

Other Meds:

Current Illness:

ID: 1707149
Sex: M
Age:
State:

Vax Date: 07/30/2021
Onset Date: 08/17/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: Test Date: 20210817; Test Name: Covid-19 test; Test Result: Positive ; Result Unstructured Data: positive test result

Allergies:

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

Symptoms: my husband goes a positive test result for covid; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (my husband goes a positive test result for covid) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 30-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Aug-2021, the patient experienced COVID-19 (my husband goes a positive test result for covid). At the time of the report, COVID-19 (my husband goes a positive test result for covid) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Aug-2021, SARS-CoV-1 test: positive (Positive) positive test result. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant history was not reported. Treatment history was not provided.

Other Meds:

Current Illness:

ID: 1707150
Sex: U
Age:
State:

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/17/2021
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: I got my 2nd shot yesterday and feel terrible today; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (I got my 2nd shot yesterday and feel terrible today) 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 02-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Sep-2021, the patient experienced FEELING ABNORMAL (I got my 2nd shot yesterday and feel terrible today). At the time of the report, FEELING ABNORMAL (I got my 2nd shot yesterday and feel terrible today) outcome was unknown. No concomitant medication information was provided. Patient had no fever though No treatment medication were provided.

Other Meds:

Current Illness:

ID: 1707151
Sex: U
Age:
State:

Vax Date: 07/01/2021
Onset Date:
Rec V Date: 09/17/2021
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: Was 42 days too long/needed to get the second shot; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Was 42 days too long/needed to get the second shot) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In July 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In 2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Was 42 days too long/needed to get the second shot). In 2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Was 42 days too long/needed to get the second shot) had resolved. No concomitant medications were provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1707152
Sex: M
Age:
State: SC

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Received expired vaccine/Punctured Vial was used beyond 12 hour expiration; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received expired vaccine/Punctured Vial was used beyond 12 hour expiration) in a 54-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. No Medical History information was reported. On 02-Sep-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 02-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received expired vaccine/Punctured Vial was used beyond 12 hour expiration). On 02-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Received expired vaccine/Punctured Vial was used beyond 12 hour expiration) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Total amount of time vial was exposed to room temperature range 46? to 77? F a little over 24 hours. Concomitant medications were not provided. Treatment information was not provided.

Other Meds:

Current Illness:

ID: 1707154
Sex: M
Age: 24
State: CA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/17/2021
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: Really feeling sick; Chills; Nausea; Headache; Body ache; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Really feeling sick), CHILLS (Chills), NAUSEA (Nausea), HEADACHE (Headache) and MYALGIA (Body ache) in a 24-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 02-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Sep-2021, the patient experienced ILLNESS (Really feeling sick), CHILLS (Chills), NAUSEA (Nausea), HEADACHE (Headache) and MYALGIA (Body ache). At the time of the report, ILLNESS (Really feeling sick), CHILLS (Chills), NAUSEA (Nausea), HEADACHE (Headache) and MYALGIA (Body ache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported No treatment information was provided

Other Meds:

Current Illness:

ID: 1707155
Sex: M
Age:
State: OK

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/17/2021
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: Entire body was shaking super bad/he had body trembling; Awake all night; Felt like somebody electrocuted him; Uncontrollable diarrhea; Sweating real bad; Back is tight; Whole body hurt; Upper body fatigue; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (Entire body was shaking super bad/he had body trembling), INSOMNIA (Awake all night), ELECTRIC SHOCK SENSATION (Felt like somebody electrocuted him), DIARRHOEA (Uncontrollable diarrhea) and HYPERHIDROSIS (Sweating real bad) in a 36-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939901) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. 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 TREMOR (Entire body was shaking super bad/he had body trembling), INSOMNIA (Awake all night), ELECTRIC SHOCK SENSATION (Felt like somebody electrocuted him), DIARRHOEA (Uncontrollable diarrhea), HYPERHIDROSIS (Sweating real bad), MUSCLE TIGHTNESS (Back is tight), MYALGIA (Whole body hurt) and FATIGUE (Upper body fatigue). At the time of the report, TREMOR (Entire body was shaking super bad/he had body trembling), INSOMNIA (Awake all night), ELECTRIC SHOCK SENSATION (Felt like somebody electrocuted him), DIARRHOEA (Uncontrollable diarrhea), HYPERHIDROSIS (Sweating real bad), MUSCLE TIGHTNESS (Back is tight), MYALGIA (Whole body hurt) and FATIGUE (Upper body fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient wife thought he was having a seizure,which kept him awake all night. No Concomitant and Treatment medication were reported.

Other Meds:

Current Illness:

ID: 1707156
Sex: F
Age: 61
State: TX

Vax Date: 08/12/2021
Onset Date: 09/02/2021
Rec V Date: 09/17/2021
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: Received Pfizer as 1st dose and Moderna as 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (Received Pfizer as 1st dose and Moderna as 2nd dose) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F2N) for COVID-19 vaccination. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) for COVID-19 vaccination. No Medical History information was reported. On 12-Aug-2021, the patient started TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (Intramuscular) 1 dosage form. On 02-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Sep-2021, the patient experienced INTERCHANGE OF VACCINE PRODUCTS (Received Pfizer as 1st dose and Moderna as 2nd dose). On 02-Sep-2021, INTERCHANGE OF VACCINE PRODUCTS (Received Pfizer as 1st dose and Moderna as 2nd dose) had resolved. No concomitant medications were provided.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am